Mechanism Of Action Of Anti-diabetic Drugs!

There is a wide range of drugs that are prescribed for Diabetes Mellitus. However, do patients really know why those drugs are prescribed and how they act? Not always.

In this article, I shall briefly describe the mechanism of action of anti Diabetic drugs as it is very important for patients to know the same.

The following are the drugs (as described by their pharmacologic names) and their actions

1) METFORMIN: Improves Insulin Sensitivity, i.e, the response of cells to Insulin, thereby promoting glucose uptake by the cells. That, in turn, would bring down the blood sugar levels. In addition, it also suppresses appetite. Metformin is the most time tested drug for Diabetes which usually does not cause low sugars. It is taken after food. ( Not advisable in renal, hepatic impairment ).

2)SUPHONYLUREAS (GLIBENCLAMIDE, GLICLAZIDE, GLIPIZIDE): These stimulate the pancreas to secrete more amount of Insulin. Hence they are potent drugs that carry the risk of low sugars if used inappropriately. These drugs are taken before food.

3)DPP4 INHIBITORS ( SITAGLIPTIN, VILDAGLIPTIN, LINAGLIPTIN, SAXAGLIPTIN): These inhibit an enzyme called DPP4 which in turn increases the concentration of hormones called Incretins. Incretins, in turn, augment Insulin secretion in the body in response to food.

4) ALPHA GLUCOSIDASE INHIBITORS ( ACARBOSE, VOGLIBOSE): These drugs decrease carbohydrate absorption from the gut. Help in bringing down postprandial sugars to some extent. They are taken along with food.

5) PIOGLITAZONE: This increases Insulin sensitivity. (May cause weight gain, fluid retention, weakness of bones. Not advisable in patients with impaired cardiac or renal

 function.)

6)SGLT2 INHIBITORS ( CANAGLIFLOZIN, DAPAGLIFLOZIN, EMPAGLIFLOZIN): Relatively new drugs. Reduce the amount of glucose that is reabsorbed into the blood from the kidneys.

7)GLP 1 ANALOGUES ( LIRAGLUTIDE, EXENATIDE): These drugs enhance Insulin secretion by the pancreas and also suppress appetite. Available as injections.May help in weight loss in obese patients.

8) INSULIN ( Injection): The most potent drug for Diabetes. Drives blood glucose into the cells. Hypoglycemia, i.e, low sugars are the only complication if used inappropriately. Can be used in conditions like renal, cardiac, hepatic impairments, sepsis and pregnancy where most oral drugs cannot be used.