Thiazolidinediones such as Pioglitazone (Actos), decrease insulin resistance
and help muscle cells to respond to insulin and use glucose more effectively.
Thiazolidinediones may be used in addition to sulfonylurea, metformin, or
insulin for insulin-resistant patients. Pioglitazone (Actos) has no significant side
effects or adverse effects.
Rapaglinide (Prandin) is used alone or in combination with metformin as
a short-acting similar to sulfonylureas, however Rapaglinide does not cause a
hypoglycemic reaction.GLUCAGON
Glucagon is a hyperglycemic hormone secreted by the alpha cells of the islets
of Langerhans in the pancreas and increases blood sugar by stimulating
glycogenolysis (glycogen breakdown) in the liver.
Glucagon protects the body cells, especially those in the brain and retina, by
providing the nutrients and energy needed to maintain body function. Glucagon,
available for parenteral use, treats insulin-induced hypoglycemia when other
methods of providing glucose are not available. Glucagon can increase blood
glucose level in patients who are semiconscious or unconscious and unable to
ingest carbohydrates.
Oral diazoxide (Proglycem) increases blood sugar by inhibiting insulin
release from the beta cells and stimulating release of epinephrine (Adrenalin)
from the adrenal medulla. Oral diazoxide (Proglycem) is used to treat chronic
hypoglycemia caused by hyperinsulinism due to islet cell cancer or hyperplasia,
but not for hypoglycemic reactions. Patients don't experience hypotension when
taking oral diazoxide (Proglycem).
A list of antidiabetic second generation drugs is provided in the Appendix.
Detailed tables show doses, recommendations, expectations, side effects, con-
traindications, and more; available on the book’s Web site (see URL in Appendix).Summary
Glands of the endocrine system produce hormones that are distributed through-
out the body by blood vessels. Hormones are messengers that influence how
tissues, organs, and other parts of your body function. Glands can overproduce
or underproduce hormones causing parts of the body to behave inappropriately.(^396) CHAPTER 21 Endocrine Medications