Posts tagged Mellitus

To compare the role of glibenclamide and pioglitazone drug in type 11 non-insulin-dependent diabetes mellitus patients. Authors: Raj Kumar Chohan, Ghulam Rasool Mashori, Ghulam Rasool Bhurgri, Shamim-u-Rehman, Mustafa DahriGhulam, anise-u-Rehman. Introduction: –

To compare the role of glibenclamide and pioglitazone drug in type 11 non-insulin-dependent diabetes mellitus patients.

Authors: Raj Kumar Chohan, Ghulam Rasool Mashori, Ghulam Rasool Bhurgri, Shamim-u-Rehman, Mustafa DahriGhulam, anise-u-Rehman.

Introduction: –

Diabetes comes from the Greek word for “siphon” What is the first member and means for many of urine is made. TRM “mellitus” comes from a Laton word “fulfilled”, the “honey” and was used because the appropriation was sweet urine (Wheeler, 2004)

Diabetic ketaocidosis is a life threatening condition that some data hospitalization and treatment. The recognition of this condition is almost important as even small delays impact on survival (Nattrass, 2006 may have). Insulin-induced hypoglycemia in part episodes in patients with diabetes. Probably the most important factor for the prescription of insulin-treated patients achieving the goals required to prevent diabetic complications, glucose. The incidence of hypoglycemia reflects the current inadequancy Mathod of insulin delievery the OT cause inappropriately high insulin concentration, particularly some individuals after eating food at night blindness, and even more important risk factor for heart disease and stroke

(Heller, 2003).

TYPES OF Diabète MELLITUSTYPE 1 diabetes mellitus (IDDM): Type I diabetes occurs in children of all ages, both sexes and all athenic groups. Type 1 diabetes usually occurs through mechanisms. It is most common metabolic condition in children and adolescents (Bui, 2004). Type1diabetes is by immunologically mediated destruction of pancreatic B-cells characterized by insulin deficiency. This leads to a common biochemical endpoint of the risk of hyperglycemia and ketoacidosis, but the clinical presentaion varies greatly depending on the speed and the degree of B-cell failure (Lambert & Bingley. 2005). Type II diabetes mellitus (NIDDM):

TYPES OF DIABETES

Type 1 diabetes mellitus (IDDM):

Type II diabetes mellitus (NIDDM):

Type II diabetes is a complex metabolic disorder associated with these B-cell dysfunction and with varying degrees of insulin resistance primary pathogenic factors of insulin resistance leads to type 2 diabetes and decreased insulin secretion, resulting from changes by the liver, skeletal muscle and pancreatic B-cells (Charles & Clark, 1996).



Gestational diabetes mellitus DIABETUS: women who develop glucose intolerance in late pregnancy and women with previously diagnosed diabetes.

Gestational diabetes DIABETUS MELLITUS

Women who develop glucose intolerance, in late pregnancy, and women with previously diagnosed diabetes.

SECONDARY DIABETUS mellitus:

SECONDARY DIABETUS mellitus:

Secondary diabetes due to diseases of the pancreas and endocrime system, genetic disorders, or exposure to chemical agents.

Type – I diabetes, formerly known as insluin diabetes mellitus (IDDM), by the destruction of pancreatic beta cells produced marked that inslulin

Type – I diabetes, formerly known as insulin dependent diabetes mellitus (IDDM) is known to produce marked by the destruction of the beta cells of the pancreas that produce insulin. Type 1 diabetes usually occures in children and young adults, but can it occures at any age. (Anderson et al in 2007).

Type-11 diabetes is not just uprward. A pancreas that does not make enough insulin. Liver, that release too much glucose, muscle cells, which do not take easily into glucose. (Carren, 2008)

Many genetic factors are involved in the development of diabetes. Because of the new genetic method to identify all researchers door closers cadidate gene for both non-insulin dependent and insulin-dependent diabetes (Bernhard, 1995).

Women who had gestational diabetes were more likely to develop type 11diabetes itself. Pergnant women with diabetes are more disadvantaged group. You need more intensive prenatal care and close monitoring of blood glucose, blood pressure and weight. (Jawed2006)

Overweight children, the progression of childhood obesity into adulthood should be developed with the early complications, including associated IgpG2 diabetes and cardiovascular diseases. Type diabetes is the most common clinical form of diabetes accountingforabout 90% of all cases it is currently the world epidemic. Type 11diabetes mellitus by endogenous infectious use of insulin is caused, it is often results from obesity and physical inactivity (WHO, 2007).



PREVALACES & IINCIDENCE:

PREVALACES & IINCIDENCE

Diabetes mellitus increases with age, in 200 of the prevalence of diabetes was estimated to be to 0. 19% Persons <20 years old and 8 6% in persons> 20 years old. It applies mellitus as geographical variation in the incidence of both type 1 and type 11 diabetes. Scavandinvian has the highest incidence of type 1 diabetes mellitus in Finland, e. g, the incidence of 35/100, 000 € per year in the Pacific a much lower price in Japan and China, the incidence has 1 to 3 / 100, 00 per year of type 1 diabetes mellitus, Northern Europe and the United States share an intermediate rate (8to17/100, 000 per year). The prevalence of type 11 diabetic mellitus is highest in certain Pacific Iceland, intermediate in countries such as India and the United States, and relatively low in Russia and China. This variability is likely due to genetic, beharioral and environmental factors (Power 2005). Diabettes mellitus prevalence is also among the different ethnic groups in a given country, it is usually directly applicable ethnic groups have their prevalence with age and increased more than 5% of people aged more than 65 years, diabetes mellitus (David Owerback 1988). The World Wide prevalence of diabetes mellitus has increased in the last two decades. expected, the prevalence of type11 diabettes mellitus, type 11 diabetes mellitus is more common in Hispanics Native America, Africa, America, and Asians, Pacific Islanders than in non-Hispanic whites, the incidence is essentially the same in women and men in all population groups . Type 11 diabetes is becoming more common as people live longer, and the prevalence of diabetes increases with age also seen more frequently than before in young people, in conjunction with the rise of obesity in children prevalenceof although type11 diabetes are still countries with the estimated here, but the cases of diabetes in 2000and 2030th

Rank Country

2000 individuals with diabetes Country (milloin)

Country

People at diabtes 2030 (in millions)

India

31st 7

India

79th 47

China

20th 8

China

42nd 3

USA

17th 7

USA

30th 3

Indonesia

8th 4

Indonesia

21st 3

Japan

6th 8

Pakistan

13th 9

Pakistan

5th 2

Brazil

11th 3

Russian Federation

4th 6

Bangladesh

11th 1

Brazil

4th 6

Japan

8th 9

Italy

4th 3

Philippines

7th 8

Bangladesh

3rd 2

Egypt

6th 7

(Wareham & FOROUHI 2oo6)



Drug treatment of diabetic mellitus:

Drug treatment of diabetic MELLITUS

Biguanides lower blood sugar, they increase glucose uptake and use it in skeletal muscle by reducing insulin resistance and reduce hepatic glucose production (gluconeogenesis). Lower blood sugar, as bars MEASUREMENT reduced low and very low MEASUREMENT lipoproteins (LDL and VLDL) or. Metformin has a half life of about three hours and is excreted unchanged in urine. Clinically in type 2 diabetes who are overweight and who is not used metformin treatment with diet alone. Side effects are dose related gastrointestinal disturbances produced e. g. loss of appetite, diarrhea, nausea, lactic acidosis, a rare but potentially fatal toxic effects. (Dale, 2003).

The improvement of insulin sensitivity by activating certain genes involved in fat and carbohydrate metabolism and synthesis Rosigilitazone Piogiltazone currently registered. Thiazolidinediones. Thiazolidinediones do not cause hypoglycemia when used alone, although they are usually taken in combination with sulfonylureas.

incouraging Some studies thaiazolidiniones have very favorable effects on the heart, produces cholestrol including reduction of blood pressure and improvement in triglycerides and cholestrol levels, including increasing HDL levels, good. You can also block a molecule called 11 Best HSCs that can play an important role in metabolic syndrome and diabetes type11. A study that rosiglitazone may even improve sugessted beta cell function and to preventing the progression of diabetes. Anemia, weight gain, increased risk of fluid buildup can worson heart failure. Troglitazone, was withdrawn after a few reports of heart failure. Liver failure abd death. Current Thiazoldinediones don not seem to have the same effect is on the liver, although there were a few reports of liver damage.

is controversial in patients with dietry failur the choice of a sulfonylurea or insulin therapy and empric benefit of insulin therapy are the studies, the improvement of post-receptor marks reported diagnosis after intensive short-term therapy in untreated diabetes mellitus type 2 (Scarlett et al, 1984) Sulfonylureas classified into two groups, or generations for their efficacy, duration, drug interactions, side effects profiles. Sulfonylureas enhance insulin action in cells in culture and stimulate the synthesis of glucose transporters (Jacobs et al 1998). A sulphonylurea drug should normally be the insulin secretagogue of choice, NICE (National Institute for Clinical Excellence) recommends also that a generic drug should be perscribed (Scsade et al1998).

RESEARCH DESIGN and material and methods:

RESEARCH DESIGN and material and methods:

This study was in the deprtment the Pharmacololgy and Therapeutics, Basic Medical Science Institute, Jinnah Postgraduate Medical Centre, Karachi under the supervision carried out kind od DRR: GhulamRsool Mashori, associate professors and head of the Department of Pharmacology and Therapeutics in colloboration with the Medical Department Unit111 Filters and Clinic, Medical Department, JPMC, Karachi.

Seventy NIDDM (Type II) diabetic patients were initially in the study from the Filter Clinic / Outpatient Medical Unit III out and diabetic clinic. Of these 60 patients were diabetic associated in the whole period of study remaining 10 patients were dropped because of poor comlpiance or change in residential areas instead. All patients were divided into two main groups, groupies and those in group II patients in this study were selected according to the inclusion and exclusion criteria.



Inclusion criteria:

Inclusion criteria



EXCLUSION CRIRERIA:

EXCLUSION CRIRERIA

MATERIAL:

MATERIAL:

DRUGS

DRUGS

Tab:Daonil 5 mg (Aventis Pharma)

Drug Category: sulphonylurea.

Generic Name: glyburide.

MFGLIC: None. FB-000,007th 000 220

MFG Date :0-06

EXP date :7-10

Lot No: B230

Tab: Pioz (Hilton Pharm) PvtLTd.

Tab: 15mg Poizer

Drug Category: Thaiazolinedione.

Generic Name: pioglitazone hydrochloride.

MFG LIC: O. Registration No. 000 136. 03 270

MFG Date :3-06

EXP date :3-o9

Lot No: 6287

Tab: Poizer (Hilton Pharma) Pvt Ltd.

PARAMETERS:

Fasting blood sugar (FBS).

Random Blood Sugar (RBS).

Weight.

Keywords: Diabetes mellitus, non-insulin diabetes mellitus, insulin diabetes mellitus depedent, Daonil, poizer, insulin.

RESULTS:

RESULTS:

Table 1

Table 1

Weight and blood sugar levels observed on baseline day 0

In group 1 and group11

Group 1

Group 11

Pioglitazone, n = 27

Glibenclamide n = 33

Weight

63rd 37

+ Second 25

¯

62nd 7

+ 15th 56

¯

Fasting blood glucose

172nd 7

+ 13th 32

¯

188th 42

+ 12th o5

¯

Random Blood Sugar

285th 11

+ 15th 532

¯

284th 18

+ 17th 07

¯

All values are expressed in mean ± SEM.

Figure-1 Weight and blood glucose observed at baseline (Day-O)

Table No. shpwing the weight (bw) and blood sugar (msg/dl0 levels, which is observed at baseline (day 0) in both groups 9group: 1 & group11)

Group: 1 Weight (Kg’s) Mean + SEM) 63 37 ± 2 25 fasting 172nd 7 ± 13th 32, and Random

Blood sugar 285th 11 ± 15 32



Group: 11 Weight (KG’s0 (mean ± SEM) 62 7 ± 1 56 fasting (42 ± 12 05 mg/dl0 188th, 284th Random blood glucose 18 ± 17th 03

Group: 11

Figure 2: Display of weight and blood glucose levels observed baseline (day 0) in Group 1 and Group 11 9 kg in weight) is their average values 63rd 37.62. 7, in fasting blood glucose (mg / dl) is located at 172nd 71, 188 42 Random blood sugar (mg / dl) is 285th 11 & 284th 18th

TABLE: 2

Group1 Peroidic surveillance in all parameters

Goup1 (pioglitazone) n = 27

P-value

Day-0

Day-45

Day-90

Day-0to45

Day 45-90

Weight

63rd 37

± 2 25

63rd 63

± 2 26

63rd 63

± 2 23

> 0. 05

(NS)

> 0. 05

(NS)

Fasting blood glucose

172nd 7

± 13th 32

165th 04

± 8th 98

153rd 37

± 7 59

> 0. 05

(NS)

0th 05

(NS)

Random Blood Sugar

285th 11

± 15 32

279th 78

± 13th 63

255th 56

± 12 65

> 0. 05

(NS)

> 0. 05

(NS)

All values are expressed in Mean±SEM . (NS) Non significant.

Table No: 2



Table No: 2

Showing the regular observations in all parameters in group 1 (piogiltazone) (n +27) P. weight value (0th day 0 to day 45)> 05 (NS). Fasting blood glucose> 0 05 (NS) Random blood glucose> 0 05 (NS) P. weight day 90 values> 0 05 (N. S), FBS> 0 05 (N. S) 7RBS> 0 05 (N. S) did not significantly

Figure 2 displays the regular monitoring in all parameters in group 1 on day 45 and day day0-90. Average in weight (kg) 63 37.63. 26.63. 63, FBS (mg / dl) 172 7165th 04 153. 37, RBS (mg / dl) 285 11 279. 78 255. 56th

TABLE NO 3

Group11 Peroidic Observation in all parameters

Group 11 (glibenclamide)

N = 33

P-value

Day-0

Day-45

Day-90

Day 0-45

Day 45-90

Weight

62nd 7

± 1 56

65th 64

± 2 10

64th 55

± 1 92

> 0 05 (NS)

0th 05 (NS0

Fasting blood glucose

188th 42

± 12 05

168th 45

± 10 99

140th 06

± 5 68

> 0 05 (NS)

> 0 05 (S)

Random blood sugar

284th 18

± 17th 03

220th 12

± 13th 39

170th 94

± 5 80

<0 005 (MS)

0th 002 (MS0

(S) was significantly (MS), moderately significant

All values are expressed as mean ± SEM.

Table No3:

Table No3:

Showing the regular monitoring of all parameters in goup: 11, groups: 11 with drugs (glibenclamide), none of the patients (n = 33). It’s P-value at day 0 to day 45> by weight 0th 05 (NS), FBS> 0 05 (N. S) RBS <0 005 (MS) <0 01 - DAY AND DAY 45-90 wt> 0 05 (NS) FBS (0 05) RBS <0 002 (M. S0 significantly moderate.



Figure 3: Shwing regular observations in all parameters in group 11 weight 62nd 7.65. 64.64. 55, FBS (mg / dl) 188 42 168. 45 140th 2006, RBS (mg / dl) 284 18 220th 12, 170 94 (day 0-day 45-90).

DISCUSSION:

DISCUSSION:

In Denmark, Beck-Nielsenet al, Skillman TG (1981) published studies that demonstrate building he glibenclamide increased number of receptors on the monocytes of patients with type 11 diabetes mellitus. Some patients were treated with a diet and in the second generation cobination sulfonyureas As agents. The number of insulin receptors in all patients before and after treatment were measured. Intrvenous glucose test shows the sustained insulin secretion afterthe starting point of drug therapy impairent. However those patients who were on drug pioglitazone of insulin secretion were obtained some results in the impairment in early drug development drug therapy. Clinical observations suggest that the second-generation sulfonylureas is its effect through potentiation of insulin-secreting insulin stimulators of other primary drug release exercise.

According to the study of WilliamC Dukworth et al (1972), AFTRS, chronic treatment with sulfonylureas is well documented that plasma insulin levels were lowered in response to oral glucose load. This seemingly occures although glucose tolerance improved in the course of treatment, levels of this study clearly states that to study the support.

The result above 11 correlated with the research group of Bonnie & Kimmel (2005) produced the same results as FBS reduced from baseline, and at the end of the study with a whole 23rd 44% discount, while the results showed at the end of the study peroid p-values were (p <0.001).

Even Michael Alvarsson et al (2003) conducted a similar type of study and found, and general changes in the exchange of 22 11% FBS and 40 88% in RBS at the end of the study were p-value (p <0 001).

But a study conducted by (Stone & Brown (2003) didnot our results correspond to the parameters of the FBS and observers, a reduction of 26. 22%.

CONCLUSION:

CONCLUSION:

In light of the discussion of the study is obiovus glibenclamide was more effective, more tolerable and safer than pioglitzone in a short period. Diabetes mellitus is a chronic disease to extend for a lifetime. Poor community can afford to go on the basis of marketing the drug in Pakistan to diabetes patients easily, and the purchase cost, in fact, most people buy it from a pharmacy without a dr’s perscription, because to know your pharmacist and patient, both on this disease. Like dispirin as an analgesic, it is a famous anti-diabetes drug in our countries over other antidiabetic agents.

Refernce:

Refernce: