antidiabetice

Antidiabetics are drugs used to manage diabetes mellitus, aiming to reduce hyperglycemia and its complications. They include insulin and a range of non-insulin medications taken by mouth or by injection.

Major classes include insulin; metformin; sulfonylureas and meglitinides; thiazolidinediones; DPP-4 inhibitors; GLP-1 receptor agonists; SGLT2 inhibitors; and alpha-glucosidase inhibitors. Mechanisms vary: insulin replacement, increased insulin secretion, improved insulin sensitivity, reduced hepatic glucose output, slowed intestinal glucose absorption, or decreased renal glucose reabsorption.

In type 1 diabetes, insulin is essential for survival. In type 2 diabetes, antidiabetics are used to control hyperglycemia and reduce complications, often starting with metformin and adding others as needed. Injectable options include insulin and GLP-1 receptor agonists. Oral agents are chosen based on patient factors such as weight, cardiovascular risk, and kidney function.

Adverse effects include hypoglycemia risk for insulin, sulfonylureas, and meglitinides; weight changes with several agents; GI symptoms with metformin and GLP-1 receptor agonists; urinary and genital infections with SGLT2 inhibitors; and rare lactic acidosis with metformin. Pancreatitis signals have been discussed with incretin-based therapies. Kidney function and liver enzymes are monitored, and dosing is adjusted for renal impairment where appropriate.

Regulatory status and research: antidiabetics are widely governed by clinical guidelines that emphasize individualized therapy. Ongoing research focuses on combination regimens, personalized treatment planning, cardiovascular and renal outcomes, and reducing adverse effects to improve long-term disease control.