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Problem in Type 2 diabetes?
- insulin resistance (muscle, adipose & liver)
- insulin secretion deficiency
- increased hepatic glucose production
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Pharmacotherapy for the following problems:
insulin resistance (muscle, adipose & liver)
insulin secretion deficiency
increased hepatic glucose production
- insulin resistance (muscle, adipose & liver) - insulin sensitizers (TZD, glitazones, biguanides)
- insulin secretion deficiency - secretagogues (sulfonylureas & incretine mimetric)
- increased hepatic glucose production - slow carb absorption (a-glucosidase inhibitors)
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Rosiglitazone
- TZDselective agonist PPARg-R
- activates insulin response genes in fat, muscle & liver
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Metformin
- biguanideactivates AMPK
- reduces hepatic gluconeogenesis & glycolysis
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Glyburide
- sulfonylureainactivates SUR1
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Exenatide
- incretine mimicGLP1-R agonist
- inc. insulin secretion & suppress glucagon secretion
- induces satiety
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Acarbose
- Alpha glucosidase inhibitor
- inhibits polysaccharide breakdown by inhibiting E
- slows down intestinal carb absorption
- blunts post prandial rise in plasma glucose
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