ANTIDIABETICS

Antidiabetics are used to treat diabetes mellitus (condition in which either the hormone

insulin is not produced, or the body's tissues have developed insensitivity to insulin).

Patients with type 1 diabetes have lost the ability to produce insulin as children or young

adults and must receive daily injections of insulin. Human insulin and synthetic derivations

produced by recombinant DNA research have largely replaced animal-derived insulin in

the management of diabetes. Rapid-acting insulins start working in 15 to 30 minutes and

last 3 to 5 hours. Short-acting insulin begins working within 30 minutes to an hour and

lasts 5 to 8 hours. Long-acting insulins have a time to onset of 1 to 3 hours and last between

24 and 36 hours.

Patients with type 2 diabetes usually develop the disease later in life and have insensitivity

to insulin. Their diabetes may be well controlled by limiting sugars in their diet and by

taking oral antidiabetic drugs. These include sulfonylureas (lower the levels of glucose in

the blood by stimulating the production of insulin), biguanides (increase the body's

sensitivity to insulin and reduce the production of glucose by the liver), alpha-glucosidase

inhibitors (temporarily block enzymes that digest sugars), thiazolidinediones (enhance

glucose uptake into tissues), and meglitinides (stimulate the beta cells in the pancreas to

produce insulin).

An insulin pump is a device strapped to the patient's waist that periodically delivers

(through a subcutaneous needle inserted in the abdomen) the desired amount of insulin.