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Date of publication:2020/7/14 10:50:41

Antidiabetic Drugs Classification and Mechanism of Action

Diabetes is a condition that leads to high levels of blood glucose (or sugar) in the body. It is assopciated with long-term micro- and macrovascular complications, and is widely recognized as a leading cause of mortality and morbidity.

Antidiabetic Drugs Classification

This happens when your body can't make or use insulin like it's supposed to. Insulin is a substance that helps your body use the sugar from the food you eat.

There are two different types of diabetes: type 1 diabetes and type 2 diabetes. Type 1 diabetes is a disease caused by the lack of insulin. Insulin must be used in type 1, which must be injected. Type 2 diabetes is a disease of insulin resistance by cells. Type 2 diabetes 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.

Antidiabetic Drugs Classification

People with either type of diabetes need medications to help keep their blood sugar levels normal. The types of drugs depend on the type of diabetes you have. This article gives you information about the classification of antidiabetic drugs and their mechanism of action.

Class Drugs Mechanism of action Side effects Contraindications
Insulins ▶ Short-acting insulin (regular insulin)
▶ Rapid-acting insulins (insulin aspart, insulin glulisine, insulin glulisine)
▶ Intermediate-acting insulin (insulin isophane)
▶ Long-acting insulins (insulin degludec, insulin detemir, insulin glargine, )
▶ Combination insulins (insulin aspart protamine-insulin aspart, insulin lispro protamine-insulin lispro, etc)
▶ Inject inslins ▶ Weight gain
▶ Blood sugar that drops too low, or hypoglycemia
▶ Rashes, bumps, or swelling at an injection site
▶ Hypersensitivity to drug/class/component.
▶ Dosage may need to be reduced in severe renal impairment.
GLP-1 agonists ▶ albiglutide
▶ dulaglutide
▶ exenatide
▶ liraglutide
▶ semaglutide (Oral semaglutide Rybelsus is the first oral GLP-1 receptor)
▶ Direct stimulation of the GLP-1 receptor ▶ Nausea
▶ Increased risk of pancreatitis and possibly pancreatic cancer
▶ Preexisting, symptomatic gastrointestinal motility disorders
Amylin analogs ▶ pramlintide ▶ Reduce glucagon release
▶ Reduce gastric emptying
▶ Increase satiety
▶ Risk of hypoglycemia
▶ Nausea
▶ Gastroparesis
Biguanide ▶ Metformin ▶ Acts on the liver to reduce gluconeogenesis and causes a decrease in insulin resistance via increasing AMPK signalling. ▶ Lactic acidosis
▶ Weight loss
▶ Gastrointestinal complaints are common (e.g. diarrhea, abdominal cramps)
▶ Reduced vitamin B12 absorption
▶ Chronic kidney disease
▶ Liver failure
▶ Metformin must be paused before administration of iodinated contrast medium and major surgery.
Sulfonylureas ▶ glimepiride
▶ gliclazide
▶ glyburide
▶ chlorpropamide
▶ tolazamide
▶ tolbutamide
▶ Increase insulin secretion from pancreatic β-cells ▶ Risk of hypoglycemia
▶ Weight gain
▶ Hematological changes: agranulocytosis, hemolysis
▶ Severe cardiovascular comorbidity
▶ Obesity
▶ Sulfonamide allergy particularly long-acting substances)
Meglitinides ▶ nateglinide
▶ repaglinide
▶ Increase insulin secretion from pancreatic β-cells ▶ Risk of hypoglycemia
▶ Weight gain
▶ Severe renal or liver failure
DPP-4 inhibitors ▶ alogliptin
▶ linagliptin
▶ saxagliptin
▶ Inhibit GLP-1 degradation → promotes glucose-dependent insulin secretion ▶ Gastrointestinal complaints
▶ Pancreatitis
▶ Headache, dizziness
▶ Arthralgia
▶ Liver failure
▶ Moderate to severe renal failure
SGLT-2 inhibitors dapagliflozin
▶ ertugliflozin
▶ Increased glucosuria through the inhibition of SGLT-2 in the kidney ▶ Genital yeast infections and urinary tract infections
▶ Polyuria and dehydration
▶ Diabetic ketoacidosis
▶ Chronic kidney disease
▶ Recurrent urinary tract infections
Alpha-glucosidase inhibitors ▶ acarbose
▶ miglitol
▶ voglibose
▶ Reduce intestinal glucose absorption ▶ Gastrointestinal complaints (flatulence, diarrhea, feeling of satiety) ▶ Any preexisting intestinal conditions (e.g.,inflammatory bowel disease)
▶ Severe renal failure
Thiazolidinediones ▶ Pioglitazone
▶ Rosiglitazone
▶ Reduce insulin resistance through the stimulation of PPARs (peroxisome proliferator-activated receptors)
▶ Increase transcription of adipokines
▶ Weight gain
▶ Edema
▶ Cardiac failure
▶ Increased risk of bone fractures (osteoporosis)
▶ Congestive heart failure
▶ Liver failure
Table: Antidiabetic drugs classification

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Featured Anti-diabetes Intermediates:

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[4] Oral Semaglutide : First Oral GLP-1 Treatment for Type 2 Diabetes
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