Insulin hypoglycemic actions

Sulfonylureas exert a hypoglycemic action by stimulating pancreatic secretion of insulin. All sulfonylureas are equally effective in lowering blood glucose when administered in equipotent doses. On average, the A1C will fall by 1.5% to 2% with FPG reductions of 60 to 70 mg/dL (3.3 to 3.9 mmol/L). 

Hypoglycemic actions have also been referred to for aloe extract in five patients with non-insulin-dependent diabetes. 

Moreover, the relative sensitivity of the tissues was in the same order as the relative sensitivity of the three species to the hypoglycemic action of the biguanides. In another investigation, a number of the effects of phenformin on metabolism in rat adipose tissue,— Inhibition of glucose oxidation and lipogenesis, both basal and insulin stimulated— were traced to an inhibition of pyruvate oxidation, presumably resulting from interference with electron transport. 

A report by Lebowitz and Feinglos (41) Indicates that, during chronic administration, part of the hypoglycemic action of the sulfonylureas Is extra pancreatic. Peripheral tissues may become more sensitive to a fixed dose of an administered hormone possibly due to an Increase In the number of insulin receptors. 

Donard, E., and H. Labbe. 1932. The existence in barley malt dust of a substance having a hypoglycemic action and acting in a manner similar to that of insulin. Comp. Rend. Acad. Sci. 194 1299-1300. 

Mathew, P.T. and August , K.T. 1973. Studies on the effect of allicin (diallyl disulphide-oxide) on alloxan diabetes. I. Hypoglycemic action and enhancement of serum insulin effect and glycogen synthesis. Indian JBiochem Biophys 20(3) 209-212. 

It has been shown that, if zinc is present, the hypoglycemic action of protamine-insulin or spermine-insulin compounds (which are more effective than pure insulin) is greatly prolonged. Insulin preparations contain zinc as a micro-constituent. 

The nurse should check the patient for hypoglycemia (see Table 49-1) at the peak time of action of the insulin (see Summary Drug Table Insulin Reparations). Hypoglycemia, which can develop suddenly, may indicate a need for an adjustment in the insulin dosage or other changes in treatment, such asa change in diet. Hypoglycemic reactions can occur at any time but are most likely to occur when insulin is at its peak activity. 

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