Insulin and Oral Hypoglycemic Agents
Insulin and Oral Hypoglycemic Agents
Insulin and Oral Hypoglycemic Agents
1. Attention to diet
2. Physical exercise
3. Medication
Drug classification
1. Insulin
Sulfonylureas
Biguanides
α-Glucosidase Inhibitor
Discovery of insulin
In 1921, Frederick G. Banting, a young Canadian
surgeon, convinced a professor of physiology in Toronto, J.
J. R. Macleod, to allow him access to a laboratory to search
for the antidiabetic principle of the pancreas. Banting
assumed that the islet tissues secreted insulin but that the
hormone was destroyed by proteolytic digestion prior to or
during extraction. Then he attempted to overcome the
problem by tying the pancreatic ducts. The acinar tissue
Frederick G. Banting
degenerated, leaving the islets undisturbed; the remaining
tissue was then extracted with ethanol and acid. Banting and
Macleod thus obtained a pancreatic extract that was
effective in decreasing the concentration of blood glucose in
diabetic dogs.
In 1923, the Nobel Prize in Medicine and Physiology was
awarded to Banting and Macleod with remarkable rapidity. J. J. R. Machleod
β(B) cells produce insulin
A cells produce glucagons
D cells produce somatostatin
2. Insulin allergy
Allergic reactions are very rare, but may occur to any insulin and to any
constituent of the formulation.
【 Adverse
3. Insulin】
effects resistance
Most insulin-treated patients develop a low titer of circulating IgG anti-
insulin antibodies that neutralize the action of insulin to a small extent. In some
diabetic patients, principally those with some degree of tissue insensitivity to
insulin (such as occurs in obese diabetics) and a history of interrupted insulin
therapy with preparations of less-than-pure beef insulin, a high titer of
circulating IgG anti-insulin antibodies develops. This results in extremely high
insulin requirements.
Sulfonylureas
Biguanides
α-Glucosidase Inhibitor
Sulfonylureas