Review Article

Safety and Mode of Action of Diabetes Medications in comparison with 5-Aminolevulinic Acid (5-ALA)

Table 2

A summary of the type 2 diabetes medications, their adverse events, and severe adverse event possibilities.

Medications and adverse eventsObserved adverse event (>5% of patients)
(>5% of patients)
Serious adverse event

5-ALA(i) Common cold symptoms
(ii) Menstrual pain
(iii) Diarrhea
(iv) Headache [12]
None

Metformin(i) Diarrhea
(ii) Nausea
(iii) Abdominal discomfort
(iv) Metallic taste
(v) Vitamin b12 deficiency
Lactic acidosis in patients lowered eGFR (contraindicated if <30 mL/min per 1.73 m2) [21, 47]

DPP4(i) Dizziness
(ii) Headache
(iii) Nasopharyngitis
(iv) URTI
(i) Severe arthralgia
(ii) Acute pancreatitis
(iii) Hepatic dysfunction
(iv) Serious skin reactions [21, 24]

Sulfonylureas(i) Weight gain
(ii) Dizziness
(iii) Headaches
(iv) Sulfonamide allergies
(i) Higher mortality after myocardial infarctions
(ii) Hypoglycemia [48, 49]

MeglitinidesWeight gainHypoglycemia (possibly less than sulfonylureas) [50]

TZDs(i) Weight gain
(ii) Edema
(iii) Macular edema
(iv) Raised LDL (rosiglitazone)
(v) Decrease in hematocrit and hemoglobin when combined with other antihyperglycemic
(i) Bladder cancer (pioglitazone)
(ii) Higher rate of myocardial infarctions (rosiglitazone)
(iii) Heart failure
(iv) Fractures
(v) Hypoglycemia [21, 5153]

Alpha-glucosidase inhibitors(i) Bloating, flatulence
(ii) Diarrhea
(i) Deranged LFTs (acarbose) [21]

SGLT2 inhibitors(i) Vulvogavinal candidiasis
(ii) Urinary tract infections
(iii) Hypotension
(iv) Dehydration
(i) Fatal urosepsis
(ii) Pyelonephritis
(iii) Bone fracture (canagliflozin)
(iv) Diabetic ketoacidosis [21, 49]

Lipase inhibitors(i) Abdominal pain
(ii) Fecal urgency
(iii) Steatorrhea
(iv) Vitamin deficiencies (A, D, E, K)
(v) Drug interactions
(vi) Flu symptoms
(i) Acute kidney injury
(ii) Oxalate nephropathy [5, 31, 54]

GLP-1 receptor agonists(i) Nausea, vomiting
(ii) Diarrhea
(i) Pancreatitis
(ii) Gallbladder disease
(iii) Renal injury [28, 53, 55]