Blood glucose concentration increase

Since the enzyme glycogen synthase catalyses the rate-limiting step in glycogen synthesis, it is the activity of this enzyme that must be increased as the blood glucose concentration increases. This is achieved via an interconversion cycle (i.e. reversible phosphorylation). A protein kinase phosphorylates it, which inactivates the enzyme, whereas a protein phosphatase dephosphorylates it, which... 

Insulin lispro induces more rapid and constant release of insulin from the injection site, since it consists of monomeric insulin. The change of one or more amino acids in the insulin molecule prevents insulin from forming dimers or hexamers. More rapid absorption, rapid availability, and rapid inactivation make the action better than that of endogenously secreted insulin. When the interval between meals is long, the premeal blood glucose concentration increases rapidly. 

The effects of thiazide-type diuretics on carbohydrate tolerance cannot be ignored (50). There is a definite relation between diuretic treatment, impaired glucose tolerance, and biochemical diabetes, and a possible relation with insulin resistance (64). It is well estabhshed that the effect of thiazides on blood glucose is dose-related, probably linearly, while the antihjrpertensive effect has httle relation to dose (65-67). There is relatively httle information on the time-course numerous short-term studies have shown that the blood glucose concentration increases in 4-8 weeks (68). The evidence that current low dosages impair glucose tolerance in the long term is not entirely consistent, perhaps because of differences between studies... 

Metabofism Glucose Indapamide increases the blood glucose concentration, increasing the risk of cardiovascular events. Patients with hypertension inadequately controlled with angiotensin II receptor antagonists were given indapamide 1 mg/day for 3 months and... 

In contrast, the effect on performance of carbohydrate feeding 30 to 60 min before exercise is unclear. Although blood glucose concentrations increased after ingestion of carbohydrate, one study reported improved and othCTS - showed no effects on performance compared to controls. There was consensus of no adverse effects on performance. Sherman et al. reported a 15% improvement in cycling performance when cyclists consumed 300 g of carbohydrate 4 h before the performance test. Thus, exogenous carbohydrate fed before exercise may be beneficial to individuals who have low glycogen stores. 

The increase in insulin concentrations produced by sulphonylureas lowers blood glucose concentrations through decreased hepatic glucose output and increased glucose utilisation, mostly by muscle ( insulin, insulin receptor). 

Figure 19-5. Variation in glucose phosphorylating activity of hexokinase and glucokinase with increase of blood glucose concentration. The for glucose of hexokinase is 0.05 mmol/L and of glucokinase is 10 mmol/L.

Figure 3.23 A sequence of processes explaining the role of glucokinase in the liver and fi-cells in regulation of the blood glucose concentration. The increase in the plasma insulin increases glucose uptake by muscle and decreases fatty acid mobilisation from adipose tissue which lowers the plasma fatty acid level which also increases glucose uptake (Chapter 12).

Therapeutic principles. In healthy subjects, the amount of insuUn is automatically matched to carbohydrate intake, hence to blood glucose concentration. The critical secretory stimulus is the rise in plasma glucose level. Food intake and physical activity (increased glucose uptake into musculature, decreased insulin demand) are accompanied by corresponding changes in insulin secretion (A, left track). 

Mechanism of Action A second-generation sulfonylurea that promotes release of insulin from beta cells of the pancreas and increases insulin sensitivity at peripheral sites. Therapeutic Effect Lowers blood glucose concentration. 

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