Chronopharmacology of Diabetes: Harnessing Biological Rhythms for Optimal Treatment

Chronopharmacology of diabetes is the study of how the timing of medication administration influences the efficacy and safety of diabetes treatments. It considers the body's circadian rhythms, which affect drug metabolism, insulin sensitivity, and glucose regulation throughout the day. By aligning medication schedules with these biological rhythms, chronopharmacology aims to optimize blood sugar control, minimize side effects, and enhance the overall management of diabetes. This approach recognizes that the timing of drug delivery can be as crucial as the drug itself in achieving optimal therapeutic outcomes.

1. Parul Institute of Pharmacy and Research
Waghodiya, Gujarat -391760
CHRONOTHERAPY OF
DIABETES
A Seminar as a part of curricular requirement for
First year M.Pharm II Semester
Presented By
Prasan Das
Department of Pharmacology
Under the guidance/Mentorship of
Dr. Jagdish Kakadiya
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2. Introduction
Risk Factor & Symptoms of Diabetes
Types of Diabetes
Chronopharmacology
Circadian Rhythm, Insulin Action & Glucose
Homeostasis
Circadian Rhythm & Diabetes
Timing of Medication in Disease Management
Chronotherapy & Insulin Sensitivity
Chronobiology of Glucose Metabolism
Conclusion
References
Content
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3. Introduction
Diabetesisachronicconditionthataffectshowbodyusesblood
sugar.
Diabetesoccurswhenbloodsugar,orbloodglucose,istoohigh.
Insulin,ahormoneproducedbythepancreas,helpsregulateblood
sugarlevels.Indiabetes,thebodyeitherdoesn'tproduceenough
insulinordoesn'tuseiteffectively.
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4. Symptoms & Risk Factors
Risk
Factors
Poor Diet
Family
History
Physical
Inactivity
History of
CVD
Hypertension
Obesity
Symptoms
Increase
Thrust
Weight
Loss
Blurred
Vision
Increase
Fatigue
Tender
Gums
Frequent
Urination
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5. Types of Diabetes
Whiletype1&type2arethemostcommonformofdiabetes,
thereareotherothers-ImpairedGlucosemetabolismorPre-
diabetes.
Therearetwopre-diabetesconditions:ImpairedGlucose
Tolerance(ICT)iswherebloodglucoselevelsarehigherthan
normalbutnothighenoughtobeclassifiedasdiabetes.
ImpairedFastingGlucose(IFG)iswherebloodglucoselevels
areescalatedinthefastingstatebutnothighenoughtobe
classifiedasdiabetes.
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6. Type1diabetesisusuallydiagnosedinchildrenandyoungadults.
Only10%ofpeoplewithdiabeteshavethisformofdisease.
Intype1diabetes,thebodydoesnotproduceInsulin.
Patientwithtype1diabeteswillneedtotakeinsulininjectionsfor
therestoftheirlife.Theymustalsoensureproperblood-glucose
levelsbycarryingoutregularbloodtestsandfollowingaspecial
diet.
Type 1 Diabetes
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7. Itgraduallygetsworseandthepatientwillprobablyenduphave
totakeinsulin,usuallyintabletform.
Overweightandobesepeoplehaveamuchhigherriskof
developingtype2diabetescomparedtothosewithahealthybody
weight.
Theriskofdevelopingtype2diabetesisalsogreaterasweget
older.
Menwhosetestosteronelevelsarelowhavealsobeenfoundto
haveahigherriskofdevelopingtype2diabetes.
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Type 2 Diabetes

8. Thistypeeffectsfemalesduringpregnancy.
Themajorityofgestationaldiabetespatientscancontroltheir
diabeteswithexerciseanddiet.Undiagnosedoruncontrolled
gestationaldiabetescanraisetheriskofcomplicationsduring
childbirth.Thebabymaybebiggerthanhe/sheshould.
Gestational Diabetes
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9. Chrono Pharmacology
Chronopharmacologyisasciencedealingwithoptimizationof
drugeffect&minimizationofadverseeffectbytiming
medicationsinrelationtobiologicalrhythm.Itisconcernedwith
theeffectofdrugsuponthetimingofbiologicaleventsand
rhythm.
ThePhysiologicalparametersshowsarhythmicchange,mostly
synchronizedwiththeperiodicchangesintheenvironment.
Circadian:Lastingforabout24hours-Sleepwakecycle.
Infradian:Cyclelongerthan24hours-Menstrualcycle.
Biological Rhythm
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10. Ultradian:Cycleshorterthanaday-Neuronalfiringtime.
Seasonal:Seasonalaffectivedisorders.
It’sanaturalmechanismoforganismwhichchangesondaily,
seasonal,yearlyorotherregularcycle.
Biological Clock
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11. Circadian Rhythm, Insulin Action & Glucose
Homeostasis
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12. Circadian Rhythm & Diabetes
Circadianrhythmsarethebody'sinternalclockthatregulates
variousphysiologicalprocesses,includingmetabolismand
hormonesecretion
Disruptionofcircadianrhythmshasbeenlinkedtoanincreased
riskofdevelopingdiabetesanditscomplications.
Chronotherapyaimstosynchronizemedicationadministration
withthebody'scircadianrhythmstoimprovetreatmentoutcomes.
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13. Somediabetesmedications,suchasmetforminandsulfonylureas,
havespecifictimingrecommendationstooptimizetheir
effectiveness.
Forexample,takingmetforminwithmealscanhelpreduce
gastrointestinalsideeffectsandimproveglucosecontrolafter
meals.
Insulintherapymayalsobenefitfromtimingadjustmentsto
bettermatchmealtimeglucosefluctuations.
Timing of Medications in Diabetes
Management
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14. Researchsuggeststhatinsulinsensitivityvariesthroughoutthe
day,withthehighestsensitivityinthemorning.
Administeringinsulinorinsulin-sensitizingmedicationsduring
timesofpeaksensitivitymayimprovetheirefficacy.
Understandingthesefluctuationscanhelptailortreatment
strategiesforbetterglycemiccontrol.
Chronotherapy & Insulin Sensitivity
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15. Glucosemetabolismfollowsacircadianpattern,withhigher
glucoselevelsinthemorningandlowerlevelsintheevening.
Thebody'sabilitytohandleglucosediffersbasedonthetimeof
day,influencingtheeffectivenessofdiabetestreatments.
Chronotherapytakesadvantageofthesenaturalfluctuationsto
optimizediabetesmanagement.
Chronobiology of Glucose Metabolism
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16. Conclusion
Chronotherapyoffersapersonalizedapproachtodiabetes
managementthatconsiderstheindividual'sbiologicalclockand
lifestylefactors.
Byharnessingthepoweroftiminginmedicationadministration,
mealplanning,andexerciseroutines,individualswithdiabetes
canachievebetterbloodsugarcontrolandqualityoflife
Embracingchronotherapyasafundamentalaspectofdiabetes
carecanpavethewayforimprovedoutcomesandabrighter
futureforthoselivingwiththischroniccondition.
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17. References
Sagar.A.andJough,S.,Chronopharmacology:Recentadvancein
thetreatmentofDiabetesMellitusthroughChronotherapy.
Chronopharmacology&itsAspect.www.pharmainfo.net
K.D.Tripathi
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18. Thank You!