Antidiabetic agents therapy

Combination Therapy—Oral Antidiabetic Agents Injectable Medication... 

Combination Therapy with Oral Antidiabetic Agents Insulin... 

Knowledge of the patient s quantitative and qualitative meal patterns, activity levels, pharmacokinetics of insulin preparations, and pharmacology of oral antidiabetic agents for type 2 DM are essential to individualize the treatment plan and optimize blood glucose control while minimizing risks for hypoglycemia and other adverse effects of pharmacologic therapies. 

The most common pancreatic disease requiring pharmacologic therapy is diabetes meliitus, a deficiency of insulin production or effect. Diabetes is treated with several formulations of insulin (all administered parentertdly at present) eind with four types of oral antidiabetic agents (Figure 41-1). 

With incretin mimetics and DPP-4 inhibitors, two novel classes of antidiabetic agents have been developed and are in the course of being approved for the treatment of patients with type 2 diabetes, which will certainly broaden the armamentarium of anti-hyperglycemic therapy. This is valid based on their properties that have already been characterized in clinical trials. Some additional properties need to be explored in future studies, but hold the promise to make a substantial contribution to changing the course of type 2 diabetes, from the prevention of the transition between the prediabetic state to manifest diabetes, to improved and more durable metabolic control with less unwanted side effects and the prevention of diabetic complications. 

Transfer from other antidiabetic therapy When transferring patients from standard oral hypoglycemic agents other than chlorpropamide to metformin, generally no transition period is necessary. When transferring patients from chlorpropamide, exercise care during the first 2 weeks because of the prolonged retention of... 

Further modification of sulfonylureas may lead to superior antidiabetic therapy, or even to nondiabetic therapeutic agents. 

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