Antidiabetic

Antidiabetic refers to substances that lower blood glucose in people with diabetes. In common usage it denotes medications used to treat diabetes mellitus, though lifestyle and other therapies can also influence glucose control.

Most antidiabetic medications are used to manage type 2 diabetes, but insulin is essential for type 1 diabetes and may be used in advanced type 2 or certain gestational cases. Treatments are often combined to address multiple aspects of hyperglycemia and to tailor therapy to the individual patient.

Antidiabetic agents work through several mechanisms, including stimulating insulin secretion, improving insulin sensitivity, reducing hepatic glucose production, delaying carbohydrate absorption, and increasing urinary glucose excretion. This diversity supports different treatment goals and tolerability profiles across patients.

Major pharmacologic classes include insulins; biguanides such as metformin; sulfonylureas such as glipizide; meglitinides such as repaglinide; thiazolidinediones such as pioglitazone; DPP-4 inhibitors such as sitagliptin; GLP-1 receptor agonists such as exenatide; SGLT2 inhibitors such as empagliflozin; and alpha-glucosidase inhibitors such as acarbose. Newer agents and combinations continue to expand options for glycemic control.

Dosing and choice of agent depend on patient factors, including type of diabetes, renal and hepatic function, age, comorbidities, and risk of hypoglycemia. Monitoring typically includes regular blood glucose testing and periodic HbA1c measurement, with attention to potential side effects such as hypoglycemia, weight change, and renal or cardiovascular effects. Regulatory guidelines vary by country.