Drugs & Medications for DM
1. Metformin
- Biguanides
- Doesn't cause hypoglycemia
- Best taken with or after meals
Function:
- Reduce gluconeogenesis in liver
- Increased sensitivity of insulin receptor
- Slowing down glucose absorption - prevent blood glucose spikes, especially after meals
Three type of release:
- Normal - max 1000mg BD
- SR (slow release) - max sebiji TDS
- XR (extended release) - max 2000mg OD
2. Sulphonylurea
- Drugs: Gliclazide, Glibenclamide, Glipzide, Glimepiride
- Causes hypoglycemia - especially when taken with NSAIDs, anticoagulants, anti-thyroid, Ξ±-blockers
- Highly protein bound
- Best taken 10-30 minutes before meal
Function: increase insulin secretion by pancreatic beta cells
3. Insulin Therapy
Administered in following conditions:
- Inadequate glycaemic control despite on optimal dose of OGLDs
- As short-term use in the following
- pregnancy, breast-feeding
- DKA, HHS
- As initial therapy in newly diagnosed T2DM
- in symptomatic hyperglycaemia
- if HbA1c >10% or FPG >13.0 mmol/L
Insulatard
- Type: basal insulin
- Cover basal insulin needs between meals and through the night
- Intermediate-acting
- Administered pre-breakfast or pre-bed
Actrapid
- Type: prandial insulin
- Cover postprandial surges of blood glucose
- Short-acting
- Administered 30 minutes before meal