Classification of Oral Hypoglycemic Drugs
Oral hypoglycemic drugs are classified into four categories. It includes sulfonylureas, metformin, thiazolidinediones, and alpha-glucosidase inhibitors. Each class of oral hypoglycemic drug has its advantage and disadvantage. Classification of these drugs is based on their effects on insulin. Either they can increase the insulin secretion or increase the cells’ sensitivity to the available insulin. However, their main purpose is to reduce the glucose level in the blood. The Food and Drug Administration (FDA) approves these drugs for treating type-2 diabetes patients only.
Mechanism of Action of the Oral Hypoglycemic Drugs
The mechanism of action of each class of oral hypoglycemic drugs is different.
Sulfonylureas: Among all oral hypoglycemic drugs, sulfonylureas are the most commonly used for treating type-2 diabetes. They stimulate the production of insulin. The sulfonylurea bind with K-ATP channels in the beta cells of the pancreas. This, in turn, stimulates these cells to produce insulin. As more insulin is released in the blood, the glucose concentrations go down. It can have some extra-pancreatic effects also. For example, it can increase the sensitivity of the tissues to insulin. However, clinically, it causes minimal ill effects. The main disadvantage of sulfonylureas is excessive hypoglycemia that can lead to unconsciousness.
Metformin: The metformin is a commonly used oral drug for the treatment of type-2 diabetes. The mechanism of function of metformin is different from sulfonylureas. Rather than directly stimulating the production of insulin, it increases the action of insulin on the tissues. Metformin stimulates protein kinase activity in the liver. Thereby reduces gluconeogenesis and lipogenesis in the liver. Metformin also promotes the uptake of glucose in muscles that are mediated by insulin. It is used in the monotherapy of diabetes mellitus treatment. However, it can be given in combination with other drugs as well.
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