Structure-Function Elucidation of Flavonoids by Modern Technologies
Dilip Ghosh, Pulok K. Mukherjee in Natural Medicines, 2019
With the increased incidence of diabetes, many synthetic drugs have been established to combat this disease, such as α-glucosidase inhibitors, sulfonylurea, biguanides, thiazolidinediones and meglitinide derivatives. These drugs pose several limitations, including lack of effectiveness, higher cost and various side effects, such as hypoglycaemia, weight gain, oedema, anaemia, congestive heart failure, liver dysfunction and gastrointestinal side effects including abdominal discomfort, bloating, anorexia and diarrhoea (Cheng and Fantus 2005; Gupta et al. 2016). Considering all of the disadvantages and side effects of already established drugs, there is need for more efficient compounds/drugs with lesser side effects. Traditional plant-based medicines are effective, economical and safe with no or lesser side effects. These herbal plants or active phytoconstituents are thus considered to be substitutive and outstanding candidates in combating diabetes (Amiot et al. 2016). As the occurrence of the disease is succeeding unabated, there is a critical need for finding effective natural plants/phytochemicals to develop new competent therapeutics (Sharma et al. 2008; Amiot et al. 2016).
Carbohydrate metabolism
Martin Andrew Crook in Clinical Biochemistry & Metabolic Medicine, 2013
Other oral agents are the thiazolidinediones or ‘glitazones’, for example rosiglitazone and pioglitazone, which activate g-peroxisome proliferator-activated receptors and which can reduce insulin resistance by a number of metabolic pathways, some of which involve increasing the transcription of nuclear proteins that control free fatty acid and tissue glucose uptake. Repaglinide is a meglitinide that increases insulin release from pancreatic β-cells and enhances tissue insulin sensitivity. The incretins are gastrointestinal hormones that increase insulin release from the pancreas after eating, for example glucagon-like peptide (GLP-1) and gastric inhibitory peptide (GIP). They are rapidly inactivated by the enzyme dipeptidyl peptidase-4 (DPP-4). Incretin mimetics such as exenatide or liraglutide or DPP-4 inhibitors such as sitagliptin, vildagliptin or saxagliptin are being used in type 2 diabetes mellitus..
Endocrine drugs*
Bev-Lorraine True, Robert H. Dreisbach in Dreisbach’s HANDBOOK of POISONING, 2001
Insulin and a number of synthetic drugs are used to treat diabetes: Sulfonylureas: acetohexamide (Dymelor), chlorpropamide (Diabinese), glimepiride (Amaryl), glipizide (Glucotrol), glyburide (Diabeta, Glynase, Micronase), tolazamide (Tolinase), tolbutamide (Orinase).Biguanides: metformin (Glucophage).Alpha-glucosidase inhibitors: acarbose (Precose), miglitol (Glyset).Thiazolidinediones: pioglitazone (Actos), rosiglitazone (Avandia).Meglitinide analog: repaglinide (Prandin).
Anti-diabetic and hypolipidemic effects of Cinnamon cassia bark extracts: an in vitro, in vivo, and in silico approach
Published in Archives of Physiology and Biochemistry, 2023
K. Vijayakumar, B. Prasanna, R. L. Rengarajan, A. Rathinam, S. Velayuthaprabhu, A. Vijaya Anand
Diabetes mellitus is one of the leading metabolic disorder, due to the insufficient or lack of insulin or its action (Kumar and Clark 2002). The metabolism of carbohydrates, proteins, and fats are getting affected due to prolonged hyperglycaemia (Lindberg et al.2004). Diabetes mellitus increases the risk of retinopathy (Bearse et al.2004), nephropathy (Huang et al.2002), cardiovascular difficulty (Svensson 2004), and neuropathy (Wallace et al.2002). Indian Council of Medical Research predicts in India, almost 31.7 million people groups are affected by diabetes, which is expanded up to 79.4 million in the year 2030 (Kaveeshwar and Cornwall 2014). The anti-diabetic medications, including sulfonylurea, biguanides, meglitinide analogue, thiazolidine, diones, α-amylase inhibitors, and α-glucosidase inhibitors are generally utilised, which may cause side effects and unfavourable impacts (Meneses et al.2015).
The role of sulfonylureas in the treatment of type 2 diabetes
Published in Expert Opinion on Pharmacotherapy, 2022
Brian Tomlinson, Nivritti Gajanan Patil, Manson Fok, Paul Chan, Christopher Wai Kei Lam
Meglitinide is the non-sulfonylurea carboxamido moiety of glibenclamide, which has hypoglycemia activity by binding to one receptor site and has overall lower binding affinity than glibenclamide [17]. Repaglinide, a benzoic acid derivative of meglitinide, was the first analogue to become available. Nateglinide, a derivative of d-phenylalanine, was subsequently developed and mitiglinide, a 3-phenylpropionic acid derivative, was developed in Japan [18]. These meglitinide or glinide derivatives have more rapid association/dissociation with the target receptor than conventional sulfonylureas and are very effective in promoting early-phase insulin secretion. Their pharmacokinetic properties also result in a short duration of action and their action is more dependent on glucose concentrations and therefore they are useful to attenuate postprandial hyperglycemia and have less risk of hypoglycemia than sulfonylureas but they have to be taken more frequently, usually with each meal [18].
Practical guidance on the initiation, titration, and switching of basal insulins: a narrative review for primary care
Published in Annals of Medicine, 2021
Roopa Mehta, Ronald Goldenberg, Daniel Katselnik, Louis Kuritzky
Any procedure that requires fasting will necessitate insulin adjustment. This is often the case with minor medical and surgical examinations or procedures, such as colonoscopy. On the day before the examination or procedure, patients should be advised to test their FPG four times (before each main meal and at bedtime) and to replace solids with fluids (sugary drinks) with the goal of ingesting 15–30 g of carbohydrates every 1–2 h [46]. If hypoglycemia occurs, the patient should take glucose tablets. Basal insulin should be taken at the usual dose. If dosing twice daily, the evening dose should be reduced to 80% if the evening FPG reading is <180 mg/dL, if the patient has frequent nocturnal hypoglycemia, has a usual FPG in the 72 mg/dL range, or had low blood glucose earlier in the day. Metformin, dipeptidyl peptidase-4 inhibitors, and thiazolidinedione should be taken as normal the day before the procedure, but GLP-1RAs, SGLT2is, sulfonylurea, and meglitinide should be omitted. On the day of the examination or procedure, the patient should be advised to omit other glucose-lowering drugs and take a half dose of basal insulin, take their insulin and glucose meter to the clinic, and aim for an FPG of 145–216 mg/dL. After the procedure, the usual insulin dose can be taken at bedtime and other glucose-lowering agents should not be taken that day. Once the patient is eating again, they can resume the usual doses of basal insulin and other agents [46].
Related Knowledge Centers
- Chronic Kidney Disease
- Metformin
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- Repaglinide
- Sulfonylurea
- Type 2 Diabetes
- Stroke
- Nateglinide
- Mitiglinide
- Hypoglycemia