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SAFETY and EFFICACY of TENELIGLIPTIN OVER OTHER HYPOGLYCEMIC AGENTS in TYPE-2 DIABETES *1 Dr

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SAFETY and EFFICACY of TENELIGLIPTIN OVER OTHER HYPOGLYCEMIC AGENTS in TYPE-2 DIABETES *1 Dr IAJPS 2018, 05 (07), 6325-6340 N. Tendu Pranadeep et al ISSN 2349-7750 CODEN [USA]: IAJPBB ISSN: 2349-7750 INDO AMERICAN JOURNAL OF PHARMACEUTICAL SCIENCES http://doi.org/10.5281/zenodo.1310608 Available online at: http://www.iajps.com Research Article SAFETY AND EFFICACY OF TENELIGLIPTIN OVER OTHER HYPOGLYCEMIC AGENTS IN TYPE-2 DIABETES *1 Dr. N. Tendu Pranadeep, 1Dr. G. Gayathri, 1Dr. B.Kavya Chowdary,1Dr.M.Anuhya, 2Dr.C. Pradeep,3Dr. G. V. Nagaraju ,4 Dr.Md.K.Rahman, 4Dr. Alias Kenny. 1,4 Clinical Pharmacist, Help Hospital, Vijayawada, Andhra Pradesh, India. 2 Dept.of General Medicine, Pradeep Diabetic Centre, Rajahmundry, Andhra Pradesh, India 3 Dept. of Pharmacy Practices, Koringa College of Pharmacy, Kakinada, A.P, India. Abstract To compare the safety and efficacy of the Teneligliptin a DPP inhibitor over other hypoglycaemic agents in Type II Diabetes Mellitus. .It is a prospective –observational study in this study was conducted at, Pradeep Diabetic Centre, Rajamahendravaram and the study was carried out for a period of 6 months from Feb 2016 to July 2016, and we are taking total of 114 patients with type 2 diabetes, in our study concludes the combination of Teneligliptin with other oral hypoglycaemic agents have been shown to improve glycaemic control efficiently when compare with the monotherapy shown inadequate glycaemic control. Patients of either gender and above 12 years, Patients diagnosed with type-II diabetes, Patients prescribed with oral hypo glycaemic agents as monotherapy, combination of oral hypoglycaemic agents along with insulin. The data and laboratory reports were collected from the case sheets of the patients and relevant sources. In this study was carried out by considering the collecting of socio demographic data of the patients such as age, gender, occupation, education and to obtain the information of patients receiving insulin as their ultimate therapy after receiving oral therapy and to assess the number, type and dose of oral hypoglycaemic drugs as prescribed and Dose of the insulin and other oral hypoglycaemic drugs that are shown in desirable therapeutic outcome or not. As well as we assess the state of their life style diet modifications after starting the therapy and compare the efficacy of Teneligliptin with combination of oral hypoglycaemic and monotherapy finally we assess the glycaemic laboratory reports of the patient before and after the treatment. In the data was analysed by applying statistics by SPSS (Statistical Package for the Social Sciences). Key Words: Teneligliptin, Hypoglycaemia, Case Study, 114 Patients, 6 Months. Corresponding Author: Dr. N.Tendu Pranadeep QR code Clinical Pharmacist, Help Hospital, Behind Victoria Museum, M.G.Road ,Vijayawada, Pin-520002A.P, India E-mail: [email protected] Mobile No-9966252747 Please cite this article in press N. Tendu Pranadeep et al., Safety and Efficacy of Teneligliptin over Other Hypoglycemic Agents In Type-2 Diabetes, Indo Am. J. P. Sci, 2018; 05(07). w w w . i a j p s . c o m Page 6325 IAJPS 2018, 05 (07), 6325-6340 N. Tendu Pranadeep et al ISSN 2349-7750 1.0 INTRODUCTION: currently diagnosed with the disease.1,2 In 2000, Diabetes mellitus is probably one of the oldest India (31.7 million) topped the world with the highest diseases known to man. It was first reported in Egypt number of people with diabetes mellitus followed by about 3000 years ago. In 1936, the distinction China (20.8 million) with the United States (17.7 between type- and type2 Diabetes mellitus was million) in second and third place respectively. clearly made. Type-II Diabetes mellitus was first According to Wild et al.3 the prevalence of diabetes described as a component of a metabolic syndrome in is predicted to double globally from 171 million in 1988.[1] Sushruta (6th century BCE) was the one 2000 to 366 million in 2030 with a maximum who identified diabetes and classified it as increase in India. It is also predicted that by 2030 Madhumeha .He further identified it with obesity and diabetes mellitus may afflict up to 79.4 million sedentary lifestyle, and also advising exercises which individuals in India, while China (42.3 million) and can help to "cure" it. The Indians tested for diabetes the United States (30.3 million) will also see by observing whether ants were attracted to a person's significant increases in those affected by the urine, , and called the disorder "sweet urine disease" disease.3,4 India currently faces an uncertain future (Madhumeha).[2]Diabetes mellitus (DM) is a chronic in relation to the potential burden that diabetes may metabolic disorder in which prevalence has been impose upon the country. The aetiology of diabetes in increasing steadily all over the world. As a result of India is multifactorial and includes genetic factors this trend, it is fast becoming an epidemic in many coupled with environmental influences such as countries of the world with the number of people obesity associated with rising living standards, steady affected expected to double in the next decade due to urban standards, steady urban migration, and lifestyle increase in ageing and population, thereby adding to changes. Obesity is one of the major risk factors for the already existing burden for healthcare providers, diabetes, yet there has been little research focusing on especially in poorly developed countries.[1]As at this risk factor across India. 6 Furthermore, Indians 2013, 382 million people have diabetes world wide . are genetically predisposed to the development of Type-II makes up about 90% of the cases. This is coronary artery disease due to dyslipidaemia and low equal to 8.3% of the adult population with equal rates levels of high density lipoproteins;14 these in both women and men.[3]In 2014, the International determinants make Indians more prone to Diabetes Federation (IDF) estimated that diabetes development of the complications of diabetes at an resulted in 4.9 million deaths. The World Health early age (20-40 years) compared with Caucasians Organization (WHO) estimated that diabetes resulted (>50 years) and indicate that diabetes must be in 1.5 million deaths in 2012, making it the 8th carefully screened and monitored regardless of leading cause of death . The discrepancy between the patient age within India.[6] two estimates is due to the fact that cardiovascular diseases are often the cause of death for individuals 1.2 Pathophysiology with diabetes; the IDF uses modelling to estimate the Normal regulation of glucose metabolism is amount of deaths that could be attributed to diabetes. determined by a feedback loop involving the islet β- More than 80% of diabetic deaths occur in low and cell and insulin-sensitive tissues in which tissue middle- income countries.[3]The first nationwide sensitivity to insulin determines the magnitude of the study on the prevalence of Type-II diabetes mellitus β-cell response. When insulin resistance is present, (T2DM) reported 2.1% and 1.5% prevalence in the the β-cell maintains normal glucose tolerance by urban and rural populations of India, respectively. [4] increasing insulin output. It is done only when the β- The present research work aims at the combination of cell is incapable of releasing sufficient insulin in the Teneligliptin with other oral hypoglycaemic agents presence of insulin resistance that glucose levels rise. have been shown to improve glycaemic control While β-cell dysfunction has a clear genetic efficient when compare with the monotherapy shown component, environmental changes play a vital inadequate glycaemic control of adult men and role.[7] woman over a region in Rajahmundry for a period of 6 months. This feedback loop relies on crosstalk between the β- cell and the insulin sensitive tissues . Insulin released 1.1 Diabetes in India in response to β-cell stimulation mediates the uptake India is the diabetes capital of the world with 41 of glucose, amino acids and fatty acids by insulin- million Indians having diabetes; every fifth diabetic sensitive tissues. In turn, these tissues feedback in the world is an Indian. It also leads in prevalence information to the islet regarding their need for of metabolic syndrome as well as obesity.[5]Diabetes insulin, the mediator of which has not yet been is fast gaining the status of a potential epidemic in identified but is likely to involve integration between India with more than 62 million diabetic individuals the brain and humoral systems. When insulin w w w . i a j p s . c o m Page 6326 IAJPS 2018, 05 (07), 6325-6340 N. Tendu Pranadeep et al ISSN 2349-7750 resistance is present, as seen most commonly with Metformin therapy for prevention of T2DM obesity, the β-cell increases its insulin output to may be considered in those patients meeting maintain normal glucose tolerance. However, when criteria for prediabetes. the β-cell is incapable of this task, the result is an At least annual monitoring for the elevation in plasma glucose.[7] development of diabetes in those with prediabetes may be utilized. Type-II diabetes results when pancreatic beta cells Screening for and treatment of modifiable are unable to secrete sufficient insulin to maintain risk factors for CVD are suggested.[10] normoglycemia,2nd typically in the context of Pharmacological therapy of Type-II diabetes has increasing peripheral insulin resistance.[8]Genes and changed dramatically in the last 10 years, with new the environment together are important determinants drugs and drug classes becoming available. These of insulin resistance and β- cell dysfunction. As our drugs allow for the use of combination oral therapy, gene pool has not changed in recent times, often with improvement of glycaemic control that environmental changes have been critical in was previously beyond the reach of medical therapy.
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