Diabetes therapy

Monitor response to all diabetic therapies by periodic measurements of FPG and HbA-ic levels. During initial dose titration, fasting glucose can be used to determine... 

Diabetes mellitus is a heterogeneous group of disorders characterized by abnormalities in carbohydrate, protein, and lipid metabolism. The central disturbance in diabetes mellitus is an abnormality in insulin production or action or both, although other factors can be involved. Hyperglycemia is a common end point for all types of diabetes mellitus and is the parameter that is measured to evaluate and manage the efficacy of diabetes therapy. 

Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group Intensive diabetes therapy and carotid intima-media thickness in type 1 diabetes mellitus. N Engl 3 Med 2003 348 2294. 

Ahren B. Exenatide a novel treatment of type 2 diabetes. Therapy 2005 2 207-22. 

Klonoff DC. Continuous glucose monitoring roadmap for 21st century diabetes therapy. Diabetes Care 2005, 28, 1231-1239. 

Pfeiffer EF. The glucose sensor the missing link in diabetes therapy. Hormone and Metabolic Research Supplement 1990, 24, 154—164. 

The Diabetes Control and Complications Trial (DCCT) has shown that intensified diabetes therapy resulted in HbAlc reductions of approximately 2% compared to conventional therapy, and that patients practicing intensified diabetes therapy enjoyed significant reductions in the feared microvascular complications of diabetes (DCCT Research Group, 1993). As such, the current aim of diabetes therapy is to achieve glycemic control that is as close to normal as possible while maintaining an acceptable quality of life for those patients for whom the therapy is prescribed.The DCCT also demon-... 

Intensive diabetes therapy and carotid intima-media thickness in type I diabetes mellitus. 

An older patient, Mrs Carmella Bianca, has recently moved to this country to live with her daughter following the death of her husband. She has very little English but whenever she comes into your pharmacy you practise your holiday Italian with her. She has been taking oral diabetic therapy, but today she brings in a prescription for insulin and needles. She does not seem her happy bubbly self. What could be the possible cause of her anxiety and how could you help to reassure her ... 

The presence of increased UAE denotes an increase in the transcapfilary escape rate of albumin and is therefore a marker of microvascuiar disease. Persistent UAE greater than 20p.g/min represents a twentyfold greater risk for the development of clinically overt renal disease in patients with type 1 and type 2 diabetes. Prospective studies have demonstrated that increased UAE precedes and is highly predictive of diabetic nephropathy, end-stage renal disease, cardiovascular mortality, and total mortahty in patients with diabetes mel-litus. The DCCT and UKPDS showed that intensive diabetes therapy can significantly reduce the risk of devel-... 

Hsiao and Salmon reported that patients beliefs about the benefits of diabetes therapy are important in determining whether they obtain and use medication. In general, the more severe the patient s disease and the greater the perceived susceptibility to complications, the more likely the patient is to be adherent. Patients must be convinced of the seriousness of their disease and empowered to monitor themselves for diabetic complications. Patients with diabetes who were at high risk for nonadherence included older people, men, and those with low socioeconomic status. 

Aside from diabetes therapy, sulfonylurease could have other uses. Table VI depicts 23 nondiabetic uses for which tolbutamide has been investigated and reported in the medical literature during the past five to six years. Tolbutamide has not been established as efficacious in most of these conditions. But it is possible that some analog of tolbutamide, perhaps one that does not lower blood sugar, could be effective in some nondiabetic condition. It should be no less thinkable today than it was in 1935 to state that a chemical dye could be effective in treating bacterial infections or in 1942 that an antibacterial drug could be effective in treating diabetes mellitus. 

Needle-free and pain-free therapy intensive diabetes therapy requires at least three to four injections per day. Orahn avoids the use of needles. 

A tiny pump promises hig time performance Binghamton University invention could sweeten diabetes therapy within five years. Science Daily, 12 June 2003. 

Lowering of blood glucose by the infusion of guanidine [89], biguanides and two linked guanidine moieties has proved to be useful for the treatment of diabetes meUims. Three compounds became available for diabetes therapy, phenformin (51), buformin (52) and metformin (53) (Figure 10.12). Phenformin (51) was withdrawn due to lactic acidosis [90]. Metformin (53), a less lipophilic biguanide, was recently approved for use in the USA after 20 years of use in Europe [91]. 

Demuth HU, McIntosh CH, Pederson RA. Type 2 diabetes -therapy with dipeptidyl peptidase IV inhibitors. Biochim Biophys Acta 2005 1751 33. ... 

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