Insulin and Other Antidiabetic Agents

Abstract Diabetes mellitus is a pathologic condition characterized by chronic hyperglycemia (elevated blood glucose) and additional disturbances of carbohydrate, fat, and protein metabolism. Diabetes is divided into two forms: Insulin‐dependent diabetes mellitus (IDDM) (Type 1) and non‐insulin dependent diabetes mellitus (NIDDM) (Type 2). Type 1 is juvenile‐onset diabetes and Type 2 is maturity‐onset diabetes. The goals of therapy include elimination of the clinical symptoms of hyperglycemia. Therapeutic regimens are usually tailored to the individual. Insulin is a peptide hormone produced in the islets of Langerhans within the pancreas, which acts as the principal regulator of glucose homeostasis. Today most insulin for human use is produced by DNA recombinant methods, although some parts of the world still use porcine and bovine insulin. Insulin preparations are classified as rapid‐, regular‐, intermediate‐, and long‐acting injections. There are six classes of diabetes pills and several combinations of oral medications available for persons with Type 2 diabetes. They are classified as insulintropic, compounds, sensitizers, thiazolidinediones, inhibitors of α‐glucose, and DDP‐4 inhibitors. Newer developments are discussed such as insulin from herbal extracts and the search for insulin in an oral form.