ORAL ANTIDIABETIC DRUGS

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NON-INSULIN DEPENDANT DIABETS MELLITUS
(NIDDM) ALLOPATHIC THERAPY

Even in projected cases of IDDM patients, attempts should be made, as a fast step, to have the control of diabetes through control of diet. But since, control through diet alone, is a bit tedious and lengthy process. These is hardly any need for trial in cases where children, young people, pregnant women, operatable cases or terminal cases are involved. There is hardly any patient’s life could be saved or, at least, the complications could be minimized. In such critical and sensitive cases, palliation should be the sole aim, by whichever method possible. The patient is not concerned with which method he is being treated; his only concern, as also of his relatives, is as to how quickly his grave symptoms subside.
About insulin therapy, with regard to IDDM patients, foregoing details will suffice to enlighten such diabetic patients. In this chapter, we will spell out details, to a reasonable extent, as far as oral anti-diabetic allopathic drugs are concerned. It has been observed that NIDDM patients are able to control diabetes, by adhering to diet control measures only and 60% of such cases do respond to low carbohydrate intake, including other necessary precautions. Those who are unable to have an effective diabetic control through diet can achieve the desired objective by taking oral antiglycaemia drugs, apart from diet control. The latter category of patients responds to diet control-cum-oral drugs application and thus 20% of such patients are seen to control their diabetes. After above mentioned two categories, the third category belongs to rest of 20% patients who have no option but to resort to insulin therapy, for which reference may be made to the preceeding chapter on IDDM.
Oral drugs can be divided into two main categories viz.
(1) Sulfonylureas
(2) Biguanides

Sulfonylureas: These drugs cause lowering of the blood glucose by stimulating the release of insulin from a patient’s own pancreas. But, in order to obtain release of insulin from the patient’s own pancreas, it is very necessary that the patient’s pancreas must be in a position to make and store insulin. Oral drugs help the pancreas in stimulating their action so that the stored insulin is released into the blood stream. If the insulin content is made, stored and released by the pancreas, then the blood sugar (glucose) level can be easily brought down, of course, if coupled with diet control. Such a possibility is possible chiefly in those diabetic patient s who have developed diabetes only after, or say mainly after 40 or 50 years of their age. This is the reason why it is termed, and quite rightly so, as ‘maturity onset diabetes not responding to diet control measure alone.

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