Diabetes Drug Notes

Prof. Miles Fisher is a former Consultant Physician, Department of Diabetes, Endocrinology and Clinical Pharmacology, Glasgow Royal Infirmary, and an Honorary Professor at the University of Glasgow, UK.Prof. Gerard A. McKay is a Consultant Physician, Department of Diabetes, Endocrinology and Clinical Pharmacology, Glasgow Royal Infirmary, an Honorary Clinical Associate Professor, University of Glasgow, as well as a Visiting Professor at the University of Strathclyde, UK. Dr Andrea Llano is a Consultant Physician, Department of Diabetes, Endocrinology and Clinical Pharmacology, Glasgow Royal Infirmary, and an Honorary Clinical Lecturer, University of Glasgow, UK.

• Foreword xxPreface xxiEditors and Contributors xxiiIntroduction 11 Clinical Pharmacology of Antidiabetic Drugs 2Andrea Llano, Gerry McKay, and Ken PatersonIntroduction 2Clinical Pharmacology 3Drug Metabolism and Elimination 6Drug Development and Clinical Trials 7Drug Licensing of Antidiabetic Drugs 12Development and Licensing of Insulin 14Development and Approval of Biosimilar Insulin 16Pharmacovigilance 19Pharmacoeconomics 21Future Developments in Diabetes Clinical Pharmacology 262 Metformin 30Joseph Timmons and James BoyleIntroduction 30Pharmacology 32Mechanism of Action 32Glycaemic Efficacy 36Safety and Side Effects 37Metformin in Type 1 Diabetes 45Place of Metformin in Current and Future Practice 463 Sulfonylureas and Meglitinides 49Joseph Timmons and James BoyleIntroduction 49Pharmacology 51Glycaemic Efficacy 53Safety and Side Effects 55Outcome Trials 56Meglitinides 61Place of Sulfonylureas and Meglitinides in Current and Future Practice 654 DPP-4 Inhibitors 67Sharon Mackin and Gemma CurrieIntroduction 67Pharmacology 68Glycaemic Efficacy 75Safety and Side Effects 79Outcome Trials 82Renal Outcomes 89The Place of DPP-4 Inhibitors in Current and Future Practice 915 SGLT2 Inhibitors 95Miles Fisher, Andrea Llano, and Gerry McKayIntroduction 96Pharmacology 96Glycaemic Efficacy 100Side Effects and Safety 103Outcome Trials 105Renal Outcome Trials 110Heart Failure Outcome Trials 116SGLT2 Inhibitors in Type 1 Diabetes 119Use of SGLT2 Inhibitors in Other Diseases 123Dare- 19 123Place of SGLT2 Inhibitors in Current and Future Practice 1246 GLP-1 Receptor Agonists 130Catherine Russell and John PetrieIntroduction 130Pharmacology 131Glycaemic Efficacy and Effect on Weight 137Side Effects and Safety 142Outcome Trials 143Use of GLP-1 Receptor Agonists in Other Diseases 153Place of GLP-1 Receptor Agonists in Current and Future Practice 1557 Animal and Human Insulins 161Ken PatersonIntroduction 161Production and Pharmacokinetic Modifications 165Hypoglycaemia and Human Insulin 170Intensified Insulin Therapy 173Place of Human Insulin in Current and Future Therapy 1768 Short-acting Insulin Analogues 179Kate Hughes and Gerry McKayIntroduction 179Factors Affecting Absorption and Metabolism of Short-acting Insulin 180Manufacturing Insulin Analogues 180Short-acting Insulin Analogues 182Second-generation Ultrafast-acting Insulin Analogues 186Other Attempts to Improve Insulin Absorption and Inhaled Insulin 189Place of Short-acting Insulin Analogues in Current and Future Practice 1909 Long-acting Insulin Analogues 194Robert LindsayIntroduction 195Development of Long-acting Insulin Analogues 196Long-acting Insulin Analogues 197Meta-analysis of Glycaemic Efficacy of Long-acting Insulin Analogues 207Safety of Long-acting Insulin Analogues 209The Place of Long-acting Insulin Analogues in Current and Future Practice 20910 Devices 214David CartyIntroduction 214Insulin Pens 215Insulin Pumps 215Self-monitoring of Blood Glucose 218Linkage of Continuous Glucose Monitoring to Insulin Pumps 223Guidelines on the Use of Devices 225Place of Devices in Current and Future Practice 22711 Acarbose and Alpha Glucosidase Inhibitors 229Miles FisherIntroduction 229Pharmacology 230Glycaemic Efficacy 231Place of Alpha Glucosidase Inhibitors in Current and Future Practice 23712 Glitazones and Glitazars 239Miles FisherIntroduction 239Pharmacology 240Glycaemic Efficacy 241Safety and Side Effects 242Glitazars 252Place of Glitazones and in Current and Future Practice 25313 Other Antidiabetic Drugs 257Maroria Oroko, Andrea Llano, and Miles FisherIntroduction 257Pramlintide 258Colesevelam 260Bromocriptine 262Hydroxychloroquine 264Antiobesity Drugs 265Place of Other Drugs in Current and Future Practice 27014 Future Antidiabetic Drugs 274Emma Johns and Miles FisherIntroduction 274Dual and Triple Agonists 275Imeglimin 288Place of New Antidiabetic Drugs in Future Practice 29115 Guidelines on Antidiabetic Drugs 294Miles Fisher and Russell DrummondIntroduction 295Guidelines on the Use of Antidiabetic Drugs in Type 2 Diabetes 298Guidelines on the Management of Type 1 Diabetes 308Special Patient Groups 311Place of Guidelines in Current and Future Practice 31816 Prescribing Antidiabetic Drugs 322Andrea Llano, Gerry McKay, Frances McManus, Catriona McClements, Joyce McKenzie, and Deborah MorrisonIntroduction 322Therapeutic Inertia 323Polypharmacy 326Nonadherence 329The Patient with Problematic Hypoglycaemia 330Prescribing in Renal Impairment 333Prescribing in Liver Disease 337Prescribing in Cardiovascular Disease 340Prescribing in Pregnancy 347Prescribing in the Young 348Prescribing in the Elderly 349The Patient with Type 1 Diabetes: a Therapeutic Journey (an Illustrative Case) 350The Patient with Type 2 Diabetes: a Therapeutic Journey (an Illustrative Case) 351Future Developments in Prescribing in Diabetes 353Appendix 357Index 359