Mnemonic for antidiabetic drugs

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Here is a complete, exam-ready mnemonic guide for antidiabetic drugs:

Mnemonics for Antidiabetic Drugs

1. "SENSE, SQUEEZE, FLUSH" - Mechanism-Based Grouping

This is one of the most intuitive mnemonics, grouping drugs by what they do:

Mechanism	Drugs
SENSE (Sensitizers)	Metformin, Pioglitazone (TZDs), Bromocriptine
SQUEEZE (Secretagogues)	Sulfonylureas, Meglitinides, GLP-1 agonists, DPP-4 inhibitors, Bile acid sequestrants
FLUSH (Excretion)	SGLT-2 inhibitors (urine), Alpha-glucosidase inhibitors (gut)

2. "IS SLIM BAG D" - All Major Drug Classes

I - Insulin
S - Sulfonylureas (glibenclamide, glipizide, glimepiride)
S - SGLT-2 inhibitors (canagliflozin, dapagliflozin, empagliflozin - the "flozins")
L - GLP-1 agonists (liraglutide, semaglutide, dulaglutide - the "tides/glutides")
I - Incretin-based (DPP-4 inhibitors: sitagliptin, vildagliptin - the "gliptins")
M - Meglitinides/Glinides (repaglinide, nateglinide)
B - Biguanides (Metformin)
A - Alpha-glucosidase inhibitors (Acarbose, Miglitol)
G - Glitazones/TZDs (Pioglitazone)
D - Dopamine agonist (Bromocriptine)

3. Drug Name Suffixes ("The -in/zone/tide Cheat Sheet")

Memorize the suffix and you know the class instantly:

Suffix	Class	Example
-formin	Biguanide	Metformin
-gliptin	DPP-4 inhibitor	Sitagliptin
-flozin	SGLT-2 inhibitor	Dapaflozin
-glutide / -tide	GLP-1 agonist	Liraglutide
-glinide	Meglitinide	Repaglinide
-glitazone	TZD	Pioglitazone
-glipizide / gli-	Sulfonylurea	Glibenclamide
-carbose	Alpha-glucosidase inhibitor	Acarbose

4. Weight Effect Mnemonic - "LOSS vs GAIN vs NEUTRAL"

Weight LOSS: GLP-1 agonists, SGLT-2 inhibitors, Metformin (neutral/loss)
Weight GAIN: Sulfonylureas, TZDs, Insulin
Weight NEUTRAL: DPP-4 inhibitors, Alpha-glucosidase inhibitors

Trick: "GLAD" drugs cause weight gain - Glimepiride (SU), Linagliptin? No - think Glitazones, SU's, insulin = GSI gain

5. Hypoglycemia Risk Mnemonic - "SMS = Safe, Metformin + SGLT2 + Sulfs risky"

Low risk: Metformin, TZDs, DPP-4i, SGLT-2i, GLP-1 RA, Alpha-glucosidase inhibitors
High risk: "SI" = Sulfonylureas + Insulin (both directly drive insulin secretion/supply regardless of glucose)

6. Cardiovascular Benefit Drugs - "SEGS"

Drugs with proven CV/renal outcome benefits:

S - SGLT-2 inhibitors (empagliflozin, dapagliflozin - heart failure + CKD benefit)
E - Empagliflozin specifically (EMPA-REG trial)
G - GLP-1 agonists (liraglutide LEADER trial, semaglutide SUSTAIN-6)
S - Semaglutide

Quick Class Summary Table

Class	MOA	Key SE	Hypo risk	Weight
Metformin	Activates AMPK, decreases hepatic glucose	Lactic acidosis, GI	Low	Neutral/loss
Sulfonylureas	Close K-ATP channels on beta cells	Hypoglycemia	High	Gain
TZDs	PPAR-γ agonist, insulin sensitizer	Edema, heart failure, fractures	Low	Gain
DPP-4i	Prevent incretin breakdown	Pancreatitis (rare)	Low	Neutral
GLP-1 RA	Mimic incretin, slow gastric emptying	GI nausea/vomiting	Low	Loss
SGLT-2i	Promote glycosuria	UTI/genital fungal infections	Low	Loss
Meglitinides	Close K-ATP channels (shorter acting)	Hypoglycemia	Moderate	Gain
Alpha-glucosidase inhibitors	Delay carb absorption	Bloating, flatulence	Low	Neutral
Insulin	Direct glucose uptake	Hypoglycemia, lipohypertrophy	High	Gain

Bottom line for exams: Know the suffix rule (#3) cold - it gets you through MCQs instantly. Then layer on the "Sense-Squeeze-Flush" framework for mechanism questions. For newer drugs (SGLT-2i, GLP-1 RA), remember they are the only ones with proven cardiovascular outcome trial data.

(Pharmacologic treatment framework: Symptom to Diagnosis, 4th Ed.)

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