Antidiabetic drugs

Antidiabetic drugs can be classified in various ways like hypoglycemics & euglycemics

Hypoglycemics drugs

Insulin

Sulfonylureas

Meglitinide

Euglycemic drugs are

Biguanides

Thiazolidinediones

Alpha glucosidase inhibitors

Oral hypoglycemic drugs

Sulfonylureas which can be further divided into first & second generation drugs e.g. Glipizide, Gliclazide

Biguanides e.g. metformin

Thiazolidinediones e.g. rosiglitazone, pioglitazones

Alpha glucosidase inhibitors e.g. Acarbose & Miglitol

Meglitinide/ Phenylalanine analogues e.g. Repaglinide, Nateglinide

Parenteral drugs e.g. insulin

New antidiabetic drugs

Insulin like growth factor-1 (Mecasermine): tried in patients with severe insulin resistance

Aldose reductase inhibitors- Alconil, Sorbinil. They prevent diabetes complications

Amylin analogue (Pramalinitide): It improve glycemic control

Incretins: GIP (glucose dependant insulinotropic polypeptide) & GLP-1 (glucagon like peptide-1) increase glucose dependant insulin secretion but rapidly metabolized by DPP IV (Dipeptidyl peptidase)

Exenatide is a GLP-I agonist that resist DPP IV & has a good glycemic control.
Sitagliptin & Vidagliptin are DPP IV inhibitors which prolong the effect of incretins