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Maximum: 15 mg subcutaneous injection once weekly Possible side effects include: Gastrointestinal (eg, nausea, diarrhea, decreased appetite, vomiting, constipation, dyspepsia, abdominal pain) Pancreatitis Acute gallbladder disease Hypoglycemia (when used with insulin or insulin secretagogues) Changes in vision (people with a history of diabetic retinopathy should be monitored closely) Acute kidney injury (primarily in people with pre-existing kidney problems who experience gastrointestinal side effects) Allergic reactions (eg, swelling, rash, dizziness) Amylin mimetic Primary mechanism(s) of action Reduces glucagon secretion, slows gastric emptying, suppresses appetite Example Pramlintide (SymlinPen 60, SymlinPen 120) Dosage Initial: 60 mcg subcutaneous injection immediately before each major meal, then increase to 120 mcg subcutaneous injection before each major meal if no significant nausea occurs after three days Maximum: 120 mcg subcutaneous injection before each major meal Possible side effects include: Nausea 11 Type 2 Diabetes Drugs Additional Details Oral Drugs Metformin has long been the preferred first-line pharmacologic agent for the treatment of type 2 diabetes in those for whom it is not contraindicated (namely those with significant kidney dysfunction, alcohol abuse, liver disease, unstable or acute heart failure, or elevated risk of lactic acidosis) (ADA 2021c

doi: 10.3390/ijms20184472 39 HarmanD