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Efficacy Of Oral Hypoglycemia Drugs For Diabetes

By on October 18, 2012

Diabetes is considered as one of the most agonizing chronic medical conditions that starts from the pancreas but eventually affect all organs and systems of the body in a slow but intricate manner. It is even more terrible because there is no absolute cure of this health issue, although considerable control can be achieved by certain medications.

Very few people know that besides insulin, there is another huge category of anti-diabetic medications that are called oral hypoglycemic drugs.

What are the indications of oral hypoglycemic drugs?

Oral hypoglycemic drugs are a preferred mode of therapy for Diabetes Type 2 and are superior to Insulin in most respects. This is because the mechanics of Diabetes type 2 are entirely different from type 1 that deals with lack of insulin.

However, in Diabetes Type 2 the insulin levels are fairly high but the tissues are relatively resistant to the action of insulin. Obviously if you inject more insulin, it will not do any good for the body. That’s why oral hypoglycemic drugs are used in Diabetes Type 2 patients.

How oral hypoglycemic drugs function?

Since Diabetes Type 2 basically deals with persistently raised blood sugar levels that do not respond to insulin secreted by pancreas due to tissue resistance, oral hypoglycemia exert its functions by using multiple target approaches:

Oral hypoglycemic drugs increases the sensitivity of tissues to insulin by increasing the number of insulin receptors, so that when insulin attaches to its receptor glucose can enter tissues.

Oral agents make sure to increase the glucose absorption from kidney tubules to prevent renal damage as a result of seepage of glucose within urine.

The most important action of some oral agents is the decrease in absorption of glucose from gut mucosa that prevents the post –meal rise of blood sugar levels. This post meal rise further impairs insulin action due to desensitization and thus oral agents are more preferred over insulin.

Contraindications of oral hypoglycemic drugs:

Despite the fact that oral hypoglycemic drugs are the most brilliant form of therapy in Type 2 Diabetic patients, there are a few conditions in which the use is strictly contraindicated. A few of these conditions are:

Nursing mothers: It is recommended to use insulin to control blood sugar levels when you are nursing your child. This is because most hypoglycemic drugs are secreted in breast milk and can likely impair the functioning of neonatal pancreas by interfering with insulin release.

Pregnant mothers: mothers who are diabetic before becoming pregnant must switch to insulin while carrying the conception. This is important for the reason mentioned above; i.e. the oral hypoglycemic drugs are normally able to cross placental barrier, being a part of blood and have the following implications in the baby:

  • It is considered teratogenic (i.e. usage during pregnancy is associated with severe congenital anomalies in the baby.
  • Babies born to mothers who consume oral agents for blood sugar control normally have severely impaired glycemic indices after birth that may be life threatening.
  • Some research studies have concluded that oral drugs for blood sugar control are directly linked to congenital heart defects and vertebral defects
  • Lastly, it has been observed that oral hypoglycemic drugs alone are not very successful in controlling blood sugar levels during pregnancy due to physiologic hormonal changes that may lead to abnormally high blood sugar levels with oral agents.

Surgery or post-surgical patient:

Once again, surgery is a state during which blood sugar levels are normally high due to the action of various stress hormones. Oral agents are normally less functional in maintaining normal blood sugar levels and thereby may interfere with normal recovery processes.  To say the least, oral agents should also be avoided due to the high risk of hypoglycemia.

Active infection in the body:

In case of any active infection, most doctors replace oral hypoglycemic agents with insulin by adjusting doses according to glycemic indices. This is required for a normal recovery pattern.

Systemic issues:

You cannot consume some of the oral hypoglycemic drugs in any likely situation of having a kidney disorder or active liver issue as it may affect the metabolism of oral hypoglycemic agents resulting in prolonged duration of action and life threatening hypoglycemia.

The efficacy and effectiveness of oral hypoglycemic drugs vary largely according to body weight. Sulfonylurea are effective in thin and lean diabetics that have less fat content; on the other hand most other oral hypoglycemic drugs are effective on obese diabetics.

Drug interactions:

You should get all your medications reviewed by your healthcare provider before starting any oral hypoglycemic agent. This is because the route of excretion of most oral agents is via liver and a number of antibiotics interfere with the metabolic capacity of your liver, by altering the level of liver enzymes leading to impaired metabolism.

Recompenses of oral hypoglycemic drugs over insulin:

In most respects, oral hypoglycemic drugs are preferred over insulin. One of this condition is already discussed in the earlier section i.e. type 2 diabetes. Other conditions are when insulin is not able to fully control glycemic levels.

As far as patient compliance is concerned, most diabetic patients are better compliant with oral agents than insulin. This is primarily due to the fact that insulin is a fairly painful method in which patients have to inject insulin in the stomach. Most of the time insulin has to be taken after a blood sugar testing, which further increases the pain of the procedure.

Insulin injections at a particular site lead to fat necrosis and other skin changes that are not seen with oral hypoglycemic agents, further enhancing patient compliance towards oral agents and not towards insulin.

The most common and preferred oral hypoglycemic combination is metformin and sulfonylurea.

Side effects of using oral hypoglycemic drugs:

One of the most well-known effects of oral hypoglycemic index is the hypoglycemia due to aggravated glucose uptake by tissues.

  • A potential risk of drug interaction that is seen with most antibiotics that interferes with liver enzymes and leads to altered metabolism of oral hypoglycemic drugs.
  • Hypoglycemic episodes that are seen soon after starting oral drugs, which resolve eventually on their own by auto-drug and dose adjustment.

How can you achieve a better control with oral hypoglycemic drugs?

For a more efficient control of blood sugar levels, it is absolutely necessary to maintain body weight under optimal range, to increase the sensitivity of body cells and tissues to insulin. Dietary intake also matters and diabetics must consume a diet low in complex carbohydrates and avoid simple sugars. You should maintain regular diet and regular exercise regimen when you are on these drugs to avoid any significant health related issue. You should sustain a hydration status and always keep up with all your check-ups. Lastly, don’t miss out doses until advised by your doctor; even if you are not having your meals, you should still consume your drug.