Question
A 68year old female patient, complains of easy fatigability for past 6 months. Routine
checkup showed her fasting blood glucose level to be 168 mg/dL, glycosylated
hemoglobin (HbA1
(a) Classify Oral anti diabetic drugs with two examples each 3 mark(s)
(b) Briefly describe Metformin 3 mark(s)
Q2 6 marks Essays ★ ✓
Answer
a) Classification of oral antidiabetic drugs, two examples each
Class Examples Sulfonylureas Glibenclamide, Glimepiride Biguanides Metformin Thiazolidinediones Pioglitazone, Rosiglitazone Alpha-glucosidase inhibitors Acarbose, Miglitol DPP-4 inhibitors Sitagliptin, Vildagliptin SGLT2 inhibitors Dapagliflozin, Empagliflozin
b) Metformin
MOA : activates AMP-activated protein kinase (AMPK) in hepatocytes, suppressing hepatic gluconeogenesis (its dominant mechanism) and modestly increasing peripheral insulin sensitivity/glucose uptake. Does not stimulate insulin release, so carries essentially no hypoglycemia risk as monotherapy — the reason it remains first-line therapy for newly diagnosed type 2 diabetes, as in this patient. Adverse effects : GI upset (nausea, diarrhea), lactic acidosis (rare but serious, risk amplified by renal impairment — contraindicated/dose-adjusted in significant renal impairment).
1 Diabetes Mellitus and Oral Hypoglycaemic Drugs
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