Diabetes, type transfer

A 35-year-old woman with type 1 diabetes was transferred after 7 years to lispro subcutaneously tds and NPH twice daily (33). Within 2 years she developed lipoatrophy and further lipoatrophy at another site 6 months later. 

Transferal of Type 2 Diabetes Patients on Insulin to Chlorpropamide Monotherapy ... 

A 54-year-old woman with type 2 diabetes had poor metabolic control, despite using 60-80 units of shortacting and long-acting human insulins for 10 years (34). Transfer to insulin lispro reduced the daily amount of insulin to 28 units. Insulin specific antibodies fell from 2.7 to 0.3% and cross-reactive antibodies, binding both human insulin and insulin lispro, fell from 44 to 16%. Specific insulin lispro antibodies rose from 0 to 0.3%. HbAic fell from 9.1% to 6.8% and body mass index from 30 to 27, probably because of the reduced dose of insulin. 

The FABPs are a family of carrier proteins for fatty acids and other lipophilic substances, such as eicosanoids and retinoids. These proteins are thought to facilitate the transfer of fatty acids between extra- and intracellular membranes. Adipocyte fatty acid-binding protein (aP2 FABP4) is expressed in adipocytes and macrophages, and integrates inflammatory and metabolic responses. Studies in aP2-deflcient mice have shown that this lipid chaperone has a significant role in several aspects of the metabolic syndrome, including type 2 diabetes and atherosclerosis. FABP has also been introduced as a plasma marker of acute myocardial infarction. 

Hirano R, Igarashi O, Kondo K, Itakura H, Matsumoto A. Regulation by long-chain fatty acids of the expression of cholesteryl ester transfer protein in HepG2 cells. Lipids 2001 36 401 06. Smaoui M, Hammami S, Attia N, Chaaba R, Abid N, Kilani N, Kchaou H, Mahjoub S, Abid M, Hammami M. Modulation of plasma cholesteryl ester transfer protein activity by unsaturated fatty acids in Tunisian type 2 diabetic women. Nutr. Metab. Cardiovasc. Dis. 2006 16 44-53. 

Schneider M, Verges B, Klein A, Miller ER, Decker V, Desrumaux C, Masson D, Gambert P, Brun JM, Fruchart-Najib J, Blache D, Witztum JL, Lagrost L. Alterations in plasma vitamin E distribution in type 2 diabetic patients with elevated plasma phospholipid transfer protein activity. Diabetes 2004 53(10) 2633-9. 

The treatment with acarbose of Type-II diabetics who had already been transferred to insulin, revealed an insulin-saving effect. The total daily insulin dosage was reduced by 10IU per patient with acarbose, while insulin and placebo increased the daily insulin dosage by 0.7 IU. Blood glucose levels in the acarbose group was lowered (Rosak, 1990) and HbA was decreased... 

David McCance D, Damm P, Mathiesen ER, Kaaja K, Dunne F, Hod M, Jensen EE, Mersebach H. No increase in insulin antibodies and no clear evidence of transfer of insulin aspart across the placenta in pregnant women with type 1 diabetes. Abstrakt ADA 2007. 

A long-term study in 53 patients with type 2 diabetes found that chlorothiazide 500 mg or 1 g daily or trichlormethiazide 4 or 8 mg daily caused a mean rise in blood glucose levels from about 6.7 to 7.8 mmol/L. Only 7 patients needed a change in their treatment 4 required more of their ord antidiabetic, 2 an increase in insulin dose, and one was transferred from tolbutamide to insulin. The oral antidiabetics used included toibutamide, chlorpropamide, acetohexamide and phenformin. ... 

Keswani, S. G., Katz, A. B., Lim, E Y, Zoltick, R, Radu, A., Alaee, D., Herlyn, M., and Crombleholme, T. M. 2004. Adenoviral mediated gene transfer of Pdgf-B enhances wound healing in type 1 and type 11 diabetic wounds. Wound Repair and Regeneration, 12,497-504. 

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