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Oral Hypoglycemic Agents

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The pancreas function as endocrine glands as well as exocrine glands. It can produce enzymes such as insulin, glucagon and somatostatin as well as digestive enzymes.  The cells located on islets of Langerhans, that is, β cells produce insulin, α produce glucagon and  Δ cells produce somatostatin. Insulin plays an important role in regulation of carbohydrate and fat metabolism. It helps cells in the body absorb glucose from the blood. It is constantly released in some propotions to remove excess glucose from the blood. When the production of insulin fails, it results in diabetes mellitus.

In order to keep blood sugar level in control, patients of diabetes are prescribed medications that are administered orally as well as can be injected. Those that are administered orally are called as oral hypoglycemic agents.

What are Oral Hypoglycemic Agents?

Anti-diabetic medications that help treat diabetes by lowering the blood sugar levels. These medications are administered orally, thus called as oral hypoglycemic agents or oral antihyperglycemic agents.

Anti-diabetic drugs include different classes of drugs. These drugs are prescribed according to:

  • The type of diabetes
  • Age of the person
  • Health of the person
  • Other related factors

The oral hypoglycemic drugs are used for patients with type 2 diabetes.

What Are the Types of Oral Hypoglycemic Agents?

The major types of oral hypoglycemic agents are:

Biguanides

These are a group of oral type 2 diabetes drugs that prevent the production of glucose in the liver. This helps in improving the body’s sensitivity to insulin. This helps in reducing the amount of glucose absorbed by the intestines. The medication available in this class includes metformin. It is the first-line treatment drug for type 2 diabetes. The two different versions of this drug include:

  • Metformin IR – This drug is immediate released and is to be taken about 3 times a day
  • Metformin SR – This is a slow releasing drug that is taken once a day

Sulphonylureas

These are a class of oral medications that help in controlling the blood sugar levels by stimulating the production of insulin and increasing the effectiveness of the insulin in the body.

These drugs are taken once or twice daily. They can be taken before a meal or on their own. They are sometimes prescribed along with metformin. The drugs in sulphonylureas include:

  • Glimepiride
  • Gilbenclamide
  • Gilclazide
  • Gilclazide
  • Gilpizide
  • Gilpizide
  • Tolbutamide

These drugs are not given to patients who are overweight or obese as the side effect of these drugs include weight gain. Another side effect includes low blood sugar levels. In some it may cause an allergic reaction like red, itchy skin.

Thiazolidinediones

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Also known as glitazones, these drugs are often prescribed along with biguanides. These drugs are to be taken once or twice daily with or without food. The mode of action of these drugs is to target the PPAR-gamma receptor that activates genes in the body and plays a role in metabolism of glucose and storage of fat in the body. the drug reduces the body’s resistance to insulin and helps improve the control of blood glucose levels.

The drugs available in this group include

  • Pioglitazone
  • Rosiglitazone
  • Troglitazone

Of these only Pioglitazone is used as the other two have either been banned (troglitazone) or suspended by EU (rosiglitazone).

As the drugs activates different types of genes, it leads to multiple side effects. These side effects include:

  • Weight gain
  • Water retention
  • Loss of sense of touch
  • Allergic skin rashes
  • Chest pain
  • Eyesight problems
  • Liver failure
  • Anaemia
  • Bone fracture

Other Major Oral Hypoglycemic Agents

The other drugs under this group include:

  • Alpha-glucosidase inhibitor
  • Meglitinides
  • DPP-4 inhibitors (gliptins)

Oral Hypoglycemic Agents Dosage

The dose for oral hypoglycemic drugs depends on individual patients. It is decided according to the patients type of diabetes, age, blood sugar levels, overall health, etc.

One needs to continue exercising and follow a strict diet, even when they begin with oral hypoglycemic drugs. Staying healthy and maintaining blood sugar levels is an important of diabetes management.

Oral hypoglycemic drugs do not cure diabetes. They just help in maintaining a healthy blood sugar level and reduce the diabetes related complications. Speak to your regarding oral glycemic drugs and make sure you follow the prescribed dose.

Written by: Saptakee sengupta
Date last updated: March 24, 2015