Insulin therapy side effects

If a patient has inadequate control on two drugs, adding a third class can be considered (e.g., a glitazone, exenatide, a dipeptidyl peptidase-IV inhibitor, or basal insulin). Therapy should be guided by the A 1C, FPG, cost, additional benefits (e.g., weight loss), and avoidance of side effects). 

Somatomedins are insulin-like polypeptide hormones that should be used with caution in diabetic patients since adjustment of antidiabetic therapy may be required. Before initiating therapy, a baseline ECG is recommended and, if abnormalities are identified, regular ECG monitoring during treatment is required. Somatomedins may cause tachycardia, cardiomegaly, ventricular hypertrophy and changes in blood glucose levels as side-effects. 

This approach was effective in that it expressed IL-4 pancreas specifically, without any side-effects from the systemic expression of IL-4. These results also indicated that autoim-mune diabetes in NOD mice is not a systemic disease, and it can be modulated from the islet compartment. Therefore, for somatic gene therapy, the rat insulin pro-moter was inserted upstream of the IL-4cDNA (Lee et al., 2001a). This plasmid, pRIP-mIL-4 was complexed with water soluble lipopolymer and transfected in vitro. The results indicated that pRIP-mIL-4 expressed IL-4 cell-type specifically. 

Although most patients with type 2 diabetes are expected to ultimately require insulin to control their disease, combination with oral medications may obviate the need for nonphysiologically large doses of insulin. This combination may improve glycemic control as well as minimize many of the undesirable side effects of insulin therapy, including weight gain and hyperinsulinemia (126). 

Therapeutic use in hypertension The cardioselective p-blockers are useful in hypertensive patients with impaired pulmonary function. Since these drugs have less effect on peripheral vascular p2 receptors, coldness of extremities, a common side effect of p-blocker therapy, is less frequent. Cardioselective p-blockers are useful in diabetic hypertensive patients who are receiving insulin or oral hypoglycemic agents. 

Insulin promotes the sequestration of fat, and weight gain is a common side effect. This is a concern particularly in type 2 diabetes in which obesity is common. In the UKPDS, obese patients on insulin therapy gained an average of 4 kg more than those treated by diet adjustment only. 

Evaluating molecular mechanisms is critical to understand the onset of a disease state. However, developing an effective and efficient therapy with minimum side effects using these concepts is more important. A classic example for this scenario is the understanding of diabetes type I (insulin-dependent diabetes). The fact that it is caused by the abnormal secretion of... 

Ultrasound was used as a complementary imaging method. The size of the lesion was checked every two months. Blood samples were taken to determine red blood cell, white blood cell and platelet counts, and complete biochemistry parameters including insulin and glucose levels were measured every two weeks during the two months following therapy. The results were used to determine possible side effects of the radionuclide treatment, with particular attention given to kidney toxicity. Insulin and glucose levels were also monitored constantly. 

---