An
anti-diabetic drug is used to treat
diabetes mellitus. They usually work by lowering the
glucose levels in the blood.
see
Insulin
These are oral hypoglycaemic agents. They bind strongly to
plasma proteins[?]. Sulfonylureas are only useful in type II diabetes, as they work by stimulating endogenous release of insulin.
They work best with patients over 40 years old, who have had diabetes mellitus for under ten years. It should not be used with type I diabetes, or diabetes of pregnancy. They can be safely used with biguanides and glitazones.
The toxicity of these drugs is relatively low.
- First generation
- acetohexamide
- chlorpropamide - the longest acting of the sulfonylurea drugs.
- tolazamide
- tolbutamide
- Second generation - these are more potent than first generation drugs.
- glimepiride
- glipizide - has the shortest half-life.
- glyburide
Biguanides work by increasing glucose uptake in the muscle, and decreasing glucose production in the liver.
They can also be taken orally, but do not bind to plasma proteins, and have a very short half-life.
- metformin
- phenformin - was withdrawn from the market in the USA.
- Pioglitazone
- Rosiglitazone
- troglitazone - the first glitazone. Is now withdrawn from the market.