1
Metabolic disorder characterized by hyperglycemia, glycosuria, ketonemia and negative nitrogen balance
Responsible for morbidity, not only in the developed countries but is gradually reaching epidemic proportions in the developing countries too
With the increased prevalence of obesity in the general population, especially in young adults, the prevalence of diabetes is also on the rise, hence diabetes has been redefined as ‘diabesity’ or ‘obesity dependent diabetes mellitus
As per International Diabetes Federation [IDF] Diabetes Atlas, 285 million people worldwide now suffer from diabetes
If the current rate of growth continues unchecked number is expected to exceed 435 million in 2030
DIABETES MELLITUS
2
Number of Cases with diabetes (20-79 years)
S. No. Country/Territory 2010(Millions)
2030(Millions)
1 India 50.8 87
2 China 43.2 62.6
3 USA 26.8 36.0
4 Russian Federation 9.6 10.3
5 Brazil 7.6 12.7
6 Germany 7.5 -
7 Pakistan 7.1 13.8
8 Japan 7.1 -
9 Indonesia 7.0 12.0
10 Mexico 6.8 11.9
3
Universal symbol for diabetes
BLUE CIRCLE
“World Diabetes day was introduced in 1991 and is celebrated every year on November 14”. The day was
chosen to honor Frederick Banting (November 14, which is also his birthday), who along with Charles Best, first
conceived the idea that led to the discovery of insulin in 1921.
4
TYPE 1 DIABETES MELLITUS (T1DM)
TYPE 2 DIABETES MELLITUS (T2DM)
GESTATIONAL DIABETES MELLITUS
Diabetes Mellitus
5
TYPE 1 DIABETES MELLITUS (T1DM)
T1DM which was previously encompassed by the terms
insulin-dependent diabetes, type 1 diabetes, or juvenile-
onset diabetes
Accounts for only 5–10% of the cases
Cellular-mediated autoimmune destruction of the β-
cells of the pancreas
6
TYPE 2 DIABETES MELLITUS (T2DM)
T2DM previously referred to as non–insulin dependent
diabetes, type 2 diabetes, or adult-onset diabetes
Accounts for approximately 90–95% of diabetes cases
The risk of developing T2DM increases with age,
obesity, and lack of physical activity
7
GESTATIONAL DIABETES
8
Complications of Diabetes Mellitus
Diabetes
Mellitus
Retinopathy
(26%)
Nephropathy
(5%)
Cardiovascular
Disorders
(17%)
Neuropathy
(28%)
Peripheral
Vascular Disorders
(6%)
Cerebrovascular
Disorders
(1%)
9
10
11
12
NORMAL GLUCOSE UPTAKE
13
T1DM
14
T2DM
15
Type-2 Diabetes Mellitus
16
DIAGNOSIS OF DIABETES MELLITUS
Fasting plasma glucose test (FPG;>126 mg/dl)
Oral glucose tolerance test (OGTT; >200 mg/dl 2 hr after
glucose challenge) glycation of hemoglobin A (HbA1c levels).8
HbA1c has been considered as the gold standard for glycemic
control monitoring.
In general, every percentage point drop in HbA1c reduces
the risk of microvascular complications by 40%. Other tests that are relevant for tracking disease progression
include fasting insulin to glucose ratios (insulin sensitivity) and lipid levels
17
Current drug therapies used for the management of T2DM
Class of drug Drugs Role
Sulfonylureas
1st generation
2nd generation
3rd generation
Acetohexamide, Chlorpropamide,
Tolbutamide, TolazamideInsulin secretagogues
Glibenclamide, Glyburide,
Glipizide Insulin secretagogues
Glimepiride Insulin secretagogues
Meglitinides(Glinides)
Repaglinide, Nateglinide Insulin secretagogues
Biguanides Metformin, PhenforminInsulin sensitizers
Thiazolidinediones(PPAR γ agonists; Glitazones)
Rosiglitazone, Pioglitazone,Insulin sensitizers
Gliptins(DPP-1V inhibitors)
Sitagliptin, Saxagliptin Insulin secretagogues
18
New Targets For The Management of T2DM
Target Role
Glycogen Synthase Kinase-3 (GSK-3) Inhibitors Activation of glycogen synthase
PPAR α/γ dual agonist Insulin sensitizers
Na+ glucose co-transporter (SGLT) inhibitors Inhibits renal glucose reabsorption from urine
HGO Inhibitors Insulin sensitizers & decrease insulin resistance
β3- Adrenoreceptor Agonist Decreases food consumption
Retinoid X receptor Controls lipid and carbohydrate metabolism
Protein Tyrosine Phosphatase 1B (PTP 1B) inhibitors
Prevents dephosphorylation of activated insulin receptor
19
Algorithm for the treatment of diabetes
THANKS
20
Top Related