This article gives a practical review of the pharmacology, clinical efficacy, safety, dosing, cost, and place in therapy for oral antihyperglycemic agents used in the treatment of type 2 diabetes mellitus. There are 5 classes of oral antihyperglycemic agents available in the United States: sulfonylurea secretagogues, biguanides, α-glucosidase inhibitors, thiazolidinediones, and nonsulfonylurea secretagogues. These agents have distinct characteristics that help in their selection for the treatment of type 2 diabetes.
Get full access to this article
View all access options for this article.
References
1.
DeFronzo RA.Pharmacologic therapy for type 2 diabetes mellitus. Ann Intern Med.1999;131: 281-303.
2.
American Diabetes Association. Implications of the United Kingdom Prospective Diabetes Study. Diabetes Care.2003;26 (suppl 1): S28-S32.
3.
Inzucchi SE.Oral antihyperglycemic therapy for type 2 diabetes. JAMA.2002;287: 360-372.
4.
Wickersham RM, Novak KK, eds. Drug Facts and Comparisons. St. Louis, Mo: Wolter Kluwer; 2006.
5.
Average wholesale prices [Drugstore.com Web site]. Available at: www.drugstore.com/pharmacy/drugindex/. Accessed February 14, 2006.
6.
Saenz A, Fernandez-Esteban I, Mataix A, et al.Metformin monotherapy for type 2 diabetes mellitus. Cochrane Metabolic and Endocrine Disorders Group. Cochrane Database Syst Rev. 2005;(3): CD002966.
7.
Wulffele MG, Kooy A, De Zeeuw D, et al.The effect of metformin on blood pressure, plasma cholesterol and triglycerides in type 2 diabetes mellitus: a systematic review. J Intern Med.2004;256: 1-14.
8.
Johnson JA, Simpson SH, Toth EL, et al.Reduced cardiovascular morbidity and mortality associated with metformin use in subjects with type 2 diabetes. Diabet Med.2005;22: 497-502.
9.
Kirpichnikov D, McFarlane SI, Sowers JR.Metformin: an update. Ann Intern Med.2002;137: 25-33.
10.
Salpeter SR, Greyber E, Pasternak GA, et al.Risk of fatal and nonfatal lactic acidosis with metformin use in type 2 diabetes mellitus. Arch Intern Med.2003;163: 2594-2602.
Van der Laar FA, Lucassen PLBJ, Akkermans RP, et al.Alpha-glucosidase inhibitors for type 2 diabetes mellitus. Cochrane Metabolic and Endocrine Disorders Group. Cochrane Database Syst Rev. 2005;(2): CD003639.
Shimabukuro M, Zhou Y-T, Lee Y, et al.Troglitazone lowers islet fat and restores beta cell function of Zucker diabetic fatty rats. J Biol Chem.1998;273: 3547-3550.
16.
Chiquette E, Ramirez G, DeFronzo R.A meta-analysis comparing the effect of thiazolidinediones on cardiovascular risk factors. Arch Intern Med.2004;164: 2097-2104.
17.
Ahmann AJ, Riddle MC.Current oral agents for type 2 diabetes: many options, but which one to choose when?Postgrad Med. 2002;111: 32-46.
18.
Dormandy JA, Charbonnel B, Eckland DJA, et al.Secondary prevention of macrovascular events in patients with type 2 diabetes in the PROactive Study (PROspective pioglitAzone Clinical Trial In macroVascular Events): a randomized controlled trial. Lancet.2005;366: 1279-1289.
19.
Choi D, Kim SK, Choi SH, et al.Preventative effects of rosiglitazone on restenosis after coronary stent implantation in patients with type 2 diabetes. Diabetes Care.2004;27: 2654-2660.
20.
Perfetti R, D’Amico E.Rational drug design and PPAR agonists. Curr Diabetes Rep.2005;5: 340-345.
21.
Nesto RW, Bell D, Bonow RO, et al.Thiazolidinedione use, fluid retention, and congestive heart failure: a consensus statement from the American Heart Association and American Diabetes Association. Diabetes Care.2004;27: 256-263.
Turner RC, Cull CA, Frighi V, et al.Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 diabetes mellitus: progressive requirement for multiple therapies (UKPDS 40). JAMA.1999;281: 2005-2012.
32.
Browne DL, Avery L, Turner BC, et al.What do patients with diabetes know about their tablets?Diabet Med. 2000;17: 528-531.
33.
Nielsen LL.Incretin mimetics and DPP-IV inhibitors for the treatment of type 2 diabetes. DDT.2005;10: 703-710.
34.
Sarabu R, Grimsby J.Targeting glucokinase activation for the treatment of type 2 diabetes—a status review. Curr Opin Drug Discov Devel.2005;8: 631-637.
35.
Diabetes in Control.Com News and Information for Medical Professionals Issue #300. FDA accepts Merck’s first in class drug application for JANUVIA™ for type 2. Available at: www.diabetes@topica.email-publisher.com. Accessed February 22, 2006.
