Pancreatic hormone and

antidiabetic drug

1
 Cont,d
• Introduction
• Overveiw of pancreatic hormone
• Diabetes mellitus
• Anti diabetic drug

2
Pancreatic hormone

3
 Diabetes Mellitus
• Diabetes mellitus:A group of chronic metabolic
disorder of carbohydrate,protein and lipid but specially
carbohydrate,secondary to resistance to the action of
insulin,absolute or reletive insufficient insulin secretion.
 Characterized by sustained hyperglycemia:
 polyuria
 polydypsia
 polyphagia

 ketonuria("excessive amount of ketone in the

urine 4
➡Types of DM
1.Type 1 DM(insulin dependent)
2.Type 2 DM(non insulin depend)
3.Gestational DM

5
 3.Gestational Diabetes(GDM)
• Gestational diabetes mellitus (GDM): is a type of
diabetes that develops during pregnancy. It is
characterized by high blood sugar levels that
occur for the first time during pregnancy and
typically resolves after childbirth.
• Glucose intolerance developing during 24 to
28 weeks(2nd and 3rd trimester).
• 97% disappear after delivery
• GDM affects about 2-10% of pregnancies
worldwide.
6
• Hyperglycemia developed because of secretion
of placental hormones, which causes insulin
resistance
• The placenta produces hormones that
help to baby's grow but can also
interfere(resistance) with the mother's
insulin function. When the body cannot
produce or effectively use insulin, glucose
(sugar) builds up in the bloodstream,
leading to high blood sugar levels.
7
 Hormones that produced by placenta are:
 Human placental lactogen(hpL)
 Human chorionic gonadotropin(hcG)
 Estrogen
 Progesterone
 Relaxin
 cortisol
• They can interfere(resist) the action of insulin in
the body.
• This is known as insulin resistance
8
Cont,d

• As the pregnancy progresses, the levels

of these hormones increase, leading to a
decrease in insulin sensitivity.
• This insulin resistance can result in
elevated blood sugar levels and the
development of GDM.

9
 Cont`d..................
• Cause:
Insulin resistance in pregnant women due
mainly to hormonal change.
Family history of diabetes mellitus.
Previous history of GDM.

10
SIGNS AND SYMPOTOMS
– Frequent urination
– Increased thirst
– Fatiuge
– Nause and vomiting
– Weight loss even with increase appetite
– Blurred vision

11
 COMPLICATION
• Complications for the mother may include:
– preeclampsia (high blood pressure during pregnancy)
– cesarean delivery(the delivary of fetus by surgical
incision through abdominal wall and uterus)
– increased risk of developing type 2 diabetes later in
life.
• For the baby, complications may include:
– macrosomia (large birth weight)
– hypoglycemia (low blood sugar) after birth
– respiratory distress syndrome
– jaundice
– increased risk of developing obesity and type 2 12
 Non pharmacology of gestational DM
 Medical nutrition therapy (MNT)
 weight management
 physical activity
 smoking cessation
 Diabetes self-management education and
support

13
 Pharmacology of Gestational DM
 Insulin: is the preferred medication for treating
hyperglycemia in gestational diabetes mellitus.
• it doesn`t cross placenta.
• it promotes the synthesis of glycogen in liver and muscle
• inhibit the breakdown of glycogen(glycogenolysis)
• prevents the production glucose by the liver(gluconeogenesis) .
 Clinical indication:
1.Diabetes mellitus type 1
2.Diabetes mellitus type 2
3.Gestational diabetes
4.Diabetic ketoacidosis(DKA)
 Adverse effect:
1. hypoglycemia
2.allergic reaction 14
3.lipodystrophy
cont,d

• Oral medication such as:

• Biguaide
Metformin
sulfonylureas
Glyburid (glibenclamid)
Glynase
Diabeta
Glimepiride

15
Pharmacology of……………………..
 Metformin: is the widely prescribed biguanide
medication. It is often prescribed when lifestyle
modifications such as dietary changes and
physical activity are not sufficient to control
blood sugar level.
• But it is not first line choice because it cross
placenta
• It has other potential benefit beyond glycemic
control, such as weight loss and improved
cardiovascular outcomes.
16
 Pharmacology of…………………
MOA:
1.educing glucose production in the liver
2.Decreasing intestinal glucose absorption
3. Improving insulin sensitivity in the body`s tissue.
4.Decreasing hepatic gluconeogenesis

17
 Pharmacology of…………..
• Clinical indication :
– Prevention and treatment of T2DM
– For Gestational DM
• Adverse effect:
– GI symptoms (diarrhea,ND,abdominal discomfort,
flatulence)
– Vit. B12 Deficiency
– Lactic acidosis

18
 Pharmacology of…………..
2.Sulfonyureas
A.Glyburid(glibenclamid): is in class of medication called
suifonylureas and works lower blood sugar by causing the
pancreas to produce insulin
 This contain:
 Diabeta
Glimepiride
MOA:
1.interaction with ATP-sensitive potassium channels
2.Inhibition of potassium efflux
3.Calcium influx
4.Increased insulin release 19
Pharmacology of…………..

• Clinical indication :
– Prevention and treatment of T2DM
– For Gestational DM
• Adverse effect:
– Hypoglycemia
– GI effect
– Weight gain
– Allergic reaction
– Skin reaction

20
• GROUP NAME.....................ID.NO
1.ABRAHAM TAMASGEN.....WU1404296
2.FIRHIWOT ABRAHAM........WU1405300
3.GENET ADUGNA................WU1405427
4.RAHEL DEGEFE.................WU1409143
5.SENA TEKELA.....................WU1500407

21
THANK YOU

22