antidiabetik

Antidiabetik refers to medications used to manage diabetes mellitus by lowering or regulating blood glucose levels. They include insulin preparations and a range of non-insulin agents that act through different mechanisms. Treatment is individualized based on the type of diabetes, patient characteristics, and target glycemic control.

Insulin therapy is essential for many people with type 1 diabetes and is commonly used in type 2 diabetes when other treatments do not achieve goals or during illness and stress. Non-insulin antidiabetics include several major classes. Metformin, a biguanide, reduces hepatic glucose output and improves insulin sensitivity. Sulfonylureas and meglitinides stimulate pancreatic insulin secretion. Thiazolidinediones increase peripheral insulin sensitivity. DPP-4 inhibitors and GLP-1 receptor agonists enhance incretin activity to increase insulin release and suppress glucagon. SGLT2 inhibitors promote renal glucose excretion. Alpha-glucosidase inhibitors slow carbohydrate absorption in the gut. Each class has specific indications, benefits, and potential side effects.

Therapy choice depends on factors such as the type and duration of diabetes, cardiovascular or renal comorbidities, risk of hypoglycemia, weight considerations, and patient preference. Often, combination regimens are used to achieve glycemic targets, along with lifestyle measures like diet and physical activity. Monitoring typically involves regular blood glucose checks and periodic HbA1c testing, with dose adjustments as needed.

Safety considerations include the risk of hypoglycemia with insulin and some oral agents, lactic acidosis risk (low with proper metformin use), and other class-specific adverse effects. Antidiabetics require ongoing medical supervision to optimize efficacy and minimize risks.