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Antidiabéticos No Insulinotrópicos

Antidiabéticos No Insulinotrópicos

Los LOS Neisseria antidiabéticos no insulinotrópicos se utilizan para tratar la diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus tipo 2 mediante mecanismos diferentes al AL Amyloidosis aumento de la secreción de insulina. Este grupo de medicamentos incluye a biguanidas, tiazolidinedionas, inhibidores de la alfa-glucosidasa, inhibidores del cotransportador de sodio-glucosa 2 y análogos de la amilina. Los LOS Neisseria mecanismos de acción varían, pero pueden incluir el aumento de la sensibilidad a la insulina periférica, la reducción de la liberación de glucagón, la inhibición de la gluconeogénesis, la disminución de la absorción de glucosa y el aumento de la saciedad. La metformina es el medicamento inicial de elección; otros pueden utilizarse como monoterapia alternativa o como terapia complementaria. La mayoría de estos medicamentos no están asociados con hipoglucemia severa, excepto los LOS Neisseria análogos de la amilina o cuando los LOS Neisseria medicamentos se utilizan junto con otros agentes hipoglucemiantes.

Last updated: Dec 15, 2025

Editorial responsibility: Stanley Oiseth, Lindsay Jones, Evelin Maza

Contents

Descripción General

Diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus mellitus, tipo 2

  • Causada por:
    • Resistencia periférica a la insulina: los LOS Neisseria receptores de insulina de las células no responden adecuadamente a la insulina
    • Disfunción de las células beta: ↑ en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la demanda de insulina a largo plazo → secreción defectuosa de insulina
  • Resulta en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum hiperglucemia
  • El tratamiento farmacológico puede dirigirse hacia:
    • Liberación de insulina
    • Resistencia a la insulina
    • Liberación de glucagón
    • Gluconeogénesis
    • Captación de glucosa

Clasificación

Los LOS Neisseria medicamentos hipoglucemiantes se pueden clasificar según su mecanismo de acción:

Medicamentos insulinotrópicos: ↑ secreción de insulina

  • Sulfonilureas
  • Meglitinidas
  • Análogos del péptido similar al AL Amyloidosis glucagón-1
  • Inhibidores de la dipeptidil peptidasa-4

Medicamentos no insulinotrópicos: no afectan la liberación de insulina

  • ↓ Resistencia a la insulina:
    • Biguanidas
    • Tiazolidinedionas
  • ↓ Absorción/reabsorción de glucosa:
    • Inhibidores de la alfa-glucosidasa
    • Inhibidores del cotransportador de sodio-glucosa 2
  • ↓ Vaciado gástrico y secreción de glucagón: análogos de la amilina

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Biguanidas

La metformina es el único medicamento disponible en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la clase de medicamentos de las biguanidas.

Farmacodinamia

  • El mecanismo de acción de la metformina no se comprende del todo, pero parece ayudar en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el control de la diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus tipo 2 al AL Amyloidosis:
    • ↓ Gluconeogénesis en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum:
      • Hígado
      • Riñones
    • ↓ Absorción gastrointestinal de glucosa
    • ↓ Resistencia a la insulina
    • ↑ Captación de glucosa por:
      • Músculo
      • Tejido adiposo
  • Efecto fisiológico:
    • ↓ Glucosa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum ayunas y postprandial
    • Estabilización o reducción de peso
    • ↓ Lipoproteína de baja densidad (LDL, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés)
    • ↑ Lipoproteína de alta densidad (HDL, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés)
Gráfico que resume las acciones de la metformina

Gráfico que resume las acciones de la metformina

Imagen por Lecturio.

Farmacocinética

  • Absorción: oral
  • Distribución:
    • Se concentra en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum:
      • Hígado
      • Riñones
      • Tracto gastrointestinal
    • Unión a proteínas insignificante
  • Excreción: por los LOS Neisseria riñones (sin metabolizar)

Indicaciones

  • Diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus tipo 2:
    • Medicamento de elección para la mayoría de los LOS Neisseria casos
    • Bien tolerado
    • Bajo costo
    • Sin riesgo de hipoglucemia con la monoterapia
  • Síndrome de ovario poliquístico (ya no es el tratamiento de 1ra línea)

Efectos secundarios

  • Efectos gastrointestinales (mejoran con la reducción de las dosis o la suspensión del medicamento):
    • Sabor metálico
    • Diarrea
    • Anorexia Anorexia The lack or loss of appetite accompanied by an aversion to food and the inability to eat. It is the defining characteristic of the disorder anorexia nervosa. Anorexia Nervosa
    • Náuseas y vómitos
  • Acidosis Acidosis A pathologic condition of acid accumulation or depletion of base in the body. The two main types are respiratory acidosis and metabolic acidosis, due to metabolic acid build up. Respiratory Acidosis láctica:
    • Rara
    • Común en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum individuos con enfermedad renal y hepática concurrente
    • Debida al AL Amyloidosis deterioro del metabolismo del ácido láctico en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria hepatocitos → es liberado al AL Amyloidosis torrente sanguíneo
  • Deficiencia de vitamina B12
    • Ocurre durante la terapia a largo plazo
    • Debido a la ↓ de la absorción gastrointestinal de vitamina B12
    • Rara vez resulta en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types megaloblástica

Contraindicaciones

  • Enfermedad renal severa
  • Antecedentes de acidosis Acidosis A pathologic condition of acid accumulation or depletion of base in the body. The two main types are respiratory acidosis and metabolic acidosis, due to metabolic acid build up. Respiratory Acidosis láctica
  • Disfunción hepática severa
  • Cetoacidosis diabética
  • Evitar su uso en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum:
    • Cirugía
    • Agentes de contraste yodados
    • Estados de hipoperfusión
    • Consumo excesivo de alcohol

Interacciones medicamentosas

Medicamentos asociados con una mayor toxicidad por metformina:

  • Etanol
  • Agentes de contraste yodados
  • Topiramato

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Metformin, Alpha Glucosidase Inhibitors and Thiazolidinediones — Diabetes Medications

Tiazolidinedionas

Medicamentos de esta clase

  • Pioglitazona
  • Rosiglitazona

Farmacodinamia

  • Trabajan en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum:
    • Músculo
    • Tejido adiposo
  • Ligandos de los LOS Neisseria receptores activados por proliferadores de peroxisomas
  • Activación de receptores activados por proliferadores de peroxisomas → ↑ transcripción de genes Genes A category of nucleic acid sequences that function as units of heredity and which code for the basic instructions for the development, reproduction, and maintenance of organisms. DNA Types and Structure implicados en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum:
    • Metabolismo de lípidos y glucosa
    • Transducción de señales de la insulina
    • Diferenciación de adipocitos y otros tejidos
  • ↑ Sensibilidad a la insulina → ↑ captación y utilización de glucosa
Mecanismo de acción de TZD Medicamentos para la diabetes no insulinotrópicos

Las tiazolidinedionas (TZD) funcionan en los adipocitos al unirse al receptor gamma activado por el proliferador de peroxisomas (PPARG, por sus siglas en inglés). El receptor gamma activado por el proliferador de peroxisomas se combina con el receptor X retinoide (RXR) para facilitar la transcripción de múltiples genes relacionados con la utilización y el metabolismo de la glucosa.

Imagen por Lecturio.

Farmacocinética

  • Absorción:
    • Buena absorción por vía oral
    • Inicio de acción retardado
  • Distribución: alta unión a proteínas
  • Metabolismo:
    • Metabolismo hepático extenso
    • Sistema de citocromo P450
    • La pioglitazona tiene metabolitos activos.
  • Excreción:
    • Pioglitazona: principalmente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las heces
    • Rosiglitazona: principalmente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la orina

Indicaciones

Las tiazolidinedionas se utilizan para el tratamiento de la diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus tipo 2:

  • Generalmente, no se utilizan en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la terapia inicial
  • Se utilizan con mayor frecuencia como terapia de 2da o 3ra línea
  • Se pueden combinar con otros agentes
  • La pioglitazona es útil en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum personas con esteatohepatitis no alcohólica concurrente.

Efectos secundarios

  • Aumento de peso:
    • Proliferación de adipocitos
    • Retención de líquidos
  • ↑ Riesgo de insuficiencia cardíaca congestiva y eventos cardiovasculares (especialmente con la rosiglitazona)
  • Desmineralización ósea y ↑ fragilidad (aumentando el riesgo de fracturas óseas)
  • Hepatotoxicidad
  • Posible ↑ riesgo de cáncer de vejiga (pioglitazona)

Contraindicaciones

  • Insuficiencia cardíaca congestiva clase III o IV
  • Insuficiencia hepática
  • Embarazo
  • Diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus tipo 1
  • Cáncer de vejiga (antecedentes o activo)
  • Edema Edema Edema is a condition in which excess serous fluid accumulates in the body cavity or interstitial space of connective tissues. Edema is a symptom observed in several medical conditions. It can be categorized into 2 types, namely, peripheral (in the extremities) and internal (in an organ or body cavity). Edema macular

Interacciones medicamentosas

  • ↑ Efecto hipoglucemiante:
    • Otros medicamentos antidiabéticos
    • Andrógenos
    • Agentes antivirales de acción directa
    • Antidepresivos
  • Retención de líquidos:
    • Pregabalina
    • Insulina
  • ↑ Riesgo de eventos isquémicos:
    • Vasodilatadores
    • Insulina

Inhibidores de la Alfa-Glucosidasa

Medicamentos de esta clase

Farmacodinamia

  • Alfa glucosidasas:
    • Enzimas situadas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el borde en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum cepillo intestinal
    • Convierten carbohidratos → monosacáridos
    • Solo los LOS Neisseria monosacáridos pueden transportarse desde la luz intestinal → torrente sanguíneo
  • Inhibición competitiva → ↓ digestión de carbohidratos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el intestino delgado proximal → diferido al AL Amyloidosis intestino delgado distal
  • Dan como resultado una absorción más lenta de la glucosa → ↓ excursión glucémica después de las comidas
Inhibidores de alfa-glucosidasa

Los inhibidores de la alfa-glucosidasa inhiben de manera competitiva las enzimas utilizadas para convertir los carbohidratos en monosacáridos (como la glucosa) en el intestino delgado proximal. Este proceso difiere la digestión al intestino delgado distal, lo que ralentiza la absorción de glucosa y reduce los picos postprandiales de glucosa en sangre.

Imagen por Lecturio.

Farmacocinética

  • Absorción:
  • Metabolismo:
    • Acarbosa: degradada en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el intestino por bacterias y enzimas digestivas
    • Miglitol Miglitol Non-insulinotropic Diabetes Drugs: ninguno
  • Excreción:
    • Acarbosa: principalmente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las heces
    • Miglitol Miglitol Non-insulinotropic Diabetes Drugs: principalmente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la orina

Indicaciones

Los LOS Neisseria inhibidores de la alfa-glucosidasa se utilizan para tratar la diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus tipo 2 como:

  • Monoterapia (generalmente no de 1ra línea)
  • Terapia complementaria

Efectos secundarios

  • Malestares gastrointestinales (debido a la fermentación de carbohidratos no digeridos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el colon Colon The large intestines constitute the last portion of the digestive system. The large intestine consists of the cecum, appendix, colon (with ascending, transverse, descending, and sigmoid segments), rectum, and anal canal. The primary function of the colon is to remove water and compact the stool prior to expulsion from the body via the rectum and anal canal. Colon, Cecum, and Appendix: Anatomy):
  • ↑ Enzimas hepáticas

Contraindicaciones

  • Insuficiencia renal
  • Deterioro hepático
  • Trastornos de la motilidad gastrointestinal
  • Predisposición a obstrucción intestinal
  • Enfermedad inflamatoria intestinal

Inhibidores del Cotransportador de Sodio-Glucosa 2

Medicamentos de esta clase

  • Dapagliflozina
  • Empagliflozina
  • Canagliflozina
  • Ertugliflozina

Farmacodinamia

  • Cotransportador de sodio-glucosa 2:
    • Situado en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el túbulo proximal
    • Responsable de la reabsorción de glucosa
  • Inhibición del cotransportador de sodio-glucosa 2 → ↓ reabsorción de glucosa filtrada
  • Resultado: ↑ excreción urinaria de glucosa y ↓ nivel de glucosa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum sangre

El cotransportador de sodio-glucosa 2 (SGLT2, por sus siglas en inglés) se expresa en el túbulo proximal:
El cotransportador de sodio-glucosa 2 es responsable de la reabsorción de aproximadamente el 90% de la glucosa filtrada. La glucosa normalmente se importa a la célula tubular renal proximal con un ion de sodio. Este ion es impulsado por el eflujo de Na fuera de la célula por la Na+/K+-ATPasa (círculo verde). La glucosa sale de la célula al torrente sanguíneo a través del transportador de glucosa 2 (GLUT2, por sus siglas en inglés).
La inhibición de SGLT2 da como resultado un aumento de la excreción renal de glucosa, lo que reduce los niveles de glucosa en sangre.

Imagen por Lecturio.

Farmacocinética

  • Absorción: rápida absorción oral
  • Distribución: unión a proteínas
  • Metabolismo:
    • Hepático
    • Glucuronidación
    • Metabolismo mínimo mediado por el citocromo P450
  • Excreción: en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum orina y heces

Indicaciones

Los LOS Neisseria inhibidores del cotransportador de sodio-glucosa 2 se utilizan para el tratamiento de la diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus tipo 2:

  • Terapia complementaria
  • Normalmente, no se utilizan como terapia inicial
  • Ayudan con la pérdida de peso
  • Beneficio potencial de morbilidad y mortalidad para personas con comorbilidades cardiovasculares y renales

Indicaciones adicionales:

  • Enfermedad renal crónica con proteinuria Proteinuria The presence of proteins in the urine, an indicator of kidney diseases. Nephrotic Syndrome in Children → ralentiza el deterioro de la función renal y reduce la proteinuria Proteinuria The presence of proteins in the urine, an indicator of kidney diseases. Nephrotic Syndrome in Children.
  • Insuficiencia cardiaca → reduce la mortalidad y las hospitalizaciones.

Efectos secundarios

  • Glucosuria Glucosuria Diabetes Mellitus → ↑ riesgo de infecciones del tracto genitourinario
  • La diuresis osmótica conduce a:
    • Poliuria
    • Hipovolemia
    • Hipotensión
    • Injuria renal aguda
  • ↑ Riesgo de fracturas
  • ↑ Riesgo de cetoacidosis diabética
  • Reacciones de hipersensibilidad
  • Amputaciones de miembros inferiores (específicamente canaglifozina)

Contraindicaciones

  • Deterioro renal grave (menos eficaz)
  • Infecciones frecuentes del tracto urinario
  • Diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus tipo 1
  • Cetoacidosis diabética

Related videos

11:34
SGLT2 Inhibitors – Diabetes Medications

Análogos de la Amilina

El pramlintida es el único medicamento en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la clase de análogos de la amilina.

Farmacodinamia

  • Generalmente, la amilina es cosecretada con insulina por las células beta del páncreas.
  • Esta secreción es deficiente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus tipo 1 y relativamente deficiente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus tipo 2.
  • Los LOS Neisseria análogos ayudan con el control de la glucosa al AL Amyloidosis:
    • Retrasar el vaciamiento gástrico y ↑ saciedad → ↓ ingesta de alimentos
    • ↓ Secreción postprandial de glucagón
Efectos de amilina

La función de la amilina en la regulación de la glucosa:
La amilina es un péptido que normalmente liberan las células beta pancreáticas junto con la insulina. Existe una deficiencia de amilina en la diabetes, por lo que se pueden administrar análogos para promover la saciedad, retrasar el vaciamiento gástrico y disminuir la secreción inadecuada de glucagón.

Imagen por Lecturio.

Farmacocinética

  • Absorción: administrado como inyección subcutánea (debe inyectarse en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum un sitio diferente al AL Amyloidosis utilizado para la inyección de insulina)
  • Metabolismo:
    • Renal
    • Metabolito activo
  • Excreción: en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la orina

Indicaciones

  • Se utilizan en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus tipo 1 y 2
  • Las personas deben recibir insulina prandial.
  • Administrados inmediatamente antes de las comidas

Efectos secundarios

  • Náuseas y vómitos
  • Anorexia Anorexia The lack or loss of appetite accompanied by an aversion to food and the inability to eat. It is the defining characteristic of the disorder anorexia nervosa. Anorexia Nervosa
  • Hipoglucemia (generalmente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus tipo 1)

Contraindicaciones

Interacciones medicamentosas

  • ↑ Efecto hipoglucemiante con otros medicamentos antidiabéticos
  • Pueden retrasar la absorción de otros medicamentos orales

Comparación de Medicamentos Antidiabéticos

La siguiente tabla compara los LOS Neisseria diferentes medicamentos para la diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus mellitus tipo 2 (no insulínicos):

Tabla: Comparación de los LOS Neisseria diferentes medicamentos para la diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus mellitus tipo 2 (no insulínicos)
Medicamento Mecanismo Indicaciones Efectos secundarios
Sulfonilureas
  • Actúan sobre los LOS Neisseria canales de K de las células beta
  • ↑ Liberación de insulina
  • Terapia complementaria
  • Hiperglucemia severa (si hay contraindicaciones a otros agentes)
  • Hipoglucemia
  • Aumento de peso
  • Reacción tipo disulfiram
  • Hepatitis
  • Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types hemolítica
Meglitinidas
  • Terapia complementaria
  • Pueden reemplazar a las sulfonilureas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum personas alérgicas
  • Hipoglucemia
  • Aumento de peso
  • Infecciones del tracto respiratorio
Agonistas del péptido similar al AL Amyloidosis glucagón-1
  • Miméticos de la incretina
  • Actúan sobre las células beta y alfa
  • ↑ Liberación de insulina
  • ↓ Liberación de glucagón
  • ↓ Vaciado gástrico y apetito
  • Terapia complementaria
  • Control de peso
  • Náuseas y vómitos
  • Diarrea
  • Pancreatitis Pancreatitis Inflammation of the pancreas. Pancreatitis is classified as acute unless there are computed tomographic or endoscopic retrograde cholangiopancreatographic findings of chronic pancreatitis. The two most common forms of acute pancreatitis are alcoholic pancreatitis and gallstone pancreatitis. Acute Pancreatitis
  • Injuria renal
Inhibidores de la dipeptidil peptidasa-4
  • Previenen la descomposición del péptido similar al AL Amyloidosis glucagón-1
  • ↑ Liberación de insulina
  • ↓ Liberación de glucagón
 Terapia complementaria
  • Nasofaringitis
  • Artralgia
  • Disfunción hepática
  • Pancreatitis Pancreatitis Inflammation of the pancreas. Pancreatitis is classified as acute unless there are computed tomographic or endoscopic retrograde cholangiopancreatographic findings of chronic pancreatitis. The two most common forms of acute pancreatitis are alcoholic pancreatitis and gallstone pancreatitis. Acute Pancreatitis
  • Insuficiencia cardíaca
Biguanidas
  • ↓ Resistencia a la insulina
  • ↓ Gluconeogénesis
  • Medicamento de elección
  • Pueden utilizarse como monoterapia
  • Síntomas gastrointestinales
  • Acidosis Acidosis A pathologic condition of acid accumulation or depletion of base in the body. The two main types are respiratory acidosis and metabolic acidosis, due to metabolic acid build up. Respiratory Acidosis láctica
  • Deficiencia de vitamina B 12
Tiazolidinedionas
  • Activación del receptor Receptor Receptors are proteins located either on the surface of or within a cell that can bind to signaling molecules known as ligands (e.g., hormones) and cause some type of response within the cell. Receptors activado por el proliferador de peroxisomas
  • ↑ Transcripción de genes Genes A category of nucleic acid sequences that function as units of heredity and which code for the basic instructions for the development, reproduction, and maintenance of organisms. DNA Types and Structure para la utilización de lípidos y glucosa
  • ↓ Resistencia a la insulina
  • Terapia complementaria
  • Pioglitazona: esteatohepatitis no alcohólica concurrente
  • Aumento de peso/retención de líquidos
  • Eventos cardiovasculares
  • Hepatotoxicidad
  • Osteoporosis Osteoporosis Osteoporosis refers to a decrease in bone mass and density leading to an increased number of fractures. There are 2 forms of osteoporosis: primary, which is commonly postmenopausal or senile; and secondary, which is a manifestation of immobilization, underlying medical disorders, or long-term use of certain medications. Osteoporosis
Inhibidores de alfa-glucosidasa
  • Inhiben la conversión de carbohidratos a monosacáridos
  • Absorción lenta de glucosa
  • ↓ Excursión de glucosa postprandial
  • Se pueden utilizar como monoterapia (no como 1ra línea)
  • Terapia complementaria
  • Síntomas gastrointestinales
  • ↑ Pruebas de función hepática
Inhibidores del cotransportador de sodio-glucosa 2
  • Inhiben la reabsorción de glucosa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el túbulo renal proximal
  • ↑ Excreción urinaria de glucosa
  • Terapia complementaria
  • Beneficio cardiovascular y renal
  • Infecciones genitourinarias
  • Cetoacidosis diabética
  • Depleción de volumen
Análogos de la amilina
  • Enlentecimiento del vaciado gástrico
  • ↑ Saciedad
  • ↓ Secreción postprandial de glucagón
  • Se utilizan en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus tipo 1 y 2
  • Se deben utilizar junto con insulina prandial
  • Náuseas
  • Hipoglucemia

Los LOS Neisseria efectos de los LOS Neisseria medicamentos para la diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus sobre el peso pueden ser un factor importante en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la elección de la terapia:

  • Pérdida de peso:
    • Miméticos del péptido similar al AL Amyloidosis glucagón-1
    • Inhibidores del cotransportador de sodio-glucosa 2
  • Peso neutro:
    • Inhibidores de la α-glucosidasa
    • Inhibidores de la dipeptidil peptidasa-4
  • Aumento de peso:
    • Insulina
    • Sulfonilureas
    • Tiazolidinedionas
    • Meglitinidas

Referencias

  1. Nolte Kennedy, M.S. (2012). Pancreatic hormones & antidiabetic drugs. In: Katzung, B. G., Masters, S. B., & Trevor, A. J. (Eds.), Basic & Clinical Pharmacology, 12th ed. McGraw-Hill Education, pp. 743–765. https://pharmacomedicale.org/images/cnpm/CNPM_2016/katzung-pharmacology.pdf
  2. Wexler, D.J. (2021). Metformin in the treatment of adults with type 2 diabetes mellitus. UpToDate. Retrieved September 12, 2021, from https://www.uptodate.com/contents/metformin-in-the-treatment-of-adults-with-type-2-diabetes-mellitus
  3. Inzucchi, S.E., Lupsa, B. (2020). Thiazolidinediones in the treatment of type 2 diabetes mellitus. (Ed.), UpToDate. Retrieved September 12, 2021, from https://www.uptodate.com/contents/thiazolidinediones-in-the-treatment-of-type-2-diabetes-mellitus
  4. McCulloch, D. (2019). Alpha-glucosidase inhibitors and lipase inhibitors for treatment of diabetes mellitus. UpToDate. Retrieved September 12, 2021, from https://www.uptodate.com/contents/alpha-glucosidase-inhibitors-and-lipase-inhibitors-for-treatment-of-diabetes-mellitus
  5. DeSantis, A. (2020). Sodium-glucose co-transporter 2 inhibitors for the treatment of hyperglycemia in type 2 diabetes mellitus. UpToDate. Retrieved September 12, 2021, from https://www.uptodate.com/contents/sodium-glucose-co-transporter-2-inhibitors-for-the-treatment-of-hyperglycemia-in-type-2-diabetes-mellitus
  6. Dungan, K. (2021). Amylin analogs for the treatment of diabetes mellitus. UpToDate. Retrieved September 12, 2021, from https://www.uptodate.com/contents/amylin-analogs-for-the-treatment-of-diabetes-mellitus
  7. Scheen, A.J. (2015). Pharmacokinetics, pharmacodynamics, and clinical use of SGLT2 inhibitors in patients with type 2 diabetes mellitus and chronic kidney disease. Clin Pharmacokinet 54:691–708. https://pubmed.ncbi.nlm.nih.gov/25805666/

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