1. Oral Hypoglycemic Drugs And Classifications
Heider SH. Qassam
MSc.PH. & TH.

2. Goal
To understand Oral Hypoglycemic Drugs And Classifications

3. Oral Hypoglycemic Drugs: These agents are useful in the treatment of patients who have Type 2 diabetes but who cannot be managed by diet alone.

4. Oral Hypoglycemic Classification
Insulin Secretagogues
Insulin Sensitizers
I.Sulfonylureas
III.Biguanides
IV. Thiazolidinediones
II.Meglitinide analogs
V.α-Glucosidase Inhibitors

6. I.Sulfonylureas (mechanism of action) : Increase release of insulin
Decrease production of glucose in the liver
Increase the number of insulin receptors
Effective only if have functioning beta cells
Side effect is hypoglycemia and weight gain
These drugs include glibenclamide, glipizide, and glimepiride .

7. II.Meglitinides
Nateglinide and repaglinide are nonsulfonylureas that lower blood sugar by stimulating pancreatic secretion of insulin
In contrast to the sulfonylureas, the meglitinides have a rapid onset and a short duration of action
They are categorized as postprandial glucose regulators
Monotherapy or in combination with metformin
Should be taken 1 to 30 minutes before a meal
Side effects hypoglycemia and weight gain

8. III.Biguanides
(mechanism of action): increases the use of glucose by muscle and fat cells, decreases hepatic glucose production, and decreases intestinal absorption of glucose
Does not cause hypoglycemia
May be used alone or in combination
Side effects include GIT disturbance and lactic acidosis
Contraindicated in liver or renal impairment. Can result in lactic acidosis.
This group include metformin

9. IV. Thiazolidinediones
(mechanism of action):Decrease insulin resistance. Through binding with PPAR lead to regulation adipocyte production and secretion of fatty acids as well as glucose metabolism, resulting in increased insulin sensitivity in adipose tissue, liver, and skeletal muscle
Side effects include weight gain, headache and anemia
Contraindicated in patients with liver disease and acute MI
May be used as monotherapy or in combination with insulin, metformin or a sulfonylurea
These drugs include Pioglitazone and rosiglitazone

10. Alpha glucosidase Inhibitors
Include acarbose and miglitol
(mechanism of action): inhibit alpha-glucosidase enzymes in GI tract. Delays absorption of complex CHO and simple sugars
Can be combined therapy with sulfonylurea
Contraindicated in malabsorption, severe renal impairment
Side effects include bloating and diarrhea

11. Thank you