Sammanfattning
Background
This review gives an overview of the
available drugs, except insulin, for treatment
of hyperglycemia in type 2 diabetes.
The mechanisms of action, clinical
effects, clinical use and the most common
adverse effects are summarized.
Material and methods
The review is based on a qualified
selection
of relevant articles found by
searching the PubMed database.
Results and conclusion
Treatment of hyperglycemia in type 2
diabetes can be challenging, and the
achievement of blood glucose control
often requests multifaceted approaches.
Life style intervention is fundamental to
all drug regimes, and the patients should
be motivated for and educated in the
importance of physical activity, a healthy
diet and weight reduction if overweight.
If this does not lead to desired blood
glucose level, medical treatment should
be initiated, and combinations of drugs
with different targets are often required.
Metformin is considered the first-line
therapy for most patients. The blood
glucose lowering efficacy for metformin,
sulfonylureas and glitazones is about
1–1.5 % reduction in HbA1c, whereas
DPP4 inhibitors, GLP-1 analogs, SGLT2
inhibitors and acarbose show a slightly
lower effect. The choice of treatment will
depend on individual characteristics and
the degree of hyperglycemia.