No abstract

The prevalence of type 2 diabetes mellitus and its resultant morbidity and mortality is rapidly increasing. An important factor in reducing the microvascular complications of diabetes is strict glycemic control. Most patients require additional insulin therapy in spite of regularly taking oral anti-diabetic drugs. Though classically used later in the natural course of the disease, newer treatment guidelines suggest early initiation of insulin analogues. The discovery of insulin has been hailed as one of the most dramatic events in the history of diabetes, improving the life-span of most diabetics. Replacement insulin therapy should mimic physiological insulin release patterns. Modern insulin and its analogues have been developed to serve as an ideal replacement therapy. There are various insulin preparations available in the market and each of them has their own advantages and disadvantages. The modern insulin’s have been developed to overcome certain side effects of the older preparations. A range of insulin products are under development that aim to increase absorption prolong action and provide alternative delivery methods. Greater patient adherence is important since most patients are reticent about insulin therapy.  This review describes the role of insulin in the management of type 2 diabetes mellitus.

Type 2 diabetes mellitus (T2DM) is caused by insulin resistance and characterized by progressive pancreatic β-cell dysfunction. Recent innovative treatment approaches target the multiple pathophysiological defects present in type 2 diabetes. The targets for glycemic control as set by the American Diabetes Association (HbA1C<7%) and the American Association of Clinical Endocrinologists (HbA1C<6.5%) sometimes appear daunting and unattainable. It is therefore of the utmost importance to have an excellent understanding of the mechanism of action of these drugs in order to optimize patient therapy. Here, we present a corresponding discussion of all the available oral antidiabetic drugs according to the different classes, their mechanisms of action and pharmacological profiles.

Background: Treatment of Alzheimer’s disease (AD) includes acetylcholinesterase inhibitors like Donepezil. American ginseng has been postulated to enhance learning and memory owing to its antiapoptotic activity as well as inhibition of formation of β amyloid plaque. Scarce data is available on effect of combination of these two drugs. Hence, we have conducted this study to evaluate the same. Aim and objectives of the study were to evaluate the role of American ginseng on working memory in rats and to compare the effect of American ginseng with Donepezil on working memory in rats.Methods: Sprague-Dawley rats of either sex, weighing 150-200g were used and obtained from animal house of Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune. To study the effects of the drugs on working memory in rats, they were trained for conditioned avoidance response (CAR) using Cook's pole climbing apparatus. The method of Fellow and Cook was used.Results: In the group C (i.e. the control group), 50% of rats showed the retention of CAR. In the group S (i.e. only scopolamine group), only 20% of rats showed the retention of CAR. In the group S+AG (i.e. scopolamine and American ginseng), 60% of rats showed the retention of CAR. In the group S+ D (i.e. scopolamine and Donepezil) 70% of rats showed retention of CAR. In the group S+D+AG (i.e. the combination group of scopolamine, Donepezil and American ginseng), 80% of rats showed the retention of CAR.Conclusions: From this study we can conclude that American ginseng and Donepezil have comparable effects in retention of working memory. The combination of American ginseng and Donepezil can have additive effect on the retention of working memory.