antihyperglycemic

Antihyperglycemic agents are medications used to lower elevated blood glucose levels in people with diabetes mellitus. They are employed to manage chronic hyperglycemia and are typically used alongside diet, exercise, and, when appropriate, other antidiabetic therapies. They are not curative but aim to reduce the risk of diabetes-related complications by improving glycemic control.

Many agents are used in type 2 diabetes, though insulin is essential for some individuals and for type 1 diabetes. Metformin, a biguanide, reduces hepatic glucose production and improves peripheral insulin sensitivity. Sulfonylureas (for example, glipizide, glyburide, glimepiride) stimulate pancreatic beta cells to release insulin. DPP-4 inhibitors (such as sitagliptin) prolong incretin hormone activity to enhance glucose-dependent insulin release. GLP-1 receptor agonists (liraglutide, exenatide) mimic incretin effects, often with weight loss benefits. SGLT2 inhibitors (empagliflozin, dapagliflozin) promote renal excretion of glucose. Thiazolidinediones (pioglitazone, rosiglitazone) increase insulin sensitivity in adipose and muscle tissue. Alpha-glucosidase inhibitors (acarbose) slow carbohydrate absorption, and meglitinides (repaglinide, nateglinide) provide rapid, short-duration insulin release.

Insulin therapy remains essential for type 1 diabetes and may be required for some individuals with type 2 diabetes. Safety considerations include the risk of hypoglycemia with insulin and certain secretagogues, potential lactic acidosis with metformin in renal impairment, edema or heart failure risk with thiazolidinediones, and genital or urinary infections with SGLT2 inhibitors. Monitoring and individualization are central to effective use.