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Oral antihyperglycemic therapy for type 2 diabetes mellitus

From the Department of Medicine, University of Toronto, and the Division of Endocrinology and Metabolism, Department of Medicine, St. Michael's Hospital (Cheng), and the Division of Endocrinology and Metabolism, Department of Medicine, Mount Sinai Hospital and University Health Network and University of Toronto, and the Department of Physiology and Core Laboratory, Banting and Best Diabetes Centre, University of Toronto (Fantus), Toronto, Ont.

Abstract

DIABETES MELLITUS IS A CHRONIC DISEASE that is growing in prevalence worldwide. Pharmacologic therapy is often necessary to achieve optimal glycemic control in the management of diabetes. Orally administered antihyperglycemic agents (OHAs) can be used either alone or in combination with other OHAs or insulin. The number of available OHAs has increased significantly in the last decade, which translates into more therapeutic options and complex decision-making for physicians. This review article is designed to help with these decisions. We review the mechanism of action, efficacy and side effects of the different classes of OHAs (-glucosidase inhibitors, biguanides, insulin secretagogues, insulin sensitizers and intestinal lipase inhibitor) and discuss the current recommendations for their use.

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