NAME : Ali Hassan
SAP ID : 39643
SUBMITTED TO : Dr Israr
ASSIGNMENT NO 1 :
Define Diabetes Mellitus? Explain treatments of Diabetes
Mellitus with Insulin analogues and other oral glucose
lowering drugs?
Diabetes Mellitus is a group of metabolic disorders characterized by chronic hyperglycemia
(high blood sugar levels) resulting from defects in insulin secretion, insulin action, or both. The
two main types are:
1. Type 1 Diabetes: An autoimmune condition where the pancreas produces little to no
insulin.
2. Type 2 Diabetes: A condition often associated with insulin resistance and relative insulin
deficiency, frequently linked to obesity and lifestyle factors.
Treatments for Diabetes Mellitus
Insulin Analogues
Insulin is crucial for managing both Type 1 and Type 2 diabetes, especially when oral
medications are insufficient. Insulin analogues are modified forms of human insulin designed to
mimic the body’s natural insulin response more closely. They can be classified based on their
onset and duration of action:
1. Rapid-acting Insulin:
o Examples: Lispro (Humalog), Aspart (Novolog), Glulisine (Apidra)
o Onset: 15 minutes
o Peak: 1-2 hours
o Duration: 3-5 hours
2. Short-acting Insulin:
o Example: Regular insulin (Humulin R, Novolin R)
o Onset: 30 minutes
o Peak: 2-4 hours
o Duration: 5-8 hours
3. Intermediate-acting Insulin:
o Example: NPH insulin (Humulin N, Novolin N)
o Onset: 1-3 hours
o Peak: 4-12 hours
o Duration: 10-16 hours
4. Long-acting Insulin:
o Examples: Glargine (Lantus, Toujeo), Detemir (Levemir)
o Onset: 1-2 hours
o Peak: Minimal (steady state)
o Duration: Up to 24 hours
5. Ultra-long-acting Insulin:
o Example: Degludec (Tresiba)
o Onset: 1 hour
o Peak: None
o Duration: Over 24 hours
Oral Glucose Lowering Drugs
Oral medications are primarily used for managing Type 2 diabetes. Various classes of drugs
work through different mechanisms:
1. Biguanides:
o Example: Metformin (Glucophage)
o Mechanism: Reduces hepatic glucose production and improves insulin sensitivity.
o Side Effects: Gastrointestinal issues, risk of lactic acidosis (rare).
2. Sulfonylureas:
o Examples: Glipizide, Glyburide, Glimepiride
o Mechanism: Stimulate insulin secretion from pancreatic beta cells.
o Side Effects: Hypoglycemia, weight gain.
3. Meglitinides:
o Examples: Repaglinide, Nateglinide
o Mechanism: Stimulate rapid insulin secretion in response to meals.
o Side Effects: Hypoglycemia.
4. Thiazolidinediones (TZDs):
o Examples: Pioglitazone, Rosiglitazone
o Mechanism: Improve insulin sensitivity in muscle and fat tissues.
o Side Effects: Weight gain, edema, potential heart issues.
5. DPP-4 Inhibitors:
o Examples: Sitagliptin, Saxagliptin
o Mechanism: Increase incretin levels, which increase insulin release and decrease
glucagon levels.
o Side Effects: Generally well-tolerated, risk of pancreatitis.
6. SGLT2 Inhibitors:
o Examples: Canagliflozin, Dapagliflozin, Empagliflozin
o Mechanism: Promote glucose excretion via urine.
o Side Effects: Genital infections, dehydration, risk of ketoacidosis.
7. GLP-1 Receptor Agonists (though often injectable):
o Examples: Liraglutide, Semaglutide
o Mechanism: Increase insulin secretion, decrease glucagon secretion, and slow
gastric emptying.
o Side Effects: Gastrointestinal issues, potential thyroid tumors.