Keterangan
In those with diabetes whose systems still manufacture some insulin, oral diabetic medications aid in blood glucose control. The following list of oral pharmaceutical types is organized by drug classifications and functional characteristics.
People with type 2 diabetes and other conditions where the body still produces some insulin may benefit from taking oral diabetes medications (taken by mouth) to help control blood sugar (glucose) levels. Along with regular exercise and dietary adjustments, these medications are given. For the best blood glucose control, many oral diabetic medicines may be combined with one another or with insulin. The various oral diabetic medications are described in general detail in this guide. You will gain additional knowledge about your drug. Take your medications exactly as prescribed by your doctor.
Ringkasan
- Diabetes is a significant health concern in India, with a large percentage of the global burden. Type 1 diabetes requires insulin treatment, while Type 2 diabetes can often be managed with oral anti-diabetic agents. The talk focuses on the latter, providing an overview of available drugs, their mechanisms, dosages, and indications.
- Normal glucose homeostasis involves insulin and glucagon. Insulin lowers blood glucose by increasing uptake in tissues and reducing glucose output from the liver. Glucagon increases glucose output from the liver. Type 2 diabetes involves insulin resistance and deficiency, resulting from eyet cell dysfunction.
- The traditional "triad" of diabetes pathophysiology has expanded to an "ominous octet," incorporating issues such as decreased incretin effect, neurotransmitter dysfunction, increased glucose reabsorption in the kidneys, and increased lipolysis.
- Oral anti-diabetic agents target different aspects of diabetes. Sulfonylureas and meglitinide analogs stimulate insulin secretion. Thiazolidinediones reduce glucose output from the liver and enhance glucose uptake. Metformin reduces gluconeogenesis. Alpha-glucosidase inhibitors act at the gut level to reduce glucose absorption. DPP-4 inhibitors reduce glucose output and enhance insulin secretion.
- Metformin is often the first-line drug for type 2 diabetes, working by reducing hepatic glucose output. It is generally weight-neutral and carries a low risk of hypoglycemia. It's avoided in patients with significant renal impairment or liver dysfunction. Common side effects include gastrointestinal disturbances.
- Sulfonylureas stimulate insulin release, posing a risk of hypoglycemia and potentially leading to beta-cell exhaustion over time. While effective, they can cause weight gain. Meglitinides are also insulin secretagogues, but are shorter-acting and have a lower risk of hypoglycemia, making them useful in patients with irregular meal patterns or at high risk of hypoglycemia.
- Thiazolidinediones like pioglitazone increase insulin sensitivity in adipocytes and hepatocytes. They can cause weight gain, edema, and are contraindicated in patients with heart failure or liver dysfunction.
- DPP-4 inhibitors work by increasing the levels of incretins, such as GLP-1, which enhance insulin secretion and reduce glucagon levels. They are weight-neutral and have a low risk of hypoglycemia.
- SGLT2 inhibitors block glucose reabsorption in the kidneys, leading to increased glucose excretion in the urine. They are insulin-independent, can result in weight loss, and have shown cardiac benefits. The oral GLP-1 agonist (oral semaglutide) promotes significant weight loss and has cardiovascular benefits.
- The choice of oral anti-diabetic agent depends on factors such as availability, affordability, co-morbidities (e.g., heart failure, renal failure), contraindications, and compelling indications (e.g., need for weight loss or cardiovascular benefits).
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