An introduction of what is Diabetes Mellitus and one of the most important drug used to treat it: Insulin, it's use, pharmacokinetics, pharmacodynamics, adverse effects and proper uses This presentation was done in around 17 minutes.

1. Diabetes Mellitus and
Insulin
By Imad Nmeir
Supervised by Doc. Lea Saab
University Holy Spirit Kaslik
Faculty of Science

2. Table of content
• Definition
• Type 1
• Type 2
• Metabolic aspect
Diabetes Mellitus
• History
• Types
• Pharmacokinetics
• Timing of injections
• Pharmacodynamics
• Adverse effects
Insulin
• Major hurdle
• Solutions
• Personal opinion
Conclusions
References

3. Diabetes Mellitus

4. Definition
Metabolic
Disorder
High levels of
glucose
Dysfunction
and failure of
various organs

5. Type 1 Diabetes Mellitus: T1DM
Autoimmune Disease β cell destruction
Autoantigen specific
against insulin
Impairment of
glucose homeostasis
Type 1

7. Type 2 Diabetes Mellitus: T2DM
Increase in
insulin
resistance
Compensatory
hyperinsulimenia
Chronic
deficiency in
glucose uptake
Rise in glucose
levels

8. Clinical aspect of Diabetes
Dysfunction of
insulin
Hyperglycemia
High glucose
plasma levels
Lipotoxicity Increase in FFA
Autoimmunity Against β cells Mainly in T1DM
Inflammation
Autoimmunity
and Islet
amyloid
Islet Amyloid
Byproduct of β
cells
Causes problem
in Excess
T2DM
Insulin
resistance
dysfunction in
insulin receptor
T2DM
Incretins
Insulin
regulatory
hormone
Symptoms are
the same

10. Insulin

11. History
Discovered in 1922
Production began in 1923
•Animal based 1930: chemical
modification to prolong
it’s action
1978: first human
recombinant insulin
produced
1982: first human
recombinant utilizing
rDNA technology
1993: first results of the
long term effect of insulin
uptake:
•Modifications to it’s
pharmacokinetics were
implemented
By 1996: first short acting
insulin
2005: further
modifications to insulin
structure were made to
improve it’s profile
2006: first inhaled insulin

12. History: 1993 clinical trial report
Most
important
clinical trial
on insulin to
date
• Was done from 1983 till 1993
• Long term effects of insulin
• Highlighted importance of
rigid daily control of glucose
levels

13. Types:

14. Pharmacokinetics
It’s a protein
Subcutaneous
injections
Can’t be
given in the
same place
twice

15. Timing of injections
It is highly important that the
patient be educated on the
timing of insulin uptake
•Usually 30 minutes before a meal.
•May change depending on the drug on-
set time

16. pharmacodynamic
Increase
plasma glucose
uptake
• In skeletal
muscle, liver, and
adipose tissue
Metabolic
effects:
• Decrease
gluconeogenesis
• Increase
glycogenesis
In the adipose
• Increase fatty
acid production

17. Adverse effects
Hypoglycemia
Weight gain
Allergy, infection,
lipoatrophy
In case of
injection in the
same site more
than once
Rarely:
anaphylaxis

18. Conclusion

19. Major Hurdle
Several injections
per day are
required.

20. Solutions implemented:
Inhaler is
bulky to use
No real
physiological
advantage in
short term use
Withdrawn
from market
in 2008
Inhaled
insulin Allow insulin
injections to
be monitored
Easier
injection
Better control
Insulin
pumps

21. Solutions implemented: Insulin pump

22. Personal opinion
T2DM: the correct
diet and the
correct medication
can cure it
T1DM: Be hopeful,
future research
holds great
promise.

23. References
 Harper’s illustrated biochemistry; Mc Graw Hill Lange
 Alternatively activated macrophages in type 1 and type 2 diabetes; Arlett
Espinosa-Jimenez, Alberto N. Peon, Louis I. Terrazas.
 Diabetes and beta cell functions: from mechanism to evaluation and clinical
implication; Simona Cernea, Minodora Dobreanu
 History of insulin; Celeste C. Quiazone, Issam Sheikh
 DCCT and EDIC: the diabetic control and complications trial and follow up
 Insulin-history, biochemistry, physiology and pharmacology; Shashank R. Joshi,
Rakesh M. Parikh, A.K. Das

24. Thank you for listening