Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Diabetes mellitus, or simply diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the pancreas does not produce enough insulin, or because cells do not respond to the insulin that is produced. The term diabetes is from the Greek word diabaineine refers a tubular organ that take-in or expels water-excessive urine discharges. In 1675, Thomas Willis added mellitus (means ―honey in Latin) to the word diabetes and called it as Diabetes Mellitus, which refers to too much of sweet taste urine. This high blood sugar produces the classical symptoms of polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger). Diabetes mellitus is a disorder of glucose regulation, characterized by an accumulating glucose concentration in the blood (Wilkins and Atanasov, 1996).
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Diabetes a slient killer
1. Diabetes Mellitus:
“the silent killer which kills part by part of
our life”
1
Dr. Vir Vikram Sharma
Prof. & Head
(Department of Pharmacology)
Genesis Institute of Dental
Science & Research
Mobile: +919878903414
Email: virvikram76@gmail.com
2. WHAT IS DIABETES ????
Diabetes means too much sugar (glucose) in the blood.
Sugar comes from the foods we eat like bread, cereals, pasta, rice, fruit,
starchy vegetables and dairy items.
Sugar is used by the body for energy— to run, skip, play and swim.
Insulin is a hormone that is made in the pancreas and works like a key to
a door – insulin opens the door of the cells of our body allowing the sugar
to go from the bloodstream into the cells where it is then used for energy.
If there is not enough insulin or if the insulin can’t open the door to the
cell, the sugar levels rise in the blood and diabetes occurs.
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3. PREVELANCE OF DIABETES
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According to WHO:
The number of people with diabetes has risen from 108 million in 1980 to
422 million in 2014 and may rise to 629 million in 2045. At the same
time, a further 352 million people with impaired glucose tolerance are at
high risk of developing diabetes (Paul and Alberti, 2016; IDF Diabetes
Atlas, 2017).
There is an urgency for greater action to improve diabetes outcomes and
reduce the global burden of diabetes now affecting more than 425 million
people, of which one-third are people older than 65 years (IDF Diabetes
Atlas, 2017).
The global prevalence of diabetes among adults over 18 years of age has
risen from 4.7% to 8.5% .
WHO projects that diabetes will be the 7th leading cause of death in
2030.
4. 4
The above data affirms an abrupt rise in diabetes and forecast
for doubling the current numbers in many regions by 2045.
6. 6
2017 2045
Rank Country/ territory Number of people with
diabetes
Rank Country/ territory Number of people
with diabetes
1 China 114.4 million 1 India 134.3 million
2 India 72.9 million 2 China 119.8 million
3 United States 30.2 million 3 United States 35.6million
4 Brazil 12.5 million 4 Mexico 21.8 million
5 Mexico 12.0 million 5 Brazil 20.3 million
6 Indonesia 10.3 million 6 Egypt 16.7million
7 Russian Federation 8.5 million 7 Indonesia 16.7million
8 Egypt 8.2million 8 Pakistan 16.1 million
9 Germany 7.5 million 9 Bangladesh 13.7 million
10 Pakistan 7.5 million 10 Turkey 11.2 million
Top ten countries for number of people with diabetes , 2017 and 2045
(IDF Diabetes Atlas - 8th Edition)
12. WHAT IS INSULIN
Insulin is released from pancreatic beta
cell in response to high blood glucose
level and promotes the uptake of
glucose by different cells of the body.
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21. DIABETIC RETINOPATHY
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Diabetic retinopathy caused by damage to the blood vessels of the light-
sensitive tissue at the back of the eye (retina).
At first, diabetic retinopathy may cause no symptoms or only mild
vision problems.
22. DIABETIC ENCEPHALOPATHY
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Damage to the brain caused by diabetes. It can induce an altered mental
state, cognitive decline, changes in personality, memory lapses, or severe
impairment like dementia, and even seizures.
23. DIABETIC CARDIOMYOPATHY
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Signs and symptoms:
Shortness of breath or trouble breathing, especially with physical
exertion.
Fatigue, Swelling in the ankles, feet, legs, abdomen and veins in
the neck.
24. DIABESITY (DIABETES+OBESITY)
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•It has long been known that overweight and obesity are predictors of
type 2 diabetes, and obesity is indeed an insulin resistant state.
•Particular people with central obesity, where fat collects around the
waist, are most likely to become insulin resistant.
27. MANAGEMENT OF DIABETES MELLITUS
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• Follow the diet, exercise, and treatment schedule as
prescribes by your physician.
• Don’t take some herbal or other types of alternate
medicine without consulting the medical expert.
29. MANAGEMENT OF DIABETES MELLITUS
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• Health practitioners can help in early
detection and monitoring of Diabetes by
checking your blood glucose.
• They can give you an advice regarding the
best use of medicines, whether to take
before/after or with food, its possible side
effects, storage, etc.
• They can also help you to take your
medicines as per the treatment schedule.
32. Now Question Rise here how we
test
Anti-Diabetic Drugs ????
Solution is Pre clinical and clinical
studies
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ANIMAL
MODELS
33. ANIMAL MODEL OF
DIABETES
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I Chemically induced
1. Streptozocin (STZ) induced diabetes
2. Alloxan induced diabetes
3. Goldthioglucose induced diabetes
II Surgically induced diabetes
III Genetically induced diabetic animal model
IV Virus induced diabetic animal model
35. Role of Herbs in the treatment of Diabetic
35
Fenugreek seeds
Jambul fruit
Bael
Garlic
Aloe
Vasica
Oscimum sanctum
Jambolana
Momordica charantia
Ocimum sanctum
Phyllanthus amarus
Pterocarpus
marsupium
Tinospora cordifolia
Trigonella foenum
graecum
Butea monospermapalasa
Camellia sinensis
Capparis deciduas
Caesalpinia bonducella
Sagarghota
Coccinia indica
Emblica officinalis
Dhatriphala
Eugenia uniflora
Eniocostema
Ficus bengalenesis
Gymnema sylvestre
Hibiscus rosa-sinensis
Ipomoea batatas
Murraya koenigii
Musa sapientum
Phaseolus vulgaris Hulga
Scoparia dulcis
Swertia chirayita chirata
Syzygium alternifolium
Terminalia chebula
Tinospora crispa
Vinca rosea
Withania somnifera
Artemisia
Areca catechu
Beta vulgaris
Boerhavia
Bombax ceiba
Annona squamosa sugar
These drugs are claimed to be devoid of any adverse effect(s)
however, these claims of efficacy and safety have not been
documented by controlled clinical trials.
36. Momordica charantica:
Botanical Name : Momordica Charantia
Family Name : Cucurbitaceae
Common Name : Bitter Melon, Bitter Gourd, Balsam Pear,
Balsam Apple, Melega Saga
Part Used : Fruits, Seeds
Habitat : It is widely cultivated in India
Product offered : Seeds, Fruits
Momordica charantica improves the glucose metabolism and thus
imparts a hypoglycemic effect in the diabetic patients.
36
(Radhakrishnan.,2014)
37. Emblica officinalis:
Botanical Name : Emblica officinalis
Family Name : Euphorbiaceae
Common Name : Gooseberry, Phyllanthus, Emblica, Indian
Gooseberry, Amla
Part Used : Fruits
Habitat : Northern and south western India
Product offered : Seeds, Fruits
Amla is known for its numerous therapeutic effects including those
of usage in cardiovascular disorders, liver dysfunction, and for
inflammation.
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(Radhakrishnan.,2014)
38. Tribulus terrestris:
Botanical Name : Tribulus terrestris
Family Name : Zygophllaceae
Common Name : Land caltrops, Puncture vine, Fokhru
Part Used : Fruits, Seeds
Habitat : Throughout India, upto 5400m, as a
weed along roadsides and waste places
Product offered : Seeds, whole plant, Fruits
It has been shown to increase the free serum testosterone and to be
effective in the treatment of sexual and erectile dysfunction by
conversion of its phyto-chemical derivative, protodioscine to
DeHydro Epi Androsterone (DHEA).
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39. Trigonella foenum graecium:
Botanical Name : Trigonella foenum gracum
Family Name : Fabaceae
Common Name : Fenugreek, Greek Hayes, Alholva, Bird’s,
Foot, Boyutu, Chinagreye, Fenegriek,
Part Used : Leaves, Seeds
Habitat : Kashmir, Punjab and upper
gangetic plains and other Indian regions
Product offered : Seeds, whole plant, Fruits
Several studies indicated the hypoglycemic and hypo-lipidemic
properties of fenugreek seeds suggesting that fenugreek may help
to control diabetes.
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40. To study the Reno-protective effect of some medicinal plants
extracts in experimentally induced nephropathy
Momordica charantia Emblica officinalis
Tribulus terrestris Trigonella foenum graecium
alone and in combination, in two models of nephropathy in rats.
If a synergistic action of combining two products is documented,
it would permit use of smaller dose of individual drug and a
concomitant decrease in blood concentration dependent adverse
effects.
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