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Table 5 Key mechanisms of antihyperglycaemic agents

From: Understanding glycaemic control and current approaches for screening antidiabetic natural products from evidence-based medicinal plants

Mechanism Function References
Delay gastric emptying Slows the passage of food from the stomach into the small intestine thereby slowing the absorption of glucose
Usually achieved via the activation of the GLP1 receptor, or the inhibition of DPP-4
[118, 119]
Enzyme inhibition Inhibition of carbohydrate digesting enzymes (e.g. alpha-amylase and alpha-glucosidase) slows release of glucose from digested food
Inhibition of enzymes involved in hepatic glucose metabolism (e.g. glucose-6-phosphatase) or reduces hepatic glucose output
Insulin secretagogue activity Stimulates insulin secretion from pancreatic β-cells [82]
Insulin-like/insulin sensitizing activity Enhances glucose uptake by target tissue by stimulating the cell surface expression of GLUT transporters (liver, adipose tissue, and skeletal muscle) [84]
Reduce intestinal glucose uptake Reduce absorption of glucose from digested food and into the blood stream either through direct inhibition of enterocyte SGLT-1 or GLUT-2 transporter proteins [123]
Reduce glucose reabsorption in the kidney Increases the amount of glucose excreted in urine by inhibiting SGLT-2 proteins in the kidneys which prevents the reabsorption of glucose into the blood stream [50,51,52]