Drug Classes to Manage Type II Diabetes Mellitus (Managing Type II Diabetes Mellitus - Part 7. Webinar)

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umair@*.com

Aug 30 2023, 5:15 pm

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umair@*.com

Aug 30 2023, 5:15 pm

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Dr. Mobeen presents the approach to managing a type II diabetic patient. Following classes of drugs are presented:

Drugs that increase the levels of inuslin (insulin secretogogues).
- Drugs that work on the beta cells.
- Sulfonylureases.
  - Potassium channel blockade causing deploraization of a beta cell leading to the secretion of insulin.
- Incretins.
  - GLP1
  - GIP
  - Exanatide
Drugs that increase peripheral sensitivity to insulin.
- Metformin
  - First line drug for managing type II diabetes mellitus.
  - Mechanism of action of metformin.
  - Actions of metformin on hepatocyte:
    - AMPK levels increased leading to the reduced cAMP levels. This reduces PKA levels. This leads to increased glycolysis and reduced gluconeogenesis.
    - FFA are reduced leading to increased insulin sensitivity.
    - Improves function of the insulin receptors.
    - Improves glucose transport inside the cell.
- TZDs
  - Work on the lipid cells.
  - Open the genes in lipid and muscle cells leading to increased sensitivity to insulin.
  - LPL receptors are increased in density. Imprving triglyceride levels. Cholestrol levels are not improved.
  - Number of lipid cells increase. Lipogenesis increases. (Not a good effect. However, lipid storage will increase reducing glucose levels temporarily.)
Drugs that increase ejection of the glucose from the gut. That is, reduce its absorption from the gut.
- Alpha glucosidase enzyme's role.
- Function of Acarbose.
- Acarbose binding to alpha glucosidase. Preventing glucose polymer breakdown.
- Diahrrhea, gas, discomfort, abdominal pain dur to increased glucose levels in the large intestine.
Drugs that eject glucose in urine.
- Sodium glucose co transporter type 2 (SGLT2) inhibitors.
- Increased risk of UTIs especially in women.
- Polyuria. Low blood volume leading to thirst and postural hypotension.
Role of diet to reduce intake of glucose.
Role of exercise to increase glucose uptake in the peripheral tissues.

In this lecture, we are going to discuss the following topics:

What are the different ways to manage type 2 diabetes mellitus?
Classes of drugs, that are used to treat type 2 diabetes mellitus.
The four primary mechanisms by which these classes of drugs act.
Administration, dosage, and side effects of these drugs.

Presented by Dr. Mobeen Syed

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