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7/31/2019 Insulin Sensitizers
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INSULININSULIN
SENSITIZERSSENSITIZERS
DR.SUJATHA. T. L
ASSISTANT PROFESSER
S.A.T.HOSPITAL
TRIVANDRUM
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MetforminMetformin
Decreases Hepatic Gluconeogensis
Increases Peripheral Tissue Sensitivity Decreases Intestinal Absorption Increases SHBG Decreases LH Decreases Appetite and Obesity
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MetforminMetformin
o Direct Action on Pancreatic Beta
cells
NO HYPOGLYCEMIA
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MetforminMetformin
Side effects
Gastro intenstinal disturbancesLactic acidosis in renal dysfunction
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Selection CriteriaSelection Criteria
Typical PCOS-Obese, Hirsute, Oligomenorrhoeic
Family h/o Diabetes
Fasting Glucose/Insulin Ratio
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Treatment ProtocolsTreatment Protocols
Metformin alone
Combination with- Clomiphene Citrate
- Ovarian Follicular Puncture- Gonadotropins
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ThiazolidinedionesThiazolidinediones
Enhance cellular Insulin Action
Peroxisome Proliferator Activated Receptor
Troglitazone-Hepatotoxicity
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D-chiro-inositolD-chiro-inositol
PhosphoglycanPost-receptor Insulin actionIncrease Intracellular glucose disposalDose-1200mg/day for 6-8 weeks
Hyponidd-epicatechinMonotherapy or combinationDose-Two tablets B.D before meals
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Results of TreatmentResults of Treatment
PregnancyRate
Pregnancyloss
Pregnancy>10 wks
Regimewith ISA
51.48% 14.65% 43.93%
Regimewithout ISA
49.60% 34.40% 32.54%
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THANK YOUTHANK YOU
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