Antidiabetic agents

Antidiabetic agents refer to all the different types of medicine involved in the treatment of diabetes. All these agents aim to reduce blood sugar levels to an acceptable range (called achieving normoglycemia) and relieve symptoms of diabetes such as thirst, excessive urination, and ketoacidosis (a serious complication of diabetes that occurs when the body cannot use glucose as a fuel source). Antidiabetic agents also prevent the development of, or slow the progression of, long-term complications of the disease, such as nephropathy (kidney disease), neuropathy (nerve damage), and retinopathy (damage to the retina of the eye).

Common antidiabetic agents include:

• alpha-glucosidase inhibitors (acarbose, miglitol)
• amylin analogs (pramlintide)
• dipeptidyl peptidase 4 inhibitors (alogliptan, linagliptan, saxagliptin, sitagliptin)
• incretin mimetics (albiglutide, dulaglutide, exenatide, liraglutide, lixisenatide)
• insulin
• meglitinides (nateglinide, repaglinide)
• non-sulfonylureas (metformin)
• SGLT-2 inhibitors (canagliflozin, dapagliflozin, empagliflozin)
• sulfonylureas (chlorpropamide, glimepiride, glipizide, glyburide, tolazamide, tolbutamide)
• and thiazolidinediones (rosiglitazone, pioglitazone).

Some are available in combination.

Type I diabetes is a condition where the body does not produce any insulin. Therefore, insulin is the only treatment effective for type 1 diabetes. Injected insulin acts just like naturally occurring insulin to lower blood glucose levels.

People with type 2 diabetes initially have insulin resistance - this is when the cells of the body do not respond to insulin in the same way as people without diabetes. Oral antidiabetic agents work in various ways to reduce blood sugar levels in people with type 2 diabetes; some stimulate insulin secretion by the pancreas, others improve the responsiveness of cells to insulin or prevent glucose production by the liver. Others slow the absorption of glucose after meals. Many people with type 2 diabetes eventually require insulin to manage their high blood sugar levels.