Classification of Oral Hypoglycemic Drugs for Diabetes
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Oral hypoglycemic drugs (also called oral antidiabetic drugs) are medications used to manage type 2 diabetes mellitus by lowering blood glucose levels. They are classified based on their mechanism of action.
Classification of Oral Hypoglycemic Drugs
Insulin Secretagogues
These drugs stimulate insulin secretion from pancreatic beta-cells.
- Sulfonylureas
- First-generation: Tolbutamide, Chlorpropamide
- Second-generation: Glipizide, Glyburide (Glibenclamide), Gliclazide, Glimepiride
- Meglitinides (Glinides)
- Repaglinide
- Nateglinide
Insulin Sensitizers
These agents enhance insulin action in peripheral tissues.
- Biguanides
- Metformin (the most commonly used first-line agent)
- Thiazolidinediones (Glitazones)
- Pioglitazone
- Rosiglitazone
Alpha-Glucosidase Inhibitors
These medications delay carbohydrate absorption in the intestine.
- Acarbose
- Miglitol
- Voglibose
Incretin-Based Therapies
These therapies increase incretin activity, which enhances insulin secretion and suppresses glucagon.
- DPP-4 Inhibitors (Gliptins)
- Sitagliptin
- Saxagliptin
- Linagliptin
- Vildagliptin
- Alogliptin
Note: These are oral formulations. Incretin mimetics like GLP-1 agonists are usually injectable.
SGLT2 Inhibitors
These drugs promote glucose excretion in the urine via the kidneys.
- Canagliflozin
- Dapagliflozin
- Empagliflozin
- Ertugliflozin
Amylin Analogs
Amylin slows gastric emptying and suppresses glucagon secretion.
- While not widely used in oral form, Pramlintide is an injectable version included here for completeness; oral formulations are currently in development.
Summary of Oral Antidiabetic Drug Classes
| Class | Examples | Mechanism |
|---|---|---|
| Sulfonylureas | Glipizide, Glimepiride | Increases insulin secretion |
| Meglitinides | Repaglinide | Increases insulin secretion (short-acting) |
| Biguanides | Metformin | Decreases hepatic glucose production; increases insulin sensitivity |
| Thiazolidinediones | Pioglitazone | Increases insulin sensitivity |
| Alpha-Glucosidase Inhibitors | Acarbose | Decreases carbohydrate absorption in the gut |
| DPP-4 Inhibitors | Sitagliptin | Increases incretin, leading to higher insulin and lower glucagon |
| SGLT2 Inhibitors | Dapagliflozin | Increases glucose excretion in urine |
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