الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Chronic hyperglycaemia associated with the diabetic state leads to glycosylation of serum and tissue proteins and the formation of advanced glycosylation end products. The incidence of type 1 diabetes is increasing and this may double the burden of disease in our youngest by 2020. The recent increase in incidence is mostly happening in the very young and those with moderate genetic susceptibility. The prevalence of type 2 diabetes is rapidly rising worldwide. Most disability and premature mortality in patients with diabetes is caused by vascular complications in particular, coronary artery disease and stroke. In type I DM, recent genetic mapping and gene-phenotype studies have revealed the genetic architecture of type 1 diabetes. T2DM is a multifactorial metabolic disorder with an initial clinical manifestation of elevated blood sugars. Subjects with T2DM have elevated fasting and postprandial plasma glucose levels. Conclusion 157 Sulphonylureas (SUs) and metformin are the current mainstays in the treatment of T2DM and represent the most commonly used oral hypoglycaemic agents (OHAs). Metformin and glibenclimide are the only OHAs included on the WHO list of essential medicines, helped in part by their availability as generics. A new perspective, even a paradigm change, has recently been brought forward by two new classes called incretin hormones and incretin enhancers. Incretins are defined as being responsible for a higher insulin response to oral intake of glucose compared with an equal intravenous glucose load. These include Exenatide, Albiglutide and Taspoglutide. The second approach of incretin effect is to enhance endogenous incretin concentrations by inhibiting/delaying their degradation mediated by the enzyme DPP-4 (also called incretin enhancers). These include Sitagliptin, Vildagliptin, Saxagliptin, Linagliptin, Alogliptin and Dutogliptin. Sodium-Coupled Glucose Cotransporter 2 Inhibitors may be useful add-on agents with a low risk of hypoglycemia and good potential for weight loss. They represents a promising drug target and an innovative approach to treatment of type 2 diabetes (and type 1 diabetes). Activating Adenosine monophosphate-activated protein kinase (AMPK) represents a promising approach for the treatment of type 2 diabetes and the metabolic syndrome. Because antidiabetic compounds such as metformin and thiazolidinediones exert many, if not all, of their therapeutic effects by activating AMPK, the question is whether the newly described compounds exhibit fewer side effects.