Diabetes Medicines Information


Diabetes mellitus is a chronic metabolic disorder, resulting from insulin deficiency, characterized by hyperglycemia, altered metabolism of carbohydrates, protein and lipids, and an increased risk of vascular complications. The insulin deficiency may be absolute or relative, and the metabolic abnormalities lead to the classic symptoms of polyuria (frequent urination), polydipsia (excessive thirst), polyphagia (excessive hunger), and fatigue. Long-term complications of DM include gangrene, proliferative retinopathy, myocardial infarction, polyneuropathy, and uremia. The disordered microcirculation (microangiopathy) underlies the majority of these complications.
(i) Insulin Dependent (Type 1 or juvenile onset; IDDM), and (ii) Noninsulin Dependent (Type II or maturity onset; NIDDM). Type 1 of IDDM usually occurs in non obese persons before the age of 30 years. Circulating insulin is virtually absent, and beta-cells fail to respond to normal stimuli. It is an autoimmune disease of beta-cells.
ORAL HYPOGLYCAEMIC AGENTS: Oral hypoglycemic agents are divided into two classes: i) Sulphonylureas; and (ii) biguanides.
SULPHONYLUREAS: The Sulphonylureas are chemically related to the sulphonamides but they have no antibacterial activity. The oral hypoglycemic do not prevent the cardiovascular complications of DM.
Sulphonylureas: Tolbutamide, Acetohexamide, Tolazamide, Chlorpropamide, Gilbenclamide, Glipzide, Glycuride.

Biguanides : The biguanides differ from the Sulphonylureas in their action. The biguanides do not lower blood glucose levels in normal non-diabetic persons but do so in diabetics, and in the absence of a functioning pancreas. Thus, they lower blood glucose in both types of diabetes mellitus. It must emphasized that the biguanides do not induce clinical hypoglycemia, but potentiate the hypoglycemic action of insulin and Sulphonylureas. They increase the plasma fibrinolytic activity. Phenformin times disintegration (DBI-TD), Metformin.
Thiazolidinedione Derivatives: 
A new class of oral antidiabetics is emerging, and currently undergoing clinical trials. It includes Troglitazone, ciglitazone, and poiglitazone. Their mode of action appears to be by enhancing the target tissue sensitivity to insulin.
Alpha-Glycosidase Inhibitor 
Postprandial hyperglycemia and hyperinsulinaemia produce the long-term complications of DM, namely, nephropathy, retinopathy, and neuropathy.


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