Agroecology for Sustainable Food Security - tnsroindia.org.in

Indian Journal Of Natural Sciences ISSN: 0976 – 0997
Vol1 / Issue 2 / October 2010 © IJONS
has become the most commonly used agent for type 2 diabetes in children and teenagers. Amongst common diabetic
drugs, metformin is the only widely used oral drug that does not cause weight gain.
Thiazolidinediones
Thiazolidinediones (TZDs), also known as "glitazones," bind to a type of nuclear regulatory protein involved in
transcription of genes regulating glucose and fat metabolism. These act on Peroxysome Proliferator Responsive
Elements (PPRE). The PPREs influence insulin sensitive genes, which enhance production of mRNAs of insulin
dependent enzymes. The final result is better use of glucose by the cells.
Alpha-glucosidase inhibitors
Alpha-glucosidase inhibitors are "diabetes pills" but not technically hypoglycemic agents because they do not have a
direct effect on insulin secretion or sensitivity. These agents slow the digestion of starch in the small intestine, so that
glucose from the starch of a meal enters the bloodstream more slowly, and can be matched more effectively by an
impaired insulin response or sensitivity.
Peptide analogs
Incretin mimetics
Incretins are insulin secretagogues. The two main candidate molecules that fulfill criteria for being an incretin are
Glucagon-like peptide-1 (GLP-1) and Gastric inhibitory peptide (aka glucose-dependent Insulinotropic peptide or
GIP). Both GLP-1 and GIP are rapidly inactivated by the enzyme dipeptidyl peptidase-4 (DPP-4).GLP agonists bind
to a membrane GLP receptor. As a consequence of this, insulin release from the pancreatic beta cells is increased.
DPP-4 (Dipeptidyl peptidase-4) inhibitors
Dipeptidyl peptidase-4 (DPP-4) inhibitors increase blood concentration of the incretin GLP-1 (glucagon-like peptide-
1) by inhibiting its degradation by dipeptidyl peptidase-4 (DPP-4).
Amylin analogues
Ramasubramaniaraja and Niranjan
Amylin agonist analogues slow gastric emptying and suppress glucagon. They have all the incretins actions except
stimulation of insulin secretion. Pramlintide is the only clinically available amylin analogue. Like insulin, it is
administered by subcutaneous injection. The most frequent and severe adverse effect of pramlintide is nausea, which
occurs mostly at the beginning of treatment and gradually reduces.
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