Diabetes Mellitus Type 2 and Drug Interactions

Diabetes mellitus type 2 is one of the most common diseases in the elderly, and often requires treatment other than antidiabetic drugs for metabolic control due to associated conditions. The German national clinical practice guidelines provide a wealth of valuable advice that includes drug interactions between antidiabetic drugs, but pharmacokinetic drug interactions are not sufficiently covered. Knowledge about enzymes and transporters related to pharmacokinetics and their substrates, inhibitors and inducers is important in understanding pharmacokinetic-related drug interactions. Antidiabetic drugs hardly evoke any clinically relevant drug interactions on other drugs, whereas pharmacokinetic-related drug interactions often aggravate or reduce the effects of antidiabetic drugs. This overview summarizes known pharmacokinetic-related drug interactions, and also highlights the impact of kidney function on any kind of type 2 diabetes treatment as this not only determines insulin dosing but also the selection and dosing of other antidiabetic drugs. The few known drug interactions for antidiabetic drugs need to be considered for both the introduction of a new drug and its withdrawal.