What are antidiabetic (anti-diabetes) drugs?

From the Guidelines

Antidiabetic drugs are medications used to manage diabetes mellitus by lowering blood glucose levels, with metformin being the preferred initial pharmacologic agent due to its efficacy, safety, and potential to reduce cardiovascular events and death 1. When considering antidiabetic drugs, several options are available, including:

• Metformin, which reduces hepatic glucose production and improves insulin sensitivity
• Sulfonylureas, such as glipizide or glyburide, that stimulate insulin secretion
• SGLT-2 inhibitors, like empagliflozin or dapagliflozin, that promote urinary glucose excretion
• GLP-1 receptor agonists, such as semaglutide or dulaglutide, that increase insulin secretion and reduce glucagon
• DPP-4 inhibitors, like sitagliptin, that prevent GLP-1 breakdown The choice of antidiabetic drug should be based on the patient's individual characteristics, disease severity, and patient preferences, as well as considerations of cost, potential side effects, and risk for hypoglycemia 1. In terms of specific treatment regimens, metformin therapy should be added at or soon after diagnosis for newly diagnosed patients who are overweight or obese, and lifestyle modifications, including physical activity and weight loss, should be initiated simultaneously 1. For patients who require combination therapy, a second agent should be added when monotherapy with a noninsulin agent at the maximum tolerated dose does not achieve or maintain the HbA1c target over 3 months, with options including sulfonylureas, thiazolidinediones, DPP-4 inhibitors, SGLT2 inhibitors, GLP-1 agonists, or basal insulin 1.

From the FDA Drug Label

ACTOS (pioglitazone hydrochloride) is an oral antidiabetic agent that acts primarily by decreasing insulin resistance.

1. 1 Drugs Affecting Glucose Metabolism ... oral anti-diabetic medications ...

Antidiabetic drugs are medications that affect glucose metabolism, including:

• Oral anti-diabetic medications
• Sulfonylureas, such as glimepiride
• Thiazolidinediones, such as pioglitazone
• Insulin
• Other medications that may increase or reduce the glucose-lowering effect, such as pramlintide acetate, angiotensin converting enzyme (ACE) inhibitors, and H2 receptor antagonists 2 3

From the Research

Definition and Types of Antidiabetic Drugs

• Antidiabetic drugs, also known as anti-diabetes drugs, are medications used to treat diabetes mellitus by lowering blood glucose levels 4, 5, 6, 7.
• These drugs can be classified into different classes, including biguanides (e.g., metformin), sulphonylureas, thiazolidinediones (e.g., pioglitazone), and others 4, 5, 6, 7, 8.

Mechanism of Action

• Metformin, a biguanide, decreases blood glucose concentration by enhancing insulin sensitivity, inducing greater peripheral uptake of glucose, and decreasing hepatic glucose output 4, 5, 6, 7.
• Pioglitazone, a thiazolidinedione, improves glycemic control by reducing insulin resistance and improving pancreatic beta-cell secretory function, with additional pleiotropic effects such as anti-inflammatory and antioxidant actions 8.

Clinical Use

• Metformin is widely considered the optimal initial therapy for patients with type 2 diabetes mellitus, due to its efficacy, low cost, weight neutrality, and good safety profile 4, 5, 6, 7.
• Pioglitazone can be used in combination with other drugs, such as metformin, sulfonylureas, or insulin, to improve glycemic control in patients with type 2 diabetes mellitus 8.
• The choice of antidiabetic drug depends on various factors, including the patient's individual needs, medical history, and potential side effects of the medication 4, 5, 6, 7, 8.