Classification and Overview of Oral Hypoglycemic Drugs
Oral hypoglycemic drugs are primarily used for managing Type 2 Diabetes Mellitus. The following outlines the classification, mechanisms, therapeutic uses, and adverse effects of the main categories.
Classification of Oral Hypoglycemic Drugs
- Sulfonylureas: Glipizide, Glyburide, Glimepiride
- Biguanides: Metformin
- Thiazolidinediones (Glitazones): Pioglitazone, Rosiglitazone
- Meglitinides (Glinides): Repaglinide, Nateglinide
- DPP-4 Inhibitors: Sitagliptin, Saxagliptin
- SGLT-2 Inhibitors: Canagliflozin, Dapagliflozin
- Alpha-Glucosidase Inhibitors: Acarbose, Miglitol
Mechanism of Action, Therapeutic Uses, and Adverse Effects
Sulfonylureas
Mechanism of Action: Stimulate pancreatic beta cells to release insulin by closing potassium channels, leading to insulin release.
Therapeutic Uses: Used in Type 2 Diabetes when diet and lifestyle changes alone are insufficient.
Adverse Effects: Hypoglycemia, weight gain, nausea, skin reactions.
Biguanides (Metformin)
Mechanism of Action: Decreases hepatic glucose production, increases insulin sensitivity, and enhances peripheral glucose uptake.
Therapeutic Uses: First-line therapy in Type 2 Diabetes, particularly useful for overweight patients.
Adverse Effects: Gastrointestinal upset, lactic acidosis, Vitamin B12 deficiency with long-term use.
Thiazolidinediones (Glitazones)
Mechanism of Action: Activate PPAR-γ receptors, increasing insulin sensitivity in muscle and adipose tissue.
Therapeutic Uses: Type 2 Diabetes, particularly in cases of insulin resistance.
Adverse Effects: Weight gain, fluid retention, increased heart failure risk, fractures.
Meglitinides (Glinides)
Mechanism of Action: Stimulate rapid insulin release from beta cells, similar to sulfonylureas, but with a shorter action duration.
Therapeutic Uses: Primarily used to manage postprandial blood glucose in Type 2 Diabetes.
Adverse Effects: Hypoglycemia, weight gain, gastrointestinal symptoms.
DPP-4 Inhibitors
Mechanism of Action: Inhibit the DPP-4 enzyme, increasing incretin hormones, which enhance insulin release and reduce glucagon.
Therapeutic Uses: Type 2 Diabetes, especially in patients with poor control on other agents.
Adverse Effects: Nasopharyngitis, headache, joint pain, rare pancreatitis.
SGLT-2 Inhibitors
Mechanism of Action: Inhibit SGLT-2 in renal tubules, leading to increased glucose excretion in urine.
Therapeutic Uses: Type 2 Diabetes, with added benefits for weight loss and cardiovascular protection.
Adverse Effects: Genitourinary infections, dehydration, hypotension, ketoacidosis.
Alpha-Glucosidase Inhibitors
Mechanism of Action: Inhibit intestinal alpha-glucosidase enzymes, slowing carbohydrate digestion and reducing postprandial glucose.
Therapeutic Uses: Type 2 Diabetes, specifically for post-meal glucose control.
Adverse Effects: Gastrointestinal disturbances, abdominal pain, diarrhea.
This overview highlights the diversity of oral hypoglycemic agents available to treat Type 2 Diabetes, their mechanisms of action, therapeutic benefits, and potential adverse effects.
