Oral Anti-diabetic Drugs

Oral Anti-diabetic DrugsChua Mei YiSeveral factors that need consideration when comparing two oral anti-diabetic drugs include gunpoint of glycemic lowering undeniable to attain target goal range, effect of the medication on weight and lipid profiles, contraindications, side effects, cost, and potential level of adherence to the regimen. The two drugs for comparison argon namely metformin and gliclazide.Besides having the same level of glycemic lowering percentage, both metformin and gliclazide are also considered one of the least expensive oral anti-hyperglycemic agents (Reinhold Earl, 2014 Mozaffari, 2013 Holt, Cockram, Flyvbjerg Goldstein, 2011). whizz of the potential problems with anti-diabetic medication, is that the conventional dosage form is given in 2 to 3 doses daily, and it causes a conflict in compliance rate for the elderly who has measly memories. In this circumstance, both metformin and gliclazide offers the option of single daily dose with either extended-relea se metformin or gliclazide modified release tablets. Of course the side effects, improvements and degree of glycemic lowering are the same as conventional tablets (Unger, 2013 Barnett, 2012).Metformin is well known for being the first line drug against diabetes type II interposition over the past decades for some reasons. First, Metformin as a biguanide, acts on pancreas independently, inhibiting the livers production of glucose, frankincense controlling blood glucose by ameliorate insulin sensitivity and reducing insulin requirement. If its taken when blood glucose is normal or low, it does not stimulate insulin release in the pancreas, thus poses little threat of hypoglycaemic (Lehne, 2013). Second, Metformin treatment results in a moderate reduction in circulating triglyceride levels, causing an improvement in lipid profiles that leads to the occurrence of weight going (Goldstein Muller-Wieland, 2013). Third, having a high frequency of GI side effects due to the inhibition of carbohydrates being digested can be minimized by slow-dose titration and by victorious the medication with food.No matter how safe a medication is, contraindications and contrary side effects still need to be observed. As for metformin, renal or hepatic dysfunction patients are contraindicated, and lactic acidosis due to metformins accumulation, is considered one of the rare but fatal adverse side effect. The only voltaic pile side of metformin is, it should be withhold prior to radiological procedures involving contrast dye, as it predisposes patients to acute renal impairment (Reinhold Earl, 2014).Gliclazide, on the other hand, is classified as sulfonylureas. It works by increasing insulin release from pancreatic beta cells, driving blood glucose levels down, causing hypoglycemia if taken when blood glucose is normal or low, thus should only be prescribed to patients likely to have regular food intake. Driving or operating machinery during the initial treatment phase needs to be treatful as hypoglycemia might occur (Lehne, 2013). Besides having minimal effect on lipid profile, Gliclazide causes undesirable weight gain due to increase insulin secretion and reduced glucose excretion (Meeking, 2011). Contraindications, particularly renal or liver disease patients, as well as rare but fatal adverse side effects of gliclazide, impairment of liver function, must still be observed (MIMS Australia, 2014).In conclusion, while there is significant debate regarding specific treatment for patients with type II diabetes, most experts agreed upon metformins usage as first line drug, judging from its effectiveness, generally well-tolerated cost effective and capacious term usage.ReferencesBarnett, A. (2012). Oxford diabetes library Type 2 diabetes (2nd ed.). UK Oxford University Press.Goldstein, B. J., Muller-Wieland, D. (2013). Type 2 diabetes Principles and practice (2nd ed.). USA Informa Healthcare.Holt, R. I. G., Cockram, C., Flyvbjerg, A., Goldstein, B.J. ( 2011). Textbook of diabetes (4th ed.). UK Wiley-Blackwell.Lehne, R. A. (2013). Pharmacology for nursing care. (8th ed.). USA Elsevier Saunders.Meeking, D. R. (2011). Understanding diabetes and endocrinology A problem-orientated approach. UK Manson create Ltd.MIMS Australia. (2014). Mimsonline. Retrieved on 28.3.2014, fromhttps//www-mimsonline-com-au.libraryproxy.griffith.edu.au/Search/Search.aspx.Mozaffari, M. S. (2013). New strategies to advance pre/diabetes care Integrative approach by PPPM. USA Springer.Reinhold, J. A., Earl, G. (2014). Clinical therapeutics primer Link to the evidence for the ambulatory care pharmacist. USA Jones Bartlett Learning.Unger, J. (2013). Diabetes management in primary care (2nd ed.). China Williams Wilkins.MIMS Australia. (2014).