Two drugs from the biguanide class, metformin and phenformin, were developed in 1957. Unfortunately, phenformin reached the U.S. market first and resulted in several deaths from lactic acidosis. When this risk surfaced, phenformin was pulled from drugstore shelves worldwide. Metformin was eventually found to be 20 times less likely to cause lactic acidosis, but it was tainted by the history of its cousin. Metformin first became available in France in 1979 and has been widely used in Europe since then, but it was not cleared for use in Type 2 diabetes in the U.S. until 1994.


Sulfonylureas, the first drug group introduced into the U.S. in 1955, stimulates the beta cells to produce more insulin. These drugs have kept many Type 2’s off injected insulin. Sulfonylureas will not work in those with Type 1 diabetes (except for a specific type) nor in anyone with Type 2 whose beta cells no longer produce insulin. Loss of insulin production, indicated by a low C-peptide level in the blood, is found in those with Type 1 diabetes, in many who have Type 1.5 diabetes, and in many others with Type 2 diabetes for more than 6 to 15 years.

The Incretins: GLP-1 Agonists and DPP-4 Inhibitors

by John Walsh, P.A, CDE

In 1902, Researchers first hypothesized that the gut might directly signal the pancreas. The term incretin was first used in 1930 to describe the enhanced glucose lowering effect that was seen when a gut extract was fed to dogs. In the 1960s, researchers discovered that almost twice as much insulin was released when they infused glucose directly into the gut rather than into the blood as an IV solution, renewing interest in a search for compounds produced by the gut that could lower blood glucose levels.

Learn About the Basics of Diabetes

Diabetes can be a complicated disease to manage, especially for the newly diagnosed. It affects men, women, and children differently. There are also multiple types of diabetes (Pre-diabetes, Type 1, Type 1.5, Type 2, etc) that have different effects on people. This section of our site gives you a great outline of diabetes diagnosis, treatments and complications. 

Newly Diagnosed

Learn the basics of diabetes, from its diagnosis and types to staying motivated while dealing with the disease.


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