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image of Therapeutic Trends in Diabetes Management: A Review on Oral Hypoglycemic Agents (OHAs) Utilization in Tertiary Care

Abstract

Introduction

Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder marked by insulin resistance and impaired insulin secretion. Effective glycemic management is critical for preventing problems, which can be achieved through Oral Hypoglycemic Agents (OHAs). Metformin is the first-line drug due to its insulin-sensitizing effects, while other classes, such as sulfonylureas, meglitinides, DPP-4 inhibitors, SGLT2 inhibitors, thiazolidinediones, and α-glucosidase inhibitors, serve complementary roles. Evolving treatment strategies increasingly favour combination therapies to increase outcomes.

Methods

The review involved an extensive search of scientific databases and relevant literature, including studies published to date in PubMed, Science Direct, and Google Scholar. Type 2 Diabetes Mellitus (T2DM), oral hypoglycaemic agents, pharmacoeconomics, insulin sensitivity, SGLT2 inhibitors, and Thiazolidinediones were among the search phrases used. The selected papers were carefully evaluated for methodological soundness and the significance of their results.

Results

There is an increased prescribing of fixed-dose combinations, such as metformin-vildagliptin, which has led to better adherence and control. Regional differences in costs have an impact on the accessibility of drugs. SGLT2 and GLP-1 drugs provide cardiovascular and renal effects, whereas DPP-4 drugs produce limited results. The difference in pharmacokinetics and a certain decline of β-cells may require the prescription of an individualized treatment, combination therapy, or the introduction of insulin over time.

Discussion

The current inclination to fixed-dose combinations improves compliance and glycemic control. Regional inequity is affected by the differences in costs. Better results in the use of SGLT2 and GLP-1 drugs favor their application in vulnerable patients, whereas the DDP-4 blocking agent is more appropriate in milder patient populations. Individualized treatment programs are a necessity, even with impaired β-cell functioning, which necessitates intensification of the therapy or insulin.

Conclusion

Optimizing T2DM management requires a personalized approach that integrates clinical efficacy, safety, and cost into account. Regular prescription audits and targeted pharmacoeconomic strategies are vital for equitable access and long-term disease control worldwide.

© 2025 Bentham Science Publishers
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2025-11-16

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/content/journals/chddt/10.2174/011871529X414055250924050309
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Therapeutic Trends in Diabetes Management: A Review on Oral Hypoglycemic Agents (OHAs) Utilization in Tertiary Care
Bentham Science Publishers ; https://doi.org/10.2174/011871529X414055250924050309
/content/journals/chddt/10.2174/011871529X414055250924050309
/content/journals/chddt/10.2174/011871529X414055250924050309
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  • Article Type:     Review Article
Keywords: Type 2 diabetes mellitus ; thiazolidinediones ; pharmacoeconomics ; T2DM ; insulin sensitivity ; SGLT2 
inhibitors ; oral hypoglycemic agents

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