Welcome To The Presentation

Welcome To The
Presentation
Presented by:
Emon Dutta
•ID: M19010606502
Md. Arfatur Rahman
•ID: M19010606516
Md. Shefat Hossain
•ID: M19010606540
Presentation Title
Current Medications for
Diabetes Mellitus
What Is Diabetes?
What Is Diabetes?
A group of diseases characterized by

high levels of blood glucose resulting
from defects in insulin production,
insulin action, or both.
What Is Diabetes?
Body does not make or properly use

insulin:
no insulin production
insufficient insulin production
resistance to insulin’s effect
What Is Diabetes?
No insulin to move glucose from blood

into cells:
 high blood glucose means:
i.fuel loss, cells starve
ii.short and long-term complications
Body function without Diabetes?
Type 1 Diabetes Mellitus
ONSET: relatively quick
SYMPTOMS: increased urination

tiredness
weight loss
increased thirst
hunger
blurred vision
CAUSE: uncertainly, likely both genetic

and environmental factors
Type 2 Diabetes Mellitus
ONSET: in children
variable timeframe
SYMPTOMS: tired, thirsty, hunger,

increased urination
some children show no

symptoms at diagnosis
Type 1 vs Type 2 Diabetes Mellitus
No insulin(Key) means sugar can’t

enter the cell
No insulin (key) means that sugar Insulin (key) cannot unlock the cell
cannot enter the cell. door. Insulin resistance or inability of
body to use insulin.
Rural-urban division among people with
diabetes
Undiagnosed percentage and undiagnosed cases of
diabetes (20-79 years) per region
Criteria for the Diagnosis of
Diabetes
Fasting plasma glucose (FPG)
≥126 mg/dL (7.0 mmol/L)
OR
2-h plasma glucose ≥200 mg/dL
(11.1 mmol/L) during an OGTT
OR
A1C ≥6.5%
OR
Classic diabetes symptoms + random plasma
glucose
≥200 mg/dL (11.1 mmol/L)
. Diabetes is Managed,
But it Does Not Go Away
GOAL:
To maintain target
blood glucose
Diabetes Management 24/7
Constant Juggling:
Insulin/medication
with:
Exercise BG
BG
&
Food intake
BG
Medicaments
Oral Hypoglycemic Drugs: The oral glucose-

lowering drugs are used for management of
type II diabetes mellitus. Conventionally, oral
therapy is indicated in any type II diabetic in
whom diet and exercise fail to achieve
acceptable glycemic control.
Classification of Oral Hypoglycemic drugs
α- Glucosidase Inhibitors
Sulphonylureas:
• Interact with receptors on pancreatic
b-cells to block ATP-sensitive potassium
channels
• Leads to opening of calcium channels
• Leads to the production of insulin
First generation agents
They include the first generation agents

like
 Chlorpropamide,
Tolbutamide
Tolazamide
Second generation agents
The second generation agents like

Glipizide (Glucotrol or Glucotrol XL),
Third generation agents
Third generation agents like

Glimepiride (Amaryl).
Biguanide
• Increase the sensitivity of insulin by
decreasing hepatic gluconeogenesis,
• Increasing skeletal muscle glucose
uptake,
• Reducing plasma triglycerides and LDL-
Cholesterol levels and increasing
peripheral insulin sensitivity
 Metformin
Meglitinides
These agents are short-acting insulin
secretagogues. They act on the ATP
dependent potassium channels in
pancreatic β-cells, allowing opening of
calcium channels and increased insulin
release.
 Repaglinide
 Nateglinide
Thiazolidinedones:
 Also callled "insulin sensitizers" that promote skeletal
muscle glucose uptake.
 Improve insulin sensitivity in muscles and in the
liver,
 Decreasing plasma triglyceride levels, but such
decreases are associated with weight gain and an
increase in LDL-cholesterol levels. They are very
expensive agents
 Rosiglitazone
 Pioglitazone
α-Glucosidase Inhibitors (α-Gis):
α-glucosidase inhibitors, such as Acarbose
(Precose) and Miglitol (Glyset), are indicated as
monotherapy or in combination with sulfonylureas
for management of type II diabetes. These agents
decrease post-prandial glucose levels by inhibiting
the breakdown of complex carbohydrates and delay
the absorption of monosaccharides from the
gastrointestinal tract. They inhibit the action of α-
glucosidase,
Insulin therapy
Insulin is added to an oral agent when glycemic
control is suboptimal at maximal doses of oral
medications. Some diabetologists prefer to initiate
insulin therapy in patients with newly diagnosed
type II diabetes.
Weight gain and hypoglycemia are common side
effects of insulin therapy
Who need insulin medicine
• Type I (insulin dependent) diabetes patients

whose body produces no insulin.
• Type 2 diabetes patients that do not always

produce enough insulin.
Types of insulin
• Regular insulins
• Insulin analogs
• Pre-mixed insulin
Regular insulins
• Human insulin: Humulin® (from E.coli),

Novalin® (from yeast)
• NPH - neutral protamine Hagedorn (NPH),
protamine mixed.
• Lente® insulin / Ultralente® insullin-
zinc added
Drug Induced Diabetes
• Drugs and hormones can impair insulin sensitivity
and reduce insulin action.
• glucocorticoids, phenytoin, thiazides &

interferon's
• Intravenous pentamidine can permanently

destroy pancreatic ß-cells.
Thank You

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Welcome To The

A group of diseases characterized by

Body does not make or properly use

No insulin to move glucose from blood

ONSET: relatively quick

SYMPTOMS: increased urination

CAUSE: uncertainly, likely both genetic

SYMPTOMS: tired, thirsty, hunger,

some children show no

No insulin(Key) means sugar can’t

Oral Hypoglycemic Drugs: The oral glucose-

They include the first generation agents

The second generation agents like

Third generation agents like

• Type I (insulin dependent) diabetes patients

• Type 2 diabetes patients that do not always

• Human insulin: Humulin® (from E.coli),

• glucocorticoids, phenytoin, thiazides &

• Intravenous pentamidine can permanently

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