Antidiabetic agents are medications used to manage blood glucose levels in individuals with diabetes mellitus.
These agents work through various mechanisms to enhance insulin action, increase insulin secretion, reduce hepatic glucose production, or decrease glucose absorption from the gastrointestinal tract.
Proper classification of antidiabetic agents is essential for selecting appropriate therapy based on the patient's specific needs, type of diabetes, and potential side effects.
Classification of antidiabetic agents
A) Sulfonylureas
Mechanism: Stimulate insulin secretion from pancreatic β-cells by closing ATP-sensitive potassium channels, leading to cell depolarization and calcium influx.
Tolbutamide
Chlorpropamide
Glipizide
Glimepiride
B) Biguanides
Mechanism: Decrease hepatic glucose production (gluconeogenesis) and increase insulin sensitivity, particularly in muscle tissues.
Metformin
C) Thiazolidinediones (TZDs)
Mechanism: Activate peroxisome proliferator-activated receptor-gamma (PPAR-γ), enhancing insulin sensitivity in adipose tissue, muscle, and the liver.
Pioglitazone
Rosiglitazone
Repaglinide
Nateglinide
D) α-Glucosidase Inhibitors
Mechanism: Delay the absorption of carbohydrates from the small intestine by inhibiting α-glucosidase enzymes, thereby reducing postprandial blood glucose spikes.
Acarbose
Voglibose
Summary of Proper Classification
Class | Agents |
Sulfonylureas | Tolbutamide, Chlorpropamide, Glipizide, Glimepiride |
Biguanides | Metformin |
Thiazolidinediones (TZDs) | Pioglitazone, Rosiglitazone |
Meglitinides | Repaglinide, Nateglinide |
α-Glucosidase Inhibitors | Acarbose, Voglibose |