Marina Adel Ibrahim

Faculty SubjectYear

1st Cognosy

PRODUCTION

Marina Adel Ibrahim

Marina Adel Ibrahim

Pharmacy ASU

*A group of metabolic diseases in which a person has high blood sugar, either because the pancreas does not produce enough insulin, or because cells do not respond to the insulin that

is produced .*This high blood sugar produces the classical

symptoms of polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger).

Diabetes mellitus

Marina Adel Ibrahim

 1 Type DM  2 Type DM

*results from the body's failure to produce insulin, and currently requires the person to inject insulin.

*results from insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency.

Marina Adel Ibrahim

* Many of the signs of Type 1 and Type 2 diabetes are similar. In both, there is too much glucose in the blood and not enough in the body cells.

For type 1Common

Signs

For type 2

Marina Adel Ibrahim

For type 1Common

Signs

For type 2

Marina Adel Ibrahim

Common Signs and Symptoms :*Fatigue, constantly tired: Body is inefficient and unable to

use glucose for fuel.*Unexplained weight loss: People are unable to process

many of the calories in the food.*Excessive urination (polyuria): Body tries to get rid of the

extra sugar in the blood by excreting it in the urine.*Excessive thirst (polydipsia): Excess urine as the kidney

spills the excess sugar. body tries to counteract this by sending a signal to the brain to dilute the blood, translated into thirst.

*Excessive eating (polyphagia): If the body is able, it will secrete more insulin in order to try to manage the excessive blood sugar levels and higher insulin levels lead to increased hunger.

*Blurred vision: Frequently present with high blood sugar levels.

Signs

Marina Adel Ibrahim

Common Signs and Symptoms :*Poor wound healing: High blood sugar levels prevent white

blood cells from defending the body against bacteria and also in cleaning up dead tissue and cells, from functioning normally. When these cells do not function properly, wounds take much longer to heal and become infected

more frequently .*Infections: Certain infections, such as frequent yeast

infections of the genitals, skin infections, and frequent urinary tract infections, may result from suppression of the immune system by diabetes and by the presence of

glucose in the tissues, which allows bacteria to grow .*Altered mental status: Agitation, unexplained irritability,

inattention, extreme lethargy, or confusion can all be signs of very high blood sugar.

Signs

Marina Adel Ibrahim

Symptoms of Type1 DM :*Symptoms of type 1 diabetes: are often dramatic and

come on very suddenly.

*Type 1 diabetes is usually recognized in childhood or early adolescence: Often in association with an illness (such as a

virus or urinary tract infection) or injury .

*The extra stress can cause diabetic ketoacidosis:Symptoms of ketoacidosis include nausea and vomiting. Dehydration and often-serious disturbances in blood levels of potassium follow .

Without treatment, ketoacidosis can lead to coma and death.

Signs

Marina Adel Ibrahim

Symptoms of Type2 DM :

*Symptoms of type 2 diabetes: are often subtle and may be attributed to aging or obesity.

*A person may have type 2 diabetes for many years without knowing it: People with type 2 diabetes can

develop hyperglycemic hyperosmolar nonketotic syndrome .

*Type 2 diabetes can be precipitated by steroids and stress: If not properly treated, type 2 diabetes can lead to complications such as blindness, kidney failure, heart disease, and nerve damage.

Signs

Marina Adel Ibrahim

Marina Adel Ibrahim

Marina Adel Ibrahim

Natural Remedies *There has been marked interest in recent

years in the use of plants for the treatment of diabetes.

*More than 400 traditional plant treatments for diabetes mellitus have been recorded, but only a small number of these have received scientific and medical evaluation to assess their efficacy.

Marina Adel Ibrahim

Examples For Drugs Used To Treat Diabetes:1 -Cassia cinnamon:

Marina Adel Ibrahim

Origin :The dried park of Cinnamomum cassia Family Lauraceae.

Active Constituents and Action: *In most cases Type 2 diabetics make enough insulin, it is just not

able to do it's job of shepherding the glucose into the cells properly.*Cinnamomum cassia 's claim to fame is that it makes the cells

more receptive to the available insulin (decreases insulin resistance) .

*Cinnamomum cassia is what is known as an insulin mimetic - in other words a substance that affects the cells in the same way as insulin itself, activating the insulin receptors. So the two substances

work together to get glucose taken up by the cells .*The active ingredient in Cinnamomum cassia was at first thought

to be MHCP but in 2004 Dr Anderson stated that that was incorrect and the real ingredient causing the changes was the water soluble polyphenol type-A polymer.

Marina Adel Ibrahim

2 -Ginger:

Marina Adel Ibrahim

Origin:The Rhizomes of Zingiber officinale Family Zingiberaceae.

Active Constituents and Action: *In type 2 diabetic patients, the capacity of skeletal muscle to

uptake glucose is markedly reduced due to impaired insulin signal transduction and inefficiency of the GLUT4.

*Gingerols (particularly the [6]- and [8]-gingerols) can increase glucose uptake by increasing the surface distribution of the protein GLUT4. When the protein localizes on the surface of muscle cells it allows transport of glucose into cells.

Marina Adel Ibrahim

3 -Fenugreek:

Marina Adel Ibrahim

Origin :The ripe seeds of Trigonella foenum-graecum Family Fabaceae.

Active Constituents and Action: *4-hydroxyisoleucine, isolated from the seeds of the herb, has

shown significant potential as an anti-diabetic agent because it suppressed progression of type 2 diabetes in mice by improving insulin sensitivity and uptake of glucose .

*Saponin compounds namely diosgenin and yamogenin.*Alkaloids consisting mainly of trigonelline.

*Fenugreek contains fiber and pectin, 55 percent soluble fiber. This gel-forming fiber absorbs water as it passes through the gut and swells up, binding with the food. It delays gastric emptying, slows down carbohydrate absorption and inhibits glucose transport.

*Some research also indicates that fenugreek seed may be helpful in preventing complications of diabetes, including eye disease such as retinopathy, when used alone or along with sodium orthovandate.

Marina Adel Ibrahim

4 -Bitter Melon:

Marina Adel Ibrahim

Origin :The fruits of Momordica charantia Family Cucurbitaceae.

Active Constituents and Action: *It has charantin, which has hypoglycemic effect .

*Bitter melon has been found to increase insulin sensitivity.*Other compounds in bitter melon have been found to activate the

AMPK, the protein that regulates glucose uptake (a process which is impaired in diabetics.)

*Bitter melon also contains a lectin that has insulin-like activity due to its nonprotein-specific linking together to insulin receptors. This lectin lowers blood glucose concentrations by acting on peripheral tissues and, similar to insulin's effects in the brain, suppressing appetite. This lectin is likely a major contributor to the hypoglycemic

effect that develops after eating bitter melon .

Marina Adel Ibrahim

5 -Catharanthus:

Marina Adel Ibrahim

Origin :The flowers of Catharanthus roseus L. Fam. Apocyanaceae.

Active Constituents and Action: * Alkaloid : vincristine & vinblastine .

* Acts as an insulin substitute and has 55 active alkaloids. the antihyperglycemic effect of this plant appears to be at least in part, due to extra pancreatic activity, including increased glucose utilization by the liver and muscle (glycolysis), enhanced glucose oxidation through shunt pathway, via activation of G6PDH, and decreased glucose production by depression of glycogenolytic

enzyme .

Marina Adel Ibrahim

6 -Garlic:

Marina Adel Ibrahim

Origin :Allium sativum Linn. Fam. Alliaceae.

Active Constituents and Action: * Contains at least 33 sulfur compounds like aliin,allicin .

*Decreases the concentration of serum lipids, blood glucose and activities of serum enzymes like alkaline phosphatase ,acid phosphatase, lactase dehydrogenase and liver Glucose-6

phosphate .

Marina Adel Ibrahim

7 -Acacia Arabica:

Marina Adel Ibrahim

Origin :Extracted gum of Acacia arabica Fam. Fabaceae.

Active Constituents and Action: *Flavonoids, sterols, triterpenoids, alkaloids , rich in linoleic

acid, oleic acid , hydroxy fatty acids, gallic acid, catechin . *It acts through release of insulin from pancreatic beta cells.

Marina Adel Ibrahim

References*Wikipedia

*Plants and their active constituents-Brazilian Journal of Pharmacognosy.

*Natural medicines from plant source used for therapy of diabetes mellitus: An overview of its pharmacological aspects - Asian Pacific Journal of Tropical Disease.