Euglucon
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Diabetes Mellitus Is Due To A Disorder Of Carbohydrate, protein And Lipid Metabolism As A Result Of An Absolute Or Deficiency In Metabolically Active Insulin.
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Euglucon
- 15. REFERENCE VALUES CONDITION FBS RBS LEVEL AT 120 mg NORMAL BELOW 115 BELOW 200 BELOW 140 IMPAIRED 115-139 ABOVE 200 140-199 DM ABOVE 140 ABOVE 200 ABOVE 200
- 17. HbA1c
- 19. PILLARS FOR THE DIABETIC TREATMENT DIABETIC THERAPY PHYSICAL ACTIVITY DIET EUGLUCON MEDICAL TREAMENT DIABETIC INSTRUCTION + SELF-MONITORING
- 35. MODE OF ACTION OF EUGLUCON ATP dependent K+ channels VDCC Ca++ CHANNEL Ca++ ACTIVATED CHANNEL Ca++ RESTING CELL K+
- 36. MODE OF ACTION OF EUGLUCON ATP dependent K+ channels VDCC Ca++ CHANNEL Ca++ ACTIVATED CHANNEL Ca++ DEPOLARIZATION K+ INSULIN SECRETION CA++
- 37. MODE OF ACTION OF EUGLUCON ATP dependent K+ channels VDCC Ca++ CHANNEL Ca++ ACTIVATED CHANNEL Ca++ REPOLARIZATION K+ - +
- 44. EUGLUCON Dosage Administration Administration scheme Daily Dose To Be Taken ½ - 1 - 2 - 2 1
- 47. THANK YOU
Editor's Notes
- Presenter’s Notes Metformin is absorbed along the entire gastrointestinal mucosa and improves peripheral and hepatic sensitivity to insulin. This results in increased uptake of glucose by peripheral tissues and decreased hepatic glucose production. It is not stored in the liver and it is excreted in the urine. It does not stimulate insulin production or release from the pancreas and therefore does not cause hypoglycemia. It is the treatment of choice in patients who are overweight.
- Presenter’s Notes Renal disease is the only absolute contra-indication to metformin and serum creatinine should be checked routinely. Gastrointestinal disturbances may include anorexia, nausea, diarrhea and a metallic taste. Lactic acidosis can be caused by excessive alcohol and symptoms include nausea, vomiting & diarrhea. Metformin is taken with meals to decrease gastrointestinal effects.
- Presenter’s Notes Sulphonyureas stimulate insulin secretion by increasing pancreatic beta cell responsiveness to glucose. All people taking Sulphonylureas should receive information about the prevention and treatment of hypoglycemia. Glipizide is a potent but shorter acting OHA. Must be given before meals or it loses 40 % efficacy. Metabolism occurs mainly in the liver. It is contra-indicated in severe renal or hepatic failure. Gliclazide restores the diminished first phase of insulin secretion that is common in type 2 diabetes. It is absorbed along the gastrointestinal tract. The liver is the probable site of metabolism. Glibenclamide is a strong and long acting OHA. Should be used in caution in the elderly. Hypoglycemia may be severe, prolonged and fatal. Tolbutamide is the drug of choice in renal disease. It is relatively short acting in comparison to other Sulphonylureas. Contra-indicated in severe renal or hepatic impairment.
- Presenter’s Notes Sulphonyureas can be used in conjunction with a biguanide. This is due to the different modes of action egg metformin and localized. There is no value in using two different types of Sulphonylureas as they do not complement each other egg localized and glipizide.
- Presenter’s notes All Sulphonylureas can cause hypoglycemia and this risk increases with age and impaired renal function. Hypoglycemia is more common with longer acting sulphonylurea egg chloropropramide and glibenclamide. Weight gain can occur due to increased insulin production.
- Presenter’s notes Used if other oral agents are ineffective. It can be used in conjunction with metformin and sulphonylurea. The action depends on inhibition of intestinal enzymes involved in the digestion of some carbohydrates and thereby reduces the post prandial rise in blood glucose levels. Precautions and side effects : gastrointestinal: flatulence, abdominal pain and distention does not produce hypoglycaemia when used alone need to treat hypoglycaemia, with quick acting glucose.
- Presenter’s notes
- Presenter’s Notes Use: Type 2 diabetes (as monotherapy or with metformin). Repaglinide is a novel short-acting oral hypoglycaemic agent structurally unrelated to the sulphonylurea drugs. It lowers blood glucose levels acutely by stimulating the release of insulin from the pancreas, an effect which is dependent upon functioning beta cells in the pancreas. Note: Meal related dosing means a person only needs to take this medication when eating a meal.
- Presenter’s Notes Like other oral hypoglycaemic agents (sulphonylureas) repaginate is capable of causing hypoglycaemia. People with impaired renal or hepatic function may be exposed to higher concentrations of repaginate than would occur with the usual doses prescribed for people with normal function. Therefore, a more conservative dose titration with longer titration intervals should be considered. The safety of repaginate during pregnancy has not been established.
- Presenter’s Notes Rezulin is currently only to be used as adjunct therapy with insulin. It is the first medication released from this class. It is absorbed within 2-3 hours of ingestion. It should be taken with food to increase absorption. Half life of 16-34 hours.
- Presenter’s Notes Rare cases of idiosyncratic hepatocellular injury have been reported and so regular monitoring is essential.