[Limitations of insulin-dependent drugs in the treatment of type 2 diabetes mellitus].
In this study, we review the efficacy and safety limitations of insulin-dependent oral antidiabetic agents. In terms of efficiency, the main drawback of metformin, sulfonylureas, gliptins and -to a lesser extent-glitazones is durability. No drug per se is able to maintain stable blood glucose control for years. Metformin, sulfonylureas and gliptins have demonstrated safety. Experience with the first two drug groups is more extensive. The main adverse effect of metformin is gastrointestinal discomfort. Major concerns related to the use of sulfonylureas are hypoglycemia and weight gain. The use of pioglitazone has been associated with an increased risk of bladder cancer, edema, heart failure, weight gain, and distal bone fractures in postmenopausal women. The most common adverse reactions associated with glucagon-like peptide-1 agonists are gastrointestinal discomfort that sometimes leads to treatment discontinuation.
Servicio de Endocrinología y Nutrición, Hospital Dr. Negrín, Las Palmas de Gran Canaria, España.
Pino Fuente
PF
Valerón
Servicio de Endocrinología y Nutrición, Hospital Dr. Negrín, Las Palmas de Gran Canaria, España; Departamento de Ciencias Médico-Quirúrgicas, Facultad de Ciencias de la Salud, Universidad de Las Palmas, Las Palmas de Gran Canaria, España. Electronic address: ppablos@dcmq.ulpgc.es.
Pedro L
PL
de Pablos-Velasco
D000075202:Contraindications; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000503:physiopathology; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004361:Drug Tolerance; D005598:Fractures, Spontaneous / Q000139:chemically induced; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D052216:Glucagon-Like Peptide 1 / Q000819:agonists; D006333:Heart Failure / Q000139:chemically induced; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000145:classification / Q000494:pharmacology / Q000627:therapeutic use*; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance; D000078790:Insulin Secretion; D008687:Metformin / Q000009:adverse effects / Q000627:therapeutic use; D000077205:Pioglitazone; D013453:Sulfonylurea Compounds / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D045162:Thiazolidinediones / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D001749:Urinary Bladder Neoplasms / Q000139:chemically induced; D015430:Weight Gain
D054873:Dipeptidyl-Peptidase IV Inhibitors; D007004:Hypoglycemic Agents; D007328:Insulin; D013453:Sulfonylurea Compounds; D045162:Thiazolidinediones; D052216:Glucagon-Like Peptide 1; D008687:Metformin; D000077205:Pioglitazone
Antidiabéticos orales; Diabetes tipo 2; Insulin; Insulina; Oral antidiabetics; Type 2 diabetes