Classification of Anti-diabetic Agents

  1. Sulphonylureas: first-generation drugs - tolbutamide and chlorpropamide, and second-generation drugs like, glipizide, 

  2. Biguanides: The most common example is metformin

  3. Meglitinides: Examples include repaglinide

  4. Thiazolidinediones: Examples include rosiglitazone

  5. Alpha-glucosidase inhibitors: Examples include acarbose.

  6. Dipeptidyl peptidase-4 (DPP-4) inhibitors: An example is sitagliptin.

  7. Glucagon-like peptide (GLP-1) analogues: An example is exenatide.

  8. Insulin: A hormone that regulates blood glucose by stimulating its uptake into cells and inhibiting its production by the liver.

  • Short Acting: Regular, Lispro, Insulin zinc
  • Intermediate Acting: Isophane (NPH)
  • Longer Acting: Protamine zinc 

Example of 2nd Generation sulfonylurea Antidiabetic Agent is Glipizide. 

Structure 



MOA 

It is a class of Sulfonylurea drugs 

(1) They act on the so-called ‘sulfonylurea receptors’ (SUR1) on the pancreatic β cell membrane. 

(2) This action causes depolarization by reducing the conductance of ATP-sensitive K+ channels. (Raised ATP production followed by raised Glucose also reduces the conductance of ATP sensitive K+ Channels)

(3) This process enhances Ca2+ influx (Followed by the stimulation of Voltage sensitive Ca++ Channel) and degranulation (followed by calcium dependent translocation), which increases the rate of insulin secretion.

Uses 

  1. To treat high blood sugar levels caused by type 2 diabetes mellitus
  2. To prevent or delay the complications of diabetes, such as heart disease, kidney disease, nerve damage, and eye problems
  3. To test the function of the pancreas in diagnosing diabetes or other conditions





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