Common uses of Anti-diabetic medication

            
                    Anti-diabetic medication 

Drugs used in diabetes treat diabetes mellitus by lowering glucose levels in the blood. 
With the exceptions of Insulin,  Exenatide, liraglutide and pramlintide, all are administered orally and are thus also called oral hypoglycemic agents or oral antihyperglycemic agents. 

There are different classes of anti-diabetic drugs, and their selection depends on the nature of the diabetes, age and situation of the person, as well as other factors.


Diabetes mellitus type 1 is a disease caused by the lack of insulin.
 Insulin must be used in Type I, which must be injected.
Diabetes mellitus type 2 is a disease of insulin resistance by cells. 

Type 2 diabetes mellitus is the most common type of diabetes. Treatments include (1) agents that increase the amount of insulin secreted by the pancreas, 

(2) agents that increase the sensitivity of target organs to insulin, and
 (3) agents that decrease the rate at which glucose is absorbed from the gastrointestinal tract.


Several groups of drugs, mostly given by mouth,
 are effective in Type II, often in combination. 

The therapeutic combination in Type II may include insulin, not necessarily because oral agents have failed completely,
 but in search of a desired combination of effects.

 The great advantage of injected insulin in Type II is that a welleducated patient can adjust the dose, or even take additional doses,
 when blood glucose levels measured by the patient, usually with a simple meter, as needed by the measured amount of sugar in the blood

 Insulin

Main article: insulin (medication)
Insulin is usually given subcutaneously, either by injections or by an insulin pump. Research of other routes of administration is underway. In acute-care settings, insulin may also be given intravenously. In general, there are three types of insulin, characterized by the rate which they are metabolized by the body. They are rapid acting insulins, intermediate acting insulins and long acting insulins.[1]
Examples of rapid acting insulins include

Regular insulin (Humulin R, Novolin R)

Insulin lispro (Humalog)

Insulin aspart (Novolog)


 Insulin glulisine (Apidra)

Prompt insulin zinc (Semilente, Slightly slower acting)

Examples of intermediate acting insulins include

Isophane insulin, neutral protamine Hagedorn (NPH) (Humulin N, Novolin N)

Insulin zinc (Lente)

Examples of long acting insulins include

Extended insulin zinc insulin (Ultralente)

Insulin glargine (Lantus)

Insulin detemir (Levemir

Most anti-diabetic agents are contraindicated in pregnancy, in which insulin is preferred.

2 Sensitizers
Insulin sensitizers address the core problem in Type II diabetes—insulin resistance.

2.1 Biguanides

Main article: Biguanide →Biguanide  is the organic compound with the formula HN(C(NH)NH₂)₂. It is a colorless solid that dissolves in water to give highly basic solution. These solutions slowly hydrolyse to ammonia and urea.


Biguanides reduce hepatic glucose output and increase uptake of glucose by the periphery, 
including skeletal muscle.

 Although it must be used with caution in patients with impaired liver or kidney function, Metformin, a Biguanide, has become the most commonly used agent for type 2 diabetes in children and teenagers. 
Among common diabetic drugs, metformin is the only widely used oral drug that does not cause weight gain.

Typical reduction in glycated hemoglobin (A1C) values for metformin is 1.5–2.0%
Metformin (Glucophage) may be the best choice for patients who also have heart failure,
 but it should be temporarily discontinued before any radiographic procedure involving intravenous iodinated contrast, as patients are at an increased risk of lactic acidosis.