Antidiabetic agents

• 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

1. 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

2. Biguanides

   • Mechanism: Decrease hepatic glucose production (gluconeogenesis) and increase insulin sensitivity, particularly in muscle tissues.
     • Metformin

3. 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

4. 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

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