Chemistry Reference
In-Depth Information
O
S
H
3
CO
H
3
CO
NH
2
N
Cl
S
−
K
+
O
N
SH
H
NH
2
Cl
CO
3
H
OCH
3
CH
3
OCH
3
CH
3
OCH
3
OCH
3
H
3
C
H
3
C
N
N
O
N
S
Oxidation
N
S
N
N
H
H
Sulfide
Omeprazole
cumene peroxide
D-(
)-diethyl tartrate
Ti(OiPr)
4
HN(iPr)
2
−
OCH
3
CH
3
OCH
3
CH
3
OCH
3
OCH
3
H
3
C
H
3
C
N
N
O
N
S
N
N
S
Asymmetric oxidation
N
H
H
Esomeprazole
Sulfide
11.5 DIABETES
Diabetes is a disease in which there are high levels of glucose in the blood. It
can be caused by too little insulin, a hormone that controls blood sugar, resis-
tance to insulin, or both. Sometimes it is called diabetes mellitus, with mellitus
derived from the Latin for honey-sweet. Type 1 involves the body's inability
to produce insulin and requires people to inject insulin as a treatment. Ges-
tational diabetes occurs during pregnancy. Among patients diagnosed with
diabetes, 90% have Type 2 disease, which is characterized by resistance to
insulin action and impairment of insulin secretion, rather than an absolute
lack of insulin production, as in patients with Type 1 disease [39]. Estimates
are that diabetes affects about 8% of the United States population and 250 mil-
lion people worldwide; it is the seventh leading cause of death in the United
States [40]. There are several drugs used to help control sugar levels and many
patients require treatment with more than one type of drug.
Metformin, dimethylbiguanide, also known as glucophage is a common
drug prescribed for diabetes. Despite being used for over 50 years and being
the most widely prescribed drug for Type 2 diabetes, the mechanism of
action remains imperfectly understood [41]. It is linked to an improved
peripheral sensitivity to insulin through a stimulated tissue glucose uptake by
a transporter-linked system [42]. It also suppresses glucose production. Its
discovery can be traced back to medieval times when French lilac was used
medicinally. Later, it was discovered that French lilac was rich in guanidine
and in the mid 1900s, Jean Sterne explored the antidiabetic properties of
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