Download PDF by Bernard Testa, Urs A. Meyer: Antidiabetic Agents: Recent Advances in their Molecular and

By Bernard Testa, Urs A. Meyer

ISBN-10: 012013327X

ISBN-13: 9780120133277

Quantity 27, the 1st thematic quantity within the sequence, presents an summary of current wisdom with reference to the pharmacological and scientific features of antidiabetic medicinal drugs. It goals to stimulate extra attention of attainable options within the improvement of latest antidiabetic medicines.

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Extra resources for Antidiabetic Agents: Recent Advances in their Molecular and Clinical Pharmacology, Volume 27

Example text

HGP still remains within normal range because of the suppressive effect of hyperglycaemia. Tissue glucose uptake, however, is markedly reduced. In diabetic subjects, the glucose uptake of muscle tissue is delayed and retarded. While in control subjects muscle glucose uptake accounts for 75% of the total glucose uptake, normal-weight NIDDM patients have a 50% reduction in insulin-mediated peripheral glucose uptake. Thus in the early stages of NIDDM, the site of insulin resistance is not at the level of the liver.

In NIDDM, with a fasting glucose concentration up to 120mg/100 ml, insulin secretion is increased to twice normal with a fasting glucose concentration of 80 mg/100 ml. As the pancreatic exhaustion continues, insulin response becomes insufficient and the absolute amount of insulin decreases. Basal blood glucose begins to rise. Once the fasting blood glucose concentration exceeds 120 mg/100 ml there is a further progressive decline in reactive insulin release in response to glucose. Basal insulin, however, still remains elevated.

There is also strong evidence of a genetic component in the aetiology of Type-I diabetes, with a close human leucocyte antigen (HLA)-DR association. 2 for HLA-DR2. At least one of the diabetic risk antigens is found in more than 80% of patients with Type-I diabetes but in only 30% of the general population. However, there is also evidence that HLA genes alone do not determine the disease and we are probably dealing with a multistage aetiology. Among monozygotic twins, there is a concordance value of only 30-50% for Type-I diabetes, pointing to a strong environmental factor.

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Antidiabetic Agents: Recent Advances in their Molecular and Clinical Pharmacology, Volume 27 by Bernard Testa, Urs A. Meyer


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