Insulin production, effect

Antidiabetic Drugs other than Insulin. Figure 3 The antihyperglycaemic effect of metformin involves enhanced insulin-mediated suppression of hepatic glucose production and muscle glucose uptake. Metformin also exerts non-insulin-dependent effects on these tissues, including reduced fatty acid oxidation and increased anaerobic glucose metabolism by the intestine. FA, fatty acid f, increase i decrease. 

Immune complex enhancement. Beta-cells activation and Increased insulin production (Btuni, 1988). Neuro-regulatory effect (Nakazawa et al., 1977 Btuni, 1988 Hiraga et al., 1993). 

Virtually all therapeutic proteins must enter the blood in order to promote a therapeutic effect. Such products must usually be administered parenterally. However, research continues on the development of non-parenteral routes which may prove more convenient, less costly and obtain improved patient compliance. Alternative potential delivery routes include transdermal, nasal, oral and bucal approaches, although most progress to date has been recorded with pulmonary-based delivery systems (Chapter 4). An inhaled insulin product ( Exubera , Chapters 4 and 11) was approved in 2006 for the treatment of type I and II diabetes. 

The RP-HPLC polishing step not only removes E. coli-derived impurities, but also effectively separates modified insulin derivatives from the native insulin product. The resultant extremely low levels of impurities remaining in these insulin preparations fail to elicit any significant immunological response in diabetic recipients. 

Pharmacokinetics The onset of action, peak effect, and duration of action depend primarily on the insulin product and site of... 

Gajjar DA, LaCreta FP, Kollia GD Stolz RR, Berger S, Smith WB, Swingle M, Grasela DM. Effect of multiple-dose gatifloxacin or ciprofloxacin on glucose homeostasis and insulin production in patients with non-insulin-depen-dent diabetes mellitus maintained with diet and exercise. Pharmacotherapy 2000 20(6 pt 2) 76S-86S. 

In the past, the main focus has been on insulin s effect on glucose uptake and hepatic glucose production. It now appears that there are many more players. The fate of glucose - or G6P - after uptake appears to be even more important for glucose metabolism, both in healthy persons and in patients with diabetes. There is an intimate interplay between the nutrient stores and between the different organs. This interplay appears well controlled, but the control is dynamic, so the detailed setup of the control system varies with the amount and type of nutrients. In this way the system can cope with almost any eating habit. 

Some of the effects of GH may be a consequence of its stimulation of synthesis and secretion of insulin by the pancreas. Such effects have been demonstrated in various systems [93], as have actions on cell growth in islets of Langerhans. The pancreas is a site of production of somatomedin C, and the possibility that this factor may mediate the actions of GH on insulin production has not been excluded. 

Clement, S. Still, J.G. Kosutic, G. McAllister, R.G. Oral insulin product hexyl-insulin monoconjugate 2 (HIM2) in type 1 diabetes mellitus the glucose stabilization effects of HIM2. Diabetes Technol. Ther. 2002, 4 (4), 459 66. Kipnes, M. Dandona, P. Tripathy, D. Still, J.G. Kosutic, G. Control of postprandial plasma glucose by an oral insulin product (HIM2) in patients with type 2 diabetes. Diabetes Care 2003, 26 (2), 421 26. 

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