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International Textbook Of Diabetes Mellitus, 4th Ed., Excerpt #59: Mechanisms Of Insulin Signal Transduction Part 3 Of 8

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #59: Mechanisms of insulin signal transduction Part 3 of 8

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #59: Mechanisms of insulin signal transduction Part 3 of 8


Home / Resources / Clinical Gems / International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #59: Mechanisms of insulin signal transduction Part 3 of 8
International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #59: Mechanisms of insulin signal transduction Part 3 of 8
Following insulin binding and receptor autophosphorylation, the next committed step in signal transduction is tyrosine phosphorylation of intracellular proteins. To accomplish this, autophosphorylation of the subunit mediates noncovalent but stable interactions between the receptor and intracellular substrate proteins, and this positions these molecules for tyrosine phosphorylation by the activated insulin receptor kinase [26 28]. Several proteins are rapidly phosphorylated on tyrosine residues by ligand-bound insulin receptors, including six insulin receptor substrate proteins (IRS-1, IRS-2, IRS-3, IRS-4, IRS-5, IRS-6) [29 33], Src-homology-collagen proteins (SHC) [34] and, growth factor receptor bound-2 (Grb2) associated binder-1 (Gab-1) [35], signal-regulatory protein (SIRP) family members [36,37], the CAP/c-Cbl complex [38,39], an adapter protein with a PH and SH2 domain (APS) [40], signal transducer and activator of transcription 5B (STAT5B) [41], and proteins referred to as downstream of kinase (DOK 1-6) [33,42].
There is no known enzymatic activity associated with insulin receptor substrate molecules; however, their primary structure is noteworthy for multiple sites capable of interaction with other proteins. The receptor substrates are characterized by a representative architecture, par Continue reading

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Sexual Health - Women - Diabetes Can't Stop Me!

Sexual Health - Women - Diabetes Can't Stop Me!


Diabetes affects many aspects of your physical and mental health. Sexual health is something that can be difficult to talk about and often people suffer in silence. However itis very important that you do talk to someone about any sexual health problems or difficulties, as there are things that can help prevent and manage any issues. Most importantly these problems can affect relationships, and as your partner is vital to your overall wellbeing, any issues need to be discussed and sorted out so you can feel united in your relationship and your lives.
Diabetes can affect both men and womens sexual health. This page will give some information about womens sexual health. You can find out more about mens sexual health here.
Many women with diabetes experience sexual problems although this is not often talked about. Research about sexual problems in women with diabetes is limited one study found 27 percent of women with type 1 diabetes experienced sexual dysfunction. Another study found 18 percent of women with type 1 diabetes and 42 percent of women with type 2 diabetes experienced sexual health problems.
Sexual problems for women with diabetes may include:
decreased vaginal lubrication, resulting in vaginal dryness
uncomfortable or painful sexual intercourse
decreased or no desire for sexual activity
Causes of sexual problems in women with diabetes include nerve damage, reduced blood flow to genital and vaginal tissues, and hormonal changes. Other possible causes include some medications, alcohol abuse, smoking, psychological problems such as anxiety or depression, Continue reading

Making Diabetes Self-Management Education Patient-Centered: Results From a North Carolina Program

Making Diabetes Self-Management Education Patient-Centered: Results From a North Carolina Program


Evidence-Based Diabetes Management > March 2017 Published on: March 05, 2017
Making Diabetes Self-Management Education Patient-Centered: Results From a North Carolina Program
How tailoring a diabetes self-management program to patients' cultural and individual needs brought success.
At present in the United States, 29 million individuals have diabetes1 and 86 million have prediabetes, and the CDC estimates that 9 of every 10 persons with prediabetes are unaware of the condition.2 The annual financial toll of the disease is $245 billion in healthcare and lost productivity costs, according to the American Diabetes Association (ADA).3
How can we change these statistics? Based on my experiences as a nurse and diabetes educator, we will not be effective in fighting the nations diabetes epidemic without more foot soldiers in the trenches alongside our patients. Its during this day-to-day work that we, as diabetes educators, spend time with our patientsevaluating them and encouraging them. Once we understand the daily barriers to success, we can make adjustments for when life happens.
In October 2014, Northwest Medical Partners of Mount Airy, North Carolina, created a Diabetic Center of Excellence. (The practice has since joined Northern Family Medicine of Surry County.4) From inception, this center was designed to produce measurable and reportable patient outcomes and, when possible, to reduce the amount of medication patients needed while improving glycated hemoglobin (A1C) levels.5 The overall goal of this program is to equip each patient with the resources, tools, and Continue reading

Quitting Smoking With Diabetes

Quitting Smoking With Diabetes


Pretty much anyone who smokes knows that its important to quit. Smoking affects so many aspects of your health, and it definitely has an impact on your diabetes management. But, according to the website Smokefree.gov , Many ex-smokers say quitting was the hardest thing they ever did. However, millions of Americans have quit smoking, so it can be done. Read on to learn the whys and hows of quitting smoking, and find out whats worked for others.
Think back to when you started smoking. Maybe you were a teenager or a young adult. Maybe you had friends or parents who smoked. You might have seen ads, TV shows, or movies that glamorized smoking. But once you start to smoke, its all too easy to get hooked, thanks to nicotine, an addictive substance found in tobacco. Nicotine can make you feel good, and it promotes relaxation and stress relief. It acts on the nervous system and the brain to boost levels of dopamine, a feel-good chemical.
The effects of nicotine wear off quickly, though, which is why someone who smokes feels the urge to light up frequently. Over time, the body starts to build up a tolerance, and more nicotine is needed to prevent feeling irritable or edgy, setting in motion a vicious cycle of dependency. If you smoke, chances are you reach for a cigarette when youre stressed out, anxious, or upset. Smoking provides quick relief and helps you calm down.
According to the American Cancer Society, two out of three smokers want to quit, and half try to quit every year, but most wont succeed without help. Nicotine causes a physical and emotional dependence thats tough Continue reading

Microneedle-array patches loaded with dual mineralized protein/peptide particles for type 2 diabetes therapy

Microneedle-array patches loaded with dual mineralized protein/peptide particles for type 2 diabetes therapy


Microneedle-array patches loaded with dual mineralized protein/peptide particles for type 2 diabetes therapy
Nature Communicationsvolume8, Articlenumber:1777 (2017)
The delivery of therapeutic peptides for diabetes therapy is compromised by short half-lives of drugs with the consequent need for multiple daily injections that reduce patient compliance and increase treatment cost. In this study, we demonstrate a smart exendin-4 (Ex4) delivery device based on microneedle (MN)-array patches integrated with dual mineralized particles separately containing Ex4 and glucose oxidase (GOx). The dual mineralized particle-based system can specifically release Ex4 while immobilizing GOx as a result of the differential response to the microenvironment induced by biological stimuli. In this manner, the system enables glucose-responsive and closed-loop release to significantly improve Ex4 therapeutic performance. Moreover, integration of mineralized particles can enhance the mechanical strength of alginate-based MN by crosslinking to facilitate skin penetration, thus supporting painless and non-invasive transdermal administration. We believe this smart glucose-responsive Ex4 delivery holds great promise for type 2 diabetes therapy by providing safe, long-term, and on-demand Ex4 therapy.
Diabetes mellitus is one of the most challenging health problems of the twentieth century, affecting more than 285 million people in 2010, with an expected rise to 439 million by 2030 1 , 2 . A typical clinical pathological feature of diabetes is a disorder of glucose regulation, which results in sever Continue reading

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