Hyperglycemia reduction

Zinc is relatively nontoxic. Nevertheless, high doses (1 g) or repetitive doses of 100 mg/day during several months may lead to disorders. Among these are gastrointestinal tract symptoms [56], a decrease in heme synthesis due to an induced copper deficiency, diminution of high-density lipoproteins (HDLs), hyperglycemia, reduction of serum ceruloplasmin and copper [57], and an increase of the intestinal and hepatic alkaline phosphatase activity. 

Initial dose 5 mg, given approximately 30 minutes before breakfast to achieve the greatest reduction in postprandial hyperglycemia. Geriatric patients or those with liver disease may be started on 2.5 mg of the immediate-release formulation. 

Compared with previously available therapy, the adverse effects associated with cyclosporine are much less severe but still worthy of concern. Nephrotoxicity, which can occur in up to 75% of patients, ranges from severe tubular necrosis to chronic interstitial nephropathy. This effect is generally reversible with dosage reduction. Vasoconstriction appears to be an important aspect of cyclosporine-induced nephrotoxicity. Hypertension occurs in 25% of the patients and more frequently in patients with some degree of renal dysfunction the concomitant use of antihypertensive drugs may prove useful. Hyperglycemia, hyperlipidemia, transient liver dysfunction, and unwanted hair growth are also observed. 

Metformin works best in patients with significant hyperglycemia and is often considered first-line therapy in the treatment of mild to moderate type II overweight diabetics who demonstrate insulin resistance. The United Kingdom Prospective Diabetes Study demonstrated a marked reduction in cardiovascular comorbidities and diabetic complications in metformin-treated individuals. Metformin has also been used to treat hirsutism in individuals with polycystic ovarian syndrome and may enhance fertility in these women, perhaps by decreasing androgen levels and enhancing insulin sensitivity. 

Phenytoin rarely causes hyperglycemia, and the blood glucose concentration can increase in phenytoin intoxication (SED-13, 139) (115). A reduction in the insulin response to glucose has been noted with therapeutic... 

Metabolic effects of tumor necrosis factor alfa include a reduction in cholesterol and high-density lipoproteins, increases in triglycerides and very low-density lipoproteins, and hyperglycemia. 

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