Rational choice of oral antihyperglycaemic agents.

ABSTRACT

Until 1995 sulphonylureas and metformin formed the mainstay of oral pharmacotherapy of type 2 diabetes mellitus. Since then many new insulin secretagogues and new classes of oral antihyperglycaemic agents have been launched. This has improved the management of type 2 diabetes mellitus. Oral agents available currently in Indian market are Those predominantly targeting beta cell dysfunction, those predominantly targeting insulin resistance and those inhibit carbohydrate absorption. Strategies for treatment with oral antihyperglycaemic agents are Targeting fasting hyperglycaemia, targeting postprandial hyperglycaemia, minimising cost therapy, minimising weight gain and minimising patient effort strategies. Special situations where antihyperglycaemic agents used are Teenage diabetes, elderly diabetes, persons with erratic lifestyle, persons with cardiac disease, renal disease and in pregnancy.