doiSerbia

The impact of currently used oral antihyperglycemic drugs on dysfunctional adipose tissue

Tomić-Naglić Dragana (Clinical Center Vojvodina, Clinic for endocrinology, diabetes and metabolic disorders, Novi Sad + Faculty of medicine, Novi Sad)
Mitrović Milena (Clinical Center Vojvodina, Clinic for endocrinology, diabetes and metabolic disorders, Novi Sad + Faculty of medicine, Novi Sad)
Novaković-Paro Jovanka (Clinical Center Vojvodina, Clinic for endocrinology, diabetes and metabolic disorders, Novi Sad + Faculty of medicine, Novi Sad)
Pejin Radoslav (Clinical Center Vojvodina, Clinic for endocrinology, diabetes and metabolic disorders, Novi Sad + Faculty of medicine, Novi Sad)
Popović Đorđe S. (Clinical Center Vojvodina, Clinic for endocrinology, diabetes and metabolic disorders, Novi Sad + Faculty of medicine, Novi Sad)
Pejaković Slađana (Clinical Center Vojvodina, Clinic for endocrinology, diabetes and metabolic disorders, Novi Sad)
Srdić-Galić Biljana (Clinical Center Vojvodina, Clinic for endocrinology, diabetes and metabolic disorders, Novi Sad + Faculty of medicine, Novi Sad)
Benc Damir (Clinical Center Vojvodina, Clinic for endocrinology, diabetes and metabolic disorders, Novi Sad + Faculty of medicine, Novi Sad)

Obesity is a disease with pandemic frequency, often accompanied by chronic metabolic and organic complications. Type 2 diabetes mellitus (T2DM) is among the most common metabolic complications of obesity. The first step in the treatment of T2DM is medical nutrition therapy combined with moderate physical activity and with advice to patients to reduce their body weight. Pharmacotherapy starts with metformin, and in the case of inadequate therapeutic response, another antihyperglycemic agent should be added. The most clinical experience exists with sulfonylurea agents, but their use is limited due to high incidence of hypoglycemia and increase in body weight. Based on the fact that dysfunction of adipose tissue can lead to the development of chronic degenerative complications, precise use of drugs with a favorable effect on the functionality of adipose tissue represents an imperative of modern T2DM treatment. Antihyperglycemic drugs of choice in obese individuals are those which cause maturation of adipocytes, improvement of secretion of protective adipokines, and redistribution of fat mass from visceral to subcutaneous depots. Oral antihyperglycemic agents that can affect the functionality of adipose tissue are metformin, SGLT-2 inhibitors, DPP-4 inhibitors, and thiazolidinediones.

Keywords: adipose tissue, adipokines, type 2 diabetes, treatment