NSC2500 - Diabetes Mellitus: Pathophysiology, Pharmacology, Treatment

This presentation provides a comprehensive overview of diabetes mellitus, beginning with a definition of the chronic disorder characterized by high blood glucose levels. It distinguishes between Type 1 and Type 2 diabetes, detailing their causes, symptoms, and underlying pathophysiology. The presentation explores pharmacological treatments, focusing on oral anti-diabetic drugs, specifically Metformin, including its mechanism of action, pharmacokinetics, pharmacodynamics, indications, contraindications, and potential side effects. Furthermore, it discusses both pharmacological and non-pharmacological treatment approaches, emphasizing the importance of lifestyle modifications. The presentation concludes with a summary of key points and a list of references. The assignment is a video presentation and abstract related to the NSC2500 course, focusing on understanding the pathophysiology of a specific disease/condition and presenting the pharmacology used to address it. The presentation adheres to the provided guidelines and addresses the course objectives.

DIABETES MELLITUS
Name of the Student:
Name of the University:

TABLE OF CONTENTS
• PHYSIOLOGY
• TYPE 1 DIABETES MELLITUS
• TYPE 2 DIABETES MELLITUS
• SYMPTOMS OF DIABETES MELLITUS
• CAUSES OF DIABETES MELLITUS
• PATHOPHYSIOLOGY
• PHARMACOLOGY
• TREATMENT
• CONCLUSION
• REFERENCES

NORMAL PHYSIOLOGY
• Diabetes mellitus is most commonly referred as diabetes, which is a
chronic disorder categorized by high blood glucose level for an
extended period of time (Australia, 2019).
• Diabetes can be either acquired or inherited disorder, cause due to
deficiency of total insulin production by pancreas.
• Two chief types of diabetes mellitus is present namely:
1. Type 1 diabetes mellitus
2. Type 2 diabetes mellitus

TYPE 1 DIABETES MELLITUS
It is previously known as Insulin- Dependent Diabetes Mellitus (IDDM)
and is considered as an autoimmune disorder.
This type of diabetes is caused due to the following reason (Katsarou et
al., 2017):
• Consumption of medicine during pregnancy.
• Smoking
• Early consumption of cereals and cow’s milk.
In type 2 diabetes mellitus no insulin is produced by the pancreases.

TYPE 2 DIABETES MELLITUS
It is previously known as Non Insulin Dependent Diabetes Mellitus
(NIDDM).
Type 2 is caused due to the following reason (Defronzo et al., 2015):
• Decrease in the number of insulin receptors
• Disturbance in insulin response in the cells
• Obesity
• Inappropriate physical activity or exercise

SYMPTOMS OF DIABETES MELLITUS
The symptoms of diabetes mellitus is as follows (Betterhealth.vic.gov.au, 2019):
• Amplified thirst
• Recurrent urination
• Extreme starvation
• Weight loss
• Tiredness
• Irritability
• Unclear vision
• Frequent infections
• Slow-healing wounds

CAUSES OF DIABETES MELLITUS
The factors causing diabetes mellitus are as following (Malone & Hansen,
2019):
• Sedentary lifestyle
• Excess consumption of food
• Obesity
• Acute stress
• Family history of diabetes mellitus
• Increasing age
• Pregnancy

PATHOPHYSIOLOGY OF TYPE 1
Viral Infection
Alteration of self cells
Auto immune response
Destruction of beta cells
Insulin deficiency (type 1 diabetes mellitus)

PATHOPHYSIOLOGY OF TYPE 2

PHARMACOLOGY
There are various oral anti-diabetic drugs that is used for treating diabetes mellitus.
The drugs are classified as:
• Insulin secretagogues
• Biguanides
• Thiazolidinediones
• Alpha-glucosudase inhibitors
• Amylin analog
Drug class- Biguanides
Drug name- Metformin

MECHANISM OF ACTION OF
METFORMIN
Metformin
Activates AMPA-PK
Reduces production of hepatic glucose
Lower blood glucose level

PHARMACOTHERAPY
Pharmacokinetics of metformin:
• Orally absorbed
• Half life of 1.5 to 3 hours
• It is excreted by kidneys
• Metformin is metabolized in liver
Pharmacodynamics of metformin:
• Decrease the production of hepatic glucose
• Decreases intestinal absorption of glucose
• Increases insulin sensitivity

Indication:
• Metformin is used for the treatment of renal dysfunction
• Chronic liver disorder, lactic acidosis, alcohol abuse, congestive heart
failure and acute myocardial infraction.
Contraindication (Dujic et al., 2015):
• Hepatic impairment
• Heart failure
• Renal impairment
• Alcoholism

Side effects:
• Anorexia
• Weight loss
• Vomiting and nausea
• Abdominal discomfort
• Diarrhea
• Dyspepsia and
• Flatulence

TREATMENT OF DIABETES
MELLITUS
There are two types of treatment approaches for diabetes mellitus that
include (Jenkins et al., 2019):
1. Pharmacological treatment- Pharmacological treatment include
consumption of insulin and glycemic medication.
2. Non-pharmacological treatment- Non-pharmacological treatment
include better diet and lifestyle changes such as adaption of yoga
and exercise, meditation and physical activity.

CONCLUSION
• Diabetes mellitus is defined as a chronic disorder of protein, fat and
carbohydrates metabolism that result due to insulin deficiency or may
be due to abnormality in the response of insulin.
• The symptoms of diabetes mellitus vary from person to person and
also depends on the types of diabetes mellitus
• If the condition is not treated properly, it can lead to various
complications that can be either long term or short term
• Different treatment approaches are available that can either be
pharmacological or non-pharmacological.

REFERENCES
• Australia, H. (2019). Type 1 diabetes.
• Betterhealth.vic.gov.au. (2019). Diabetes. Retrieved from https://
www.betterhealth.vic.gov.au/health/conditionsandtreatments/diabetes
• DeFronzo, R. A., Ferrannini, E., Groop, L., Henry, R. R., Herman, W. H., Holst, J. J., ... & Simonson, D. C.
(2015). Type 2 diabetes mellitus. Nature reviews Disease primers, 1, 15019.
• Dujic, T., Zhou, K., Donnelly, L. A., Tavendale, R., Palmer, C. N., & Pearson, E. R. (2015). Association of organic
cation transporter 1 with intolerance to metformin in type 2 diabetes: a GoDARTS study. Diabetes, 64(5), 1786-
1793.
• Jenkins, A. J., Scott, E., Fulcher, J., Kilov, G., & Januszewski, A. S. (2019). Management of diabetes mellitus.
In Comprehensive Cardiovascular Medicine in the Primary Care Setting (pp. 113-177). Humana Press, Cham.
• Katsarou, A., Gudbjörnsdottir, S., Rawshani, A., Dabelea, D., Bonifacio, E., Anderson, B. J., ... & Lernmark, Å.
(2017). Type 1 diabetes mellitus. Nature reviews Disease primers, 3, 17016.
• Malone, J. I., & Hansen, B. C. (2019). Does obesity cause type 2 diabetes mellitus (T2DM)? Or is it the
opposite?. Pediatric Diabetes, 20(1), 5-9.
• Wang, Q., Zhang, M., Torres, G., Wu, S., Ouyang, C., Xie, Z., & Zou, M. H. (2017). Metformin suppresses
diabetes-accelerated atherosclerosis via the inhibition of Drp1-mediated mitochondrial fission. Diabetes, 66(1),
193-205.