Anti diabetIc drugs

learning objectives




· describe the main strategies used by drugs to lower blood glucose levels


· list the main classes of anti-diabetic drugs

· describe M . O -
A of the main classes of anti-diabetic drugs

·
give examples of anti-diabetic drugs




to lower blood glucose levels
strategies




1 . decrease
glucose absorption

2 . Increase glucose excretion in the urine


. increase
3 insulin secretion



4 :

give insulin and insulin analogues

.
s Increase responsiveness/sensitivity




main classes of antidiabetic drugs




1. Insulin and insulin I and 2
analogues] type

.
2
Biguanides (metformin




!
. K-ATP
3 inhibitor


mimetics diabetes
4 Glp-1 .


Type 2




s .
DPP-4 inhibitor


6. thiazolidinediones


7 .
SGLT-2 inhibitor




1. Insulin and insulin analogues




Insulin :




·
protein composed of 2 chains >
-
chain A and B




·
can be degraded by the Gl
system

· subcutaneous administration


be recombinant bacteria
· can DNA
technology from or yeast

, Insulin M O . . A




insulin analogues


shortest onset and duration of action
>
-


· same M . O.A as insulin



·
different onset and duration of action




duration
>
- longest
·
Rapid acting insulins : Lispro of action



·
short acting insulins :
regular insulin



· intermediate insulins : NPH



·
long acting insulins :
glargine




why are they so different ?




To develop an insulin that acts rapidly (goes to blood) : To develop an insulin that acts even longer :




· more the equilibrium towards the monomer · more the equilibrium towards insulin complexes/ precipitates

· insulin lispro-insulin with altered amino acid requence ·
glargine - insulin with altered AA
sequence >
-
forms precipitates

that are
slowly diluted to monomers



To develop an insulin that acts longer :

· more the equilibrium towards insulin complexes/ precipitates

· Intermediate action (NPK) - insulin with added protamine and line