Effect of add-on proton pump inhibitors on parameters of glycemic control in type-2 diabetic patients

Proton pump inhibitors (PPIs) block the parietal cell H+/K+ ATPase, are superior at suppressing acid secretion & promoting peptic ulcer healing, wildly used clinically for the therapy of gastro-esophageal reflex disease, gastritis due to excess stomach acid, and gastric ulcers. After blocking the production of gastric acid, the proton-pump inhibitors indirectly elevate serum gastrin levels via a negative feedback effect. Evidences are reported that gastrin promotes β cell neogenesis in pancreatic ductal complex, modest pancreatic β cell replication and improvement of glucose tolerance in animal models. Some recent clinical studies have shown improved glucose tolerance in type-2 diabetes mellitus (T2DM). Although PPIs may be possible candidates for a new approach in the therapy of diabetes, a prospective, long-term, randomized, double-blind, placebo-controlled study is needed to establish the effect of PPIs on glycemic control in a large number of patients with T2DM

Awareness study of Pharmacovigilance among the health care professionals (nursing staff) at tertiary care hospital, Solapur, Maharashtra, India

Background: Early detection of adverse drug reaction is one step towards the prevention of ADRs. Foundation of Pharmacovigilance is spontaneous reporting which is minimal in India. Among the all health care professionals, nurses are caregivers at bedside. Improvement in knowledge and practice of adverse drug reaction reporting among nurses will definitely increases spontaneous reporting. In this study, knowledge, attitude and practice of nursing staff about pharmacovigilance was evaluated.Methods: It was prospective, cross-sectional, observational, questionnaire-based study among the nurses of the tertiary care hospital Solapur. A questionnaire evaluating knowledge, attitude and practice was distributed among nursing staff and filled questionnaire were collected back and analyzed by microsoft excel 2013.Results: Response rate of our study was 44.88%.  38.61% doctors were knowing meaning of pharmacovigilance while 61.38% participants knew that all drugs available in market are not safe. Taking proper medication history before prescribing drugs was considered important by 92.57% participants. 79.70% participants were aware about Pharmacovigilance program of India. 64.35% doctors answered correctly to elements which are mandatory to record. Only 24.75% participants were knowing the basis that pharmcovigilance provides for.Conclusions: Nursing staff of tertiary care hospital, Solapur had very appreciable and positive attitude towards pharmacovigilance but there is a need for improvement in knowledge and practice of ADR reporting

Environmental pharmacology: an emerging science

With continuous rapid expansion of the human population there is escalating demand for resources, including human and veterinary pharmaceuticals. This has lead to rapid development of global pharmaceutical industry and with that increase in issues caused by pharmaceutical products. In recent years a great concern has been expressed over the occurrence and persistence of pharmaceutical products in the environment and their potential impact on environment. Owing to this the new branch of science called environmental pharmacology has sprouted. Environmental pharmacology deals with dispersion and impact of pharmaceutical products on environment. Solutions need to be suggested to save this only liveable planet from ill effects of these pharmaceutical products. This has given birth to the science of Ecopharmacovigilance (EPV)

Role of conventional oral antidiabetic drugs in 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

Role of insulin in management of type 2 diabetes mellitus

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