Tiêu đề 25. HYPOGLYCEMIC AGENTS.pdf ✅

PHARMD GURU Page 1 INTRODUCTION: Diabetes is the seventh leading cause of death. Diabetes is the condition in which blood glucose (sugar) levels rise higher than normal. Our body needs glucose (from food) to make energy. Insulin is a chemical produced and released by the pancreas, which helps the body to utilize glucose. It acts like a key that opens the body cells for glucose to enter so that it can be used for energy production. When cells do not take up glucose, it overflows and floods the blood system, referred to as high blood sugar or hyperglycemia. Diabetes is a progressive disease that gradually “wears out” critical body functions, including nerves, vision, muscles and vital body organs, such as the liver and pancreas. Untreated diabetes can lead to limb amputation, blindness, fatty liver disease, kidney disease and a variety of cardiovascular diseases, as well as premature, preventable death. TYPES OF DIABETES: TYPE-1: DIABETES OR INSULIN-DEPENDENT DIABETES (CONGENITAL) As people with type-1 diabetes need insulin for survival, this type of diabetes is called as insulin-dependent diabetes mellitus or juvenile-onset diabetes. It may account for 5-10 % of all diagnosed cases of diabetes. Type-1 diabetes results from absolute lack of insulin. It is of a sudden onset and can develop at any age but usually occurs before the age of 30, and especially in childhood. The causes of this are when the pancreas cannot produce insulin. Risk factors associated with type-1 diabetes are less than for type-2 diabetes, but autoimmune, genetic, and environmental factors are involved in the development of this type of diabetes. TYPE-2: DIABETES OR INSULIN RESISTANCE DIABETES (PREVENTABLE): Type-2 diabetes is also called as insulin resistance diabetes or non-insulin- dependent diabetes mellitus or adult-onset diabetes. It may account for about 90- HYPOGLYCEMIC AGENTS

PHARMD GURU Page 3  Slow to healing of cuts and wound  More infections than usual Nausea, vomiting, or stomach pains may accompany some of these symptoms in the abrupt onset of insulin-dependent diabetes. PREVENTION AND TREATMENT FOR TYPE-2 DIABETES: Physical activity can significantly reduce the risk of developing type-2 diabetes. Treatment typically includes diet control, exercise, blood glucose testing, and in some cases, oral medication and/or insulin. INSULIN AND ITS PREPARATIONS: Insulin was the first identified in 1921 by Banting and Best. It is essential for normal carbohydrate, protein, and fat metabolism. Insulin is a hormone synthesized in the pancreas by beta cells. These cells are located in a part of the pancreas called the “islets”. Human insulin or insulin analogs are generally used to treat type-1 diabetes as there is a loss of the beta cells. The human insulin does not come from humans, but has the same “make-up” as human insulin. It is produced by bacteria or by yeast using genetic engineering i.e. recombinant DNA techniques. The human gene, which codes for the insulin protein was cloned (copied) and then put inside of bacteria or yeast. A number of operations were performed on this gene to make the bacteria or yeast to constantly make insulin. The analog insulin has slight changes that make their activity resemble normal insulin activity. BIOSYNTHESIS OF INSULIN: Insulin is synthesized in the beta cells of pancreas in the form of pre- proinsulin as a precursor and gene for insulin. Within a minute after synthesis it is discharged into endoplasmic reticulum where it is cleaved into proinsulin by proteolytic enzymes. Proinsulin link with A and B chains through a C-peptide chain (connecting chain) and then transported by microvesicles to the Golgi apparatus. Proinsulin is then released in vesicles. Conversion of proinsulin to insulin continues in maturing granules through the action of pro-hormone convertase-2, pro-hormone convertase-3 and carboxy peptidase.