• Diabetes is a metabolic disorder; it is mainly caused

by dysfunction of the β cells of the pancreas. This in turn leads to

decreased production of the hormone insulin and/or increased
resistance to the action of insulin in the peripheral tissues.
• Diabetes can be categorized into two types:
type 1 and type 2.

TYPE1 (Insulin Dependent Diabetes Mellitus) :-

It is immune mediated or idiopathic diabetes mellitus,
characterized by destruction of beta cells of pancreas by T- cell
mediated immune attack and life span of pancreatic cell is
decreased by one third along with ketoacidosis in body tissues
and fluid.
Type-II or ( Non-insulin Dependent
Diabetes Mellitus) (NIDDM)
Lack of insulin secretion in response to blood glucose levels
demonstrates NIDDM. Reduced insulin sensitivity is
predominant abnormality, leading to hyperglycemia
which can be reversed by drugs improving insulin
sensitivity or reducing glucose production by liver.
2.Symptoms of Diabetes-

Symptoms of Diabetes
The early symtoms of untreated Diabetes are related to
elevated blood suger level and loss of glucose in the
urine .
 Strategy for Treatment of
Diabetes
1.Diabetes mellitus is chronic disease which can not be
cured except of specific situation ,management concentrates
to keeping blood sugar levels. As close to normal as
possible without causing hypoglycemia.

2.Can usually be accomplished with diet ,exercise and use of

appropriate medication . (insulin in the case of type 1
diabetes, oral medication as well as possibly insulin in type
2 Diabetes )
 Insulin Treatment for
Diabetes
1.People with type 1 diabetes cannot make insulin because the beta cells in
their pancreas are damaged or destroyed. Therefore, these people will
need insulin injections to allow their body to process glucose and avoid
complications from hyperglycemia.

2.People with type 2 diabetes do not respond well or are resistant to

insulin. They may need insulin shots to help them better process sugar
and to prevent long-term complications from this disease. Persons with
type 2 diabetes may first be treated with oral medications, along with diet
and exercise. Since type 2 diabetes is a progressive condition, the longer
someone has it, the more likely they will require insulin to maintain blood
sugar levels.

Various types of insulin are used to treat diabetes and include:

Rapid-acting insulin: It starts working approximately 15 minutes after
injection and peaks at approximately 1 hour but continues to work for
two to four hours. This is usually taken before a meal and in addition
to a long-acting insulin.

Short-acting insulin: It starts working approximately 30 minutes

after injection and peaks at approximately 2 to 3 hours but will
continue to work for three to six hours. It is usually given before a
meal and in addition to a long-acting insulin.

Intermediate-acting insulin: It starts working approximately 2 to 4

hours after injection and peaks approximately 4 to 12 hours later and
continues to work for 12-18 hours. It is usually taken twice a day and
in addition to a rapid- or short-acting insulin.

Long-acting insulin: It starts working after several hours after

injection and works for approximately 24 hours. If necessary, it is often
used in combination with rapid- or short-acting insulin.
Disadvantages of
Insulin.

1. Can cause weight gain

2. Can be expensive
3.insulin therapy are like local pain, inconvenience of
multiple injections, insulin edema, lipohypertropy,
insulin allergy, resistance and above all of this are
weight gain .
Allopathic antidiabetic medicines available in marketed
formulation.
DRUG CLASS INDIVIDUAL DRUG
1st Genration
Sulfonylureas 1. tolbutamide
2. chloropropamide
2nd Genration
3. Glipizide
4. glyburide
Meglitinides 1. Nateglinide
2. Repaglinide
Biguanides 1. Metformin
Thiazolidined 1. Pioglitazone
iones (TZDs) 2. Rosiglitazone
Alphaglucosidase 1. Acarbose
inhibitors 2. miglitol
Dipeptidyl Peptidase 1. Sitagliptin
(DPP) IV inhibitors
 SIDE EFFECTS OF ANTI DIABETIC MEDICINES
More common –
•Less common
•Abdominal or stomach discomfort
•Anxiety
•cough or hoarseness •chest discomfort
•cold sweats
•decreased appetite
•coma
•diarrhea •confusion
•fast or shallow breathing •cool, pale skin
•depression
•fever or chills •difficult or labored breathing
•general feeling of discomfort •dizziness
•fast, irregular, pounding, pulse
•lower back or side pain •feeling of warmth
•muscle pain or cramping •headache
•increased hunger
•painful or difficult urination •increased sweating
•sleepiness •nausea
•nervousness
Herbal Drugs for Diabetis
Mellitus.
 Herbal Drugs use in Anti-Diabetes.

1. Gymne sylvestre R.Br (Gurmar

booti)
Family:
Apocynaceae Genus:
Gymnema B.O: G.
sylvestre

Chemical constituents-
Dried leaves contanig: Resin, pararabin,
triterpene glycoside (gymnemic acid 6%),
peptide gurmarin), alkaloids (gymnamine),
lupenol, quercitol, coloring matter and
anthraquinones.
MOA-
There are some possible mechanisms by which the leaves
and especially Gymnemic acids from G. sylvestre
to shows the hypoglycemic effects are -
1. It increases secretion of insulin
2. It promotes regeneration of islet cells.
3.It increases utilization of glucose: It is shown to increase the activities of
enzymes responsible for utilization of glucose by insulin dependent pathways,
an increase in phosphorylase activity, decrease in gluconeogenic enzymes and
sorbitol dehydrogenase and
4. It causes inhibition of glucose absorption from intestine, the exact action
being unknown. It could be involve one or more mechanisms
use of Gymnema-
Gymnema has most important role in Ayurvedic medicine fo r centuries. Its use
has been confined primarily to the management of diabetes mellitus and similar
hypo/hyperglycemic condition
 2. Momordica charantia (Karela)

Family:
Cucurbitaceae
Genus: Momordica
Species: Charantia
Parts are used-
Fruits,seeds

•Chemical onstituents-
The main
constituents of bitter
melon which are
responsible for the
antidiabetic effects are
triterpene
(Momordicin Charantin), steroid, alkaloid, inorganic, lipid, and
phenolic compounds
Pharmacological effect-
Oral administration of fresh fruit juice
(dose, 6 c.c. /kg. body wt.) lowered the
blood sugar level in normal and alloxan
diabetic rabbits.
A p-Insulin, polypeptide from the fruits
and seeds rapidly decreased and
normalized the blood sugar level in rats.

Studies have reported that the compounds

are more effective than the oral
hypoglycemic agent tolbutamide
Uses
Apart from anti-diabetic property, Bitter melon is also
traditionally known for its other medicinal properties such as
anticancer, anti-inflammation, antivirus, and cholesterol
lowering effects
7.Jambul (Syzygium Cumini)
Family:
Myrtaceae.
Family:
Myrtaceae Genus:
Syzygium Species:
cumini

Chemical
constituents-
Jambul seeds contain a glycoside, named Jamboline which
helps in the maintenance of glucose levels as in the normal
limits.

The Jambul fruits also contains natural acids which helps in

Pharmacological study:
It has significantly decreased the levels of blood glucose
and increased glucose tolerance. The hypoglycemic
efficacy was found to be comparable with that of
glibenclamide, a standard hypoglycemic drug.

USES:
It cures many health problems like cardiac, diabetes, ulcer,
diarrohea and liver .
 4. Melia azadirchta
Family: Meliaceae.
Genus: Melia
Species: azadirchta

Chemical
constituents:
Chemical
Constituents Neem
has been found to
possess several
types of chemicals.
Neem seeds mostly
contain the
complex
Neem oil obtained from seeds also shows the presence of these
constituents along with other compounds such as nimbolides,
olichinolide B and azadiradione. The leaves also contain
azadirachtin, meliantrol, salanin, β-sitosterol, stigmasterol and
flavonoids such as nimatone, quercetin, myrecetin and kaempferol.
The bark shows the presence of riimbin, nimbidim and nimbinin
like antiviral agents and margolone and margolonone like
antibacterial principles.

Pharmacological study:
It has significantly decreased the levels of blood glucose and
increased glucose tolerance.

Uses:
Antiseptic,used in rheumatism and skin diseases, anti-
inflammatory,anti bacterial, antipyretic activities have also
been reported