Question

Compare and contrast the use of oral and parenteral antidiabetic therapy. Compare and contrast the use of oral and parenteral antidiabetic therapy.

Answer 1

Question: Compare and contrast the use of oral and parenteral antidiabetic therapy.

Antidiabetic drugs are Drugs that are used to control diabetes mellitus - a chronic disease that affects carbohydrate metabolism

There are two groups of antidiabetic agents:  Insulin & oral hypoglycemic agents

1.   Oral hypoglycemic agents are the  synthetic preparations that stimulate insulin release or alter metabolic response to hyperglycemia.

• Used in the treatment of Type 2 DM.
• Used by persons with NIDDM ( Non Insulin Dependant Diabetic Mellitus) - should NOT be used by persons with  IDDM( Insulin DependantDiabetic Medicine)
• NIDDM has some degree of insulin secretion by pancreas.
• Oral hypoglycemic agents are used as a supplement to diet and exercise for controlling diabetes.
• Pills can be easier to take than insulin. But side effects are more.

Several classes of oral hypoglycemic agents are available. There are 3 categories of oral hypoglycemic drugs

a) Insulin secretagogues - stimulates insulin secretion.

  b) Insulin Sensitizers: Sensitize the tissues( Liver & adipose) to the action of insulin

c) Affect absorption of glucose - Retard the absorption of sugars from GI tract.

2. Parenteral antidiabetic therapy: Insulin is used for parenteral administration.  Insulin is a protein secreted from the beta cells of the pancreas that is necessary for carbo metabolism & has an important role in protein & fat metabolism.

• It is the only treatment available for Type 1 DM.
• insulin remains the most potent and effective treatment for elevated blood glucose. It is a more natural substance than pills (chemically similar to the insulin produced by the body), and lacks many of the potential side-effects inherent to oral medications.
• Once glucose levels are controlled and lifestyle changes are in place, people may be able to use oral medications instead of insulin .

• Types of Insulin's - 3 standard types

1. Rapid-acting - Regular insulin - clear solutionn without added substances to prolong insulin action.

    Onset = 1/2 to 1 hour; Peak = 2 to 4 hours; Duration = 6 to 8 hours

2. Intermediate-acting - NPH, Lente - contain protamine (a protein that prolongs the action of the insulin)

    Onset = 1 to 2 hours; Peak = 6 to 12 hours; Duration = 18 to 24 hours

3. Long-Acting - Ultralente - contain lg. crystals which dissolve slowly to prolong duration

    Onset = 4 to 8 hours, Peak = 14 to 20 hours; Duration = 24 to 36 hours