Metabolic Disorders

Obesity is now the most common nutritional disorder
Obesity is now the most common nutritional disorder in western industrialised countries and arises from the accumulation of excess fat in the body from over consumption of fatty foods. (Source: ABPI)
Rimonabant
Rimonabant has been developed from the knowledge that cannabis smokers often experience extreme hunger pangs, which cannabis smokers refer to as 'the munchies'. (Source: ABPI)

Byetta risk factors
Risk factors complications. (Source: ABPI)
Blood-glucose level control
If Exenatide is approved for clinical use it may enable type 2 diabetics to effectively control their blood-glucose levels while reducing or eliminating the risk of hypoglycaemia and weight gain.
Clinical trial results
Results from clinical trials reported to date suggest Exenatide is well tolerated.

Metabolic syndrome
Obesity is included in the ATP III diagnostic criteria for metabolic syndrome.
Obesity contributory factors
Figures from the American Heart Association suggest 20% to 25% of US adults have metabolic syndrome, for which obesity is a contributory factor.
Clinical obesity
Clinical obesity is usually defined as a BMI of greater than 30.
UK rates of obesity
Rates of obesity in the UK increased significantly during the 1990s and continue to rise.
Lipase inhibitors
Various therapeutic strategies have been explored for the treatment of obesity including the use of lipase inhibitors.


Osteoporosis increases in later life, particularly in post-menopausal women, as bone density decreases.

Amgen's denosumab has now progressed to phase III development.

Phases in the skeletal life cycle.


Diabetics who require insulin to keep their blood sugar levels under tight control currently have to administer it by injection. (Source: ABPI)

Onset of Type 1 Diabetes. (Source: ABPI)

Exubera is an inhaled short-acting insulin preparation indicated for the treatment of type 1 and type 2 diabetes.

Concerns have been raised about the safety of inhaled preparations and whether Exubera will compromise lung capacity or damage lung tissue in long-term use.

Types of insulin.

Left uncontrolled, diabetes can lead to coronary heart disease, kidney failure, blindness, limb amputations and premature death.


Phases in skeletal life cycle. (Source: ABPI)

Factors which increase the risk of developing Osteoporosis.


The US NCEP Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol ATP III criteria are among the most widely used for diagnosis of metabolic syndrome.

Figures from the American Heart Association suggest 20% to 25% of US adults have metabolic syndrome.

Some 70 million US adults are believed to have insulin resistance.

Lack of physical activity together with obesity and insulin resistance can contribute to the development of metabolic syndrome.


Management of type 2 diabetes requires the maintenance of good glycaemic control together with tight control of blood lipid levels and blood pressure.

A range of injectable insulins and oral antidiabetic medications are used in the treatment of diabetes.

Raised blood pressure and obesity are features common to people who develop type 2 diabetes. (Source: ABPI)

Type 2 diabetes accounts for up to 95% of all cases of diabetes.

Current estimates indicate that worldwide about 170 million people suffer from diabetes, which is projected to reach 366 million by 2030.


Januvia has been approved in the US and the EU for the treatment of type 2 diabetes.

The three-way action of Januvia has been proven to lower levels of blood sugar.

Merck is conducting further trials on Januvia to test its efficacy with minimal side effects.

Management of type 2 diabetes
Management of type 2 diabetes requires maintenance of good glycaemic control together with tight control of blood lipid levels and blood pressure.
Features common to people who develop type 2 diabetes
Raised blood pressure and obesity are features common to people who develop type 2 diabetes.
Novo Nordisk’s NovoMix 30
Novo Nordisk’s NovoMix 30 is a unique insulin analogue that combines rapid and intermediate acting insulin aspart, providing the insulin requirement in a single injection.
Novo Nordisk’s repaglinide
Novo Nordisk’s repaglinide (NovoNorm) is an oral antidiabetic agent for the treatment of type 2 diabetes in patients who uncontrolled by diet and exercise.

Anti-obesity pharmaceutical market
The anti-obesity pharmaceutical market is growing as the proportion of the world's population who are overweight is steadily increasing.
Anti obesity drug clinical trials
Arena's lorcaserin has demonstrated positive results in clinical trials and the drug is now awaiting FDA approval.
Anti-obesity drugs
Medical and related costs of obesity are $123bn per year in the US; something that anti-obesity drugs could help to lessen.


There are a range of symptoms that may be suggestive of diabetes, including excessive thirst and tiredness.

Typical day-to-day patterns of blood glucose levels in several individuals.

Risk factors for diabetic complications.

Age of onset of type 1 diabetes, formerly known as insulin-dependent diabetes.

Management of diabetes requires not only good glycaemic control but also control of blood pressure and blood lipid levels. Effective control significantly reduces the risk of diabetes-related complications.

Type 2 diabetes accounts for the vast majority of cases.

Features common to people who develop type 2 diabetes
Raised blood pressure and obesity are features common to people who develop type 2 diabetes.
Percentage of men and women in England classified as obese
The percentage of men and women in England classified as obese has been increasing over time.
Management of type 2 diabetes
Management of type 2 diabetes requires maintenance of good glycaemic control together with tight control of blood lipid levels and blood pressure.
characteristics of patients with type 2 diabetes
Common characteristics of patients with type 2 diabetes.


The percentage of men and women in England classified as obese has been increasing over time.
Percentage of men and women classified as obese
The proportion of men with a healthy BMI drops rapidly towards midlife and the proportion classified as obese peaks at about the same age. Similar changes are seen in women, although obesity peaks later, after the menopause.

Maintaining the Basal Metabolic Rate (metabolism) accounts for 60–75% of daily energy expenditure in most people, while physical activity accounts for only 10–15%.

Initial weight loss interventions, based on BMI and waist circumference, recommended in the National Institute for Clinical Excellence (NICE) guidelines.

Some of the chemical signals that influence eating
Some of the chemical signals (blue) that influence eating and affect the production and action of the body's fuels (green). The hypothalamus is the part of the brain that is responsible for controlling energy balance.
The proportion of men with a healthy BMI
The proportion of men with a healthy BMI drops rapidly towards midlife and the proportion classified as obese peaks at about the same age. Similar changes are seen in women, although obesity peaks later, after the menopause.
Metabolism
Maintaining the basal metabolic rate (metabolism) accounts for 60–75% of daily energy expenditure in most people, while physical activity accounts for only 10–15%.
Initial weight loss interventions
Initial weight loss interventions, based on BMI and waist circumference, as recommended in NICE guidelines.
Medicines in development for treating obesity
Some of the targets for medicines in development for treating obesity. Tesofensine is one of those set to enter trials as an anti-obesity medication.


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