Question
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- (a) Enumerate Oral Anti diabetic drugs. Describe the mechanism of action, uses and adverse effects of any two groups. ( 4 mark(s)
- (b) Briefly describe Insulin analogs. 6 mark(s)
Answer
a) Oral antidiabetic drugs — two groups in detail
| Class | Examples |
|---|---|
| Sulfonylureas | Glibenclamide, Glimepiride |
| Biguanides | Metformin |
| Thiazolidinediones | Pioglitazone |
| DPP-4 inhibitors | Sitagliptin |
| SGLT2 inhibitors | Dapagliflozin |
Sulfonylureas: MOA: bind and close ATP-sensitive K⁺ channels on pancreatic beta cells, depolarizing the membrane and triggering insulin release. Uses: type 2 diabetes, second-line/combination therapy. Adverse effects: hypoglycemia, weight gain.
Biguanides (Metformin): MOA: activates AMPK, suppressing hepatic gluconeogenesis; no insulin-secretagogue action, so minimal hypoglycemia risk. Uses: first-line for type 2 diabetes. Adverse effects: GI upset, lactic acidosis (rare, renal impairment risk).
b) Insulin analogs Recombinant insulins with amino-acid substitutions altering onset/duration to mimic physiological secretion more closely than regular/NPH insulin. Rapid-acting (Lispro, Aspart, Glulisine) — faster absorption, dosed with meals, better post-prandial control. Long-acting (Glargine, Detemir, Degludec) — smooth, peakless basal profile, once-daily dosing, less nocturnal hypoglycemia than NPH. Advantages: closer mimicry of physiological basal-bolus secretion, greater dosing flexibility, significantly reduced hypoglycemia risk.