ANTIDIABETIC DRUGS

BY

Dr. SAMINATHAN KAYAROHANAM

M.PHARM, PhD, M.B.A, PhD

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 TABLE OF CONTENT
S.NO TITLE PAGE

1 OVERVIEW OF DIABETES MELLITUS 4-8

2 PATHOPHYSIOLOGY DIABETES MELLITUS 9

3 TYPES OF DIABETES 10

4 WHO DIABETES DIAGNOSTIC CRITERIA 18

5 MOST SIGNIFICANT SYMPTOMS OF DIABETES 19,20

6 CLASSIFICATION AND MECHANISM OF ANTIDIABETIC 21,22

DRUG
7 CLASSIFICATION AND MECHANISAM OF INSULLIN 23-25

8 DURATION OF ACTION OF SOME ORAL HYPOGLYCEMIC 26

AGENTS
9 SOME ADVERSE EFFECTS OBSERVED WITH ORAL 27
HYPOGLYCEMIC AGENTS
10 ADVERSE EFFECTS OBSERVED WITH INSULIN 28

Dr.K.Saminathan.M.Pharm, PhD, M.B.A, Ph.D

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LEARNING OUTCOMES

1. Able to understand the diabetes mellitus

2. Able to demonstrate the diagnosis and symptom of diabetes
mellitus
3. Able to classified the different types of diabetes mellitus
4. Able to the list the classification of drug used to treat diabetes
mellitus
5. Able to demonstrate the various mechanism of anti-diabetes
drugs
6. Able to understand some side effects of anti-diabetes drugs

Dr.K.Saminathan.M.Pharm, PhD, M.B.A, Ph.D 3

 1. OVERVIEW OF DIABETES MELLITUS
 Diabetes mellitus is derived from the Greek word diabetes meaningsiphon
- to pass through and the Latin word mellitus meaning honeyed or sweet.
This is because in diabetes excess sugar is found in blood as well as the
urine.
 Diabetes mellitus (DM), commonly referred to as diabetes, is a group of
metabolic diseases in which there are high blood sugar levels over a
prolonged period. Symptoms of high blood sugar (hyperglycaemia) include
frequent urination, increased thirst, and increased hunger.
 Diabetes is a chronic disease, which occurs when the pancreas does not
produce enough insulin, or when the body cannot effectively use the insulin
it produces. This leads to an increased concentration of glucose in the blood
 Type 1 diabetes (previously known as insulin-dependent or childhood-onset
diabetes) is characterized by a lack of insulin production.
 Type 2 diabetes (formerly called non-insulin-dependent or adult-onset
diabetes) is caused by the body’s ineffective use of insulin. It often results
from excess body weight and physical inactivity.
 Gestational diabetes is hyperglycaemia that is first recognized during
pregnancy.
Dr.K.Saminathan.M.Pharm, PhD, M.B.A, Ph.D 4
 WHO 10 FACTS OF DIABETES MELLITUS
1. About 347 million people worldwide have diabetes
There is an emerging global epidemic of diabetes that can be traced back to
rapid increases in overweight, including obesity and physical inactivity.
2. Diabetes is predicted to become the 7th leading cause of death in the
world by the year 2030.Total deaths from diabetes are projected to rise by
more than 50% in the next 10 years.
3. There are two major forms of diabetes
Type 1 diabetes is characterized by a lack of insulin production and type 2
diabetes results from the body's ineffective use of insulin.
4. A third type of diabetes is gestational diabetes
This type is characterized by hyperglycaemia, or raised blood sugar, with values
above normal but below those diagnostic of diabetes, occurring during
pregnancy. Women with gestational diabetes are at an increased risk of
complications during pregnancy and at delivery. They are also at increased risk
of type 2 diabetes in the future.
5. Type 2 diabetes is much more common than type 1 diabetes
Type 2 accounts for around 90% of all diabetes worldwide. Reports of type 2
diabetes in children – previously rare – have increased worldwide. In some
countries, it accounts for almost half of newly diagnosed cases in children and
adolescents. Dr.K.Saminathan.M.Pharm, PhD, M.B.A, Ph.D 5
6. Cardiovascular disease is responsible for between 50% and 80% of
deaths in people with diabetes
Diabetes has become one of the major causes of premature illness and death
in most countries, mainly through the increased risk of cardiovascular disease
(CVD).
7. In 2012 diabetes was the direct cause of 1.5 million deaths.
8. 80% of diabetes deaths occur in low- and middle-income countries
In developed countries most people with diabetes are above the age of
retirement, whereas in developing countries those most frequently affected are
aged between 35 and 64.
9. Diabetes is a leading cause of blindness, amputation and kidney failure
Lack of awareness about diabetes, combined with insufficient access to health
services and essential medicines, can lead to complications such as blindness,
amputation and kidney failure.

10. Type 2 diabetes can be prevented

Thirty minutes of moderate-intensity physical activity on most days and a
healthy diet can drastically reduce the risk of developing type 2 diabetes. Type
1 diabetes cannot be prevented.
Dr.K.Saminathan.M.Pharm, PhD, M.B.A, Ph.D 6
Dr.K.Saminathan.M.Pharm, PhD, M.B.A, Ph.D 7
INTERNATIONAL DIABETES FEDERATION
ESTIMATION IN 2015

Dr.K.Saminathan.M.Pharm, PhD, M.B.A, Ph.D 8

2. PATHOPHYSIOLOGY DIABETES MELLITUS

Dr.K.Saminathan.M.Pharm, PhD, M.B.A, Ph.D 9

 TYPES OF DIABETES .3

SECONDARY DIABETES
(OCCUR ONLY IF THERE IS AN
UNDERLYING DISEASE) E,G,: GESTATIONAL
CUSHING DISEASE, DIABETES
PANCREATECTOMY, GROWTH
HORMONE TUMOR.

TYPE I TYPE II
(FORMALLY IDDM OR (FORMALLY NIDDM
JUVENILE) OR ADULT)

Dr.K.Saminathan.M.Pharm, PhD, M.B.A, Ph.D 10

 TYPE 1 DIABETES
A chronic condition in which the pancreas produces little or no insulin.

Dr.K.Saminathan.M.Pharm, PhD, M.B.A, Ph.D 11

 TYPE 2 DIABETES
A chronic condition that affects the way the body processes blood sugar (glucose).

Dr.K.Saminathan.M.Pharm, PhD, M.B.A, Ph.D 12

 GESTATIONAL DIABETES
A form of high blood sugar affecting pregnant women.

Dr.K.Saminathan.M.Pharm, PhD, M.B.A, Ph.D 13

DIFFERENT BETWEEN TYPE1 AND 2

Dr.K.Saminathan.M.Pharm, PhD, M.B.A, Ph.D 14

DIFFERENT BETWEEN TYPE1 AND 2

Dr.K.Saminathan.M.Pharm, PhD, M.B.A, Ph.D 15

DIFFERENT BETWEEN TYPE1 AND 2

Dr.K.Saminathan.M.Pharm, PhD, M.B.A, Ph.D 16

COMPARISON OF TYPE 1 AND 2 DIABETES

Dr.K.Saminathan.M.Pharm, PhD, M.B.A, Ph.D 17

 4. WHO DIABETES DIAGNOSTIC CRITERIA

•Fasting plasma glucose level ≥ 7.0 mmol/l (126 mg/dl)

•Plasma glucose ≥ 11.1 mmol/l (200 mg/dl) two hours after a 75 g oral glucose
load as in a glucose tolerance test
•Symptoms of high blood sugar and casual plasma glucose ≥ 11.1 mmol/l
(200 mg/dl)
•Glycated hemoglobin (HbA1C) ≥ 48 mmol/mol (≥ 6.5 DCCT %)
Dr.K.Saminathan.M.Pharm, PhD, M.B.A, Ph.D 18
 5. MOST SIGNIFICANT SYMPTOMS OF DIABETES

Dr.K.Saminathan.M.Pharm, PhD, M.B.A, Ph.D 19

 MOST SIGNIFICANT SYMPTOMS OF DIABETES

Dr.K.Saminathan.M.Pharm, PhD, M.B.A, Ph.D 20

6.CLASSIFICATION AND MECHANISM OF ANTIDIABETIC DRUG

Dr.K.Saminathan.M.Pharm, PhD, M.B.A, Ph.D 21

SUMMARY OF ORAL AGENTS USED TO TREAT DIABETES

Dr.K.Saminathan.M.Pharm, PhD, M.B.A, Ph.D 22

7.CLASSIFICATION AND MECHANISAM OF INSULLIN

Dr.K.Saminathan.M.Pharm, PhD, M.B.A, Ph.D 23

7. MECHANISAM OF INSULLIN

Dr.K.Saminathan.M.Pharm, PhD, M.B.A, Ph.D 24

INJECTION LOCATION OF INSULLIN

Dr.K.Saminathan.M.Pharm, PhD, M.B.A, Ph.D 25

8. DURATION OF ACTION OF SOME ORAL
HYPOGLYCEMIC AGENTS

Dr.K.Saminathan.M.Pharm, PhD, M.B.A, Ph.D 26

9. SOME ADVERSE EFFECTS OBSERVED WITH ORAL
HYPOGLYCEMIC AGENTS

Dr.K.Saminathan.M.Pharm, PhD, M.B.A, Ph.D 27

10. ADVERSE EFFECTS OBSERVED WITH INSULIN

Dr.K.Saminathan.M.Pharm, PhD, M.B.A, Ph.D 28

THANK YOU FOR YOUR ATTENTION
AND ANY QUESTION?

Dr.K.Saminathan.M.Pharm, PhD, M.B.A, Ph.D 29