Hypoglycemic Agents in the Management of Type 2 Diabetes Mellitus
Josephine Ho, Alexander K.C. Leung and Doreen Rabi
Affiliation: Division of Pediatric Endocrinology, Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, Alberta, Canada, T3B 6A8.
Keywords: Type 2 diabetes, hypoglycemic agents, pharmacotherapy, hyperglycemia, morbidity, mortality, obesity, PATHOGENESIS, polymorphisms, peroxisome proliferator-activated, glycogen synthase, glucose transporter 1, oxidative stress, metformin, glycemic control, myocardial infarction, anorectic, cardiovascular, actic acidosis among, Insulin Secretagogues, ATP dependent, potassium channels, calcium, sulphonylureas, diarrhea, cytokines, polypeptide, beta cell, apoptosis, insulinotropic effect, analogues, B-cell, pancreatitis, Amylin, Interleukin-1, proinflammatory, renal glucosuria, depression, anxiety, Glucokinase Activators, depolarization, Phosphodiesterase Inhibitors, islet cell, lipid peroxidation, anti-hyperglycemic, Citrullus colocynthus
Type 2 diabetes is increasing in prevalence and causes a significant health care burden due to associated microvascular and macrovascular complications. Type 2 diabetes is diagnosed by clinical findings of hyperglycemia and laboratory confirmation of elevated plasma glucose. Initial therapy includes diet and exercise, followed by the use of oral hypoglycemic agents and potentially subcutaneous insulin injections. Of the oral hypoglycemic agents currently available, metformin is the first-line choice. Recently, new adjunct therapies have been introduced that can improve glycemic control, although the long term effects on modifying the disease outcome in terms of diabetes complications remain to be seen. A review of the mechanism of action of current, non-insulin therapies will be presented. This review article will also discuss recent patents related to the field.
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