Insulin therapy metabolism

Taira M, Takasu N, Komiya I, Taira T, Tanaka H. Voglibose administration before the evening meal improves nocturnal hypoglycemia in insulin-dependent diabetic patients with intensive insulin therapy. Metabolism... 

M/sce/Zaneows-Allergic reactions. Sodium retention and edema may occur, particularly if previously poor metabolic control is improved by intensified insulin therapy. Antibody production. 

Little is known of any regidation of the metabolism of sialic acid on a level higher than the enzymic level just described. The few experiments performed with animals point to an influence exerted by hormones. Thus, increase of the synthesis of sialoglycoeonjugate (mucus) has been described as occurring in mouse vaginal-epithelium under the influence of estrogen.240 Similarly, insulin therapy restored the sialic acid content of rat hepatocyte-membrane which was decreased in streptozotocin-induced diabetes.241... 

In type I diabetes, the disease begins early in life and quickly becomes severe. This disease responds to insulin injection, because the metabolic defect steins from a paucity of pancreatic /3 cells and a consequent inability to produce sufficient insulin. IDDM requires insulin therapy and careful, lifelong control of the balance between... 

Unterberger I, Bauer G, Lechleitner M. Increase in postprandial serum insulin levels in epileptic patients with valproic acid therapy. Metabolism 2002 51(10) 1274—8. 

Sorensen JT, A physiologic model of glucose metabolism in man and its use to design and assess improved insulin therapies for diabetes, 1985. 

Diabetes mellitus ( sweet urine ) involves relative over-production of glucose by the liver and under-utilization by other organs. Diabetes is the most serious metabolic disease in terms of its social impact. Obesity and the indulgent Western diet correlates with mature age diabetes. Type 1 diabetes (juvenile diabetes) typically manifests at less than 20 years from autoimmune destruction of the insulin-producing pancreatic (3 cells. Type 1 diabetes is insulin-dependent diabetes mellitus (IDDM) and is fatal without exogenous insulin. Type 2 diabetes mellitus (mature age diabetes) occurs later in life and typically involves both deficient insulin production and insulin resistance , that is, the target cells are less responsive to insulin. Type 2 diabetes is initially non-insulin-dependent diabetes (NIDDM) but insulin therapy (in addition to oral antidiabetics) may eventually be required. Hyperglycaemia due... 

It has been observed (D6) Aat addition of vitamin Be to insulin therapy allowed the employment of lower doses of insuhn and, in one subject, the total cessation of insulin administration. Finally, Oka and Leppanen (04) studied the tryptophan metabolism in 10 patients with diabetes mellitus and in 12 control subjects by determining the urinary excretion of 5-hydroxyindoleacetic acid, kynurfenine, and anthranilic, 3-hydroxyanthranilic, and xanthurenic acids before and after a load of 2 g L-tryptophan. The authors noted a markedly increased excretion of... 

Buysschaert et al. (1983) reported a better glycaemic control of totally insulin-dependent diabetic patients under continuous insulin infusion compared with conventional insulin therapy (Lager et al., 1983). An improved metabolic control, an increased glucose-disposal rate and an inverse insulin resistance following a more physiological insulin regimen with continuous insulin infusion compared with conventional therapy was also reported (Jarret, 1986). Similar results were observed by Muhlhauser et al. (1987) where an intensified insulin injection therapy performed as routine treatment of Type-1 diabetics significantly lowered HBA) levels (Fig. 13). 

An improved metabolic control with intensified insulin therapy compared with a conventional treatment was reported by Wolf et al. (1987). A continuous insulin infusion with insulin pump therapy, monitored over 1 year, however, did not exhibit a clear advantage. The management of even preschool children with insulin pump therapy was not associated with an increased frequency or an accelerated rate of development of ketosis (Flores et al., 1984 Brambilla et al., 1987). However, Marshall et al. (1987) reported more abscesses and ketoacidosis in children on CS1I, and an increased risk of developing cutaneous infections was also noted in patients treated by CSII in the Oslo Study (Dahl-Jorgensen et al., 1985). 

M. N. Sack, and D. M. Yellon, Insulin Therapy as an Adjunct to Reperfusion After Acute Coronary Ischemia, A Proposed Direct Myocardial Cell Survival Effect Independent of Metabolic Modulation, J Am Coll Cardiol 41,1404-07 (2003). 

Ryysy L, Hakkinen AM, Goto T, et al. Hepatic fat content and insulin action on free fatty acids and glucose metabolism rather than insulin absorption are associated with insulin requirements during insulin therapy in type 2 diabetic patients. Diabetes 2000 49 749-758. 

In most cases, rehydration and insulin therapy will correct the metabolic acidosis, and no further therapy is indicated. However, in the most severe ca.ses when the hydrogen ion concentration is greater than 100 nmol/l. i.v. sodium bicarbonate may be indicated. 

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