Diabetes mellites ( DM )

‫داء السكر‬

-:Define
Its chronic metabolic disease characterized by hyperglycemia
due to absolute or relative insulin deficiency
or to cellular resistance to insulin Types of DM

Normal Blood Glucose ( 70 – 110 ) Fasting

Pre-DM ( 110 – 124 ) mg/dl

Diabetic patient > 124 mg/dl

HbA1c
normal…………… <5,7
Pre-DM……….. 5,7 – 6,5
DM ……………. > 6.5
Symptoms of DM
 Treatment of DM

Non pharmacological

pharmacological
Non pharmacological
pharmacological
There is many medication can use for Tx DM depend on type
and blood sugar reading

Anti- Diabetes medication present as

1 Oral hypoglycemic drugs Type 1 DM is treatment only by

insulin

Type 2 DM is treatment by ( OHD ) 1st

and may use insulin if (OHD) not
sufficient

2 Insulin
1 Oral hypoglycemic drugs

Sulfonylurea
OHD
Meglitinides

Biguanides

Glitazones

Alpha glucoside inhibition

 Sulfonylurea
-:MOA
Decrease level of blood sugar by stimulate pancreas to secret insulin

Should be taken with meal to avoid Hypoglycemia

C/I in pregnancy & lactation
May cause weight gain

Glimepiride Amaryl 1 – 2 – 3 – 4 – 6 mg
Gliclazide Dimicron 30 – 60 – 90 – 120 mg
Clinolamide Daonil 5
 Meglitinides

-:MOA
Decrease blood sugar lever by stimulate pancrease to
secret more insulin
These drugs has rapid action and short duration
So used with each meal
May cause hypoglycemia sever
C/I in pregnancy & lactation

Nateglinide Starlix 60 – 120 mg

Repaglinide Novonorm
 Biguanides
-:MOA
Decrease glucose secretion which store in liver ,
decrease glucose absorption by gut
Increase sensitivity of liver & tissue to insulin

Best drug for type 2 DM

May cause gastric upset & weight loss
 Glitazones
-:MOA
Increase insulin effect
Improve insulin resistance

Has slow onset of action may weeks to months

Cause weight gain & retention of body fluid C/I heart disease
Never use in liver disease
Pioglitazone ( Actos )

Rosiglitazone ( Avaglit )
Alpha glucoside inhibition

-:MOA
Help to decrease time of digestion & absorption of Cho
in gut

Dose not cause hypoglycemia if taken only

Should be start by lower dose & increase gradually
Take before meal
May cause bloating and Diarrhea

Acarbose ( Glucobay )