The four classes of oral hypoglycemic agents currently used to treat T2DM facilitate glycemic control via separate mechanisms (Table 6 and Figure 7). The insulin secretagogues (sulfonylureas and meglitinides) act on pancreatic b-cells to increase insulin secretion and bioavailability. Biguanides suppress excessive hepatic glucose production and improve hepatic insulin action. Thiazolinediones improve peripheral insulin sensitivity, especially in muscle and adipose tissues. a-Glucosidase inhibitors delay gastrointestinal absorption of dietary glucose, decreasing postprandial glucose excursions. Each class can be used as monotherapy or in combination.
Was this article helpful?