The traditional choices of drugs are metformin, thiazolinediones and meglitinides
. Modern diabetes management options including newer sulfonylureas, incretin based therapies (DPP-4 inhibitors and GLP-1 analogues), SGLT-2 inhibitors, analogue basal and prandial insulins, and modern insulin pumps address the issue of GV effectively.2,11
Presently, there are 11 different classes of hypoglycemic agents (biguanides, sulfonylureas, thiazolidinediones (TZD), [alpha]-glucosidase inhibitors, dipeptidyl peptidase-4 (DPP-4) inhibitors, sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide-1 receptor agonists, amylin mimetics, meglitinides
, dopamine-2 agonists, and bile acid sequestrants) along with numerous insulin preparations available as a treatment option for type 2 DM.
(repaglinide, nateglitinide) are similar to sulfonylureas, but with less efficacy, more rapid onset and shorter duration of action.
Oral synthetic diabetic drugs such as meglitinides
, sulfonylureas, and others may cause hypoglycemia.
(glitinides) are insulin secretagogues, and they stimulate insulin release from pancreas [1-3].
(#) Alpha-glucosidase inhibitors, meglitinides
, DPP4 inhibitors, and amylin mimetics.
In patients with type 1 diabetes, insulin is used, whereas in patients with type 2 diabetes, sulfonylurea, biguanides, meglitinides
, dipeptidyl-peptidase-4 (DPP-4) inhibitors, alpha-glucosidase inhibitors, sodium glucose cotransporter 2 inhibitors (SGLT2), and glucagon-like peptide-1 (GLP-1) agonist are used.
These drugs are divided into several groups according to their mechanisms as secretogogues (sulfonylureas and meglitinides
), insulin sensitizers (biguanides and thiazolidinediones), and [alpha]-glucosidase inhibitors (miglitol and acarbose) (7).
There are seven pharmacologic subclasses of oral antidiabetic agents: alpha-glucosidase inhibitors, biguanides, dipeptidyl peptidase-4 inhibitors, meglitinides
, sulfonylureas, sodium-glucose cotransporter-2 inhibitors, and thiazolidinediones.
The greatest compliance was observed with alpha-glucosidase inhibitors (100%) and meglitinides
(100%); nonetheless, only 5 participants used these drugs.
Oral and injectable noninsulin hypoglycemic drugs available in 2008 included metformin, sulfonylureas, alpha-glucosidase inhibitors, amylinomimetics, thiazolidinediones (TZDs), dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 agonists (GLP-1), and meglitinides
. During the study period, all TZDs, DPP-4s, GLP-ls, and meglitinides
were single-source, brand-only preparations.
The OGA group contains the following OGAs: metformin, sulphonylurea, thiazolidinediones, alfa glucosidase inhibitors, DPP4 inhibitors, meglitinides
, and GLP-1 receptor agonists.