scholarly journals Atherogenicity of blood plasma lipid spectrum during sugar-reducing therapy in patients with noninsulin-dependent diabetes mellitus

1995 ◽  
Vol 41 (3) ◽  
pp. 13-16
Author(s):  
A. S. Ametov ◽  
N. V. Perova ◽  
N. L. Vinnitskaya ◽  
V. Z. Topchiashvili
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Insulin Therapy ◽  
Blood Plasma ◽  
Plasma Lipid ◽  
High Density Lipoproteins ◽  
Dependent Diabetes Mellitus ◽  
Low Density ◽  
Secondary Failure ◽  
Lipid Spectrum

Blood plasma lipoprotein spectrum and phospholipid spectrum of high density lipoproteins (HDLP) was studied in patients with newly detected noninsulin-dependent diabetes mellitus (NIDDM) and in patients with "secondary failure" of sulfanilamide drugs. Hyperlipidemia, mainly at the expense of increased concentration of triglycerides, very low density lipoproteins, total cholesterol, and low density lipoprotein cholesterol, was detected in the patients. HDLP phospholipid composition was disturbed, with sphyngomyelin level increased and lecithin content decreased. Glurenorm therapy led to reduction of the atherogenicity of blood plasma lipid spectrum despite the persistent basal and postload hyperinsulinemia, thus indirectly indicating an improved function of endogenous insulin. Antiatherogenic effect of glurenorm is evidently mediated by reduction of insulin resistance due to extrapancreatic effect of the drug. Intensive insulin therapy of patients with secondary failure led to a marked reduction of atherogenic components of lipid spectrum. The hypolipidemic effect of insulin therapy seems to be due to recovery of the inhibitory effect of insulin on lipolysis against the background of improved sensitivity to insulin and reduced insulin resistance. A positive effect of insulin therapy on lipid metabolism should not be regarded as an evidence in favor of theoretical assumptions and apprehensions about increased risk of atherogenesis as a result of exogenous hyperinsulinemia.

Influence of Metabolic Control on Thromboxane Biosynthesis and Plasma Plasminogen Activator Inhibitor Type-1 in Non-insulin-dependent Diabetes mellitus

1996 ◽  
Vol 76 (01) ◽  
pp. 034-037 ◽  
Author(s):  
Giovanni Davì ◽  
Mario Belvedere ◽  
Sergio Vingneri ◽  
Isabella Catalano ◽  
Carlo Giammarresi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Metabolic Control ◽  
Platelet Activation ◽  
Macrovascular Disease ◽  
Dependent Diabetes Mellitus ◽  
Secondary Failure ◽  
Diet And Exercise ◽  
Strict Diet ◽  
Niddm Patients ◽  
Pai 1

SummaryWe have previously shown that tight metabolic control by insulin therapy reduced thromboxane-dependent platelet activation in noninsulin-dependent diabetes mellitus (NIDDM) patients. The present study was undertaken to determine whether a similar effect could be obtained without switching diabetics in secondary failure to insulin treatment. For this purpose, we gave strict diet and exercise advise program and adjusted on a weekly basis the oral antidiabetic therapy (glipizide) that 26 patients with NIDDM had been given over the previous months.Basal measurements of urinary ll-dehydro-TXB2 and PAI-1 confirmed previous findings of enhanced levels of these parameters in NIDDM patients with macrovascular disease in comparison to age-and sex-matched controls. After 2-6 weeks, 16 patients achieved tight metabolic control associated with significant reduction of both thromboxane biosynthesis and PAI-1 levels; 10 patients remained in poor control and no significant decrease of both parameters was observed.We conclude that reduction of in-vivo platelet activation and PAI-1 antigen levels after metabolic improvement obtained by frequent reassessment of sulphonylurea therapy together with strict diet and exercise programs may have beneficial effects on the progression of diabetic micro- and macrovascular disease.

Insulin Therapy in Pregnancy Hypertensive Diseases and its Effect on the Offspring and Mother Later in Life

2019 ◽  
Vol 17 (5) ◽  
pp. 455-464 ◽  
Author(s):  
Alfonso Mate ◽  
Antonio J. Blanca ◽  
Rocío Salsoso ◽  
Fernando Toledo ◽  
Pablo Stiefel ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Insulin Therapy ◽  
Polycystic Ovary ◽  
Ovary Syndrome ◽  
Insulin Resistant ◽  
Hypertensive Disorders ◽  
The Impact ◽  
In Pregnancy

Pregnancy hypertensive disorders such as Preeclampsia (PE) are strongly correlated with insulin resistance, a condition in which the metabolic handling of D-glucose is deficient. In addition, the impact of preeclampsia is enhanced by other insulin-resistant disorders, including polycystic ovary syndrome and obesity. For this reason, there is a clear association between maternal insulin resistance, polycystic ovary syndrome, obesity and the development of PE. However, whether PE is a consequence or the cause of these disorders is still unclear. Insulin therapy is usually recommended to pregnant women with diabetes mellitus when dietary and lifestyle measures have failed. The advantage of insulin therapy for Gestational Diabetes Mellitus (GDM) patients with hypertension is still controversial; surprisingly, there are no studies in which insulin therapy has been used in patients with hypertension in pregnancy without or with an established GDM. This review is focused on the use of insulin therapy in hypertensive disorders in the pregnancy and its effect on offspring and mother later in life. PubMed and relevant medical databases have been screened for literature covering research in the field especially in the last 5-10 years.

Insulin action and resistance in obesity and noninsulin-dependent type II diabetes mellitus

1982 ◽  
Vol 243 (1) ◽  
pp. E15-E30 ◽  
Author(s):  
J. M. Olefsky ◽  
O. G. Kolterman ◽  
J. A. Scarlett
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Insulin Receptor ◽  
Insulin Action ◽  
Insulin Receptors ◽  
Tissue Level ◽  
Dependent Diabetes Mellitus ◽  
Target Tissue ◽  
Severe Insulin Resistance ◽  
Glucose Clamp Technique

Resistance to the action of insulin can result from a variety of causes, including the formation of abnormal insulin or proinsulin molecules, the presence of circulating antagonists to insulin or the insulin receptor, or defects in insulin action at the target tissue level. Defects of the latter type are characteristic of obesity and of noninsulin-dependent diabetes mellitus. Analysis of the nature of the insulin resistance in those disorders has been investigated in intact subjects with the use of the euglycemic glucose clamp technique, and both insulin receptors and insulin-mediated glucose metabolism have been studied in adipocytes and monocytes from affected individuals. In both conditions, the cause of insulin resistance is heterogeneous. In some, insulin resistance appears to be due to a defect in the insulin receptor, whereas others have a defect both in the receptor and at the postreceptor level. In both groups, more severe insulin resistance is due to the postreceptor lesion and is correctable with appropriate therapy.

scholarly journals RELUCTANCE OF PATIENTS WITH DIABETES MELLITUS TO INSULIN THERAPY; PSYCHOLOGICAL INSULIN RESISTANCE

2021 ◽  
Vol 71 (2) ◽  
pp. 602-05
Author(s):  
Umair Ali ◽  
Muhammad Wajid Munir ◽  
Jahanzeb Maqsood ◽  
Mahwash Jamil ◽  
Syed Saif Ur Rehman ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Insulin Therapy ◽  
Demographic Data ◽  
Tertiary Care ◽  
Negative Attitude ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Validated Questionnaire ◽  
Patients With Diabetes

Objective: To evaluate factors resulting in reluctance of initiation of insulin therapy in patients with type 2 diabetes mellitus. Study Design: Cross sectional study. Place and Duration of Study: Medical OPD of a private tertiary care multi-specialty hospital in Islamabad, from Apr to Jul 2019. Methodology: Patients with diabetes mellitus between age of 30-70 years, who had poor glycaemic control on two oral antidiabetic drugs having HbA1c>9% and were insulin naïve, were included in this study. A validated questionnaire was developed which had two sections; first including the demographic data of the study populations and second having closedended dichotomous questions which were asked from patients by the treating physicians Results: A total of 180 patients with diabetes mellitus eligible for insulin therapy were included in the study, among them 52 (28.9%) were agreed to initiate the insulin. Negative attitude and beliefs include painful way of administration 85 (66.4%), difficult insulin storage 98 (76.6%), risk of hypoglycemia 82 (64.1%).The mean negative perception Score was 7.35 (SD 0.98). Conclusion: Psychological insulin resistance is present in significant diabetic population, and it is a big obstacle in insulin therapy initiation and compliance.

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