oa SA Pharmaceutical Journal - Oral hypoglycaemic drugs for the treatment of type 2 diabetes mellitus : review

Volume 79, Issue 3
  • ISSN : 2221-5875
  • E-ISSN: 2220-1017



The failure of diet and exercise to manage type 2 diabetes mellitus usually requires the introduction of an oral hypoglycaemic drug. Currently, metformin remains the first-line agent, particularly in overweight patients. Shorter-acting sulphonylureas, such as glipizide, may be considered in normal or underweight patients, and in those who cannot use or tolerate metformin. Alpha-glucosidase inhibitors (acarbose) may reduce cardiovascular risk, while thiazolidinediones (glitazones) have been associated with higher cardiovascular risk. Bile-acid sequestrants and bromocriptine mesylate may be contemplated as adjunct treatment in type 2 diabetes mellitus. Dipeptidyl peptidase-4 (DPP-4) inhibitors and sodium-glucose transporter-2 (SGTL-2) inhibitors are promising new therapeutic classes for the treatment of type 2 diabetes mellitus.

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