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Unit4

In: Business and Management

Submitted By farishta
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NEWER ANTIDIABETIC DRUGS
A. Sundaram* , C. R. Anand Moses*, S. Ilango*, V. Seshiah** INTRODUCTION The basic defects in Type 2 diabetes consist of (1) Insulin deficiency (2) Insulin resistance and (3) increased hepatic glucose production (HGP) leading to glucotoxicity, beta cell exhaustion and finally beta cell failure. The treatment strategies to overcome these defects are: 1) Modified meal Plan 2) Exercise 3) Blood glucose lowering drugs and 4) Insulin The current oral blood glucose lowering agents and dietary measures only partially correct the multiple metabolic defects in NIDDM with insulin resistance remaining relatively impervious to treatment Hypoglycaemia and secondary failure are common with presently available sulphonylureas and hence the need for newer blood glucose lowering drugs. In case of NIDDM, a successful new drug should correct atleast one of the major underlying metabolic disturbances. i.e. reduce insulin resistance, enhance insulin production and secretion in response to glucose, suppress exessive hepatic glucose production or improve glucose uptake and utilisation in peripheral tissues particularly, skeletal muscle. Within the last few years three new groups of drugs have been identified and they are: a) Alpha glucosidase inhibitors, eg. Acarbose b) Insulin Sensitizer, eg. Troglitazone. c) Insulin secretoguogues, eg. Glimepiride and Repaglinide The following review will discuss each of these groups of drugs in detail. ALPHA-GLUCOSIDASE INHIBITORS In human salivary amylase, pancreatic amylase and alpha-glucosidase are the enzymes involved in the digestion of starch. All complex carbohydrates like starch and sucrose have to be converted to simple carbohydrates in the small intestine by an enzyme 2. Irreversible glucosidase Gasternospermine. inhibitor eg: alpha-glucosidase before absorption. Drugs which inhibit the action of alpha-glucosidase…...

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