Oral Hypoglycemic Drugs

What is oral hypoglycemic drugs?

Various oral hypoglycemic drugs that improve insulin secretion and insulin resistance have been used alone or in combination. Oral hypoglycemic drugs can be broadly divided into five groups: pancreatic agents, hepatic glucose-synthetic blockers, peripheral insulin sensitivity enhancers, gastrointestinal tract agents, and recently developed incretin enhancers.

What are the criteria for prescribing oral hypoglycemic drugs?

Oral hypoglycemic drugs are prescribed for each patient based on the level of blood sugar drop, drug expression and duration, drug metabolism and excretion, frequency and side effects.

Types of Oral hypoglycemic drugs

Depending on the mechanism of action of the drug, it can be divided into sulfonylurea, biguanide, alphaglucosidase inhibitor, thiazolidinedione, meglitinide, and DPP-4 inhibitor.

Sulfonylurea

It stimulates the beta cells of the pancreas and promotes insulin secretion to help regulate blood sugar. In addition, there are extra-pancreatic effects that allow the secreted insulin to bind well to the cell and prevent the liver from producing new sugars.

Biguanide

It does not affect the insulin secretion of pancreatic beta cells, but it is known to reduce blood sugar by enhancing insulin action in peripheral tissues.

Alpha Glucosidase Inhibitors

It inhibits the action of enzymes that break down the disaccharides, oligosaccharides, and polysaccharides that are ingested as food in the small intestine to slow the absorption of glucose into the intestine. It has nothing to do with insulin secretion and action, but it prevents digestion after eating and prevents rapid blood sugar rise after eating.

Meglitinide

It stimulates the beta cells of the pancreas and promotes insulin secretion to help regulate blood sugar.

Thiazolidinediones

In addition to lowering insulin resistance in muscle and liver, it also regulates blood sugar by inhibiting glucose production in the liver.

DPP-4 inhibitor

When you eat, a hormone called incretin (GLP-1, GLP, etc.) is released from your gut, which stimulates insulin secretion. Incretin hormones are broken down by an enzyme called DPP-4, which inhibits this enzyme, allowing it to act for a long time, increasing insulin secretion.

SGLT 2 Inhibitor

It is a new type of diabetes medication that inhibits glucose resorption from the kidneys and improves blood sugar by releasing excess 70g (280kcal) of urine per day through urine. Weight loss and blood pressure reduction effects can also be expected.

What drugs affect oral hypoglycemics?

  • Drugs that raise blood sugar
    • Diuretics (thiazide)
    • Thyroid hormone drugs
    • Tuberculosis drugs (isoniazid, rifampin)
    • Corticosteroids
    • Oral contraceptives
    • Growth hormone
  • Drugs that lower blood sugar
    • Aspirin
    • Anticoagulants (warfarin)
    • Anti Gout Drug (Provenedide)
    • Antibiotic
    • Alcohol

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