Topic overview

Start with the big picture

The lesson surveys adverse effects and precautions across insulin, secretagogues, insulin sensitizers, incretin-based therapies, SGLT2 inhibitors, and other agents. Key patterns include hypoglycemia with insulin and secretagogues; gastrointestinal effects with several drug classes; and class-specific concerns such as metformin-associated lactic acidosis, TZD-related heart failure exacerbation, and SGLT2 inhibitor-associated volume depletion or euglycemic DKA. Special considerations include dose adjustment or avoidance in renal impairment, caution in older adults, and practical measures such as rotating insulin injection sites. The topic also addresses selected risks and interactions, including impaired absorption with colesevelam and treating hypoglycemia during α-glucosidase inhibitor use with glucose rather than sucrose.