Diabetes mellitus glucose homeostasis

Gajjar DA, LaCreta FP, Kollia GD Stolz RR, Berger S, Smith WB, Swingle M, Grasela DM. Effect of multiple-dose gatifloxacin or ciprofloxacin on glucose homeostasis and insulin production in patients with non-insulin-depen-dent diabetes mellitus maintained with diet and exercise. Pharmacotherapy 2000 20(6 pt 2) 76S-86S. 

Since changes in glucose balance after diuretics tend to be reversible on withdrawal, measures of carbohydrate homeostasis should be assessed after several months of thiazide treatment to detect those few patients who experience significant glucose intolerance (353). With this approach, the small risk of diabetes mellitus secondary to diuretic therapy can be minimized. 

Gatifloxacin was well tolerated in patients with non-insu-lin-dependent diabetes mellitus maintained with diet and exercise (432). It had no significant effect on glucose homeostasis, beta cell function, or long-term fasting serum glucose concentrations, but it caused a brief increase in serum insulin concentrations. 

To sum up the essential life-supporting function of insulin is the maintenance of glucose homeostasis. The question therefore is, how is insulin doing that We shall focus therefore on transport and metabolism of glucose and its control by insulin. Thus the scope of this chapter is quite narrow, dealing only with insulin actions. Although the classical human type 2 diabetes mellitus is caused by both an impairment of insulin... 

Pharmacologically mediated adverse effects can be placed into one of three categories (1) primary pharmacodynamic (PD) effects, (2) secondary PD effects, and (3)those either not linked to the primary PD effect or caused by an unknown mechanism. Primary pharmacodynamic adverse effects are those which represent an overexpression of the primary, intended pharmacological effect of the xenobi-otic. An example of an adverse primary PD effect occurs when an overdose of insulin, a critical hormone involved in the homeostasis of blood glucose, is administered. A deficiency of insulin results in diabetes mellitus and is expressed by hyperglycemia. Overdosing of insulin results in hypoglycemia, which can have immediate and severe clinical consequences. 

As elevated 11 p-HSD activities and the resulting increased GC productirai have been reported to impair the glucose and Upid homeostasis and lead to the development of insulin resistance, inhibitory effect of GA could represent a potential therapeutic intervention in the treatment of type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS) [13-18]. 

---