DIABETES: EPIDEMOLOGY, PATHOPHYSIOLOGY AND DRUG THERAPY

Diabetes and its different types is an age-old disease for clinicians since centuries. Many aspects of Diabetes needs to be explored with respect to physiological actions of insulin and the various clinical features of this disease such as tissue complication, since this is life style disease, so proper treatment in relation to diet and anti diabetic agents is emphasized. In the present review attempts have been made to understand various aspects of diabetes in relation with its cause, epidemiology, pathophysiology, site and mechanism of action for anti diabetic agents diet, treatment, recent innovation and scope for future research.

DIABETES: EPIDEMOLOGY, PATHOPHYSIOLOGY AND DRUG THERAPY

 Sumeet Dwivedi 1, Shanti Bhushan Mishra 2 and Shashi Alok 3

1, Chordia Institute of Pharmacy, Indore (M.P.)

2, Vinayaka Mission’s College of Pharmacy, Salem (T.N.)

3, I.E.S.College of Pharmacy Bhopal (M.P.)

For Correspondence

Shanti Bhushan Mishra

Vinayaka Mission’s College of Pharmacy,

Salem (T.N.)

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INTRODUCTION

Diabetes and its different types is an age-old disease for clinicians since centuries. Many aspects of Diabetes needs to be explored with respect to physiological actions of insulin and the various clinical features of this disease such as tissue complication, since this is life style disease, so proper treatment in relation to diet and anti diabetic agents is emphasized. In the present review attempts have been made to understand various aspects of diabetes in relation with its cause, epidemiology, pathophysiology, site and mechanism of action for anti diabetic agents diet, treatment, recent innovation and scope for future research.

Diabetes mellitus is a group of syndrome. These syndromes are characterised by hyperglycemia, changed metabolism of lipids, proteins and carbohydrates. Further an increased risk of complication from vascular disease is seen. Hyperglycemia (increase in blood glucosein the body)is a condition in which blood glucose level is high and there is diminished action of insulineither because of decrease in the circulatory concentration of insulin(insulin dificiency)or due to a decrease in their response of peripheral tissueto insulin(insulin resistance). These abnormalities give use to altered metabolism of lipids, carbohydrate and amino acids. All these effects produce Hyperglycemia. Diabetes mellitus may arise occasionally from any disease, which results in extensively destruction of pancreatic islets. e.g.pancreatitis, certain drugs , iron over load, (hemochromatosis), tumors, certain acquired or genetic endrocrinopathiesand surgical excision.Diabetes give rise to long term complication in blood vessels, kidney, eyes, and nerves. These result in major causes of morbidity and death from diabetes. This discovery is attributed to Banting and Best during the early decades of 20th century. (Banting et al..1992). They obtained a pancreatic extracts that was effective in decreasing in concentration of blood glucose in diabetic dogs. Then stable extracts were prepared during that era patients in many parts of North America were treated with insulin from porcine and bovine sources.In present time, recombinant DNA technology has made use of human insulin for therapy,(American Diabetes Association 2004).