Diabetes Medicines and Treatment

Intrudoction

The goal of diabetes treatment is to maintain as much normoglycemia as possible. Normoglycemia refers to normal blood sugar level of our body.  There are three approaches for diabetes therapy. They are, according to importance, 

1. Diet
2. Oral hypoglycemic agents
3. Insulin

Diet is the first line of choice of treatment in diebetes patients. Those who have mild diabetes, their diabetes can be managed simply by a well balanced diet. In moderate. In moderate to severe cases, blood glucose lowering agents (Oral hypoglycemic agents) and insulin is required but diet is maintained all the time. Diabetes diet should always contain low carbohydrate sugar and fat content. There should be plenty of fruits and vegetables. 

 Oral Hypoglycemic Agents

1) Sulphonylurea  (insulin secretagogue* ): 

  a)First generation : Acetohexamide, Chlorpropamide, Tolazamide, Tolbutamide,
  b)Second generation: Glibenclamide, Gliclazide, Glimepiride, Glipizide, Blyburide, Gilyquidone

2)Biguanides : Metformin, Phenformin, Buformin
    Indication: They are the most widely used medicines to treat type 2 diabetes.

Drugs for Diabetic Peripheral Neuropathy

1)alpha glucosidase inhibitors: Acarbose:
     Indication: It is indicated as an adjunct to lower blood glucose in patients with Type 2 diabetes,
     whose hyperglycemia cannot be managed on diet alone. 
     

2)Thiazolidinediones  (insulin sensitizers*) : Troglitazone, Pioglitazone, Rosiglitazone

3) Meglitinides (insulin secretagogue) : Rapaglinide, Nateglinide

    Indication: It is indicated as an adjunct to lower blood glucose in patients with Type 2

    diabetes, whose hyperglycemia cannot be managed on diet alone; same as the indication of 

    acarbose            

Insulin and Its Preparations

Insulin is injected subcutaneously in type 1 diabetic patients and in type 2 diabetic patients if the blood sugar level goes too high. There are three types of insulin preparation in diabetic patients:

• Short acting insulin

• Medium acting insulin

• Long acting insulin

 Other Drugs in Pipeline:  

1)GLP-1 or glucagon like peptide 1 and analogues,

2)GIP or gastric inhibitory polypeptide and Amylin.
___________________________________________________________________________

*insulin secretagogue : Promotes or facilitate insulin secretion from pancreas

*insulin sensitiszers : increase the action of insulin on its receptor