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[News in oral therapy of diabetes mellitus]
1Klinika za endokrinologiju, dijabetes i bolesti metabolizma, Institut za interne bolesti, Klinicki centar Novi Sad.
Introduction:
Recent interest in regard to therapy of diabetes mellitus has focused on novelties in the field of insulin and other kinds of therapies disregarding the contemporary achievements in oral therapy.
Dietary Plant Fiber:
Dietary habits and food preferences in developed countries reveal lack of dietary plant fiber associated with the epidemiologic expansion of widespread noninfectious diseases (metabolic, cardiovascular and some malignant neoplasms). INHIBITORS OF INTESTINAL ALPHA-GLYCOSIDASES: These are substances which competatively and reversibly inhibit the intestinal alpha-glycosidases. The best known among them is acarbose, already in clinical usage for some time. Its wide application has been limited due to fairly distressing side effects.
New Oral Hypoglycemic Agents:
Although metformin is not a new agent, it deserves attention because it is a novelty in our country. It is extremely useful in therapy of obese diabetics with insulin resistance and hyperinsulinemia. Furthermore, glimepiride--a new sulphonyluretic agent is also at disposal, being better than the previous due to not inhibiting vasodilatory reaction and so it can be used in treatment of some heart diseases. A completely new group of oral hypoglycemics is represented by thiazolidine agents which represent the so-called insulin sensitisers. Apart from that, they have a favourable effect on some lipid fractions and arterial blood pressure.
Some Other Hypoglycemic Agents:
Among numerous substances with hypoglycemic effect it seems that in the future sulphonyluretic agents might be replaced by benzoic acid preparations.