Current Approaches in Diabetes Treatment and Other Strategies to Reach Normoglycemia

2020 ◽  
Vol 20 (32) ◽  
pp. 2922-2944
Author(s):  
Worood Sirhan ◽  
Ron Piran
Keyword(s):  
Blood Glucose ◽  
Current Knowledge ◽  
Type I Diabetes ◽  
Current Status ◽  
Control Individual ◽  
Diabetic Patients ◽  
Regulation Mechanism ◽  
Type I ◽  
Glucose Levels ◽  
Blood Glucose Levels

: Cells are mainly dependent on glucose as their energy source. Multicellular organisms need to adequately control individual glucose uptake by the cells, and the insulin-glucagon endocrine system serves as the key glucose regulation mechanism. Insulin allows for effective glucose entry into the cells when blood glucose levels are high, and glucagon acts as its opponent, balancing low blood glucose levels. A lack of insulin will prevent glucose entry to the cells, resulting in glucose accumulation in the bloodstream. Diabetes is a disease which is characterized by elevated blood glucose levels. All diabetes types are characterized by an inefficient insulin signaling mechanism. This could be the result of insufficient insulin secretion, as in the case of type I diabetes and progressive incidents of type II diabetes or due to insufficient response to insulin (known as insulin resistance). We emphasize here, that Diabetes is actually a disease of starved tissues, unable to absorb glucose (and other nutrients), and not a disease of high glucose levels. Indeed, diabetic patients, prior to insulin discovery, suffered from glucose malabsorption. : In this mini-review, we will define diabetes, discuss the current status of diabetes treatments, review the current knowledge of the different hormones that participate in glucose homeostasis and the employment of different modulators of these hormones. As this issue deals with peptide therapeutics, special attention will be given to synthetic peptide analogs, peptide agonists as well as antagonists.

The effect of pirenzepine on growth hormone and blood glucose levels in Type I diabetes mellitus

1988 ◽  
Vol 117 (3) ◽  
pp. 315-319 ◽  
Author(s):  
P. Pietschmann ◽  
G. Schernthaner
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Type I Diabetes ◽  
Anticholinergic Drug ◽  
Serum Levels ◽  
Type I Diabetes Mellitus ◽  
Diabetic Patients ◽  
Type I ◽  
Glucose Levels ◽  
Blood Glucose Levels

Abstract. Increased GH levels in Type I diabetes mellitus have been implicated in the pathogenesis of metabolic complications such as the so-called dawn phenomenon. GH secretion is under control of cholinergic mechanisms. In 21 Type I diabetic patients the effect of oral administration of the anticholinergic drug pirenzepine in addition to intensive insulin therapy on GH and blood glucose levels was studied. At 21.30, 08.00 and 12.00 h, all patients received in random order 50 mg of pirenzepine or placebo po. Blood for determination of GH, blood glucose, cortisol and Cpeptide levels were obtained at 3-h intervals. Serum levels of plasma glucose and GH were significantly lower under pirenzepine than under placebo (P < 0.05 and P < 0.01, respectively). Serum levels of cortisol, free insulin and C-peptide were comparable on the test and the control day. Our data indicate that in Type I diabetes mellitus the anticholinergic drug pirenzepine is effective in decreasing both GH and blood glucose levels.

Antidiabetic effect of Psychotria malayana Jack in induced type 1 diabetic rat

MEDISAINS ◽  
2020 ◽  
Vol 18 (1) ◽  
pp. 19
Author(s):  
Fairuz Fairuz ◽  
Hasna Dewi ◽  
Humaryanto Humaryanto
Keyword(s):  
Blood Glucose ◽  
Side Effects ◽  
Type I Diabetes ◽  
Langerhans Cell ◽  
Diabetic Rat ◽  
Type I ◽  
Antidiabetic Effect ◽  
Glucose Levels ◽  
Blood Glucose Levels

Background: Therapies for hyperglycemic treatment, including insulin and oral diabetes medications, have been confirmed to cause several side effects. Thus, finding new drugs with fewer side effects is of high importance. Salung leaf herb (Psychotria malayana Jack) reported used in traditional societies as a treatment for diabetes. However, the scientific proof of this plant for diabetes treatment is still lacking.Objective: To evaluate the antidiabetic effect of the P. malayana jack in induced type 1 diabetic rats by assessing blood glucose level and pancreatic cells in white rats.Methods: Alloxan used to induce type I diabetes. Rats randomly divided into six groups. A Group P1 received 250 mg/kg BW; group P2 received 500 mg/kg BW, group P3 received 1000 mg/kg BW. While group 4 basal received no treatment, group 5 received distilled water as a negative control, and group 6 received glibenclamide as a positive control. Medications are given for six days. Glucose levels were measured, and observation of pancreatic Langerhans cell damages.Results:  A decrease in blood glucose levels observed in all treatment groups. The most significant reduction (49.76%; 1000 mg/kg BW) occurred in the P3 group. Morphological features of pancreatic Langerhans cell damage were slightly high in the P1 group.Conclusion: P. malayana Jack can consider having an antidiabetic effect in a type 1 diabetic rat by reducing blood glucose levels.

Conventional approach to glucose management for diabetic patients undergoing coronary artery bypass surgery

Perfusion ◽  
2002 ◽  
Vol 17 (2) ◽  
pp. 141-144 ◽  
Author(s):  
Patricia A Gustafson ◽  
Debra L Zarro ◽  
David A Palanzo ◽  
Norman J Manley ◽  
Ralph M Montesano ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Insulin Infusion ◽  
Diabetic Patients ◽  
Type I ◽  
Cardioplegic Solution ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Continuous insulin infusion was not an effective mode of treatment in maintaining safe blood glucose levels (<200 mg/dl) during the intraoperative period of diabetic patients requiring open-heart surgery. The two modifications investigated to gain better control of the blood glucose were a change in the base solution of the cardioplegia and the use of a sliding insulin scale. Fifty patients including Type I and Type II diabetics were selected for the purpose of this study. The patients were then randomly divided into two groups categorized by the type of cardioplegic solution administered and the mode of insulin treatment. Group I patients received a dextrose 5%-based cardioplegic solution and blood glucose was treated via continuous intravenous insulin infusion. Group II patients received normal saline 0.9%-based cardioplegic solution and blood glucose was treated via sliding scale. Blood glucose levels were monitored pre- and postcardio- pulmonary bypass (CPB) and every 30 min while on CPB. Glucose values were analyzed by group t test. A p value of < 0.05 was considered statistically significant. When comparing Group I (mean=258 mg/dl) with Group II (mean= 158 mg/dl), there was a statistically significant difference between the glucose values at each of the time intervals when the glucose values were recorded. In conclusion, Group II maintained an acceptable blood glucose level (<200 mg/dl) throughout the entire intra- operative period, which suggests that the combination of the sliding insulin scale and modification of the base cardioplegic solution was an effective mode of treatment.

Activated Akt Is Associated with Hyperglycemia and Platelet Hyperactivity in a Mouse Model of Diabetes

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 5360-5360
Author(s):  
Lin Lu ◽  
Donna Woulfe
Keyword(s):  
Blood Glucose ◽  
Mouse Model ◽  
Platelet Activation ◽  
Diabetic Patients ◽  
Type I ◽  
Platelet Activity ◽  
Akt Phosphorylation ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Fibrinogen Binding

Abstract Platelet hyperactivation has been reported in patients with both Type I and Type II diabetes mellitus and likely contributes to the increased prevalence of thrombotic complications in diabetic patients. However, the mechanisms leading to platelet hyperactivity in diabetes are not fully understood. Our previous studies showed that the Akt signaling pathway positively regulates platelet activity. Here, we evaluate the effect of hyperglycemia on Akt phosphorylation and platelet activation using a Type I diabetic mouse model. Hyperglycemia was induced by intraperitoneal injection of streptozotocin (STZ 50mg/kg for 5 days) in C57BL/6 mice. Blood glucose levels were elevated in 12 mice 4 weeks after STZ injection (mean ± SD: 410 ± 70 mg/ml) compared with 11 mice without STZ injection (212 ± 50 mg/ml). Platelets from hyperglycemic mice showed enhanced agonist-dependent aggregation (max % aggregation: 58% ± 10% in hyperglycemia versus 0% in normoglycemia at 0.6mM AYPGKF, n=3 each), fibrinogen binding (62.2% fibrinogen-bound cells ± 5.4% in hyperglycemic conditions versus 46.1% ± 16.3% in normoglycemia at 2mM AYPGKF) and P-selectin binding (42.1% cells with surface P-selectin ± 3.7% in hyperglycemic platelets, 25.3% ± 5.9% in normoglycemia at 2mM AYPGKF) compared with platelets from mice with normal glucose levels. The blood glucose levels were directly correlated with Alexafluor-fibrinogen binding (r=0.65, p=0.042) when platelets were stimulated with thrombin receptor agonist peptide AYPGKF (1.5mM), and also directly correlated with P-selectin surface exposure (r=0.95, p=0.003) after platelets were stimulated with 1.5mM AYPGKF. To determine whether the Akt pathway is involved in enhanced platelet activation in diabetes, we tested phosphorylation of Akt ser473 by immunoblotting. Akt phosphorylation of this residue was increased (35% ± 4%) in platelets from hyperglycemic mice compared with platelets from nondiabetic mice. In conclusion, platelets from hyperglycemic mice are more sensitive to PAR4 agonist-induced fibrinogen binding and P-selectin exposure compared with nondiabetic platelets. Enhanced activation of Akt in platelets under hyperglycemic conditions may play a role in platelet hyperactivation in diabetes.

Predicting Blood Glucose Levels Around Meals for Patients With Type I Diabetes

2010 ◽  
Author(s):  
Fraser Cameron ◽  
Gu¨nter Niemeyer
Keyword(s):  
Blood Glucose ◽  
Type I Diabetes ◽  
Type I ◽  
Start Time ◽  
Predictive Algorithm ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Multiple Hypothesis ◽  
Continuous Glucose Monitors

Insulin pumps and continuous glucose monitors enable automatic control of blood glucose (BG) levels for patients with type 1 diabetes. Such controllers should carefully assess the likely future BG levels before injecting insulin, since the effects of insulin are prolonged, potentially deadly, and irreversible. Meals pose a strong challenge to this assessment as they create large, fast disturbances. Fortunately, meals have consistent and predictable effects, if their size and start time are known. We present a predictive algorithm that embeds meal detection and estimation into BG prediction. It uses a multiple hypothesis fault detector to identify meal occurrences, and linear Kalman filters to estimate meal sizes. It extrapolates and combines the state and state covariance estimates to form a prediction of BG values and uncertainties. These inputs enable controllers to assess and trade off the acute risks of low and chronic risks of high BG levels. We evaluate the predictor on simulated and clinical data.

Nutritional Interventions and Considerations for the Development of Low Calorie or Sugar Free Foods

2020 ◽  
Vol 16 (4) ◽  
pp. 301-312 ◽  
Author(s):  
Jyoti Singh ◽  
Prasad Rasane ◽  
Sawinder Kaur ◽  
Vikas Kumar ◽  
Kajal Dhawan ◽  
...  
Keyword(s):  
Metabolic Disease ◽  
Blood Glucose ◽  
Human Population ◽  
Artificial Sweeteners ◽  
Diabetic Patients ◽  
Nutritional Interventions ◽  
Low Calorie ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Diet Plan

Diabetes is a globally prevalent chronic metabolic disease characterized by blood glucose levels higher than the normal levels. Sugar, a common constituent of diet, is also a major factor often responsible for elevating the glucose level in diabetic patients. However, diabetic patients are more prone to eat sweets amongst the human population. Therefore, we find a popular consumption of zero or low-calorie sweeteners, both natural and artificial. But, the uses of these sweeteners have proved to be controversial. Thus, the purpose of this review was to critically analyze and highlight the considerations needed for the development of sugar-free or low-calorie products for diabetic patients. For this purpose, various measures are taken such as avoiding sugary foods, using natural nectar, artificial sweeteners, etc. It cannot be ignored that many health hazards are associated with the overconsumption of artificial sweeteners only. These sweeteners are high-risk compounds and a properly balanced consideration needs to be given while making a diet plan for diabetic patients.

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