Insulin effects diabetes

Early applications of crystalline fructose focused on foods for special dietary applications, primarily calorie reduction and diabetes control. The latter application sought to capitalize on a signiftcandy lower serum glucose level and insulin response in subjects with noninsulin-dependent diabetes melUtus (21,22) and insulin-dependent diabetes (23). However, because fmctose is a nutritive sweetener and because dietary fmctose conversion to glucose in the hver requires insulin in the same way as dietary glucose or sucrose, recommendations for its use are the same as for other nutritive sugars (24). Review of the health effects of dietary fmctose is available (25). 

Prolonged hypoglycemic effect in diabetic dogs due to subcutaneous administration of insulin liposomes, Diabetes, 31. 506-511. 

The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl I Med 1993 329 977-986. 

Frati AC, Jimenez E and Ariza CR. 1990b. Hypoglycemic effect of Opuntia ficus-indica in non-insulin dependent diabetes mellitus patients. Phytother Res 4 195—197. 

Figure 11.2 Structure of the insulin receptor (a). Binding of insulin promotes autophosphorylation of the (3-subunits, where each (3-subunit phosphorylates the other (3-subunit. Phosphate groups are attached to three specific tyrosine residues (tyrosines 1158, 1162 and 1163), as indicated in (b). Activation of the (3-subunit s tyrosine kinase activity in turn results in the phosphorylation of various intracellular (protein) substrates which trigger the mitogen-activated protein kinase and/or the phosphoinositide (PI-3) kinase pathway responsible for inducing insulin s mitogenic and metabolic effects. The underlying molecular events occurring in these pathways are complex (e.g. refer to Combettes-Souverain, M. and Issad, T. 1998. Molecular basis of insulin action. Diabetes and Metabolism, 24, 477-489)...

A comprehensive, randomized, placebo-controlled trial of infused bolus L-arg and its enantiomer (D-arg) included healthy subjects, non-insulin dependent diabetics, hypertensive subjects, and normotensives with primary hypercholesterolemia [147]. A blood-pressure drop and an acute inhibition of ADP-induced aggregation in platelet-rich plasma were observed in all subjects after L-arg administration (<5 g). Both responses to L-arg infusion closely correlated in magnitude, were weaker in noninsulin dependent diabetics and hypercholesterolemics, and declined with increasing age. Notably, D-arg did not elicit any of the L-arg effects, which were reduced by some 70% when superimposed upon ongoing, nonselective NOS inhibition with infused L-N-monomethyl-arginine (L-NMMA). Since D-arg is not a NOS substrate, and L-NMMA is a substrate-competitive NOS inhibitor, the L-arg effects observed in this study were theorized to reflect a rise in vascular NO production by eNOS. In contrast, the inhibition of platelet aggregation observed in vitro after a 5 min L-arg infusion (160 mg total dose) into healthy subjects and patients with angiographic... 

Ul. Umeda, F., Watanabe, J., Inouue, K., Hisatomi, A., Mimura, K., Yamauchi, T., Sako, Y., Kunisaki, M., Tajiri, Y., and Nawata, H., Effect of pravastatin on serum lipids, apolipopro-teins and lipoprotein (a) in patients with non-insulin dependent diabetes mellitus. Endocrinol. Jpn. 39, 45-50 (1992). 

Wise S, Chien J, Yeo K, Richardson C (2006) Smoking enhances absorption of insulin but reduces glucodynamic effects in individuals using the Lilly-Dura inhaled insulin system. Diabet Med 23 510-515. 

Another form of diabetes is non-insulin-dependent diabetes mellitus (NIDDM, or adult diabetes, or type II diabetes). In this case, insulin is produced and a normal insulin level is detected in blood. But for various reasons its effect is reduced. This may be caused by a reduced number of insulin receptors on cells, or reduced effectiveness in binding to these receptors. The cause is complex and may involve genetic make-up, changes in lifestyle, nutritional habits, and environmental factors. 

Insulin resistance - Diabetes can usually be controlled with daily insulin doses 40 to 60 units or less however, an occasional patient develops such resistance or becomes so unresponsive to the effect of insulin that daily doses of several hundred or even several thousand units are required. Patients who... 

Cyclosporine appears to have promise in the treatment of autoimmune diseases. It has a beneficial effect on the course of rheumatoid arthritis, uveitis, insulin-dependent diabetes, systemic lupus erythematosus, and psoriatic arthropathies in some patients. Toxicity is more of a problem in these conditions than during use in transplantation, since higher doses of cyclosporine are often required to suppress autoimmune disorders. 

Gin, H., Rigalleau, V., Caubet, O., Masquelier, J., and Aubertin, J., Effects of red wine, tannic acid, or ethanol on glucose tolerance in non-insulin-dependent diabetic patients and on starch digestibility in vitro. Metabolism, 48, 1179, 1999. 

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