Challenges related to glycemic control in type 2 Diabetes Mellitus patients.

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Kheirandish M, Mahboobi H, Yazdanparast M, Kamal MA

Challenges related to glycemic control in type 2 Diabetes Mellitus patients.

Curr Drug Metab. 2017 Jan 15.

PubMed ID

28093996 [ View in PubMed

]

Abstract

Diabetes mellitus (DM) is a chronic disease with long-term complications. Glycemic control is an important part in management of DM. The first line in treatment of type 2 DM (T2DM) is diet and life style change. Metformin is the first choice of medication in T2DM patients. Sulfonylureas have high risk of hypoglycemia. Glinides are associated with lower risk of hypoglycemia in comparison to sulfonylureas. Also alpha-glucosidase inhibitors decrease the polysacarides digestion in small intestine and less effective in comparison to metformin and sulfonylureas in lowering hemoglobin A1c (HbA1c). These have no risk for hypoglycemia, but gastrointestinal symptoms are common. Thiazolidinediones are known as insulin sensitizers are effective for a longer duration in comparison to sulfonylureas, however, have side effects such as fluid retention, edema and heart failure. Incretin mimetics including exenatide and liraglutide act through increase in insulin secretion by pancreatic beta cells, in a glucose-dependent manner. Therefore, these are associated with no risk of hypoglycemia. Pramlintide is an amylin agonist which is also effective in lowering postprandial blood glucose. Sitagliptin and vildagliptin are dipeptidyl peptidase-4 inhibitors and have no risk of hypoglycemia when used as monotherapy. Canagliflozin and dapagliflozin decrease blood glucose level by increasing urinary glucose excretion and are associated with weight loss.

DrugBank Data that Cites this Article

Pharmaco-metabolomics

Drug	Drug Groups	Metabolite	Change	Description
Pramlintide	Approved Investigational	Glucose	decreased	Pramlintide decreases the level of Glucose in the blood
Canagliflozin	Approved	Glucose	decreased	Canagliflozin decreases the level of Glucose in the blood
Dapagliflozin	Approved	Glucose	decreased	Dapagliflozin decreases the level of Glucose in the blood
Metformin	Approved	Glucose	decreased	Metformin decreases the level of Glucose in the blood