CHAPTER 8 Endocrine System^361
Type II:
- Maintain ideal body weight through diet and exercise.
- Regular monitoring of blood glucose.
- Administer oral sulfonylureas to stimulate secretion of insulin from the pan-
creas (see Table 8-2). - Administer oral biguanides to reduce blood glucose production by the liver:
- metformin
- Administer thiazolidinediones to sensitize peripheral tissues to insulin:
- rosiglitazone
Drug Onset Peak Duration Comments
Oral sulfonylureas
chlorproamide 1 hr 4 to 6 hrs 12 to 24 hrs chlorpropamide—use
glyburide 1 hr 4 to 6 hrs 40 to 60 hrs caution with renal or
glipizide 15 min–1 hr 2 to 8 hrs 10 to 24 hrs hepatic patients
glimepiride
tolbutamide
tolazamide
Oral biguanides 2 to 2.5 hrs 10 to 16 hrs Decreases glucose pro-
metformin duction in liver; decrease
intestinal absorption of
glucose and improves
insulin sensitivity
Oral alpha- Delays glucose absorption
glucosidose and digestion of carbs;
inhibitor lowers blood sugar;
acarbose 1 hr reduces plasma glucose
miglitol Rapid 2 to 3 hrs and insulin
DPP4 inhibitors Stimulate secretion of
meglitinide analogs insulin from pancreas
D-phenylalanine Stimulates insulin
derivative production
incretin mimetics Assists pancreatic insulin
production; regulates
liver production of glu-
cose; decreases appetite;
slows glucose transit
from stomach to intestineTable 8-2 Oral Hypoglycemic Agents