Antidiabetic drugs are needed when the body is unable to self-regulate blood glucose levels using the body’s own insulin.
What are antidiabetic drugs?
Monitoring blood glucose and taking antidiabetic medications for diabetes mellitus can prevent damage to blood vessels and nerves from permanently elevated blood glucose levels. Antidiabetics are drugs used to treat the metabolic disease diabetes mellitus (diabetes). In a healthy body, the “beta cells” located in the pancreas produce sufficient insulin. Insulin ensures that the body absorbs sugar and thus reduces the blood sugar level as soon as it rises after the intake of food containing carbohydrates. Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the “beta cells” in the pancreas, resulting in a decrease in insulin production. The hallmark of type 2 diabetes, on the other hand, is “insulin resistance“: insulin that may be present in the body does not work properly at its target sites, so that blood glucose levels cannot be reduced sufficiently. In type 2 diabetes, the body’s own insulin production may be sufficient, but it may also be limited. If no antidiabetic drugs are taken in diabetes mellitus, permanently elevated blood glucose levels lead to damage to blood vessels and nerves and to circulatory disorders. Consequential diseases can include blindness, stroke and heart attack. Severe circulatory disorders due to diabetes sometimes necessitate amputations if not treated in time with antidiabetic drugs.
Medical application, effect, and use
Antidiabetic drugs are used only when other forms of therapy, such as dietary changes or increased physical activity, do not sufficiently lower blood glucose levels. Based on their mode of action, antidiabetic drugs are classified as either “insulinotropic” (promoting insulin secretion) or noninsulinotropic: Either antidiabetic drugs provide enhanced sugar breakdown after a food intake or they cause insulin to be delivered directly. Insulinotropic antidiabetic drugs are primarily used in type 1 diabetes to compensate for or stimulate the body’s own insulin production, insofar as this is possible due to the presence of sufficient beta cells. Non-insulinotropic antidiabetic agents are used in type 2 diabetes when the body produces sufficient insulin but this insulin is not effective. If the body also produces too little insulin in the presence of insulin resistance (type 2 diabetes), treatment is also carried out with an insulinotropic antidiabetic. According to their form of administration, oral antidiabetics (taken by mouth) are distinguished from parenteral antidiabetics (mostly administered by injection under the skin or by infusion into the bloodstream) and antibiotics taken by inhalation. Oral antidiabetics are used primarily in type 1 diabetes, and nonoral antidiabetics are used in type 2 diabetes.
Herbal, natural, and pharmaceutical antidiabetic agents.
Oral antidiabetic agents include “alpha-glucosidase inhibitors.” Glucosidase is an enzyme that, during the digestion of food in the small intestine, causes complex sugar and starch molecules to be broken down, resulting in rapid distribution of sugar in the blood. (Enzymes are proteins that accelerate certain biochemical processes). Glucosidase inhibitors prevent a rapid rise in blood sugar after meals. “Biguanide” drugs, on the other hand, decrease sugar production in the liver and also inhibit sugar release. “Glitazones” cause increased formation of proteins that ensure sugar transport from the bloodstream into the cells. “Glinides” have a short duration of action and are therefore taken about thirty minutes before a meal to stimulate insulin production exactly during a digestive process. Sulfonylureas block potassium channels in the beta cells of the pancreas, allowing for increased insulin release. Non-orally administered antidiabetic drugs primarily include insulin, which is injected under the skin or into a vein. Hundreds of medicinal plants also have antidiabetic effects, some of which have been demonstrated in clinical studies.Plant parts that act like antidiabetics include the pods of the common bean, the leaves of the blueberry, and the fruits or seeds of the “java plum”.
Risks and side effects
Antidiabetic alpha-glucosidase inhibitors may cause bloating, abdominal pain, gas, nausea, and diarrhea. Alpha-glucosidase inhibitors should not be taken for chronic digestive disorders. Possible side effects of biguanides include vomiting, nausea, diarrhea, and lactic acidosis. When glitazones are taken, headache, disorders of water excretion and accumulation of water in body tissues (edema formation), and mild anemia (anemia) may occur. Glitazones must not be taken simultaneously with insulin administration. Glinides partially induce hypoglycemia (low blood glucose), which can lead to cravings, decreased brain power, aggressiveness, seizures, or shock. Sulfonylureas pose an even greater risk of hypoglycemia. In addition, sulfonylureas are not compatible with alcohol consumption, which can cause sweating, increased heart rate (tachycardia) and low blood pressure (hypotension) in addition to nausea, vomiting, headache, dizziness and itching due to an accumulation of toxic acetaldehyde (an alcohol metabolite) in the liver. Taking sulfonylureas leads to an average increase in body weight of 2 kilograms. In some cases, there is a decreased number of red or white blood cells (anemia or leukopenia, respectively) or a decrease in the number of platelets (thrombocytopenia). Cross-allergies with sulfonamide antibiotics or with (diuretic) thiazides are also possible. Sulfonylureas should not be taken during pregnancy or in renal insufficiency. The effect of sulfonylureas increases with concomitant administration of insulin and beta-blockers, while the effect of these antidiabetic agents is reduced by concomitant use of certain other drugs.
