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Pancreatic Hormones & Antidiabetic Drugs

Pancreatic Hormones & Antidiabetic Drugs. By S. Bohlooli, PhD Pharmacology Department School of Medicine, Ardabil University of Medical Sciences. Pancreatic islet cells and their secretory products. Diabeted mellitus. Two major type of diabetes mellitus Type I Type II

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Pancreatic Hormones & Antidiabetic Drugs

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  1. Pancreatic Hormones & Antidiabetic Drugs By S. Bohlooli, PhD Pharmacology Department School of Medicine, Ardabil University of Medical Sciences

  2. Pancreatic islet cells and their secretory products

  3. Diabeted mellitus • Two major type of diabetes mellitus • Type I • Type II • Both require careful monitoring of: • Diet, fasting, postprandial blood glucose • Hemoglobin A1c,

  4. Insulin • Physiology • Proinsulin: 86 amino acid • C-peptide: 31 amino acid • Effects • Liver • Skeletal muscle • Adipose tissue

  5. Structure of human proinsulin

  6. One model of control of insulin release from the pancreatic B cell

  7. Glucose transporters.

  8. Schematic diagram of the insulin receptor

  9. Insulin promotes synthesis

  10. Endocrine effects of insulin (1)

  11. Endocrine effects of insulin (2)

  12. Endocrine effects of insulin (3)

  13. Insulin preparation • Rapid-acting • Short-acting • Intermediate-acting • Long-acting • Insulin delivery systems

  14. Extent and duration of action of various types of insulin

  15. Hazards of insulin use • Hypoglycemia • Insulin induced immunologic complication

  16. Non Insulin antidiabetic drugs • Insulin secretagogues • Biguanide metformin • Thiazolidinediones • Alpha-glucosidase inhibitors

  17. Regulation of insulin release

  18. Insulin secretagogues • Group drugs: • Sulfunylureas: tolbutamide, chlorpropamide, glyburide, glipizide, glimepride • Mechanism of action • Closure of potassium channel • Toxicity • Hypoglycemia, allergic reactions • Weight gain

  19. Insulin secretagogues: Sulfonylureas

  20. Insulin secretagogues: Sulfonylureas • First-Generation Sulfonylureas • Tolbutamide, Chlorpropamide, Tolazamide • Second-Generation Sulfonylureas • Glyburide, Glipizide, Glimepiride

  21. Insulin secretagogues: Meglitinides

  22. Biguanides: metformin • Mechanism of action • Inhibit gluconeogenesis • Induction of glucose uptake in periphery • Slowing the absorption of glucose • Reduction of glucagon level • Toxicity • Gastrointestinal distress • Lactic acid in some patiets

  23. Thiazolidinediones • Group drugs: • rosiglitazone, pioglitazone • Mechanism of action • Increase target tissue sensivity • Activating: peroxisome proliferator-activated receptor-gamma nuclear receptor (PPAR- receptor) • Toxicity • Fluid retention, MI, bone fracture • Liver enzyme inducers

  24. Thiazolidinediones

  25. Alpha glucosidase inhibitors:acarbose, miglitol • Mechanism of action • Inhibit -glucosidase • Toxicity • Flatulence, diarrhea, abdominal pain

  26. Alpha glucosidase inhibitors

  27. Miscellaneous • Paramlitide • Exenatide • Sitagliptin

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