Insulin mellitus

There are multiple causes of diabetes. Whereas the molecular bases of some forms of diabetes are well understood, in many cases etiologies are unknown. It is customary to divide diabetes into two main forms insulin-dependent diabetes mellitus (IDDM), also referred to as Type I or juvenile-onset diabetes, and noninsulin-dependent diabetes mellitus (NIDDM), also called Type II or maturity-onset diabetes (3). 

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 Mellitus Insulin Receptor Glucose Transporters ATP-dependent K+Channel PPARs... 

Blood sugar (blood glucose) in human beings is controlled by the secretion of (—>) insulin by the beta (B- or (3-) cells of the islands of Langerhans in the pancreas. Loss of insulin synthesis leads to (—>) diabetes. Type 1 diabetes (insulin dependent diabetes mellitus, EDDM) begins in juveniles as an organ-specific autoimmune reaction, the destructive insulitis. 

Diabetes mellitus is defined as hyperglycaemia (fasting > 7 mM and/or 2 h postprandial >11.1 mM) due to absolute or relative lack of insulin. The most common forms are type 1 diabetes (prevalence 0.25%), with absolute lack of insulin, and type 2 diabetes (prevalence 4-6%) which is due to the combination of insulin resistance and insufficient insulin secretion. 

Diabetes Mellitus. Table 1 Pharmakokinetic characteristics of the most commonly used insulin preparations and analogs... 

Knockout mice have been reported for several FATPs [1]. As insulin desensitization has been closely linked to excessive fatty acid uptake and intracellular diacylgly-cerol and TG accumulation, these animal models were particularly evaluated in the context of protection from diet-induced type 2 diabetes ( Type 2 Diabetes Mellitus (T2DM)). In addition, studies on human subjects have also established genetic links between polymorphisms in FATP genes and metabolic alterations [1]. 

At present, the only available drug that stimulates glucose transport is insulin. Insulin increases the abundance of the GLUT4 in plasma membranes of adipose and muscle cells by its recruitment from intracellular storage sites (for a detailed description of its mechanism, see Chapter Diabetes Mellitus). 

Insulin Receptor ATP-dependent K+ Channels Diabetes Mellitus... 

Disorders of lipoprotein metabolism involve perturbations which cause elevation of triglycerides and/or cholesterol, reduction of HDL-C, or alteration of properties of lipoproteins, such as their size or composition. These perturbations can be genetic (primary) or occur as a result of other diseases, conditions, or drugs (secondary). Some of the most important secondary disorders include hypothyroidism, diabetes mellitus, renal disease, and alcohol use. Hypothyroidism causes elevated LDL-C levels due primarily to downregulation of the LDL receptor. Insulin-resistance and type 2 diabetes mellitus result in impaired capacity to catabolize chylomicrons and VLDL, as well as excess hepatic triglyceride and VLDL production. Chronic kidney disease, including but not limited to end-stage... 

MODY is a type of non-insulin-dependent diabetes mellitus caused by rare autosomal-dominant mutations. Presently there are six known forms of the disease which are all due to ineffective insulin production or... 

Meglitinide contains a benzamide group. Meglitinide-related compounds such as nateglinide are non-sulfonylurea oral hypoglycemic drugs used in the treatment of type 2 (non-insulin dependent) diabetes mellitus. 

Diabetes mellitus ATP-dependent K+ Channels Antidiabetic Drugs Other than Insulin... 

First trials with CD3 antibodies for therapy of autoimmune diseases (insulin-dependent diabetes mellitus psoriatic arthritis... 

Diabetes mellitus is a complicated, chronic disorder characterized by either insufficient insulin production by the beta cells of die pancreas or by cellular resistance to insulin. Insulin insufficiency results in elevated blood glucose levels, or hyperglycemia As a result of the disease, individuals with diabetes are at greater risk for a number of disorders, including myocardial infarction, cerebrovascular accident (stroke), blindness, kidney disease, and lower limb amputations. 

Insulin and the oral antidiabetic dmgi, alongwith diet and exercise are die cornerstones of treatment for diabetes mellitus. They are used to prevent episodes of hypoglycemia and to normalize carbohydrate metabolism. 

Type 1—Insulin-dependent diabetes mellitus (IDDM). Fonner names of this type of diabetes... 

Those with type 1 diabetes mellitus produce insulin in insufficient amounts and tiierefore must have insulin supplementation to survive Type 1 diabetes usually has a rapid onset, occurs before die age of 20 years, produces more severe symptoms tiian type 2 diabetes, and is more difficult to control. Major symptoms of type 1 diabetes include hyperglycemia, polydipsia (increased thirst), polyphagia (increased appetite), polyuria (increased urination), and weight loss. Treatment of type 1 diabetes is particularly difficult to control because of the lack of insulin production by die pancreas. Treatment requires a strict regimen tiiat typically includes a carefully calculated diet, planned physical activity, home glucose testing several times a day, and multiple daily insulin injections. 

Type 2 diabetes mellitus affects about 90% to 95% of individuals witii diabetes. Those with type 2 diabetes mellitus eitiier have a decreased production of insulin... 

Insulin is necessary for controlling type 1 diabetes mellitus that is caused by a marked decrease in the amount of insulin produced by die pancreas. Insulin is also used to control the more severe and complicated forms of type 2 diabetes mellitus. However, many patients can control type 2 diabetes with diet and exercise alone or with diet, exercise, and an oral antidiabetic drug (see section Oral Antidiabetic Dmgp ). Insulin may also be used in the treatment of severe diabetic ketoacidosis (DKA) or diabetic coma. Insulin is also used in combination with glucose to treat hypokalemia by producing a shift of potassium from die blood and into die cells. 

If the patient has recently received a diagnosis of diabetes mellitus and has not received insulin or if the patient is known to have diabetes, the initial physical... 

Insulin glargine is given SC once daily at bedtime This type of insulin is used in the treatment of adults and children with type 1 diabetes mellitus and in adults widi type 2 diabetes who need long-acting insulin for die control of hyperglycemia. 

Ms. Baxter, age 37years, has been taking insulin for the past 6 years for type 1 diabetes mellitus. An assessment at the outpatient clinic reveals a blood... 

Amenorrhea, other menstrual irregularities, development of cushingoid state, suppression of growth in children, secondary adrenocortical and pituitary unresponsive (particularly in times of stress), decreased carbohydrate tolerance, manifestation of latent diabetes mellitus, increased requirements for insulin or oral hypoglycemic agents (in diabetics)... 

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