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Drug classification | Type of action | Drug varieties | Reason for recommendation |
|
Injections | Short-acting insulin | Recombinant human insulin, biosynthetic human insulin | Cheap price |
Insulin aspart, insulin lispro | Low risk of hypoglycemia |
Intermediate-acting insulin | Protamine zinc recombinant human insulin, protamine biosynthetic human insulin | Cheap price |
Premixed insulin | Protamine recombinant human insulin (30/70), protamine biosynthetic human insulin (premixed 30R) | Cheap price |
Insulin aspart 30, protamine zinc recombinant insulin lispro (50R) | Low risk of hypoglycemia |
Long-acting insulin analogue | Insulin glargine | Included in the National Essential Medicines List of China |
Insulin degludec | A novel ultra-long-acting insulin with low risk of hypoglycemia [37]. |
GLP-1RA | Liraglutide | It is included in the National Essential Medicines List of China and is the GLP-1RA with the strongest evidence of cardiovascular benefit. |
Dulaglutide | A weekly preparation, with evidence of cardiovascular and renal benefits [24, 32]. |
|
Oral antihyperglycemic agents | Biguanides | Metformin | |
Sulfonylureas | Glimepiride | A new generation of sulfonylureas with low risk of hypoglycemia; research has shown its cardiovascular safety similar to that of DPP-4i [38]. |
| Gliclazide sustained-release tablets | ADVANCE research suggests that gliclazide sustained-release tablets may have a renal protection; there is a low risk of hypoglycemia. |
Glinides | Repaglinide | It can be used throughout the course of CKD, with no need to adjust the dose. |
α-Glucosidase inhibitors | Acarbose | Widely used in the Chinese population [36], with cheap price. |
DPP-4i | Linagliptin | It can be used throughout the course of impaired hepatic and renal function, with no need to adjust the dose. |
| Alogliptin | Meta-analysis reveals its good effect in Asian populations [39]; it has high affinity for DPP-4 and high bioavailability. |
SGLT-2i | Empagliflozin | It has definite benefits for ASCVD, HF, and CKD [22], and nowadays, it is the only marketed drug to reduce the risk of death from CVD. |
| Dapagliflozin | It is included in the National Essential Medicines List of China. This drug has definite benefits for both HF and CKD [21], but there is insufficient evidence to determine whether it has benefit for ASCVD. |
Thiazolidinediones | Pioglitazone | PROACTIVE has found that it can reduce the risk of stroke recurrence [29]. |
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