Date of Award

5-2019

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Jay Metzger

Keywords

glucagon-like peptide-1, sulfonylurea, diabetes mellitus, second line treatment

Abstract

Type II diabetes mellitus (T2DM) is a prevalent disease in our country. Bullard et al. (2018) report approximately 21 million adults have T2DM in the United States. “The total estimated cost of diagnosed diabetes in 2017 is $327 billion, including $237 billion in direct medical costs and $90 billion in reduced productivity” (Yang et al., 2018). Treatment of T2DM is individualized to each patient based on their co-morbidities, fiscal responsibility, and route of administration options. Sulfonylureas and Glucagon-like Peptide-1s (GLP-1) are two classes of antidiabetic drugs that are available for use as second line treatment options after metformin. This review of literature is from articles published in 2008 or later found in the following electronic databases: PubMed, Cochrane Database of Systematic Reviews, DynaMed Plus, ClincalKey, and Scopus. Articles included randomized control trials, systematic reviews, and meta analyses with participants being at least eighteen years old. The review found several benefits of GLP-1s for the treatment of T2DM. The risks of GLP-1s are not found to be as serious as the risks associated with sulfonylureas. Sulfonylureas demonstrate historical data for their use and are available in oral forms as opposed to GLP-1s which is newer but in an injectable form only. Overall, GLP-1s offer greater benefits with minimal side effects that are less severe than sulfonylureas. Limitations to this literature review include lack of articles having direct reviews of GLP-1s and sulfonylureas.

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