Causes and pathogenesis of type 2 diabetes mellitus and classification of oral hypoglycemic drugs

1. INTRODUCTION TO TYPE 2
DIABETES MELLITUS
&
CLASSIFICATION OF OHAs
Devaansh Syngle
2nd MBBS
SGRRIM&HS

2. DIABETES MELLITUS
• Metabolic disorder characterised by :
Hyperglycemia
Glycosuria
Hyperlipidemia
NegaFve
nitrogen balance
Ketonaemia

3. TYPE 2 DIABETES MELLITUS
• Noninsulin-dependent diabetes mellitus
• Maturity onset diabetes mellitus
• Moderate reducFon in B cell mass
• Insulin- high, low or normal
• No anF B cell anFbody
• GeneFc predisposiFon
• Over 90% cases

4. CAUSES
• Abnormality in gluco receptors of beta cells so
that they respond at higher glucose
concentraFon or relaFve beta cell deficiency
• Reduced sensiFvity of peripheral Fssues to
insulin : reducFon in number of insulin
receptors, down regulaFon of insulin
receptors
• Excess of hypercalcaemic hormones such as
glucagon/obesity

5. CAUSES

6. PATHOGENESIS
Causes of Diabetes. Jennifer Jiang, Dr. Shuchismita Du7a
h7ps://pdb101.rcsb.org/global-health/diabetes-mellitus/about/causes-of-diabetes

7. CLASSIFICATION OF OHAs
Enhance
insulin
secreFon
Overcome
insulin
resistance
Miscellaneous
anFdiabeFc
drugs
According to mechanism of acFon

8. ENHANCE INSULIN SECRETION
Sulfonylureas
• First generaFon: Tolbutaminde
• Second generaFon: Glipezide, Glimepride
MegliFnides
• Nateglinide
• Repaglinide
GLP 1 receptor
agonists
• ExenaFde
• LiragluFde
DPP 4
Inhibitors
• SitaglipFn AloglipFn VildaglipFn
• SaxaglipFn LiraglipFn

9. OVERCOME INSULIN RESISTANCE
• Meormin
Biguanides
• Pioglitazone Thiazolidinedi
ones

10. MISCELLANEOUS ANTIDIABETIC
DRUGS
• Dapagliflozine • BromocripFne
• PramlinFde • Acarbose
• Voglibose
α –
Glucosidase
inhibitors
Amylin
analogues
SGLT 2
Inhibitors
Dopamine
D2 receptor
agonist