ANTIDIABETICS – INTRODUCTION
Antidiabetic drugs are medicines that help control blood sugar levels in people with diabetes mellitus (sugar diabetes)
ANTIDIABETICS – INDCATION
Antidiabetic drugs are medicines developed to stabilise and control blood glucose levels amongst people with diabetes. Antidiabetic drugs are commonly used to manage diabetes.
ANTIDIABETICS – INFORMATION
Drugs used in diabetes treat diabetes mellitus by lowering glucose levels in the blood. With the exceptions of insulin, exenatide, liraglutide and pramlintide, all are administered orally and are thus also called oral hypoglycemic agents or oral antihyperglycemic agents. There are different classes of anti-diabetic drugs, and their selection depends on the nature of the diabetes, age and situation of the person, as well as other factors.
Diabetes mellitus type 1 is a disease caused by the lack of insulin. Insulin must be used in Type I, which must be injected.
Diabetes mellitus type 2 is a disease of insulin resistance by cells. Type 2 diabetes mellitus is the most common type of diabetes. Treatments include (1) agents that increase the amount of insulin secreted by the pancreas, (2) agents that increase the sensitivity of target organs to insulin, and (3) agents that decrease the rate at which glucose is absorbed from the gastrointestinal tract.
Several groups of drugs, mostly given by mouth, are effective in Type II, often in combination. The therapeutic combination in Type II may include insulin, not necessarily because oral agents have failed completely, but in search of a desired combination of effects. The great advantage of injected insulin in Type II is that a well-educated patient can adjust the dose, or even take additional doses, when blood glucose levels measured by the patient, usually with a simple meter, as needed by the measured amount of sugar in the blood.
Blood sugar— The concentration of glucose in the blood.
Glucose— A simple sugar that serves as the body’s main source of energy.
Hormone— A substance that is produced in one part of the body, then travels through the bloodstream to another part of the body where it has its effect.
Metabolism— All the physical and chemical changes that occur in cells to allow growth and maintain body functions. These include processes that break down substances to yield energy and processes that build up other substances necessary for life.
Pregnancy category— A system of classifying drugs according to their established risks for use during pregnancy. Category A: Controlled human studies have demonstrated no fetal risk. Category B: Animal studies indicate no fetal risk, but no human studies; or adverse effects in animals, but not in well-controlled human studies. Category C: No adequate human or animal studies; or adverse fetal effects in animal studies, but no available human data. Category D: Evidence of fetal risk, but benefits outweigh risks. Category X: Evidence of fetal risk. Risks outweigh any benefits.
Salicylates— A group of drugs that includes aspirin and related compounds. Salicylates are used to relieve pain, reduce inflammation, and lower fever.
Seizure— A sudden attack, spasm, or convulsion.
Antidiabetic agents aim to achieve normoglycemia and relieve diabetes symptoms, such as thirst, polyuria, weight loss, ketoacidosis. The long term goals are to prevent the development of or slow the progression of long term complications of the disease. Choice of antidiabetic agent depends on the type of diabetes.
Type I diabetes is where the body does not produce any insulin, so insulin is the only treatment choice. Injected insulin acts similar to endogenous insulin to lower blood glucose levels.
Type 2 Diabetes is first treated with oral antidiabetic medicines. These medicines, either makes the pancreas produce more insulin, helps decrease insulin requirements by the body or reduces gluconeogenesis by the liver. If normoglycemia is not achieved with oral medicines then insulin can be added to the therapy.
Currently, there are nine drug classes of oral diabetes medications approved for the treatment of type 2 diabetes.
Sodium-glucose cotransporter (SGLT)-2 inhibitors
Bile acid sequestrants
These medications differ in the way they function in the body to reduce blood glucose.