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Oral Antidiabetic Biguanides

Thursday, September 6th 2012. | Medical Treatment

Oral Antidiabetic Biguanides Definition

Biguanides have the ability to regulate sugar levels in the blood.

They have anti hyperglycemic, lowering both basal and postprandial, they do not stimulate insulin secretion and therefore does not cause hypoglycemia.

Biguanides are intended for non-insulin dependent diabetes, and are administered orally.

Oral Antidiabetic Biguanides Mechanisms

Oral Antidiabetic Biguanides

Oral Antidiabetic Biguanides (img thanks to wreporter.com)

Biguanides may act via three mechanisms:

  • Reducing hepatic glucose production by inhibiting gluconeogenesis and glycogenolysis.
  • In muscle, by increasing insulin sensitivity and uptake and peripheral utilization of glucose.
  • By delaying intestinal glucose absorption

Their action, however, requires the presence of endogenous or exogenous insulin.

Absorption, and elimination half-life of a product are important parameters because they determine the mode of administration of the product and the number of daily doses to maintain efficacy.

  • The digestive absorption is correct ,
  • The elimination is urinary
  • The elimination half-life is 4 hours and there is no metabolism.

These pharmacokinetic parameters permit the administration of these products with 2 to 3 times per day with meals.

Oral Antidiabetic Biguanides Objectives

Prescription biguanides aims to:

  • The regulation of blood glucose lowering rates to maintain glycemic control to stabilize the progression of the disease,
  • Prevention of micro and macro vascular complications.

Oral Antidiabetic Biguanides Indications

Biguanides are the first-line drug for type II diabetes, non-insulin dependent.

They are also used in diabetes already treated with insulin in addition to insulin.

Oral Antidiabetic Biguanides Adverse

These are some complications that can occur when taking the drug, knowing that induced side effects vary among individuals.

When taking biguanide were reported:

  • Digestive disorders dose-dependent
  • Lactic acidosis: from façonexceptionnelle, but fatal in 30-50% of cases, favored by kidney failure, liver failure, alcohol poisoning.

Oral Antidiabetic Biguanides Precautions

It is recommended to discontinue treatment with biguanide 2 days before and after surgical or radiological examinations with iodinated contrast media.

We need to take insulin if surgery or other causes of decompensation of diabetes.

Pregnancy and lactation

During pregnancy, diabetes should be treated with insulin.

About breastfeeding: either stop breastfeeding or stopping treatment with biguanide.

Driving and using machines

Biguanides do not cause hypoglycemia by themselves, but it should be remembered that hypoglycemic events (palpitations, nausea, blurred vision, loss of the ability to perform a task …) may occur in case of associations with other hypoglycemic, which can compromise driving and operating machinery.

Oral Antidiabetic Biguanides Lifestyle

Taking a drug can lead to propose some precautions in the management of everyday life.

The early and active participation of the patient in his care is essential

  • II diabetes with overweight: essential treatment of the diabetes, accounting for 80% of diabetes is diet, to encourage the return to a weight close to the desirable weight, ie less than 10% overweight.
  • II diabetes in normal weight: Delete alcohol, and foods rich in carbohydrates
  • In all cases, regular exercise (more than 30 minutes per day) is required.

Oral Antidiabetic Biguanides Interactions

  • Combinations not recommended: with alcohol, iodinated contrast danazol.
  • Associations used with caution because of the risk of hyperglycemia: corticosteroids, diuretics, neuroleptics and high dose progesterone.
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