Glucose metabolism, disorders

The development or worsening of insulin-dependent diabetes mellitus is limited to isolated case reports in patients treated with interferon alfa or interferon alfa plus inter-leukin-2 (SEDA-20, 328) (SEDA-21, 371). In chronic hepatitis, diabetes mellitus was noted in only 10 of 11 241 treated patients (16). Although a relation between chronic hepatitis C and the occurrence of glucose metabolism disorders is possible (183), reports of diabetes mellitus in patients treated with interferon alfa were probably more than coincidental. Indeed, there have been reports of prompt amehoration or complete recovery after interferon alfa withdrawal (SED-13, 1092)... 

Insulin is a peptide hormone, secreted by the pancreas, that regulates glucose metabolism in the body. Insufficient production of insulin or failure of insulin to stimulate target sites in liver, muscle, and adipose tissue leads to the serious metabolic disorder known as diabetes mellitus. Diabetes afflicts millions of people worldwide. Diabetic individuals typically exhibit high levels of glucose in the blood, but insulin injection therapy allows diabetic individuals to maintain normal levels of blood glucose. 

Diabetes is a metabolic disorder where glucose metabolism in the body is impaired. Type 1 diabetes is an early onset disease in which the pancreatic cells lose the function of insulin secretion either by genetic disposition or by a viral attack. Type 2 diabetes is a late onset disease developed due to insufficient insulin secretion or insulin resistance resulting in impaired glucose metabolism. 

Another class of carbohydrate and fatty acid metabolism disorders is caused by systemic metabolic defects that affect the brain. Glucose-6-phosphatase deficiency (glycogenosis type I, Von Gierke s disease)... 

Nordberg A, Amberla K, Shigeta M, Lundqvist H, Viitanen M, Hellstrom-Lindahl E, Johansson M, Andersson J, Hartvig P, Lilja A, et al. (1998). Long-term tacrine treatment in three mild Alzheimer patients effects on nicotinic receptors, cerebral blood flow, glucose metabolism, EEG, and cognitive abilities. Alzheimer Dis Assoc Disord. 12(3) 228-37. 

Hypomania Hypomania has been the most common severe psychiatric side effect reported. This has been largely limited to patients in whom disorders characterized by hyperkinetic symptoms coexist with, but are obscured by, depressive affect. Diabetes There is conflicting evidence as to whether MAOIs affect glucose metabolism or potentiate hypoglycemic agents. Consider this if used in diabetics. Epilepsy The effect of MAOIs on the convulsive threshold may vary. Do not use with metrizamide discontinue MAOl 48 hours or more prior to myelography and resume 24 hours postprocedure. 

T. Viljanen, K. Ahonen, J.O. Rinne, Regional cerebral glucose metabolism in monozygotic twins discordant for Alzheimer s disease. Dement. Geriatr. Cogn. Disord. 16 (2003) 245-252. 

Baxter, L.R., Jr. (1994) Positron emission tomography studies of cerebral glucose metabolism in obsessive compulsive disorder. J Clin Psychiatry 55 Suppl 54—59. 

Swedo, S.E., Pietrini, R, Leonard, H.L., Schapiro, M.B., Rettew, D.C., Goldberger, E.L., Rapoport, S.I., Rapoport, J.L., and Grady, C.L. (1992) Cerebral glucose metabolism in childhood-onset obsessive-compulsive disorder. Revisualization during pharmacotherapy. Arch Gen Psychiatry 49 690-694. 

Baxter LR, Phelps ME, Mazziotti JC, et al Cerebral metabohc rates for glucose in mood disorders. Arch Gen Psychiatry 42 441-447, 1985 Baxter LR Jr, Thompson JM, Schwartz JM, et al. Trazodone treatment response in obsessive-compulsive disorder—correlated with shifts in glucose metabolism in the caudate nuclei. Psychopathology 20 (suppl 1 114-122, 1987 Beale MD, Kellner CH, Pritchett JT, et al Stimulus dose-titration in ECT a 2-year clinical experience. Convulsive Therapy 10 171-176, 1994 Beale MD, Kellner CH, Pritchett JT, et al ECT for OCD. J Clin Psychiatry 56 81-82, 1995... 

Since its isolation in 1921, insulin has been the object of an enormous amount of experimentation aimed at clarifying its mode of action. It is produced by the P cells of the pancreatic islets of Langerhans and released into the bloodstream in response to elevated glucose levels. Tire absence of insulin or of a normal response to insulin results in the condition of diabetes mellitus, which is the most prevalent human metabolic disorder (see Box 17-G).343... 

In contrast to its effects on glucose metabolism, tacrolimus offers potential advantages over ciclosporin for lipid disorders (1101). Compared with ciclosporin-based immunosuppressive regimens, total cholesterol and LDL cholesterol serum concentrations were lower in patients taking tacrolimus for 1 year (1102). Both findings were considered to result from a significant glucocorticoidsparing effect of tacrolimus. 

Metabolic disorders are common, especially diabetes mellitus, a disorder of the glucose control. Most serious is type 1 diabetes, where the beta cells are destructed, typically by an autoimmune reaction, so the patient must be given insulin the rest of his/her life. Untreated it can lead to death within some months to a few years. It attacks mainly younger adults or children. The second, called type 2 diabetes, affects older people, typically in their 60s and typically obese. The disease is a combination of a decreased insulin production and an impaired glucose disposal. It evolves slowly and many patients can, at least in the beginning, be controlled with diet and exercise. 

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