| Pharmacotherapy in Type 2 Diabetes: A Functional Schema for Drug Classification. | |
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MedLine Citation:
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PMID: 22515702 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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With growing awareness that long-term hyperglycemia is directly implicated in the tissue damage characteristic of diabetes, there has been a corresponding increase in clinicians' willingness to employ intensive treatment to achieve euglycemia, which may require diabetes drugs in combination. The expanding array of drugs with different mechanisms of action calls for a clear method of classification to guide rational combination therapy. Contemporary and historical literature was surveyed to document changes in awareness of toxicity from hyperglycemia and consequent changes in treatment strategy. References were selected for clinical applicability and explanation of drug mechanisms of action, with the goal of proposing a useful schema for classification. Diabetes drugs may be classified in the following categories: insulin providers, which increase the supply of insulin through administration of exogenous human insulin or analogs or drugs that stimulate endogenous insulin secretion (sulfonylureas and meglitinides are direct insulin secretagogues, whereas glucagon-like peptide-1 analogs and dipeptidyl peptidase-4 inhibitors act to increase the supply of insulin); insulin sensitizers (metformin, thiazolidinediones), which offset the effects of insulin resistance; and insulin-independent drugs, which work in the gut to impede intestinal absorption of glucose into the circulation (α-glucosidase blockers) or in the kidney to prevent renal reabsorption of glucose back into the circulation (sodium glucose cotransporter 2 blockers, currently investigational). Awareness of these categories facilitates rational combinations of drugs with differing mechanisms of action to address hyperglycemia from separate directions, in accordance with current treatment guidelines. |
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Authors:
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Janet B McGill |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-4-20 |
Journal Detail:
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Title: Current diabetes reviews Volume: - ISSN: 1875-6417 ISO Abbreviation: - Publication Date: 2012 Apr |
Date Detail:
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Created Date: 2012-4-20 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101253260 Medline TA: Curr Diabetes Rev Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Medicine, Washington University School of Medicine, 660 S. Euclid, Campus Box 8127, St. Louis, MO 63110, USA. jmcgill@dom.wustl.edu. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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