Diabetes mellitus insulin secretion increase

CF-related diabetes shares characteristics of both type 1 and type 2 diabetes mellitus but is categorized separately. The primary cause of CFRD is insulin deficiency resulting from both reduced functional pancreatic islet cells and increased islet amyloid deposition. Insulin secretion is delayed in response to glucose challenge, and absolute insulin secretion over time is reduced. Some insulin resistance may also be present in CFRD however, sensitivity may be increased in CF patients without diabetes.8... 

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. 

The peptide hormone insulin (see Box 13.1) is produced by the pancreas and plays a key role in the regulation of carbohydrate, fat, and protein metabolism, hi particular, it has a hypoglycaemic effect, lowering the levels of glucose in the blood. A malfunctioning pancreas may produce a deficiency in insulin synthesis or secretion, leading to the condition known as diabetes mellitus. This results in increased amounts of glucose in the blood and urine, diuresis, depletion of carbohydrate stores, and subsequent breakdown of fat and protein. Incomplete breakdown of fat leads to the accumulation of ketones in the blood, severe acidosis, coma, and death. 

Diabetes mellitus is a group of devastating metabolic dis-eases caused by insufficient insulin synthesis, increased insulin destruction, or ineffective insulin action. All of its metabolic effects result when the body s cells fail to acquire glucose from the blood. The metabolic imbalances that occur have serious, if not life-threatening, consequences (Figure 16A). In insulin-dependent diabetes mellitus (IDDM), also called type I diabetes, inadequate amounts of insulin are secreted because the (3-cells of the pancreas have been destroyed. Because IDDM usually occurs before the age of 20, it has (until recently) been referred to as juvenile-onset diabetes. Noninsulin-dependent diabetes mellitus (NIDDM), also called type II or adult-onset diabetes, is... 

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