Oral agents for the treatment of type 2 diabetes mellitus: Pharmacology, toxicity, and treatment☆
Received 9 December 1999; received in revised form 17 October 2000 and 15 December 2000; accepted 2 January 2001.
Abstract
Currently available oral agents for the treatment of type 2 diabetes mellitus include a variety of compounds from 5 different pharmacologic classes with differing mechanisms of action, adverse effect profiles, and toxicities. The oral antidiabetic drugs can be classified as either hypoglycemic agents (sulfonylureas and benzoic acid derivatives) or antihyperglycemic agents (biguanides, α-glucosidase inhibitors, and thiazolidinediones). In this review, a brief discussion of the pharmacology of these agents is followed by an examination of the adverse effects, drug-drug interactions, and toxicities. Finally, treatment of sulfonylurea-induced hypoglycemia is described, including general supportive care and the management of pediatric sulfonylurea ingestions. The adjunctive roles of glucagon, diazoxide, and octreotide for refractory hypoglycemia are also discussed. [Harrigan RA, Nathan MS, Beattie P. Oral agents for the treatment of type 2 diabetes mellitus: pharmacology, toxicity, and treatment. Ann Emerg Med. July 2001;38:68-78.]
Address for correspondence: Richard A. Harrigan, MD, Division of Emergency Medicine, Temple University Hospital, Jones Hall, 10th Floor, Park Avenue and Ontario Street, Philadelphia, PA 19140;,215-707-5034,fax 215-707-3494;,E-mail rharriga@nimbus.temple.edu.
Division of Emergency Medicine, Temple University Hospital, Philadelphia, PA.
ABSTRACT