Anti-diabetic drug

Insulin see Insulin

Sulfonylurea drugs 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

Biguanide drugs 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• phenformin - was withdrawn from the market in the USA.

Glitazones

• Pioglitazone
• Rosiglitazone
• troglitazone - the first glitazone. Is now withdrawn from the market.

Alpha-glucosidases inhibitors

Use of glucagon for treatment