To the assessment of the use of sugar-reducing drugs from the position of safety

Abstract

The results and the degree of safety of hypoglycaemic drugs are presented. The current work analyses the safety of the use of sulfonylurea derivatives, biguanides, thiazolidinediones, meglitinides and α-glucosidase inhibitors according to clinical studies published in the scientific literature. Macrovascular complications in diabetes mellitus (DM) develop much earlier than microvascular complications and cause death in 75 % — 80 % of patients. The safety of hypoglycaemic therapy is assessed by the occurrence of hypoglycaemia, changes in body weight, effects on the gastrointestinal tract, and, of course, is associated with the risk of cardiovascular disease. In evaluating the results of numerous clinical studies, the use of sulfonylurea drugs (except gliclazide), meglitinides, alpha-glucosidase inhibitors (acarbose), and thiazolidinediones are not recommended in patients with a very high cardiovascular risk for treating type 2 diabetes due to evidence of an adverse effect on prognosis, or the presence of conflicting data or the lack of sufficient arguments for the cardiovascular safety of drugs. Metformin remains the preferred initial therapy with good tolerability.