Abstract

A COMPREHENSIVE REVIEW OF ORAL HYPOGLYCEMIC AGENTS (OHAS), FOCUSING ON THEIR MECHANISM OF ACTION, EFFICACY, AND SAFETY PROFILES

Ansuman Verma*, Devendra Kumar, Vaishnavi Tripathi, Amit Kumar Verma and Sarita Verma

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Abstract

In the 1950s, oral antidiabetic medications were first used in clinical settings. The safety and tolerability profiles of biguanides and sulfonylureas are well established, and they are still widely used today. The advent of second- and third-generation sulfonylureas, modifiedrelease formulations, and fixed-dose formulations containing metformin and new medications are examples of advancements and improvements within these classes. These latter include the thiazolidinediones, which have been closely studied since troglitazone's severe hepatotoxicity was discovered. These drugs have a hypothesized genomic mode of action. Edema and the potential for thiazolidinediones to cause heart failure in susceptible persons have been the main concerns in recent years. The long-term safety of thiazolidinediones will only be determined by extended exposure. In some patient groups with specific comorbidities, such as those with renal impairment, rapid-acting non-sulfonylurea secretagogues seem to be safer and more effective than sulfonylureas. Acarbose has been demonstrated to slow the transition from impaired glucose tolerance to type 2 diabetes, and α-glucosidase inhibitors have a stellar safety record. However, tolerability concerns restrict their use. The meglitinide analogues (repaglinide, nateglinide, and mitiglinide) are one such class of medications. These medications work best when taken in conjunction with metformin. They might also work well when taken with thiazolidinedione, a kind of medication that fights insulin resistance. When type 2 diabetes is managed late, exogenous insulin is frequently needed.

Keywords: Oral antidiabetic, biguanides, sulfonylureas, metformin, thiazolidinediones, hepatotoxicity, Acarbose, a-glucosidase.