1

Dr.Chamara De Zoysa
Endocrine System

Dr.Chamara De Zoysa
 
 2
Introduction

Dr.Chamara De Zoysa
A. The Endocrine system is made up of the cells,
tissues, and organs that secrete Hormones into
body fluids.
B. Hormones diffuse into the bloodstream to act Target
cells some distance away.
C. The body has two kinds of glands, exocrine (secretes
products into ducts) and endocrine (secrete products into
body fluids to affect target cells).
 
 3
General Characteristics of the Endocrine System

Dr.Chamara De Zoysa
A. The endocrine system’s function is to
communicate with cells using chemicals called
hormones.
B. Endocrine glands and their hormones regulate a
number of metabolic processes within cells, and the
whole body.
 4
C. Their actions are precise, they only affect
specific target cells.

Dr.Chamara De Zoysa
D. Endocrine glands include the pituitary gland,
thyroid gland, parathyroid glands, adrenal
glands, pancreas, and other hormone-
secreting glands and tissues.  
 Dr.Chamara De Zoysa
5
 6
Hormone Action

Dr.Chamara De Zoysa
A. Hormones are Steroids, Amines, Peptides,
Proteins, or Glycoproteins;
 7
Pancreas
A. The Pancreas secretes hormones as an

Dr.Chamara De Zoysa
endocrine gland, and digestive juices to the
digestive tract as an exocrine gland.
 Dr.Chamara De Zoysa
8
 9
B. Structure of the Gland
1. The pancreas is an elongated organ

Dr.Chamara De Zoysa
posterior to the stomach.
2. Its endocrine portions are the islets of Langerhans
that include two cell types--alpha cells that secrete
glucagon, and beta cells that secrete insulin.
10

Dr.Chamara De Zoysa
 11
C. Hormones of the Islets of Langerhans
1.Glucagon increases the blood levels of glucose by

Dr.Chamara De Zoysa
stimulating the breakdown of glycogen and the
conversion of non carbohydrates into glucose.
a. The release of glucagon is
controlled by a negative feedback
system involving low blood
glucose levels.
 12
2. Insulin decreases the blood levels of
glucose by stimulating the liver to form

Dr.Chamara De Zoysa
glycogen, increasing protein synthesis,
and stimulating adipose cells to store
fat.
a. The release of insulin is
controlled by a negative feedback
system involving high blood
glucose levels.
 13
3. Insulin and glucagon coordinate to
maintain a relatively stable blood

Dr.Chamara De Zoysa
glucose concentration.
 Diabetes Mellitus 14

 Diabetes Mellitus, often simply referred to as Diabetes—is

a group of metabolic diseases in which a person has high
blood sugar, Either because the body does not produce
enough insulin, or because cells do not respond to the
insulin that is produced.
 15

 Diabetes Mellitus is characterized by recurrent or persistent

hyperglycemia, and is diagnosed by demonstrating any one of the
following:
 Fasting plasma glucose level ≥ 7.0 mmol/L (126 mg/dL).
 Plasma Glucose ≥ 11.1 mmol/L (200 mg/dL) two hours after a
75 g oral glucose load as in a glucose tolerance test.
 Symptoms of Hyperglycemia and casual Plasma Glucose
≥ 11.1 mmol/L (200 mg/dL).
Blood Glucose Level 16
 Types of Diabetes 17

 In type 1 diabetes, the pancreas makes little or no insulin,

so sugar cannot get into the body's cells for use as energy.
 In type 2 diabetes (adult onset diabetes), the pancreas
makes insulin, but it either doesn't produce enough, or the
insulin does not work proper
 18

 Prediabetes occurs when your blood sugar is higher than

normal, but it’s not high enough for a diagnosis of type 2
diabetes.
 Gestational diabetes is high blood sugar during pregnancy.
Insulin-blocking hormones produced by the placenta cause
this type of diabetes.
Symptoms of Diabetes 19

 Increased hunger
 Increased thirst
 Weight loss
 Frequent urination
 Blurry vision
 Extreme fatigue
 Sores that don’t heal
Gestational Diabetes 20

 Most women with gestational diabetes don’t have any

symptoms.
 The condition is often detected during a routine blood sugar test
or oral glucose tolerance test that is usually performed between
the 24th and 28th weeks of gestation.
 In rare cases, a woman with gestational diabetes will also
experience increased thirst or urination.
 Risk Factors of Diabetes 21

 Overweight
 Age 45 or older
 Have a parent or sibling with the condition
 Aren’t physically active
 Have had gestational diabetes
 Have prediabetes
 Have high blood pressure, high cholesterol, or high
triglycerides
Clinical Complications of 22
Diabetes
 Heart Disease, Heart Attack, and Stroke
 Neuropathy
 Nephropathy
 Retinopathy and vision loss
 Hearing loss
 Foot damage such as infections and sores that don’t heal
 Skin conditions such as bacterial and fungal infections
 Depression
 Dementia
 Gliclazide 23

(Glyclapan)
 Gliclazide is an oral hypoglycemic (anti-diabetic drug) and is
classified as a sulfonylurea.
 Gliclazide was proven to protect human pancreatic beta-cells
from hyperglycemia-induced apoptosis.
 It was also proven to have a potent antiatherogenic effect in type
2 diabetes.
Form and composition 24

 Each immediate-release tablet contains 80 mg.

Modified release formulations contain 30 mg and 60
mg of Gliclazide.
 Drug Indication 25

 Gliclazide is used for control of hyperglycemia in Gliclazide-

responsive diabetes mellitus of stable, mild, non-ketosis prone,
type 2 diabetes.
 It is used when diabetes cannot be controlled by proper dietary
management and exercise or when insulin therapy is not
appropriate
 Mode of action 26

 Gliclazide selectively binds to sulfonylurea receptors (SUR-1)

on the surface of the pancreatic beta-cells.
 It was shown to provide cardiovascular protection as it does not
bind to sulfonylurea receptors (SUR-2A) in the heart
 Dosage 27

 The dosage for the 80 mg formulation is 40 to 320 mg daily in

two divided doses, while the 30 mg and 60 mg modified release
formulation may be given at a dose of 30 to 120 mg once daily
at breakfast.
Contraindications 28

 Type 1 diabetes
 Hypersensitivity to sulfonylurea
 Severe renal or hepatic failure
 Pregnancy and lactation
 Miconazole co prescription
Adverse effects 29

 Hypoglycemia
 Gastrointestinal disturbance (reported)
 Skin reactions (rare)
 Hematological disorders (rare)
 Hepatic enzyme rises (exceptional)
 Metformin 30

 An oral ant diabetic drug in the.

 It is the first-line drug of choice for the treatment of type 2
diabetes, in particular, in overweight and obese people and
those with normal kidney function
 31

 It is using for gestational diabetes, although safety concerns

still preclude its widespread use in this setting.
 It is also used in the treatment of polycystic ovary
syndrome, and has been investigated for other diseases
where insulin resistance may be an important factor.
Side Effects 32

 the most common is gastrointestinal upset—and is associated

with a low risk of hypoglycemia.
 Lactic acidosis (a buildup of lactate in the blood)
 Metformin helps reduce LDL cholesterol and triglyceride
levels, and is not associated with weight gain, and is the only
anti diabetic drug that has been conclusively shown to
prevent the cardiovascular complications of diabetes.
Drug Indications 33

 Metformin is primarily used for type 2 diabetes however is increasingly

being used in Polycystic Ovary Syndrome (PCOS),
 Non-Alcoholic Fatty Liver Disease (NAFLD) and
 Premature Puberty
 Other diseases that feature insulin resistance
 34

 The main use for Metformin is in the treatment of diabetes

mellitus type 2, especially in overweight people.
 In this group, over 10 years of treatment, Metformin reduced
diabetes complications and overall mortality by about 30%
when compared with insulin and sulfonylurea .
 Prediabetes and Metformin 35

 Metformin treatment of people at risk for type 2 diabetes may

decrease their chances of developing the disease, although
intensive physical exercise and dieting work significantly
better for this purpose.
 Gestational Diabetes 36

 Metformin is as effective and safe as insulin for the management

of gestational diabetes.
 children of women given Metformin instead of insulin may be
healthier in the neonatal period.
 Nonetheless, several concerns have been raised regarding
studies published thus far, and evidence on the long-term safety
of Metformin for both mother and child is still lacking.
Adverse effects 37

 The most common adverse effect of Metformin is

gastrointestinal upset, including diarrhea
 Cramps
 Nausea
 Vomiting and increased flatulence
 Metformin is more commonly associated with gastrointestinal
side effects than most other anti diabetic drugs.
 The most serious potential side effect of Metformin use is
lactic acidosis
Mechanism of action 38

 Metformin improves hyperglycemia primarily by

suppressing glucose production by the liver (hepatic
gluconeogenesis).
 The "average" person with type 2 diabetes has three times
the normal rate of gluconeogenesis;
 Metformin treatment reduces this by over one third.
Pharmacokinetics 39

 Metformin has an oral bioavailability of 50–60% under

fasting conditions, and is absorbed slowly.
 Metformin is not metabolized. It is cleared from the body
by tubular secretion and excreted unchanged in the urine;
 Metformin is undetectable in blood plasma within 24
hours of a single oral dose
 40

Dr.Chamara De Zoysa
 THANK YOU………………………