April 21, 2017
Ambulatory Glucose Profile
This article is about commonly used drugs for diabetes available in Indian market. Diabetes being a polymorphic disease with a complex pathophysiology, there are number of pharmacological targets that have been tried and are being still developed. Though most of these drugs would lower the glucose levels to some extent, their efficacy and longevity of efficacy would depend on the basic pathophysiology. The complex pathophysiology and etiological classification of diabetes has been separately discussed on this page. On this page only those drugs are listed that are approved for use in India. There are a few more drugs that are approved and used in specific countries.
1. Sensitizers – These are the group of drugs that improve insulin sensitivity. They are further divided into Bigunides and TZDs, each group having only one drug currently approved for use, Metformin and Pioglitazone respectively.
2. Secretogogues – These are the drugs that increase insulin secretion from beta cells. They are of 2 types â€“ Sulphonylurea and Non Sulphonylurea. Under Sulphonylurea subtypes we have options like Glibenclamide, Gliclazide, Glipizide and Glimeperide. Under non sulphonylurea type available options are Rapaglinide and Nataglinide.
3. Alpha Glucosidase Inhibitors – These drugs prohibit the digestion of carbohydrates in small intestine and currently available options are Acarbose, Miglitol and Voglibose.
4. DPP4 Inhibitors – These are a new class of drugs and they inhibit breakdown of GLP1. Currently we have Sitagliptin, Vildaglipting, Saxagliptin, Linagliptin and Tenaligliptin in Indian market.
5. SGLT2 Inhibitors – This group of drugs increases excretion of glucose through kidneys. In India Dapagliflozin, Canagliflozin and Empagliflozin are approved for use.
6. Others – There are a few other drugs like Glitazars and Barberine which are available in India.
1. Insulins – Human recombinant insulin is available in 3 formulations. Regular, NPH and Premixed insulin.
2. Insulin Analogues – There are number of rapid acting analogues like Aspart, Glulysin and Lispro. The long acting analogues like Detemir, Lantus and Degludec are also available. Recently a mixture of analogues has also been approved for use with the brand name of Ryzodeg.
3. GLP 1 Analogues – Exenetide and Liraglutide have been in market for long time. Ultralong acting analogues requiring once a week injections are soon to be launched.
This is only the list of available drugs, though there are enumerable combinations of these drugs and all these combinations are marketed under number of brand names.