Diabetes mellitus glucagon

The answer is a. (Hardman, p 1510.) Although the mechanism of action of metformin and other biguanicies is unclear, biguanides virtually never cause hypoglycemia They operate independently of pancreatic p cells but are not useful in insulin-dependent diabetes mellitus (IDDM). Some possible mechanisms of action are direct stimulation of glycolysis in peripheral tissues, increased sensitivity to insulin, and reduction of glucagon levels. 

Diabetes mellitus with neuropathy, hypothyroidism, panhypopituitarism, pheochromocytoma, hypercalcemia, enteric glucagons excess. 

Glucagon-like peptide 1 abasis of a new class of treatment for type 2 diabetes. Journal of Medicinal Chemistry, 47, 4128 134 (b) Vahl, T.P. and D Alessio, D.A. (2004) Gut peptides in the treatment of diabetes mellitus. Expert Opinion on Investigational Drugs, 13, 177-188 (c) Meier, J.J. and Nauck, M.A. 

Sitagliptin is a dipeptidylpeptidase-4 inhibitor that increases insulin secretion and lowers glucagon secretion. Sitagliptin is available for oral administration. It is indicated in patients with type 2 diabetes mellitus in combination with either metformin (biguanide) or a sulphonylurea or a thiazolidinedione. 

Sitagliptin is a selective dipeptidylpeptidase 4 (DPP-4) inhibitor which increases the active form of GLP-1 (glucagon-like-peptide-1) and GIP (glucose-dependent insulinotropic peptide). This enzyme-inhibiting drug is to be used either alone or in combination with metformin or a thiazolidinedione for control of type 2 diabetes mellitus. Adverse effects were as common with sitagliptin (whether used alone or with metformin or pioglitazone) as they were with placebo, except for nausea and common cold-like symptoms. 

Several tests use glucagon to diagnose endocrine disorders. In patients with type 1 diabetes mellitus, a classic research test of pancreatic beta-cell secretory reserve uses 1 mg of glucagon administered as an intravenous bolus. Because insulin-treated patients develop circulating anti-insulin antibodies that interfere with radioimmunoassays of insulin, measurements of C-peptide are used to indicate beta-cell secretion. 

The metabolic abnormalities of diabetes mellitus result from a deficiency of insulin and a relative excess of glucagon. These aberrant hormonal levels most profoundly affect metabolism in three tissues liver, muscle, and adipose tissue (Figure 25.3). 

UNIT V Integration of Metabolism Chapter 23 Metabolic Effects of Insulin and Glucagon 305 Chapter 24 The Feed/Fast Cycle 319 Chapter 25 Diabetes Mellitus 335 Chapter 26 Obesity 347 Chapter 27 Nutrition 355 Chapter 28 Vitamins 371... 

Holst JJ. Therapy of type 2 diabetes mellitus based on the actions of glucagon-like peptide-1. Diabetes Metab Res Rev 2002 18(6) 430-41. 

Several peptide products used in the treatment of diabetes mellitus, in addition to insulin, are currently administered by subcutaneous injection and these drugs are candidates for development of nasal formulations. Glucagon-like peptide-1 (GLP-l)-related peptides stimulate the insulin response to glucose and diminish the release of glucagon after a meal. These effects diminish the excessive postprandial increase in glucose observed after a meal in persons with type 2 diabetes mellitus. GLP-1-related peptides must be administered by subcutaneous injection before meals in order to be effective. This requirement for injection before each meal is likely to impact the utilization of these products by persons with type 2 diabetes. Exendin-4 is a GLP-1-related peptide with a molecular mass of 4.2 kDa. The development of a GLP-1-related peptide nasal formulation containing an absorption enhancer would allow patients to scll-administer one of these drugs just before a meal without the need for a subcutaneous injection. 

The islet cells of the pancreas synthesize and secrete insulin and glucagon. These hormones are important in regulating glucose uptake and use, as well as in other aspects of energy metabolism. Problems in the production and effects of insulin are typical of a disease known as diabetes mellitus. Diabetes mellitus can be categorized into two primary forms type 1 diabetes, which is caused by an absolute deficiency of insulin, and type 2 diabetes, which is caused by a decrease in peripheral insulin effects, combined with abnormal insulin release. 

J. Y. and Stoffers, D. A. (2006) Role of glucagon-like peptide-1 in the pathogenesis and treatment of diabetes mellitus. hit J Biochem Cell Biol 38, 845-859. 

Because insulin normally inhibits lipolysis, a diabetic has an extensive lipolytic activity in the adipose tissue. As is seen in Table 21.4, plasma fatty acid concentrations become remarkably high. /3-Oxidation activity in the liver increases because of a low insulin/glucagon ratio, acetyl-CoA carboxylase is relatively inactive and acyl-CoA-camitine acyltransferase is derepressed. /3-Oxidation produces acetyl-CoA which in turn generates ketone bodies. Ketosis is perhaps the most prominent feature of diabetes mellitus. Table 21.5 compares ketone body production and utilization in fasting and in diabetic individuals. It may be seen that, whereas in the fasting state ketone body production is roughly equal to excretion plus utilization, in diabetes this is not so. Ketone bodies therefore accumulate in diabetic blood. 

Gallwitz, B. 2005. Glucagon-like peptide-l-based therapies for the treatment of type 2 diabetes mellitus. Treat. Endocrinol, 4, 361-370. 

Diabetes mellitus, the most common serious metabolic disease, is due to metabolic derangements resulting in an insufficiency of insulin and an excess of glucagon relative to the needs of the individual. The result is an elevated blood-glucose level, the mobilization of triacylglycerols, and excessive ketone-body formation. Accelerated ketone-body formation can lead to acidosis, coma, and death in untreated insulin-dependent diabetics. 

Glucagon, which is produced in the alpha cells of the islets of Langerhans, is used in diabetes mellitus type 1 to stimulate glucose output from the liver during hypoglycemia (1 mg subcutaneously, repeated once or twice) when glucose cannot be given intravenously. In some countries... 

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