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Incretin Mimetics #antidiabetic #pharmacology

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Glucagon like peptide-1 (GLP-1) and glucose dependent insulinotropc peptide (GIP) are the two incretins. Incretins are the gut hormones released in response to food intake. Incretins decrease the sugar level in hyperglycemia by increasing insulin secretion, decreasing glucagon secretion, delaying gastric emptying and decreasing the appetite. Incretins are degraded by dipeptidyl peptidase IV (DPP-IV). Incretin mimetics are the drugs which act as agonist at GLP1 receptor or GIP receptor or by inhibiting DPP-IV.

Namaskar today we’ll study encrypt in my matrix this incurred these incredible mimetics are nothing but your anti-diabetic agents both oral and parental agents are there so they they are used in diabetes mellitus so what is this diabetes mellitus it is a chronic metabolic disorder characterized by hyperglycemia so the fasting blood sugar increases more than

Seven millimeter per liter and two hour postpartum blood sugar increases more than 11.1 millivolt per liter and this diabetes is of mainly two types type 1 and type 2 and mainly based on the insulin hormone so one type one is insulin dependent diabetes simulators where there is absolute deficiency of insulin because of selective beta cell destruction uh in

The highlight of langerhans of pancreas and the type 2 is non-insulin dependent diabetes simulators where there is a relative deficiency of insulin secretion or insulin resistance and if other causes other causes other than insulin are there we can include them as type three diabetes mellitus and during pregnancy there is also due to hormonal changes there is a

Hyperglycemia that is called gestational diabetes so in addition to insulin so insulin is the hormone which regulates our glucose level and in addition to insulin recently we found this gut hormone in cretins so insulin mainly regulates the glucose level by acting on the insulin receptor and it causes synthesis and recruitment of glucose transporter increases

The transcription of enzymes involved in glycogenesis and same in the same way decreases in those enzymes involved in glycogenolysis and gluconeogenesis it also universally policies favors lipogenesis and increases amino acid entry into muscle and causes protein synthesis so all these actions are done by insulin and so in addition to insulin now we have

Another hormone called increating which are gut hormones so in in response to food when we ingest food the human gut releases two hormones called incretins one is glucagon like peptide one glp one and the other is glucose dependent insulin or tropic polypeptide that is gip so these ingredients they will act on their specific receptor glp1 action glp1 receptor

And gip action gip receptor and they those receptors are present in pancreas in pancreas the islet of langerhans pancreas in the alpha cell they name it glucagon secretion so decrease the glucose level and in on the beta cell they stimulate the insulin secretion so in this way by increasing the insulin secretion insulin actions are mediated so this is one

And second they they are also present in g8 and delay gastric emptying and in the hypothalamus they suppress the apatite and all these effects ultimately reduce the sugar level if hyperglycemia is there so when the normal blood sugar level comes the negative feedback mechanism operates and there will be no more release of ingredients and these ingredients are

Degraded by dipeptide peptides for dpp4 enzyme uh and encryptions are degraded so we can also give dpp4 inhibitors to increase this inheritance so the drugs which act as increase in mimetics or which increase the increase in action can be dpp 4 inhibitors or glp-1 agonist so we can have drugs like dpp4 inhibitors which will increase the encryption level or we

Can use glp-1 agonist and initially parenteral glp-1 agonists were developed and just recently we have one oral glp one agonist and similarly we can have gip receptor agonist though we don’t have any specific gip receptor agonist uh just recently we one drug is developed which is agonized at both glp-1 receptor and gip receptor dual uh increasing receptor

Agonist so the drugs they they all these drugs they decrease the sugar level by these three mechanisms by or in total you can say four mechanisms by inhibiting glucagon secretion by increasing insulin secretion by suppressing appetite and by delaying gastric emptying so you can classify them as glp-1 receptor agonists only one drug is there which is error oral

That is hemoglobin and the others are parenteral the first drug was extended then other drugs were developed lexicote all these are parental glp1 receptors and in 2020 1222 uh this dual glp 1 gip receptor agonist is approved by a fda and that is called terezepathide this is the most central and these dpp-4 inhibitors which are used orally uh like cetaglebtine

Buildagliptin saxoglyptin so all these drugs are dpp4 inhibitors which increase the level of increasing like glp1 and gip and decrease the sugar levels so we can use them uh in in resistant type 2 diabetes simulators along with metformin under or any sulfonylurea like glimmer plate so that’s all about encrypted mathematics thank you

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Incretin Mimetics #antidiabetic #pharmacology By PKS Classes