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Conclusion Of Insulin

Conclusion - Insulin Resistance - Alpf Medical Research

Conclusion - Insulin Resistance - Alpf Medical Research

Last Updated on Mon, 17 Sep 2018 | Insulin Resistance The dietary glycemic index concept supports a role for the rate of carbohydrate digestion in the prevention and treatment of chronic disease, including those diseases which have been highlighted in the dietary fiber and insulin -resistance syndrome hypotheses. This concept should not be seen as particularly radical at a time when pharmacological approaches to slowing absorption, notably the a-glycoside hydrolase inhibitors, are now accepted in the management of diabetes. Further longer term efficacy studies as well as effectiveness studies are required to better determine the importance of the glycemic index in the regulation of blood glucose and the prevention of diabetic complications, particularly in relations to CHD risk factors. The possible role of the glycemic index in decreasing postprandial oxidative stress and pro-inflammatory processes also merits further investigation. 1 Jenkins DJ, Leeds AR, Gassull MA, et al: Decrease in postprandial insulin and glucose concentrations by guar and pectin. Ann Intern Med 1977;86:20-23. 2 Crapo PA, Reaven G, Olefsky J: Plasma glucose and insulin response to orally administered simple and complex carbohydrates . Diabetes 1976;25:741-747. 3 Jenkins DJ, Wolever TM, Taylor RH, et al: Glycemic index of foods: a physiological basis for carbohydrate exchange. Am J Clin Nutr 1981;34:362-366. 4 Wolever TM, Bolognesi C: Source and amount of carbohydrate affect postprandial glucose and insulin in normal subjects. J Nutr 1996;126:2798-2806. 5 Jenkins DJ, Ghafari H, Wolever TM, et al: Relationship between rate of digestion of foods and post-prandial glycaemia. Diabetologia 1982;22:450-455. 6 Thorne MJ, Thompson LU, Jenkins DJ: Factors affecting starch digestibility and the glycemic re Continue reading >>

Could A Smart Insulin Patch Mean No More Diabetic Injections?

Could A Smart Insulin Patch Mean No More Diabetic Injections?

Could a smart insulin patch mean no more diabetic injections? "A 'smart' insulin patch could replace painful injections to help millions of people with diabetes keep their blood sugar levels in check," the Daily Mirror reports; though the technology has only been tested on mice. Insulin is a hormone that plays a vital role in regulating blood glucose levels. People with type 1 diabetes , as well as advanced type 2 diabetes , require regular insulin injections, as their body either doesnt produce enough insulin or reacts to it in the wrong way. Researchers have developed a new type of glucose-sensing patch, which is worn on the skin and delivers insulin in response to sensing high levels of glucose. The study showed that the patch was capable of reducing blood glucose levels to normal in mice with chemically induced diabetes over about four hours. This research is at an early stage, so we therefore don't know if it will be both safe and effective in humans. Before any human testing can occur, researchers will need to study the longer-term effects on animals. Researchers will also need to work out whether they can deliver enough insulin to regulate blood glucose levels in humans, and how often the patches need to be changed. All in all, we wouldnt expect to see these patches at your local chemist in the near future. The study was carried out by researchers from the University of North Carolina and North Carolina State University. It was funded by the American Diabetes Association, and the North Carolina Translational and Clinical Sciences Institute, which is supported by the National Institutes of Health. The study was published in the peer-reviewed scientific journal Proceedings of the National Academy of Sciences (PNAS). The UK medias reporting of the study was patchy. Continue reading >>

An Overview Of The Pancreas

An Overview Of The Pancreas

Pancreas Essentials The pancreas maintains the body’s blood glucose (sugar) balance. Primary hormones of the pancreas include insulin and glucagon, and both regulate blood glucose. Diabetes is the most common disorder associated with the pancreas. The pancreas is unique in that it’s both an endocrine and exocrine gland. In other words, the pancreas has the dual function of secreting hormones into blood (endocrine) and secreting enzymes through ducts (exocrine). The pancreas belongs to the endocrine and digestive systems—with most of its cells (more than 90%) working on the digestive side. However, the pancreas performs the vital duty of producing hormones—most notably insulin—to maintain the balance of blood glucose (sugar) and salt in the body. Without this balance, your body is susceptible to serious complications, such as diabetes. Anatomy of the Pancreas The pancreas is a 6 inch-long flattened gland that lies deep within the abdomen, between the stomach and the spine. It is connected to the duodenum, which is part of the small intestine. Only about 5% of the pancreas is comprised of endocrine cells. These cells are clustered in groups within the pancreas and look like little islands of cells when examined under a microscope. These groups of pancreatic endocrine cells are known as pancreatic islets or more specifically, islets of Langerhans (named after the scientist who discovered them). Hormones of the Pancreas The production of pancreatic hormones, including insulin, somatostatin, gastrin, and glucagon, play an important role in maintaining sugar and salt balance in our bodies. Gastrin: This hormone aids digestion by stimulating certain cells in the stomach to produce acid. Glucagon: Glucagon helps insulin maintain normal blood glucose by working in the Continue reading >>

The Discovery Of Insulin: A Medical Marvel For The Sugar Sickness

The Discovery Of Insulin: A Medical Marvel For The Sugar Sickness

Conclusion “A person who is an insulin dependant diabetic must have insulin. Without it, they die... insulin is life-sustaining. It is, for people who only have a partial deficit of insulin, still the most powerful way to reduce the blood sugar in those people. So it is a very powerful tool” (Hellman). The impact of Dr. Banting's research is seen in 23.6 million children and adults in the United States who have diabetes today, many of whom depend on insulin. Every 20 seconds, someone learns they have diabetes and in the next 24 hours, 4,320 new cases will be diagnosed ("Diabetes Statistics"). Because of insulin, many of these people have the opportunity to live longer, stronger, and free of suffering. As a type one diabetic for nearly eight years now, my life depends on insulin every day. I have had my own small encounters with extremely high blood sugars, and find the pain and discomfort hard to bear for just an hour or two. I cannot imagine being forced to live my whole life in pain without hope of relief. Insulin is only a diabetic treatment. A cure has yet to be discovered. However, I strongly believe that insulin is by far one of the most significant innovations in the medical field, and its impact on diabetics' lives has changed the world for the better. Continue reading >>

Insulin Pump Therapy In Type 1 Diabetes Mellitus

Insulin Pump Therapy In Type 1 Diabetes Mellitus

REVIEW ARTICLE Raphael Del Roio Liberatore Jr.I; Durval DamianiII IProfessor Coordenador, Doutor. Chefe, Serviço de Endocrinologia Pediátrica, Departamento de Pediatria e Cirurgia Pediátrica, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brasil IIProfessor Livre-Docente. Chefe, Unidade de Endocrinologia Pediátrica, Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brasil ABSTRACT OBJECTIVE: To review the current experience with insulin pump therapy in children and adolescents in order to guide pediatricians regarding indications and complications. SOURCES OF DATA: Systematic review of articles published in the literature referring to the use of insulin pump therapy, indications, complications and response to treatment. All articles published between 1995 and 2005 and appearing in the MEDLINE and LILACS databases were reviewed. The keywords were: insulin pump, type 1 diabetes mellitus and diabetes mellitus. The articles covering the subject of interest and referring to children and adolescents were selected. SUMMARY OF THE FINDINGS: Insulin pump therapy is not required for all patients with type 1 diabetes, since intensive treatments produce very similar results in terms of glycated hemoglobin and control of complications over the medium and long terms. However, the pump allows for greater comfort for patients, with less rigid meal schedules and better quality of life. The first requirement for patients intending to use the pump is getting used to having a device attached to the body and following strict glucose control; otherwise, pump therapy is not advantageous. Complications are rare due to the technologies currently available. The cost, however, is greater than Continue reading >>

Everything You Need To Know About Insulin

Everything You Need To Know About Insulin

Insulin is a hormone made in your pancreas, a gland located behind your stomach. It allows your body to use glucose for energy. Glucose is a type of sugar found in many carbohydrates. After a meal or snack, the digestive tract breaks down carbohydrates and changes them into glucose. Glucose is then absorbed into your bloodstream through the lining in your small intestine. Once glucose is in your bloodstream, insulin causes cells throughout your body to absorb the sugar and use it for energy. Insulin also helps balance your blood glucose levels. When there’s too much glucose in your bloodstream, insulin signals your body to store the excess in your liver. The stored glucose isn’t released until your blood glucose levels decrease, such as between meals or when your body is stressed or needs an extra boost of energy. Diabetes occurs when your body doesn't use insulin properly or doesn't make enough insulin. There are two main types of diabetes: type 1 and type 2. Type 1 diabetes is a type of autoimmune disease. These are diseases in which the body attacks itself. If you have type 1 diabetes, your body can’t make insulin. This is because your immune system has destroyed all of the insulin-producing cells in your pancreas. This disease is more commonly diagnosed in young people, although it can develop in adulthood. In type 2 diabetes, your body has become resistant to the effects of insulin. This means your body needs more insulin to get the same effects. Therefore, your body overproduces insulin to keep blood glucose levels normal. However, after many years of overproduction, the insulin-producing cells in your pancreas burn out. Type 2 diabetes also affects people of any age, but typically develops later in life. Injections of insulin as a replacement or supplement Continue reading >>

Intensive Insulin Therapy In Critically Ill Patients

Intensive Insulin Therapy In Critically Ill Patients

Intensive Insulin Therapy in Critically Ill Patients Van den Berghe. NEJM 2001; 345: 1359-1367. doi:10.1056/NEJMoa011300 In post-operative patients requiring mechanical ventilation, does intensive insulin therapy compared to conventional insulin therapy reduce mortality? Hyperglycaemia associated with critical illness is common and may be associated with complications such as polyneuropathy, increased susceptibility to infection and worsening organ dysfunction Glycaemic control after myocardial infarct has been shown to improve outcomes This trial investigated if tight glycaemic control in critical illness may also improve outcomes, but it should be read in combination with NICE-SUGAR that followed Single-centre, predominantly post-operative intensive care unit Allocation performed using sealed envelopes Stratification in blocks of 10 according to the type of critical illness: cardiac surgery vs non-cardiac surgery Clinical staff were not blinded to allocation Outcome assessors including laboratory staff, electophysiologists and pathologists were blinded to allocation Powered to detect at 0.05 alpha significance level (beta error or Power level not specified): Absolute risk reduction in mortality of 5% for those staying 5 days or more in Intensive Care Absolute risk reduction in mortality of 2% for all Intensive Care patients Trial was terminated early after fourth planned interim study as threshold of P < 0.01 had been met Single Intensive Care Unit in Leuven, Belgium Intensive insulin therapy group: 103 mg/dl (5.7 mmol/l) Conventional insulin therapy group: 153 mg/dl (8.5 mmol/l) Insulin infusion commenced if blood glucose exceeded 110 mg/dl (6.1 mmol/l) Infusion titrated to maintain blood glucose in the range 80 110 mg/dl (4.4 6.1 mmol/l) If > 140 mg/dl: Increased b Continue reading >>

Introduction

Introduction

INTRODUCTION Glucose in the blood provides a source of fuel for all tissues of the body. Blood glucose levels are highest during the absorptive period after a meal, during which the stomach and small intestine are breaking down food and circulating glucose to the bloodstream. Blood glucose levels are the lowest during the postabsorptive period, when the stomach and small intestines are empty. Despite having food only periodically in the digestive tract, the body works to maintain relatively stable levels of circulatory glucose throughout the day. The body maintains blood glucose homeostasis mainly through the action of two hormones secreted by the pancreas. These hormones are insulin, which is released when glucose levels are high, and glucagon, which is released when glucose levels are low. The accompanying animation depicts the functions of these hormones in blood glucose regulation. CONCLUSION Throughout the day, the release of insulin and glucagon by the pancreas maintains relatively stable levels of glucose in the blood. During the absorptive period blood glucose levels tend to increase, and this increase stimulates the pancreas to release insulin into the bloodstream. Insulin promotes the uptake and utilization of glucose by most cells of the body. Thus, as long as the circulating glucose supply is high, cells preferentially use glucose as fuel and also use glucose to build energy storage molecules glycogen and fats. In the liver, insulin promotes conversion of glucose into glycogen and into fat. In muscle insulin promotes the use of glucose as fuel and its storage as glycogen. In fat cells insulin promotes the uptake of glucose and its conversion into fats. The nervous system does not require insulin to enable its cells to take up and utilize glucose. If glucose Continue reading >>

Refuting The Ugdp Conclusion That Insulin Treatment Does Not Prevent Vascular Complications In Diabetes

Refuting The Ugdp Conclusion That Insulin Treatment Does Not Prevent Vascular Complications In Diabetes

Refuting the UGDP Conclusion that Insulin Treatment does not Prevent Vascular Complications in Diabetes Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 119) If the late complications of diabetes are indeed the direct and/or indirect consequences of insulin deficiency, we would anticipate that therapeutic measures which effectively normalize blood glucose levels should reduce the frequency and severity of cardiovascular complications associated with diabetes. Therapeutic measures which substantially reduce blood glucose levels but fall short of achieving euglycemia might also be expected to reduce cardiovascular complications if the relationship between the two is linear, but not necessarily if the relationship is more complex. Normalize Blood Glucose LevelReduce Blood Glucose LevelPlacebo SubjectIntermediate Acting InsulinSignificant Weight Change These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves. This is a preview of subscription content, log in to check access. Continue reading >>

How Do We Reach Conclusion That A Person's Cells Are Insulin Insensitive?

How Do We Reach Conclusion That A Person's Cells Are Insulin Insensitive?

Answered Oct 4, 2018 Author has 182 answers and 118.1k answer views Insulin insensitive or Insulin resistant is defined clinically as the inability of a known quantity of exogenous or endogenous insulin to increase glucose uptake and utilization in an individual as much as it does in a normal person. Firstly, the pancreatic beta cell is able to compensate by increasing insulin levels, leading to hyperinsulinemia. This compensation is able to keep glucose levels normal for a period of time but IGT develops with mild post meal hyperglycemia, as insulin resistance worsens, more defects in insulin secretion occur which result in an increased glucose production by the liver thereby leads to further elevations in fasting blood glucose levels. With insulin resistance, the pancreas produces more and more insulin until the pancreas can no longer produce sufficient insulin for the body's demands, and then blood sugar rises and an individual develops type 2 diabetes in which 50% beta cells are destroyed. Obesity, high fat diets, inadequate sleep, stress and inactive lifestyle are all contributing factors to develop insulin resistance in an individual and following are the markers used to identify insulin resistance: Clinical markers of insulin resistance includes elevated plasma glucose concentrations under fasting condition and elevated insulin levels in the body. Physical markers of insulin resistance includes Acanthosis Nigricans and skin tags Acanthosisnigricans is a darkening and thickening of the skin, especially in folds such as the neck, under the arms, and in the groin and is strongly associated with insulin resistance Skin tags occur more frequently in patients with insulin resistance. A skin tag is a common, benign condition where a bit of skin projects from the surrou Continue reading >>

Insulin Pumps For Diabetes

Insulin Pumps For Diabetes

This document was published more than 2 years ago. The nature of the evidence may have changed. The SBU assessment of available knowledge Good control of the blood glucose level is vital to avoid diabetes complications. In type 1 diabetes and sometimes in type 2 diabetes, intensive insulin therapy is required, which involves multiple daily injections. The most common complication associated with this therapy is low blood glucose (hypoglycaemia), which can have serious consequences. An alternative to injections for intensive insulin therapy is continuous insulin delivery using a pump, also known as continuous subcutaneous insulin infusion (CSII). Insulin pumps for diabetes are commonly used today, especially in the treatment of children and adolescents. However, there is a considerable lack of knowledge regarding the effects of insulin pump therapy on illness and mortality. This lack of knowledge also extends to the use of insulin pumps in combination with continuous glucose monitoring, so called sensor-augmented pump therapy (SAP). More well-performed long-term studies of all patient groups with diabetes are required. People with diabetes are considerably moresatisfied with SAP than with intensive injection therapy and self-monitoring of blood glucose with test strips. Being satisfied with the treatment may be important in terms ofachieving better blood glucose control. Availableknowledge is less clear when it comes to treatment satisfaction with insulin pumps only. There is limited or insufficient knowledgeregarding the effect of insulin pumps or SAP on quality of life, ketoacidosis and severe hypoglycaemia. The intervention cost of insulin pump therapy is SEK 11,000 more per patient and year compared to injection therapy. For adults, insulin pumps are used predominan Continue reading >>

Conclusion - Insulin Delivery And Glucose Monitoring Methods: Future Research Needs - Ncbi Bookshelf

Conclusion - Insulin Delivery And Glucose Monitoring Methods: Future Research Needs - Ncbi Bookshelf

For type 1 diabetes, three expert Stakeholders ranked adolescents as the highest priority among patients with type 1 diabetes for future research, and three Stakeholders ranked artificial pancreas as the highest priority for future research. For glucose monitoring methods, all stakeholders prioritized rt-CGM for anyone with type 1 diabetes. For younger populations (children and adolescents) adherence was ranked highest by many Stakeholders. For adults and elderly, the majority ranked severe hypoglycemia as high priority. Among insulin-requiring patients with type 2 diabetes, three stakeholders ranked adults as the highest priority. For all patients with insulin-requiring type 2 diabetes, three stakeholders ranked sensor-augmented insulin pump as the highest research need for insulin delivery. Likewise, for glucose monitoring methods, three stakeholders prioritized rt-CGM for patients with insulin-requiring type 2 diabetes. For outcomes, majority of the stakeholders ranked HbA1c as the highest priority. Continue reading >>

Conclusion | Aaha

Conclusion | Aaha

Management of DM requires the commitment and coordinated efforts of the veterinary healthcare team and the pet-owner client. For this reason, proactive client education is an essential component of a DM treatment plan. Client education includes instruction on insulin administration, signs of favorable clinical response or lack thereof, measuring BG levels, and the importance of non-insulin therapies, including dietary management. Diabetes mellitus has a multifactorial etiology, requiring practitioners to consider and assess the possible roles of the patients body condition score, diet, concurrent diseases, medications, neutering status, and genetic predisposition. When the relevant DM-causative factors have been identified, a well-defined, case-specific treatment plan can be developed with a reasonable expectation for control, and in the case of cats, a chance for remission. The distinction between clinical and subclinical DM and transient hyperglycemia is an important factor in the approach to treatment. Insulin therapy is reserved for patients with clinical DM. Patients at risk for developing DM should be managed using monitoring strategies and non-insulin modalities, with an emphasis on dietary management. Diagnosis of DM focuses on a combination of predisposing factors, characteristic clinical signs, and laboratory diagnostic values outside the reference ranges. These factors should be considered in their totality rather than as isolated indicators. The mainstay of treatment for clinical DM in dogs and cats is insulin along with dietary modification. Goals include controlling BG below the renal threshold for as much of a 24 hr period as possible, which will improve clinical signs of DM, and avoiding clinically significant hypoglycemia. There are many insulin formul Continue reading >>

Frontiers | The Role Of Leptin In The Control Of Insulin-glucose Axis | Neuroscience

Frontiers | The Role Of Leptin In The Control Of Insulin-glucose Axis | Neuroscience

Front. Neurosci., 08 April 2013 | The role of leptin in the control of insulin-glucose axis Marie Amitani *, Akihiro Asakawa , Haruka Amitani and Akio Inui Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan Obesity and diabetes mellitus are great public health concerns throughout the world because of their increasing incidence and prevalence. Leptin, the adipocyte hormone, is well known for its role in the regulation of food intake and energy expenditure. In addition to the regulation of appetite and satiety that recently has attracted much attentions, insight has also been gained into the critical role of leptin in the control of the insulin-glucose axis, peripheral glucose and insulin responsiveness. Since the discovery of leptin, leptin has been taken for its therapeutic potential to obesity and diabetes. Recently, the therapeutic effects of central leptin gene therapy have been reported in insulin-deficient diabetes in obesity animal models such as ob/ob mise, diet-induced obese mice, and insulin-deficient type 1 diabetes mice, and also in patients with inactivating mutations in the leptin gene. Herein, we review the role of leptin in regulating feeding behavior and glucose metabolism and also the therapeutic potential of leptin in obesity and diabetes mellitus. Obesity and diabetes mellitus are important public health concerns throughout the world because of their increasing incidence and prevalence. The pooled prevalence of obesity is currently as high as 23.5%, and the general prevalence of diabetes among adults in the US is 6.3% ( Sullivan et al., 2005 ). Obese individuals have an increased risk of morbidity because of the various related disorders, including diabetes, cardiovascu Continue reading >>

Incretins Under Siege? Dont Jump To Conclusions

Incretins Under Siege? Dont Jump To Conclusions

As a rule, prescription drugs only make news twice: when first cleared by the FDA, and when their safety profile is questioned. In diabetes treatment, Avandia, a one-time blockbuster drug produced by GlaxoSmithKline linked to elevated risks of heart disease, and Actos, a Takeda Pharmaceuticals product tied to significantly increased risks of bladder cancer, have generated more headlines and reports than all the combined successful uses of diabetes drugs since the discovery of insulin. Is this fair? Perhaps not. Is it reality? Absolutely. If it bleeds, it leads is the way many content decisions are made. This is particularly true given the almost astronomical multiplication of content sources competing for our attention during the last 15 years. So, when the Journal of the American Medical Association {JAMA} published a study earlier this year finding that patients using glucagon-like peptide-1 (GLP-1) receptor agonists, known commercially as Byetta and Victoza, were twice as likely to be hospitalized with pancreatitis (inflammation of the pancreas) and pancreatic cancer, medical and media alarm bells sounded everywhere. But, this wasnt a new story. Dr. Peter Butler of UCLA published Initial feedback on these risks in 2010, in an issue of the ADAs Diabetes Care. The JAMA article was the second in as many years reporting research that showed increased risk of pancreatitis in GLP-1s, as well as another class of type 2 drugs known as DPP-4, or dipeptidyl petidase 4 inhibitors. In the JAMA report, Januvia, a DPP-4 inhibitor, was also found to increase pancreatitis risk, while other DPP-4 inhibitors, Tradjenta and Onglyza, were found to slightly increase the same risk, but not to the extent as Byetta, Victoza, and Januvia. Yikes! Are these five on-patent medicines, generatin Continue reading >>

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