Oral Hypoglycemic Drugs And Classifications

Heider SH. QassamMSc.PH. & TH.

To understand Oral Hypoglycemic Drugs And Classifications

Goal

Oral Hypoglycemic Drugs: These agents are useful in the treatment of patients who have Type 2 diabetes but who cannot be managed by diet alone.

Oral Hypoglycemic Classification

Insulin Secretagogues

I.Sulfonylureas

II.Meglitinide analogs

Insulin Sensitizer

s

III.Biguanides

IV. Thiazolidinediones

V.α-Glucosidase Inhibitors

(mechanism of action) :A. Increase release of insulinB. Decrease production of glucose in the liverC. Increase the number of insulin receptorsD. Effective only if have functioning beta cells Side effect is hypoglycemia and weight gain These drugs include glibenclamide, glipizide,

and glimepiride .

I.Sulfonylureas

Nateglinide and repaglinide are nonsulfonylureas that lower blood sugar by stimulating pancreatic secretion of insulin

In contrast to the sulfonylureas, the meglitinides have a rapid onset and a short duration of action

They are categorized as postprandial glucose regulators

Monotherapy or in combination with metformin Should be taken 1 to 30 minutes before a meal Side effects hypoglycemia and weight gain

II.Meglitinides

(mechanism of action): increases the use of glucose by muscle and fat cells, decreases hepatic glucose production, and decreases intestinal absorption of glucose

Does not cause hypoglycemia May be used alone or in combination Side effects include GIT disturbance and

lactic acidosis Contraindicated in liver or renal impairment.

Can result in lactic acidosis. This group include metformin

III.Biguanides

(mechanism of action):Decrease insulin resistance. Through binding with PPAR lead to regulation adipocyte production and secretion of fatty acids as well as glucose metabolism, resulting in increased insulin sensitivity in adipose tissue, liver, and skeletal muscle

Side effects include weight gain, headache and anemia

Contraindicated in patients with liver disease and acute MI

May be used as monotherapy or in combination with insulin, metformin or a sulfonylurea

These drugs include Pioglitazone and rosiglitazone

IV. Thiazolidinediones

Include acarbose and miglitol (mechanism of action): inhibit alpha-

glucosidase enzymes in GI tract. Delays absorption of complex CHO and simple sugars

Can be combined therapy with sulfonylurea

Contraindicated in malabsorption, severe renal impairment

Side effects include bloating and diarrhea

Alpha glucosidase Inhibitors

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