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Drugs for Diabetes Mellitus

Drugs for Diabetes Mellitus

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Published by GerardLum
Drugs for Diabetes Mellitus
Drugs for Diabetes Mellitus

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Published by: GerardLum on Jun 07, 2010
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05/26/2012

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Drugs for Diabetes MellitusPancreasEndocrine Gland Exocrine Gland
Islet of Langerhans Pancreatic Juice
Produce
Insulin (β cell)Glucagon (α cell)Somatostatin (δ cell)Contain Digestive EnzymesFurther Breakdown Carbohydrates,Protein, Fat in chime
GlucoseHypoglycaemia Hyperglycaemia
Blood Glucose Blood GlucoseHypoglycaemic Shock
Coma
DeathDiabetes Mellitus (DM)
Diabetes Mellitus
↑ Blood Sugar (Glucose)/ HyperglycaemiaDue to Absolute, Relative lack of Insulin (Insulin Resistance)
Chronic ComplicationsMacrovascular
CardiovascularCerebrovascularPeripheral Vascular System
 Microvascular
NephropathyNeuropathyRetinopathy
 TypesType 1
Destruction of Islet β cellsInsulin Dependent DM (IDDM)Juvenile-onset DiabetesChildren, Teenagers, Young AdultsAutoimmunedestruction of pancreatic β cells(produce little, no insulin)Requiresexogenous Insulin (Insulin Injections)
Type 2
Insulin ResistanceLoss of response to InsulinNon-Insulin Dependent Diabetes(NIDDM)Older IndividualsInsulin Deficiency, ResistanceRisk Factors
 
Age
 
Lack of Exercise
 
Obesity
 
Hypertension
 
Dyslipidemia
 
GeneticSigns, Symptoms
 
Dry Mouth
 
Extreme Thirst
 
Frequent Urination
 
Drowsiness
 
Frequent Bed Wetting
 
Stomach Pain
Gestational
Pregnant women who never haddiabetes before↑ Blood Sugar during PregnancyAffects 4% of Pregnant WomenMayPrecede Development Type 2 
Congenital Diabetes
Genetic Defects of Insulin Secretion
Cystic Fibrosis-related DiabetesSteroid Diabetes
Induced by ↑ Dose Glucocorcoids
Blood Glucose LevelsFasting RandomVenous Plasma Glucose
7.0 mmol/L 11.1 mmol/LFasting Test – Most Appropriate to determine blood glucose levels (Diabetes)
Managing Diabetes
DietExerciseMedication – Insulin, Oral Anti-Diabetic Agent
 jslum.com|Medicine   
 
InsulinExogenous Insulin Required in
Gestational DiabetesDiabetes Type 1Diabetes Type 2 (sometimes)
Orally Subcutaneous IV
Insulin isdegraded inGIT(polypeptide) byProteolytic enzymesInjectionsAcute Care settingInsulin Pump
DrugOnset Peak Duration
Length of Time beforeinsulin reachesbloodstream, begin to↓ Blood SugarTime Period whenInsulin is most Effectivein ↓ Blood SugarDuration Insulincontinues to ↓ BloodSugar
Insulin Types, ActionsTypes of Insulin
 
Rapid-Acting Short-Acting Intermediate-Acting Long-ActingExamples
Insulin Lispro (Humalog®)Insulin Aspart (NovoLog®)Regular(Humulin ®) Isophane Insulin (NPH®)Insulin Zinc (Lente®)Insulin Zinc, Extended (Ultralente®)Insulin Glargine (Lantus®)
Onset
25 mins 30 mins 1 hour 1-3 hours 4 6 hours
Peak
30 mins 1 hour 2 -5 hours 6-14 hours 16 24 hours
Duration
2 4 hours 5 10 hours 18 24+ hours 24 28+ hours
Injections/ DayTwo Three Four
MorningMainly used forMore Controlof  DIabetesLateAfternoon  (Mix of Short, Intermediate)
Onset, Duration of ActionAdverse Effects of Injections
Insulin Shock –Hypoglycaemi 
Excess Levels of Insulin in Body
WeakDrowsyConfusedHungryDizzy Loss of Consciousness,Coma 
Insulin Injection DevicesSyringe/ NeedleInsulin Pump/ Refillable
Catheter at the end of the Insulin Pump is inserted through a needleInto theAbdominal FatDosage Instructions – Inserted into pump’s computer(Appropriate amount of Insulin Injected into body,Controlled Manner)
Prefilled Insulin PensInhalable Insulin
Exubera(Withdrawn from market due to lack of acceptance)Powdered form of Recombinant Human InsulinInhaler →Lungs→ Absorbed
Transdermal Insulin
Insulin is too largeto get through the skinPatches using Electrical Currents, Ultrasound waves, Chemicals to helptransport insulin through skin 
 jslum.com|Medicine   

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