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REVIEW ARTICLE
Year : 2016  |  Volume : 4  |  Issue : 3  |  Page : 46-51

Newer oral anti diabetic drugs, are they useful to Indian Diabetics compared to the existing drugs


Professor

Correspondence Address:
Mala Dharmalingam
Director, Bangalore Endocrinology and Diabetes Research Center

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2666-1802.258523

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There are a number of new oral anti diabetic drugs, available for the treatment of Type 2 diabetes mellitus. These include the Dipeptidyl peptidase 4 Inhibitors (DPP4I) and the Sodium-Glucose Cotransporter 2Inhibitors(SGLT 2 inhibitors). The pathophysiologic mechanisms of Type 2 Diabetes have emerged from the triumvirate of insulin resistance at the level of the muscle, fat cell and the liver, insulin deficiency at the level of the beta cell of the pancreas and increased hepatic glucose output from the liver, to the ominous octet which now includes pathophysiologic mechanism at different levels of alpha cell, brain, kidney, gut etc. There are now drugs working at these mechanisms. These include the DPP4I that, work at the level of the incretin system,suppress glucagon and increase insulin. Bromocriptine has a sympatholytic D2 Dopamine agonist working centrally and resetting the dopaminergic and sympathetic tone within the central nervous system. The most recent are the SGLT2 inhibitors that work at the level of the kidney preventing reabsorption of glucose. The effect of these drugs on the glycemic control, durability, the cardiovascular outcomes and effect on cancer are the considerations of this review. This will allow the physician to make a calculated decision on which oral medication to use for the diabetic patient.


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