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Antihyperglycemic Agents

This module provides a comprehensive overview of antihyperglycemic agents used in the management of type 2 diabetes in Canada. Through historical context, formulary considerations, and practical case studies, the session explores how to select the right medication for the right patient based on age, comorbidities, kidney function, hypoglycemia risk, and access to coverage. Participants will review the evolution of oral and injectable therapies—from metformin and sulfonylureas to SGLT2 inhibitors, DPP-4 inhibitors, GLP-1 receptor agonists, and dual agents such as tirzepatide. Emphasis is placed on individualized A1C targets in older adults, minimizing hypoglycemia risk, understanding when medication changes are warranted, and recognizing when stability is the best course of action. This module supports thoughtful, patient-centered prescribing and collaborative diabetes care. Learning Objectives By the end of this module, participants will be able to: Describe the major classes of antihyperglycemic agents available in Canada and their mechanisms of action. Compare benefits and risks of different agents, including hypoglycemia risk and renal considerations. Individualize A1C targets based on age, comorbidities, and functional status. Apply case-based reasoning to determine when to adjust, discontinue, or maintain current therapy. Explain how non-insulin agents can be safely combined with insulin and when medications do not need to be held, particularly in hospital settings.