Diabetes and its treatment by glucagon- like peptide 1 analogs and DI-peptidy 1 peptidase 4 inhibitors

The burden of diabetic patients on healthcare has increased over the period of time. Management of diabetes presents a challenge to the physician. The availability of newer drugs, tested in high quality clinical trials, has marked a new era in the treatment of diabetes. Glucagon-like peptide 1 [GLP-1] analogs act by increasing the pancreatic beta-cell mass and subsequent insulin secretion. Dipeptidase-4 [DPP-4] inhibitors inhibit the enzyme that degrades GLP-1, resulting in the augmentation of GLP-1 in the body. Hence, the two drugs can be used synergistically. It was seen that severe hypoglycemia seldom occurred with GLP-1 analogues and DPP-4 inhibitors. Gastrointestinal upset and the development of antibodies to the drug in the body was mainly attributed to GLP-1 analogs. DPP-4 inhibitors showed increased risk of nasopharyngitis, urinary tract infections and headache. There is a need for further advances in our understanding, through randomized control clinical trials in larger settings, to establish the role and safety of these newer agents in the treatment of diabetes. The initiation of a modern set of medications may help us control type2 diabetes better

Undetected common variable immune deficiency in a young adult of Pakistani descent

Common variable immune deficiency [CVID] is a syndrome which is due to deficiency of humoral immune response resulting in increased susceptibility to infections. We report a case of CVID in a 24-year-old male who presented with a history of recurrent pneumonias