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Diabetes Oral Antidiabetic Drugs

The drugs used to treat diabetes can be classified according to their mode of action as

hypoglycaemic agents, i.e. those which act to lower blood glucose levels
anti-hyperglycaemic agents, i.e. those which act to prevent blood glucose levels from rising.

There are four groups of oral antidiabetic drugs, which can be classified as shown below.

Hypoglycaemic drugs

sulphonylureas
meglitinides (repaglinide)

Anti-hyperglycaemic drugs

biguanides (metformin)
alpha-glucosidase inhibitors (acarbose)

The anti-hyperglycaemic drugs, when used as the only treatment, do not cause hypoglycaemia. The choice of antidiabetic drug is initially made by careful assessment of all the individual factors relevant to the person's condition. These may include presence or absence of osmotic symptoms, blood glucose levels and glycaemic control, presence or absence of diabetic complications, previous response to nutrition therapy, body weight, and other medication being taken.

A drug belonging to one group may be used at first as monotherapy (i.e. the only one prescribed) but it may later prove necessary to add another drug from a different group. It is also necessary to choose the most appropriate drug from within the group as each has somewhat different properties. However, oral antidiabetic drugs are not prescribed for pregnant women or nursing mothers who are treated with insulin.