- Body system
- Endocrine
- Name stem
- -gliptin, -gliflozin, -glutide, -glitazone
- Drug cards
- 2 in this guide
Drugs in this class
Other examples: Sitagliptin, Empagliflozin, Dapagliflozin, Semaglutide, Liraglutide, Pioglitazone, Glyburide, Glimepiride, Tirzepatide.
How oral and non-insulin antidiabetic drugs work
Biguanides lower liver glucose output; sulfonylureas stimulate insulin release; DPP-4 inhibitors and GLP-1 receptor agonists increase glucose-dependent insulin release; SGLT2 inhibitors make the kidney excrete glucose; thiazolidinediones improve insulin sensitivity.
Uses
- Type 2 diabetes
- Heart failure and chronic kidney disease (SGLT2 inhibitors)
- Weight management (some GLP-1 receptor agonists)
Adverse effects
- GI upset and lactic acidosis (metformin)
- Hypoglycemia and weight gain (sulfonylureas)
- Genital yeast infections, dehydration and euglycemic ketoacidosis (SGLT2 inhibitors)
- Nausea, vomiting and pancreatitis risk (GLP-1 receptor agonists)
- Fluid retention and heart failure (thiazolidinediones)
Nursing considerations
- Check kidney function before metformin and SGLT2 inhibitors.
- Hold metformin around iodinated contrast in at-risk patients, per protocol.
- SGLT2 inhibitors are often held a few days before surgery to prevent ketoacidosis, per the label and protocol.
Patient teaching
- Take metformin with meals.
- Do not skip meals with a sulfonylurea.
- Report severe abdominal pain with vomiting (GLP-1 agonists) or unusual tiredness with nausea and fast breathing (ketoacidosis).
Oral and non-insulin antidiabetic drugs NCLEX practice questions
Answer each question to see the rationale.
3 questions. Choose an answer to see the rationale.
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Which test result should the nurse check before giving metformin to a patient scheduled for a CT scan with IV contrast?
Show answer
Answer A: eGFR or serum creatinine Iodinated contrast can impair kidney function, and metformin builds up in kidney impairment, raising the risk of lactic acidosis.
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Which drug is most likely to cause hypoglycemia when used alone?
Show answer
Answer D: Glipizide Sulfonylureas stimulate insulin release regardless of the glucose level, so hypoglycemia is their main risk.
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A patient taking empagliflozin should be taught to watch for which effect?
Show answer
Answer B: Genital yeast infections SGLT2 inhibitors put glucose into the urine, which raises the risk of genital fungal infections and urinary infections.
Frequently asked questions
What are oral and non-insulin antidiabetic drugs?
Type 2 diabetes drugs lower glucose in different ways. Metformin is first-line; sulfonylureas cause hypoglycemia; SGLT2 inhibitors and GLP-1 receptor agonists also protect the heart and kidneys in selected patients.
How do oral and non-insulin antidiabetic drugs work?
Biguanides lower liver glucose output; sulfonylureas stimulate insulin release; DPP-4 inhibitors and GLP-1 receptor agonists increase glucose-dependent insulin release; SGLT2 inhibitors make the kidney excrete glucose; thiazolidinediones improve insulin sensitivity.
What are examples of oral and non-insulin antidiabetic drugs?
Metformin, Glipizide, Sitagliptin, Empagliflozin, Dapagliflozin, Semaglutide, Liraglutide and Pioglitazone.
What are the nursing considerations for oral and non-insulin antidiabetic drugs?
Check kidney function before metformin and SGLT2 inhibitors. Hold metformin around iodinated contrast in at-risk patients, per protocol.