- Effects of different antidiabetic drugs on the serum uric acid level in patients with type-2 diabetes mellitus.
| Drugs class | Serum UA levels | Mechanisms |
|---|---|---|
| Metformin | ↓ | Ameliorates insulin resistance and hyperinsulinemia, which increases urinary clearance of UA and reduces UA production. |
| Sulfonylureas | ||
| Glibenclamide | NS | NA |
| Gliclazide | NS | |
| Glimepiride | NS | |
| Dipeptidyl peptidase 4 inhibitors | ||
| Sitagliptin | ↑ | Unknown |
| Alogliptin | ↑ | Decreases UA production by suppressing |
| Linagliptin | ↓ | xanthine oxidase activity |
| Vildagliptin | ↓ | Unknown |
| Alpha-glucosidase inhibitors | ||
| Acarbose | No data | NA |
| Voglibose | NS | NA |
| Thiazolidinediones | ||
| Troglitazone | ↓ | Ameliorates insulin resistance and |
| Rosiglitazone | ↓ | hyperinsulinemia; increases urine pH, which |
| Pioglitazone | ↓ | enhances urinary excretion of UA |
| Insulin | ↑ | Increases urate reabsorption via URAT1 or sodium-dependent anion cotransporter in renal proximal tubules |
| Glucagon-like peptide-1 receptor agonists | ||
| Exenatide | NS | NA |
| Liraglutide | NS | |
| Lixisenatide | NS | |
| Dulaglutide | NS | |
| Sodium-glucose cotransporter 2 inhibitors | ||
| Empagliflozin | ↓ | Increases renal excretion of urate by altering renal tubular UA transporters (GLUT9 and URAT1); decreases flux through the pentose phosphate pathway via indirect activation of sirtuin-1, which can inhibit xanthine oxidase |
| Dapagliflozin | ↓ | |
| Canagliflozin | ↓ | |
| Luseogliflozin | ↓ | |
| Tofogliflozin | ↓ | |
| Ipragliflozin | ↓ | |
GLUT9: glucose transporter 9, NA: not applicable, NS: not significant, UA: uric acid, URAT1: urate transporter 1