Medications used for diabetes mellitus include insulin, sulfonylureas and other insulin secretagogues, alpha-glucosidase inhibitors (acarbose, miglitol), biguanides (metformin), thiazolidinediones (pioglitazone, rosiglitazone), sodium glucose transporter (SGLT2) inhibitors, and peptide analogs (pramlintide, exenatide) or enhancers (sitagliptin) (see Chapter 27). Of these, insulin and the insulin secretagogues are the most likely to cause hypoglycemia. Metformin can cause lactic acidosis, especially in patients with impaired kidney function or after intentional drug overdose. Euglycemic diabetic ketoacidosis has been reported with SGLT2 use. Table 27–5 lists the duration of hypoglycemic effect of oral hypoglycemic agents and Table 27–6 the extent and duration of various types of insulins.