11. Sulfonylureas - Mechanism
ďSUR 1 RECEPTORS
ďDecrease conductance of
ATP sensitive K+ channels
ďDepolarization of beta
cells
ďDecrease glucagon
release
12. 1 st generation
ďChlorpropamide,
Tolbutamide, Tolazamide
ďLonger half-life
ďMore hypoglycemia
ďMore side effects
13. 2 nd generation
ď Type 2 DM of recent onset
ď Reduce both fasting and PP glucose
ď Start at low doses â increase after
1-2 weeks interval
ď Just before a meal â increase insulin
acutely
(With chronic therapy â more
sustained release)
23. ďUsed as supplements with
others in type 2
ďSometimes monotherapy in mild
with diet, exercise
ďâDecreased mortality due to
MI/Strokeâ
ďNON-RESPONDERS â With
low baseline insulin
30. ďRole as adjuvant in obese
diabetics
ďStart at 25 mg evening
ď50-100 mg with each meal
max dose
ďMiglitol â more potent in
inhibiting sucrase
32. NOTE:
ďGradual upward dose
titration
ďAvoid in IBD, gastroparesis
ďIf hypoglycemia from
other treatments occurs
while taking these
agents, use glucose
41. RESVERATROL
ďNatural compound found in
grape skin
ďFood sensors activated in
shortage of food like IGF &
TOR
ďMimic effect of dietary
restriction
ďIncrease longeivity
42. SALSALATE
Wall Street Journal Health Blog
research on using Salsalate to
prevent or treat type II
diabetes:
ďFasting glucose levels of those
who took salsalate declined 13%
compared with those who took
a placebo