What are Antidiabetic Drugs? Medication for Sugar Diabetes

Diabetes mellitus is a disease with high blood glucose levels resulting from a deficiency of insulin. Drugs that are used in treatment of diabetes mellitus are called antidiabetic drugs. It is useful for reducing blood sugar levels. Insulin, its analogues and oral hypoglycemic drugs are the commonly used antidiabetic drugs.

What are common antidiabetic injections?

Common Diabetes Medication Injections

Most popular insulin preparations are a short-acting insulin called regular (crystalline) insulin. Other insulin preparations available are rapid-acting insulins (lispro, glulisin, aspart), intermediate-acting insulins (neutral protamine Hagedorn [NPH], lente insulin) and long-acting insulins (glargine, detemir, ultralente, protamine-zinc insulin).

Incretin mimetics or GLP-1 analogues (exenatide, liraglutide) and amylin mimetics (pramlintide) are non-insulin antidiabetic drugs that are injected subcutaneously.

What are the common oral antidiabetic drugs?

Common Diabetes Medication Tablets and Capsules

The common oral antidiabetic (hypoglycemic) drugs are :

• sulfonylureas (glimepiride, gliburide, glipizide, gliclazide)
• meglitinides (repaglinide, nataglinide)
• biguanides (metformin)
• thiazolidinediones (pioglitazone, rosiglitazone)
• α-glucosidase inhibitors (acarbose, miglitol)
• dipeptidyl peptidase-4 (DPP-4) inhibitors (sitagliptin, saxagliptin).

How do antidiabetic drugs act?

Actions of Diabetes Drugs

Insulin and its analogues reduce the blood sugar levels by increasing glucose uptake from blood to the tissues. Insulin is also responsible for a host of other actions that is responsible for its beneficial effects.

• Sulfonylureas and meglitinides stimulate insulin release from pancreatic beta cells.
• Biguanides decrease glucose production in liver and increase the sensitivity of insulin on the muscle and fat.
• Thiazolidinediones increase sensitivity of insulin receptors to insulin in liver and muscle by genetically modulating certain steps involved in glucose metabolism.
• α-glucosidase inhibitors reduce digestion of carbohydrates and glucose absorption by blocking a group of carbohydrate digesting enzymes in the intestine.
• DPP-4 inhibitors and incretin mimetics increase insulin release in response to the glucose increase in blood and reduce the glucagon (blood glucose increasing hormone) levels after meals.
• Amylin analogues like pramlintide can reduce appetite, delay gastric emptying and reduce post-meal plasma glucagon levels.

What are the uses of antidiabetic drugs?

Effects of Diabetes Medication

Antidiabetic drugs are primarily used to treat diabetes mellitus, but specific indications for the drugs vary. Insulin and insulin analogues are the only treatment approved for type 1 diabetes, gestational diabetes (diabetes in pregnancy) and diabetes resulting from surgical removal of pancreas. It is also used to treat type 2 diabetes which is not well controlled with oral drugs, in type 2 diabetic patients with serious infections and injury and those patients undergoing major surgery.

Oral antidiabetics and other non-insulin antidiabetics are used for treating type 2 diabetes.

What are the adverse effects of antidiabetic drugs?

Side Effects of Diabetes Medication

The most important adverse effect of antidiabetic drugs is hypoglycemia (low blood sugar levels). Of all the antidiabetic drugs, it is the biguanides, thiazolidinediones and α-glucosidase inhibitors that are the least likely to cause hypoglycemia. Severe hypoglycemia is more likely to occur with insulin, sulfonylureas, thiazolidinediones and pramlintide.

Insulin obtained from animal source can cause allergic reactions but human insulin is relatively free of such hypersensitivity. Weight gain may be a problem with insulin, thiazolidinediones and sulfonylureas. Older sulfonylureas were associated with bone marrow suppression and jaundice.

Metformin can cause gastrointestinal disturbances and very rarely lead to lactic acidosis especially in patients prone to develop hypoxia. Thiazolidinediones are found to cause fluid retention and edema. Cardiovascular events have been found to be increased with rosiglitazone. α-glucosidase inhibitors, incretin mimetics and pramlintide are known to cause prominent gastrointestinal side effects. Acute pancreatitis has been seen, although rarely, with incretin mimetics and DPP-4 inhibitors. DPP-4 inhibitors have also been associated with drug hypersensitivity reactions and increased incidence of infections of respiratory tract and urinary tract.

Who should not use antidiabetic drugs?

Contraindications for Diabetes Medication

Insulin has no known contraindication. All oral antidiabetic drugs are generally contraindicated in pregnant and lactating women, in diabetic patients undergoing major surgery, those with serious infections, following severe trauma, hepatic (liver) failure, renal (kidney) failure, or type 1 diabetes. Conditions predisposing to hypoxia (chronic cardiac or respiratory diseases) and patients with past history of lactic acidosis should also not use metformin. Thiazolidinediones are contraindicated in cardiac failure patients. Intestinal obstruction and inflammatory bowel diseases are additional contraindications for α-glucosidase inhibitors. Known allergy is a contraindication for the respective drug. A family history of medullary carcinoma is a contraindication for liraglutide.

Dr. Ben Myers

He is a dedicated pharmacist with a wealth of pharmaceutical knowledge and a commitment to ensuring safe and effective medication management. His expertise in drug interactions makes him an invaluable resource for both healthcare professionals and patients seeking optimal medicinal care.