Vildagliptin is a dipeptidyl peptidase 4 DPP 4 inhibitor which is believed to exert its actions in patients with type 2 diabetes by slowing the inActivation of incretin hormones Incretin hormones including glucagon like peptide 1 GLP 1 and glucose dependent insulinotropic polypeptide GIP are released by the intestine throughout the day and levels are increased in response to a meal These hormones are rapidly inActivated by the enzyme DPP 4 The incretins are part of an endogenous system involved in the physiologic regulation of glucose homeostasis When blood glucose concentrations are normal or elevated GLP 1 and GIP increase insulin synthesis and release from pancreatic beta cells by intracellular signaling pathways involving cyclic AMP GLP 1 also lowers glucagon secretion from pancreatic alpha cells leading to reduced hepatic glucose production By increasing and prolonging Active incretin levels Vildagliptin increases insulin release and decreases glucagon levels in the circulation in a glucose dependent manner Metformin The pharmacologic mechanism of action of Metformin is different from other classes of oral antihyperglycemic agents Metformin decreases hepatic glucose production decreases intestinal absorption of glucose and increases peripheral glucose uptake and utilization

Encelin M 50 500 Tablet 10 s should not be used in patients with type 1 diabetes or with diabetic ketoacidosis Some diabetic patients while taking Encelin M 50 500 Tablet 10 s might develop a rare but serious condition called lactic acidosis In this condition there is too much lactic acid accumulated in the blood that can damage the working of your liver and kidney required for the elimination of excess lactic acid from the blood Before you start taking Encelin M 50 500 Tablet 10 s tell your doctor if you ve ever had pancreatitis inflammation of the pancreas kidney disease and low vitamin B12 level Encelin M 50 500 Tablet 10 s when used with insulin may extremely lower the blood sugar level leading to hypoglycaemia condition which can be fatal In this case your doctor may adjust the dose by lowering the dose of insulin or Encelin M 50 500 Tablet 10 s Prolonged intake of Encelin M 50 500 Tablet 10 s may lower your thyroid stimulating hormone TSH hence an annual check up of TSH is recommended In rare cases you may also develop a serious skin reaction known as bullous pemphigoid that requires immediate medical attention Tell your doctor if you are going to have a diagnostic test with an injection of dye or X ray contrast agent The use of Encelin M 50 500 Tablet 10 s should be stopped for a short time before having an X ray procedure