How to Use Oral Hypoglycemie Agents in Diabetic Patients?(Series "Treatment of Diabetes Mellitus" (2))

Various kinds of oral hypoglycemic agents (OHA) are currently available for the treatment of type 2 diabetes mellitus. OH As are only recommended after the introduction of diet and exercise therapy for several months, because life-style modification generally improves glucose control effectively. Sulfonylureas are often prescribed for individuals with fasting hyperglycemia and insulin-deficiency, whereas biguanides or thiazolidinediones are often used among insulin-resistant diabetic patients. α-Glucosidase inhibitors or fast-acting insulin secreting drugs are suitable for patients with post-prandial hyperglycemia. OHA treatment target is to maintain a HbAlc level below 6.5% without hypoglycemia. Combination of two or more OH As is often effective in cases where mono-therapy yields unfavorable result. Large-scale clinical trials showed that sulfonylurea or biguanide postponed diabetic complications. However, research evidence on the effectiveness of OHAs, especially among the Japanese diabetic population, is still insufficient. We analyzed the database of OHAs prescription and the clinical information of patients at Tokyo Women's Medical University Hospital. We found that OHA therapy was only successful when patients complied with diet and exercise therapy. Thus, type 2 diabetes treatment remains a difficult challenge