Assessment Of Pancreatic Hormones In Diabetes Mellitus & Non-diabetes Mellitus Patient: A Case-Control Study done on the group of people with unknown status.
This case presentation discusses a 81-year-old male patient diagnosed with type 2 diabetes mellitus and uncontrolled blood sugar. Type 2 diabetes is characterized by high blood sugar due to insulin resistance or lack of insulin production. The patient's medical history and lab results are presented. His treatment plan involves multiple oral hypoglycemic agents and lifestyle modifications to control his blood sugar levels and comorbidities like hypertension. Drug interactions and counseling points are also outlined.
SIGNIFICANCE
OVERVIEW
WHAT IS DIABETES?
DEFINITION
MECHANISM
PREVELANCE
EPIDEMIOLOGY
CLASSIFICATION
GESTATIONAL DIABETES
RISK FACTORS
DIAGNOSIS
COMPLICATIONS
MEDICAL TEST
MEDICAL NUTRITIONAL THERAPY
HERBS FOR DIABETES
MYTHS AND FACTS
REFERENCES
This document discusses the management of diabetes mellitus. It covers non-pharmacological and pharmacological treatment methods, goals of treatment for type 1 and type 2 diabetes, steps in glycemic control, drug classifications including sulfonylureas, metformin, alpha-glucosidase inhibitors, thiazolidinediones, and incretins. It also discusses indications for insulin use, characteristics of insulin preparations, hypoglycemia, and combination therapy approaches.
This document discusses microvascular complications of diabetes, including retinopathy, nephropathy, and neuropathy. For retinopathy, high blood sugar can damage small blood vessels in the retina, causing blurred vision. Treatment includes injections of anti-VEGF drugs or lasers. Nephropathy involves kidney damage from high blood sugar, diagnosed by testing urine albumin levels. Treatment focuses on glycemic control, blood pressure control, and blocking the renin-angiotensin system. Neuropathy refers to nerve damage, often in the legs and feet, from high blood sugar and other factors. Treatment aims to slow progression through blood sugar control and uses medications to relieve pain and manage complications.
Type 2 diabetes results from insulin resistance and beta cell dysfunction. It progresses from normal blood sugar levels to prediabetes to diabetes as insulin resistance and secretion abilities decline. Diagnosis is based on symptoms and elevated fasting blood sugar, oral glucose tolerance tests, or random blood sugar. Treatment goals include an A1C below 7, managing blood pressure and cholesterol, and initially using metformin, sulfonylureas, or TZDs alone or in combination. Later stages may require insulin. Strict control can prevent diabetes complications.
This document discusses diabetes, including its definition, types, symptoms, management, and statistics. Some key points include:
- Diabetes is a metabolic disorder characterized by high blood glucose caused by insufficient insulin production or action.
- Over 25 million Americans have diabetes, and it is projected to affect over 333 million people worldwide by 2025, with 90% having type 2 diabetes.
- There are two main types of diabetes - type 1 is usually diagnosed in childhood and requires insulin injections, while type 2 usually occurs in adulthood and can sometimes be managed through diet and exercise.
- Symptoms vary depending on type but include increased urination, thirst, fatigue, and weight changes. Proper management is important to prevent
Mr. Hassan, a 45-year-old diabetic patient, felt severe epigastric pain and repeated vomiting and sweating. He was admitted to the hospital where tests found very high blood sugar, ketones in his urine, and abnormal electrolyte and blood gas levels. The diagnosis was a myocardial infarction complicated by diabetic ketoacidosis due to stress from the heart attack. He was admitted to the intensive care unit for monitoring, treatment of his conditions, and consultation with cardiology for potential intervention due to his history of heart disease.
This case presentation discusses a 81-year-old male patient diagnosed with type 2 diabetes mellitus and uncontrolled blood sugar. Type 2 diabetes is characterized by high blood sugar due to insulin resistance or lack of insulin production. The patient's medical history and lab results are presented. His treatment plan involves multiple oral hypoglycemic agents and lifestyle modifications to control his blood sugar levels and comorbidities like hypertension. Drug interactions and counseling points are also outlined.
SIGNIFICANCE
OVERVIEW
WHAT IS DIABETES?
DEFINITION
MECHANISM
PREVELANCE
EPIDEMIOLOGY
CLASSIFICATION
GESTATIONAL DIABETES
RISK FACTORS
DIAGNOSIS
COMPLICATIONS
MEDICAL TEST
MEDICAL NUTRITIONAL THERAPY
HERBS FOR DIABETES
MYTHS AND FACTS
REFERENCES
This document discusses the management of diabetes mellitus. It covers non-pharmacological and pharmacological treatment methods, goals of treatment for type 1 and type 2 diabetes, steps in glycemic control, drug classifications including sulfonylureas, metformin, alpha-glucosidase inhibitors, thiazolidinediones, and incretins. It also discusses indications for insulin use, characteristics of insulin preparations, hypoglycemia, and combination therapy approaches.
This document discusses microvascular complications of diabetes, including retinopathy, nephropathy, and neuropathy. For retinopathy, high blood sugar can damage small blood vessels in the retina, causing blurred vision. Treatment includes injections of anti-VEGF drugs or lasers. Nephropathy involves kidney damage from high blood sugar, diagnosed by testing urine albumin levels. Treatment focuses on glycemic control, blood pressure control, and blocking the renin-angiotensin system. Neuropathy refers to nerve damage, often in the legs and feet, from high blood sugar and other factors. Treatment aims to slow progression through blood sugar control and uses medications to relieve pain and manage complications.
Type 2 diabetes results from insulin resistance and beta cell dysfunction. It progresses from normal blood sugar levels to prediabetes to diabetes as insulin resistance and secretion abilities decline. Diagnosis is based on symptoms and elevated fasting blood sugar, oral glucose tolerance tests, or random blood sugar. Treatment goals include an A1C below 7, managing blood pressure and cholesterol, and initially using metformin, sulfonylureas, or TZDs alone or in combination. Later stages may require insulin. Strict control can prevent diabetes complications.
This document discusses diabetes, including its definition, types, symptoms, management, and statistics. Some key points include:
- Diabetes is a metabolic disorder characterized by high blood glucose caused by insufficient insulin production or action.
- Over 25 million Americans have diabetes, and it is projected to affect over 333 million people worldwide by 2025, with 90% having type 2 diabetes.
- There are two main types of diabetes - type 1 is usually diagnosed in childhood and requires insulin injections, while type 2 usually occurs in adulthood and can sometimes be managed through diet and exercise.
- Symptoms vary depending on type but include increased urination, thirst, fatigue, and weight changes. Proper management is important to prevent
Mr. Hassan, a 45-year-old diabetic patient, felt severe epigastric pain and repeated vomiting and sweating. He was admitted to the hospital where tests found very high blood sugar, ketones in his urine, and abnormal electrolyte and blood gas levels. The diagnosis was a myocardial infarction complicated by diabetic ketoacidosis due to stress from the heart attack. He was admitted to the intensive care unit for monitoring, treatment of his conditions, and consultation with cardiology for potential intervention due to his history of heart disease.
The document discusses the metabolic syndrome, including its definition, major features, epidemiology, pathophysiology, approach to diagnosis, and management. Regarding management, lifestyle modifications like weight loss through calorie restriction and increased physical activity are emphasized. Pharmacological treatments and metabolic/bariatric surgery may also be considered in some cases to treat individual components of the metabolic syndrome.
The document discusses the diagnosis of diabetes mellitus. It outlines the evolution of diagnostic guidelines and tests over time, from initial diagnosis based on sugar in the urine to current use of HbA1c, fasting plasma glucose, and oral glucose tolerance tests. Key tests discussed include insulin, C-peptide, proinsulin, glucagon, and autoantibodies which can help distinguish types of diabetes.
Diabetes mellitus is a group of metabolic diseases characterized by high blood glucose levels resulting from defects in insulin production or insulin action. There are several types of diabetes including type 1, type 2, gestational diabetes, and other rare forms. The long-term complications of diabetes include damage to various organs such as the eyes, kidneys, nerves, and heart. Prediabetes is a condition where blood glucose levels are higher than normal but not high enough to be diagnosed as diabetes. Lifestyle changes such as diet and exercise have been shown to prevent or delay the onset of type 2 diabetes in those with prediabetes.
The document provides information on diagnosing and classifying diabetes mellitus, including:
- Diagnosis is based on fasting plasma glucose levels, oral glucose tolerance tests, or A1C levels according to guidelines from the American Diabetes Association.
- There are criteria for diagnosing prediabetes conditions like impaired fasting glucose and impaired glucose tolerance.
- Type 1 diabetes is characterized by beta cell destruction and absolute insulin deficiency. Type 2 diabetes involves insulin resistance with relative insulin deficiency.
This patient presents with multiple metabolic risk factors including obesity, elevated triglycerides and fasting blood glucose, and a family history of diabetes. While she does not meet the criteria for metabolic syndrome, her 10-year risk of heart disease is elevated. Her LDL cholesterol goal according to NCEP guidelines is less than 160 mg/dL. Fasting glucose would be most influential in determining her treatment plan given her risk factors.
The document summarizes the management of diabetes mellitus. It discusses the types and pathophysiology of diabetes, signs and symptoms, diagnosis, treatment goals, and management of type 1 and type 2 diabetes. Recent advances discussed include new insulin regimens, hypoglycemic drugs for type 1 diabetes, and combination drug therapies for type 2 diabetes.
This document discusses diabetes mellitus type 1 and presents a case study. It begins with an introduction to type 1 diabetes, including its epidemiology, pathophysiology, clinical manifestations, diagnosis, and treatments. It then presents a case study of a 7-year-old female patient who presented with symptoms of weight loss, excessive thirst and urination, nausea, and fatigue. Testing revealed her random blood sugar level was elevated, and she was diagnosed with mild ketosis secondary to newly diagnosed type 1 diabetes. The document outlines her treatment plan, which involved insulin injections and dietary modifications to manage her blood glucose levels.
Diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia. It occurs when the pancreas does not produce enough insulin or the body cannot effectively use the insulin it produces, and there are three main types: type 1, type 2, and gestational diabetes. Long-term complications of diabetes include microvascular damage to the eyes, kidneys, and nerves, as well as macrovascular damage increasing the risk of heart disease and stroke. Management of diabetes focuses on glycemic control through diet, exercise, oral medications, and sometimes insulin to reduce the risk and progression of complications.
Type 2 diabetes management case study for reference. Diabetes management is important to prevent further damage to organs. this case study is simple illustration about diabetes management, dietary modification and lifestyle changes.
1. The study aimed to compare the blood glucose lowering effects of the traditional Indian plant Vijayasar (Pterocarpus marsupium) and the pharmaceutical agent tolbutamide in managing diabetes.
2. A total of 365 newly diagnosed type 2 diabetes patients were randomized to receive either Vijayasar or tolbutamide for 36 weeks.
3. The results showed that Vijayasar was as effective as tolbutamide in lowering blood glucose with no significant differences in effects on lipids or safety profiles.
This document discusses diabetes mellitus, including its causes, symptoms, diagnosis, and complications. It defines diabetes as a group of metabolic disorders characterized by high blood sugar levels over a prolonged period. The main types are type 1, where the body cannot produce enough insulin, and type 2, where tissues do not respond well to insulin. Complications of long-term high blood sugar levels include damage to small blood vessels (retinopathy, nephropathy), nerves (neuropathies), and increased risk of infections that can require amputation in severe cases of diabetic foot. The document also outlines risk factors, diagnostic tests, and the roles of insulin and other hormones in regulating blood sugar levels.
Diabetes mellitus (DM) is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both.
The term diabetes mellitus describes a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both.
The effects of diabetes mellitus include long–term damage, dysfunction and failure of various organs.
The document discusses diabetes mellitus (DM), including its classification into types 1 and 2, gestational diabetes, and other types. It covers the anatomy and functions of the pancreas, which produces insulin and digestive enzymes. Diagnostic criteria for DM include hemoglobin A1C, fasting plasma glucose, and oral glucose tolerance tests. Complications of uncontrolled DM are also mentioned. Treatment involves lifestyle changes, insulin therapy, and managing comorbidities.
This document discusses the complications of diabetes mellitus. It begins by defining diabetes and describing the different types. It then explains the acute and chronic complications that can occur, including microvascular complications affecting the eyes, kidneys, and nerves, as well as macrovascular complications increasing the risk of cardiovascular disease. The document outlines the main mechanisms behind these complications, such as the accumulation of sorbitol and the glycation of proteins, which can cause tissue damage. Finally, it discusses the importance of glycemic control through diet, exercise and medication in managing diabetes and preventing associated health issues.
This document discusses the classification, diagnosis, and prevalence of diabetes mellitus. It begins by classifying diabetes into type 1, type 2, and other specific types. The criteria for diagnosing diabetes include an A1C of 6.5% or higher, a fasting plasma glucose of 126 mg/dL or higher, or a 2-hour plasma glucose of 200 mg/dL or higher during an oral glucose tolerance test. The document also discusses gestational diabetes, noting it affects 4-5% of pregnancies. Risk factors for testing asymptomatic individuals are outlined.
What is diabetes mellitus, Epidemiology of diabetes, Diabetes diagnosis, Features of diabetes, WHO classification of Diabetes Mellitus, Complications of diabetes, Metabolic alterations of diabetes, Oral glucose tolerance test, WHO criteria of OGTT interpretation, Classification of diabetes mellitus, Gestational diabetes, Pre-diabetes, Insulin, Biosynthesis of insulin, Insulin actions, Hypoglycemia, Impaired fasting glucose, Insulin structure
Type 2 diabetes pathogenesis involves multiple complex pathophysiological abnormalities that result in hyperglycemia. Key factors include insulin resistance caused by genetic and environmental factors like obesity, and beta cell dysfunction caused by glucotoxicity, lipotoxicity, and other stresses that impair insulin secretion and lead to loss of beta cell function and mass over time. Genetic factors also contribute significantly, as seen in familial risk and heritability studies, though identifying specific genes has been challenging due to the polygenic nature of type 2 diabetes.
The document discusses diabetes, including:
- Diabetes is a group of metabolic disorders characterized by hyperglycemia due to defects in insulin secretion or action.
- India currently has 63 million people with diabetes, the second highest number after China.
- There are two main types of diabetes - type 1 caused by beta cell destruction leading to insulin deficiency, and type 2 caused by insulin resistance and relative insulin deficiency.
- Treatment involves diet, exercise, oral medications like metformin and sulfonylureas, and sometimes insulin therapy. The goal is to control blood sugar levels and prevent complications like damage to eyes, kidneys, nerves, and blood vessels.
Managing your type ii diabetes: patient educationmdlv1974
This document provides information on managing type 2 diabetes, including when and how to check blood glucose levels, symptoms of high and low blood glucose, proper testing supplies and techniques, treatment options, diet recommendations, potential complications, and additional control measures. It also lists various resources for further information on diabetes management.
This document discusses diabetes mellitus, including its diagnosis, types, complications, management, and treatment. It defines diabetes as a chronic disorder resulting from insulin deficiency or abnormal insulin function. There are three main types - type 1 caused by autoimmune destruction of beta cells, type 2 often associated with obesity and aging, and gestational diabetes during pregnancy. Complications arise from long-term hyperglycemia and include damage to various organs. Management involves dietary changes, physical activity, medication including insulin when needed, and treating complications.
The document discusses endocrine disorders and focuses on diabetes mellitus. It defines the endocrine system and describes how hormones are secreted and transported. It then discusses the different types of diabetes (type 1, type 2, gestational), their causes and pathophysiology. Type 1 diabetes results from an autoimmune destruction of insulin-producing pancreatic beta cells, leading to little or no insulin production. This causes unchecked glucose production and fasting/postprandial hyperglycemia.
This document discusses the pathogenesis and etiology of metabolic disorders, including disorders of carbohydrate and lipid metabolism. It covers several key points:
1. Metabolic disorders can be caused by genetic factors like enzymopathies, damage to membranes/receptors, endocrine dysfunction, and neural impairment.
2. Dietary and digestive issues as well as other organ dysfunction can also contribute to metabolic disorders.
3. Glucose regulation is maintained through a balance of insulin and counter-regulatory hormones like glucagon, with disorders resulting in hyperglycemia or hypoglycemia.
4. The two primary types of diabetes mellitus - type 1 and type 2 - differ in etiology and pathogenesis
The document discusses the metabolic syndrome, including its definition, major features, epidemiology, pathophysiology, approach to diagnosis, and management. Regarding management, lifestyle modifications like weight loss through calorie restriction and increased physical activity are emphasized. Pharmacological treatments and metabolic/bariatric surgery may also be considered in some cases to treat individual components of the metabolic syndrome.
The document discusses the diagnosis of diabetes mellitus. It outlines the evolution of diagnostic guidelines and tests over time, from initial diagnosis based on sugar in the urine to current use of HbA1c, fasting plasma glucose, and oral glucose tolerance tests. Key tests discussed include insulin, C-peptide, proinsulin, glucagon, and autoantibodies which can help distinguish types of diabetes.
Diabetes mellitus is a group of metabolic diseases characterized by high blood glucose levels resulting from defects in insulin production or insulin action. There are several types of diabetes including type 1, type 2, gestational diabetes, and other rare forms. The long-term complications of diabetes include damage to various organs such as the eyes, kidneys, nerves, and heart. Prediabetes is a condition where blood glucose levels are higher than normal but not high enough to be diagnosed as diabetes. Lifestyle changes such as diet and exercise have been shown to prevent or delay the onset of type 2 diabetes in those with prediabetes.
The document provides information on diagnosing and classifying diabetes mellitus, including:
- Diagnosis is based on fasting plasma glucose levels, oral glucose tolerance tests, or A1C levels according to guidelines from the American Diabetes Association.
- There are criteria for diagnosing prediabetes conditions like impaired fasting glucose and impaired glucose tolerance.
- Type 1 diabetes is characterized by beta cell destruction and absolute insulin deficiency. Type 2 diabetes involves insulin resistance with relative insulin deficiency.
This patient presents with multiple metabolic risk factors including obesity, elevated triglycerides and fasting blood glucose, and a family history of diabetes. While she does not meet the criteria for metabolic syndrome, her 10-year risk of heart disease is elevated. Her LDL cholesterol goal according to NCEP guidelines is less than 160 mg/dL. Fasting glucose would be most influential in determining her treatment plan given her risk factors.
The document summarizes the management of diabetes mellitus. It discusses the types and pathophysiology of diabetes, signs and symptoms, diagnosis, treatment goals, and management of type 1 and type 2 diabetes. Recent advances discussed include new insulin regimens, hypoglycemic drugs for type 1 diabetes, and combination drug therapies for type 2 diabetes.
This document discusses diabetes mellitus type 1 and presents a case study. It begins with an introduction to type 1 diabetes, including its epidemiology, pathophysiology, clinical manifestations, diagnosis, and treatments. It then presents a case study of a 7-year-old female patient who presented with symptoms of weight loss, excessive thirst and urination, nausea, and fatigue. Testing revealed her random blood sugar level was elevated, and she was diagnosed with mild ketosis secondary to newly diagnosed type 1 diabetes. The document outlines her treatment plan, which involved insulin injections and dietary modifications to manage her blood glucose levels.
Diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia. It occurs when the pancreas does not produce enough insulin or the body cannot effectively use the insulin it produces, and there are three main types: type 1, type 2, and gestational diabetes. Long-term complications of diabetes include microvascular damage to the eyes, kidneys, and nerves, as well as macrovascular damage increasing the risk of heart disease and stroke. Management of diabetes focuses on glycemic control through diet, exercise, oral medications, and sometimes insulin to reduce the risk and progression of complications.
Type 2 diabetes management case study for reference. Diabetes management is important to prevent further damage to organs. this case study is simple illustration about diabetes management, dietary modification and lifestyle changes.
1. The study aimed to compare the blood glucose lowering effects of the traditional Indian plant Vijayasar (Pterocarpus marsupium) and the pharmaceutical agent tolbutamide in managing diabetes.
2. A total of 365 newly diagnosed type 2 diabetes patients were randomized to receive either Vijayasar or tolbutamide for 36 weeks.
3. The results showed that Vijayasar was as effective as tolbutamide in lowering blood glucose with no significant differences in effects on lipids or safety profiles.
This document discusses diabetes mellitus, including its causes, symptoms, diagnosis, and complications. It defines diabetes as a group of metabolic disorders characterized by high blood sugar levels over a prolonged period. The main types are type 1, where the body cannot produce enough insulin, and type 2, where tissues do not respond well to insulin. Complications of long-term high blood sugar levels include damage to small blood vessels (retinopathy, nephropathy), nerves (neuropathies), and increased risk of infections that can require amputation in severe cases of diabetic foot. The document also outlines risk factors, diagnostic tests, and the roles of insulin and other hormones in regulating blood sugar levels.
Diabetes mellitus (DM) is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both.
The term diabetes mellitus describes a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both.
The effects of diabetes mellitus include long–term damage, dysfunction and failure of various organs.
The document discusses diabetes mellitus (DM), including its classification into types 1 and 2, gestational diabetes, and other types. It covers the anatomy and functions of the pancreas, which produces insulin and digestive enzymes. Diagnostic criteria for DM include hemoglobin A1C, fasting plasma glucose, and oral glucose tolerance tests. Complications of uncontrolled DM are also mentioned. Treatment involves lifestyle changes, insulin therapy, and managing comorbidities.
This document discusses the complications of diabetes mellitus. It begins by defining diabetes and describing the different types. It then explains the acute and chronic complications that can occur, including microvascular complications affecting the eyes, kidneys, and nerves, as well as macrovascular complications increasing the risk of cardiovascular disease. The document outlines the main mechanisms behind these complications, such as the accumulation of sorbitol and the glycation of proteins, which can cause tissue damage. Finally, it discusses the importance of glycemic control through diet, exercise and medication in managing diabetes and preventing associated health issues.
This document discusses the classification, diagnosis, and prevalence of diabetes mellitus. It begins by classifying diabetes into type 1, type 2, and other specific types. The criteria for diagnosing diabetes include an A1C of 6.5% or higher, a fasting plasma glucose of 126 mg/dL or higher, or a 2-hour plasma glucose of 200 mg/dL or higher during an oral glucose tolerance test. The document also discusses gestational diabetes, noting it affects 4-5% of pregnancies. Risk factors for testing asymptomatic individuals are outlined.
What is diabetes mellitus, Epidemiology of diabetes, Diabetes diagnosis, Features of diabetes, WHO classification of Diabetes Mellitus, Complications of diabetes, Metabolic alterations of diabetes, Oral glucose tolerance test, WHO criteria of OGTT interpretation, Classification of diabetes mellitus, Gestational diabetes, Pre-diabetes, Insulin, Biosynthesis of insulin, Insulin actions, Hypoglycemia, Impaired fasting glucose, Insulin structure
Type 2 diabetes pathogenesis involves multiple complex pathophysiological abnormalities that result in hyperglycemia. Key factors include insulin resistance caused by genetic and environmental factors like obesity, and beta cell dysfunction caused by glucotoxicity, lipotoxicity, and other stresses that impair insulin secretion and lead to loss of beta cell function and mass over time. Genetic factors also contribute significantly, as seen in familial risk and heritability studies, though identifying specific genes has been challenging due to the polygenic nature of type 2 diabetes.
The document discusses diabetes, including:
- Diabetes is a group of metabolic disorders characterized by hyperglycemia due to defects in insulin secretion or action.
- India currently has 63 million people with diabetes, the second highest number after China.
- There are two main types of diabetes - type 1 caused by beta cell destruction leading to insulin deficiency, and type 2 caused by insulin resistance and relative insulin deficiency.
- Treatment involves diet, exercise, oral medications like metformin and sulfonylureas, and sometimes insulin therapy. The goal is to control blood sugar levels and prevent complications like damage to eyes, kidneys, nerves, and blood vessels.
Managing your type ii diabetes: patient educationmdlv1974
This document provides information on managing type 2 diabetes, including when and how to check blood glucose levels, symptoms of high and low blood glucose, proper testing supplies and techniques, treatment options, diet recommendations, potential complications, and additional control measures. It also lists various resources for further information on diabetes management.
This document discusses diabetes mellitus, including its diagnosis, types, complications, management, and treatment. It defines diabetes as a chronic disorder resulting from insulin deficiency or abnormal insulin function. There are three main types - type 1 caused by autoimmune destruction of beta cells, type 2 often associated with obesity and aging, and gestational diabetes during pregnancy. Complications arise from long-term hyperglycemia and include damage to various organs. Management involves dietary changes, physical activity, medication including insulin when needed, and treating complications.
The document discusses endocrine disorders and focuses on diabetes mellitus. It defines the endocrine system and describes how hormones are secreted and transported. It then discusses the different types of diabetes (type 1, type 2, gestational), their causes and pathophysiology. Type 1 diabetes results from an autoimmune destruction of insulin-producing pancreatic beta cells, leading to little or no insulin production. This causes unchecked glucose production and fasting/postprandial hyperglycemia.
This document discusses the pathogenesis and etiology of metabolic disorders, including disorders of carbohydrate and lipid metabolism. It covers several key points:
1. Metabolic disorders can be caused by genetic factors like enzymopathies, damage to membranes/receptors, endocrine dysfunction, and neural impairment.
2. Dietary and digestive issues as well as other organ dysfunction can also contribute to metabolic disorders.
3. Glucose regulation is maintained through a balance of insulin and counter-regulatory hormones like glucagon, with disorders resulting in hyperglycemia or hypoglycemia.
4. The two primary types of diabetes mellitus - type 1 and type 2 - differ in etiology and pathogenesis
The document discusses screening methods and goals for managing diabetes. It describes laboratory blood glucose tests such as the glucose oxidase method and use of glucometers to test blood sugar levels. The HbA1c test measures average blood sugar over the past 3 months. The document also lists the top 10 countries for diabetes prevalence and risk factors, types, and complications of the disease.
Nursing Management · Monitor blood sugar and use a sliding scale to treat high levels of glucose · Educate patient about diabetes · Examine feet .
Diagnosis involves measuring blood glucose levels. Ongoing specialized assessment and evaluation for complications are essential for diabetes management.
The pancreas is a gland located near the stomach that functions as both an exocrine gland, producing enzymes to digest food, and an endocrine gland, producing hormones like insulin and glucagon to regulate blood sugar levels. It contains clusters of cells called islets of Langerhans that secrete different hormones - alpha cells secrete glucagon, beta cells secrete insulin, delta cells secrete somatostatin, and F cells secrete pancreatic polypeptide. Insulin and glucagon work to tightly control blood glucose levels. Diabetes occurs when the pancreas does not produce enough insulin or the body does not properly use insulin. The two main types are type 1 diabetes where the pancreas produces little insulin and type
The pancreas secretes enzymes to help digest food and hormones like insulin and glucagon to regulate blood sugar levels. Diabetes occurs when the pancreas does not produce enough insulin or the body does not respond properly to insulin, resulting in high blood sugar. There are three main types of diabetes: type 1 is characterized by lack of insulin production; type 2 is caused by insulin resistance; and gestational diabetes develops during pregnancy. Long-term complications of high blood sugar include damage to organs and blood vessels. Diagnosis involves testing blood sugar levels through fasting plasma glucose tests or oral glucose tolerance tests.
This document summarizes key aspects of insulin and glucagon regulation of blood glucose levels. It discusses that insulin and glucagon are polypeptide hormones secreted by the pancreas that have opposing functions. Insulin is produced in response to high blood glucose to promote glucose uptake and storage. Glucagon is produced in response to low blood glucose to promote glucose release from stores. The document also summarizes the different types of diabetes, their causes and treatments.
The document discusses regulation of blood glucose levels and metabolic derangements in diabetes. It describes how hormones like insulin and glucagon tightly regulate blood glucose levels by controlling glucose uptake and release. In diabetes, there is either insufficient insulin production or insulin resistance, leading to hyperglycemia. This causes symptoms like excessive thirst and urination as the body tries to eliminate excess glucose through urine. Without treatment, high blood glucose in diabetes can cause serious complications like diabetic ketoacidosis or hyperosmolar coma.
This document provides an overview of diabetes mellitus, including its definition, classification, types, signs and symptoms, investigations, management, complications, and nursing care considerations. It defines diabetes as a metabolic disorder involving disturbances in carbohydrate, protein and fat metabolism due to defects in insulin secretion or action. Diabetes is classified into type 1, type 2, and gestational diabetes. Type 1 is characterized by lack of insulin production while type 2 involves insulin resistance. Nursing care aims to attain euglycemia, prevent complications, and educate patients on self-management.
Diabetes mellitus refers to a group of diseases that affect how the body uses blood sugar (glucose). Glucose is an important source of energy for the cells that make up the muscles and tissues. It's also the brain's main source of fuel.
Diabetes mellitus (DM) is a syndrome of chronic hyperglycaemia is due to one of two mechanisms:
Inadequate production of insulin , or
Inadequate sensitivity of cells to the action of insulin.
It affects more than 220 million people worldwide, and it is estimated that it will affect 440 million by the year 2030
"Diabetes" comes from the Greek word for "siphon", and implies that a lot of urine is made.
The second term,"mellitus" comes from the Latin word, "mel" which means "honey", and was used because the urine was sweet.
• The onset of type 1 diabetes may also be associated with sudden weight loss or nausea, vomiting, or abdominal pains, if DKA has developed.
This document defines diabetes mellitus as a metabolic disorder characterized by hyperglycemia due to defects in insulin secretion or action. It classifies diabetes into four main types: type 1, type 2, gestational diabetes, and other specific types. The document provides details on the pathogenesis, clinical manifestations, diagnosis, medical management including oral medications and insulin therapy, dietary management, nursing interventions, nursing diagnoses, and complications of diabetes.
The pancreas is a J-shaped gland located behind the stomach that contains both exocrine and endocrine tissues. The exocrine tissues secrete digestive enzymes, while the endocrine tissues contain clusters of cells called islets of Langerhans. The main islet cell types are alpha cells which secrete glucagon, and beta cells which secrete insulin, which regulates blood glucose levels by facilitating glucose uptake into cells and inhibiting glucose production. Diabetes mellitus occurs when insulin production or function is inadequate, leading to high blood glucose levels. The two main types are type 1 caused by beta cell deficiency, and type 2 caused by insulin resistance.
Mr. G, a 47-year-old businessman, was admitted to the hospital on September 27th at 11:05pm for diabetes mellitus, ischemic heart disease, hyperlipidemia, and hypertension. His medical history includes hypertension, diabetes, ischemic heart disease in 2008, and peripheral vascular disease in 2010. On examination, he had dry skin, flaky skin on his lower legs and feet, and an IV in his left hand. Lab tests showed elevated glucose, cholesterol, and kidney function. Imaging found an old heart attack and brain infarct. The patient's diabetes is managed through diet, exercise, oral medications, and possibly insulin therapy depending on his ability to control blood sugar levels.
Type 1 diabetes is characterized by little or no insulin production due to destruction of pancreatic beta cells. It commonly develops in childhood or adolescence and requires lifelong insulin treatment. Symptoms include increased thirst, urination, hunger, and weight loss. Complications can include retinopathy, neuropathy, kidney disease and cardiovascular disease if not properly managed. Treatment involves frequent blood glucose monitoring, insulin administration, following a balanced diet, and regular exercise.
Alpha-amylase inhibitors: alternative approach for the treatment of type 2 di...RajdeepaKundu
This document discusses alpha-amylase inhibitors as an alternative treatment for type 2 diabetes. It begins by introducing diabetes and its causes and symptoms. It then discusses the different types of diabetes and current diabetes medication options. Finally, it focuses on alpha-amylase inhibitors, explaining that they work by inhibiting the alpha-amylase enzyme involved in starch digestion, which helps control post-meal blood sugar spikes for type 2 diabetes patients.
This document provides information on diabetes mellitus. It begins with objectives of reviewing the anatomy of the pancreas and classifications, signs, and treatments of diabetes. It then covers the anatomy of the pancreas and classifications of diabetes types I and II. Key differences and clinical manifestations are described for each type. Complications are identified including cardiovascular, renal, and neurological issues. The document concludes with nursing diagnoses and interventions for managing diabetes.
Etiopathogenesis and pharmacotherapy of diabetes
a. the pathophysiology of selected disease states and the rationale for drug therapy;
b. the therapeutic approach to management of these diseases;
c. the controversies in drug therapy;
d. the importance of preparation of individualised therapeutic plans based on diagnosis;
e. needs to identify the patient-specific parameters relevant in initiating drug therapy,
and monitoring therapy (including alternatives, time-course of clinical and laboratory
indices of therapeutic response and adverse effects);
f. describe the pathophysiology of selected disease states and explain the rationale for
drug therapy;
g. summarise the therapeutic approach to management of these diseases including
reference to the latest available evidence;
h. discuss the controversies in drug therapy;
i. discuss the preparation of individualised therapeutic plans based on diagnosis; and
j. identify the patient-specific parameters relevant in initiating drug therapy, and
monitoring therapy (including alternatives, time-course of clinical and laboratory indices of therapeutic response and adverse effects).
Similar to Assessment Of Pancreatic Hormones In Diabetes Mellitus & Non-diabetes Mellitus Patient: A Case Control Study (20)
DECODING THE RISKS - ALCOHOL, TOBACCO & DRUGS.pdfDr Rachana Gujar
Introduction: Substance use education is crucial due to its prevalence and societal impact.
Alcohol Use: Immediate and long-term risks include impaired judgment, health issues, and social consequences.
Tobacco Use: Immediate effects include increased heart rate, while long-term risks encompass cancer and heart disease.
Drug Use: Risks vary depending on the drug type, including health and psychological implications.
Prevention Strategies: Education, healthy coping mechanisms, community support, and policies are vital in preventing substance use.
Harm Reduction Strategies: Safe use practices, medication-assisted treatment, and naloxone availability aim to reduce harm.
Seeking Help for Addiction: Recognizing signs, available treatments, support systems, and resources are essential for recovery.
Personal Stories: Real stories of recovery emphasize hope and resilience.
Interactive Q&A: Engage the audience and encourage discussion.
Conclusion: Recap key points and emphasize the importance of awareness, prevention, and seeking help.
Resources: Provide contact information and links for further support.
Exploring the Benefits of Binaural Hearing: Why Two Hearing Aids Are Better T...Ear Solutions (ESPL)
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Assessment Of Pancreatic Hormones In Diabetes Mellitus & Non-diabetes Mellitus Patient: A Case Control Study
1. Assessment Of Pancreatic Hormones In Diabetes
Mellitus & Non-diabetes Mellitus Patient: A Case Control
Study
Presented By : Rahul
Course & Semester : M.Sc. MLS-Biochemistry – 4th Semester.
2. OBJECTIVES OF PRESENTATION
• The Pancreas
• Anatomy & Histology of Pancreas
• Hormones of Endocrine Pancreas
• Insulin
• Glucagon
3. OBJECTIVES OF
PRESENTATION• Disorders of Pancreatic Hormones.
• Diabetes Mellitus -Types
• Signs & Symptoms
• Causes
• Aim of Study or Objectives of Study
• Materials & Methods
• Results
• Summary & Conclusion
4. OBJECTIVES OF STUDY
1. Screening of Diabetic and Non-Diabetic patients - based on
their HbA1c or sugar profile.
2. Estimation of Insulin and Glucagon in diabetes mellitus and
Non-diabetes mellitus patients.
3. Statistical analysis of the data.
5. PANCREAS
• The Endocrine system is the collection of glands that produce
hormones that regulates metabolism, growth and development tissue
function, sexual function, reproduction, sleep, and mood, among other
things.
• The word pancreas comes from the Greek language (pan means “all”)
& (keas means, “flesh”).
• The pancreas plays vital role in human body.
• The pancreas is an organ of the digestive system and endocrine
system of vertebrates.
• In humans, it is located in the abdomen behind the stomach and
functions as a gland.
• The pancreas has both an endocrine and a digestive exocrine function.Contd.
6. • As an endocrine gland, its functions mostly to regulate blood sugar , hormones like
insulin , glucagon , somatostatin, and pancreatic polypeptide.
• As a part of the digestive system it functions as an exocrine
gland secreting pancreatic juice into the duodenum through the pancreatic duct.
• This juice contains bicarbonate, which neutralizes acid entering the duodenum from the
stomach; and digestive enzymes, which breakdown carbohydrates, proteins, and fats in food
entering the duodenum from the stomach.
• Inflammation of the pancreas is known as pancreatitis, with common causes
including chronic alcohol use and gallstones. Because of its role in the regulation of
blood sugar, the pancreas is also a key organ in diabetes mellitus.
• The function of the pancreas in diabetes has been known since at least 1889, with its
role in insulin production identified in 1921.
Contd
7. ANATOMY & HISTOLOGY OF PANCRAS
• The pancreas is a long, slender organ, most of
which is located posterior to the bottom half
of the stomach.
• Although it is primarily an exocrine gland,
secreting a variety of digestive enzymes, the
pancreas has an endocrine function.
• Its pancreatic islets—clusters of cells
formerly known as the islets of Langerhans—
secrete the hormones glucagon, insulin,
somatostatin, and pancreatic polypeptide
(PP).
• The pancreas contain a Head , body, tail.
Contd
8. Islets of Langerhans play a crucial role in carbohydrate metabolism
and so in a plasma glucose concentration. It involves:
• Islets of Langerhans play a crucial role in carbohydrate metabolism and so in a plasma
glucose concentration. It involves:
• Glycolysis – the anaerobic conversion of glucose to lactate. Occurs in the red blood cells,
blood cells, renal medulla and skeletal muscles.
• Glycogenesis – the synthesis of glycogen from glucose. Glucose is stored (in liver,
liver, muscle) in the form of glycogen and this serves to maintain a constant plasma
glucose concentration.
• Glycogenolysis – the breakdown of glycogen to glucose.
• Gluconeogenesis – the production of glucose from non-sugar molecules (amino acids,
acids, lactate, glycerol)
• Lipolysis – the breakdown of triacylglycerols into glycerol and free fatty acids.
• Lipogenesis – the synthesis of triacylglycerols.
Contd
9. THE PANCREATIC ISLETS EACH CONTAIN FOUR VARIETIES OF
CELLS
CELL TYPES IN PANCREATIC ISLETS OF LANGERHANS.
Cell types
Approximate Percentage of Islet Volume
Secretory ProductsDorsally Derived
(Anterior Head, Body,
Tail)
Ventrally Derived
(Posterior Portion of
Head)
A cell (α) 10% < 0.5%
Glucagon, proglucagon,
glucagon-like peptides
(GLP-1 and GLP-2)
B cell (β) 70–80% 15–20%
Insulin, C peptide,
proinsulin, amylin, γ-
aminobutyric acid (GABA)
D cell (δ) 3–5% < 1% Somatostatin
PP cell (F cell) < 2% 80–85% Pancreatic polypeptide
10. HORMONES OF THE ENDOCRINE PANCREAS
HORMONES OF THE PANCREAS
Associated hormones Chemical class Effect
Insulin (beta cells) Protein Reduces blood glucose levels
Glucagon (alpha cells) Protein Increases blood glucose levels
Somatostatin (delta cells) Protein
Inhibits insulin and glucagon
release
Pancreatic polypeptide (PP
cells)
Protein Role in appetite
11. DISORDERS OF PANCREATIC HORMONES
• Insulin and glucagon, the two key hormones that orchestrate
fuel storage and utilization, are produced by the islet cells in
the pancreas. Islet cells are distributed in clusters
throughout the exocrine pancreas.
• Together, they comprise the endocrine pancreas. Diabetes
mellitus, a heterogeneous disorder, is the most common
disease of the endocrine pancreas
DIABETES MELLITUS (DM),
• commonly known as diabetes, is a group of metabolic
disorders characterized by a high blood sugar level over a
prolonged period of time.
Contd
12. • Diabetes is due to either the pancreas not producing enough insulin, or the cells of
the body not responding properly to the insulin produced.
• There are three main types of diabetes mellitus:
1. Type 1 diabetes results from the pancreas's failure to produce enough insulin due
insulin due to loss of beta cells, this form was previously referred to as "insulin-
dependent diabetes mellitus" (IDDM) or "juvenile diabetes.
2. Type 2 diabetes begins with insulin resistance, a condition in which cells fail to
fail to respond to insulin properly. As the disease progresses, a lack of insulin may
also develop This form was previously referred to as "non-insulin-dependent
diabetes mellitus" (NIDDM) or "adult-onset diabetes". The most common cause is
a combination of excessive body weight and insufficient exercise.
3. Gestational diabetes is the third main form, and occurs when pregnant
women without a previous history of diabetes develop high blood sugar levels.
Contd
13. SIGN AND SYMPTOMS
• Diabetes symptoms vary depending on how much your blood sugar is elevated.
Some people, especially those with prediabetes or type 2 diabetes, may not
experience symptoms initially. In type 1 diabetes, symptoms tend to come on
quickly and be more severe.
• Some of the signs and symptoms of type 1 and type 2 diabetes are:
• Increased thirst
• Frequent urination
• Extreme hunger
• Unexplained weight loss
• Presence of ketones in the urine Fatigue
• Irritability
• Blurred vision
• Slow-healing sores
14. PATHOPHYSIOLOGY
• Insulin is the principal hormone that regulates the uptake of glucose from
the blood into most cells of the body, especially liver, adipose tissue and
muscle, except smooth muscle, in which insulin acts via the IGF-1.
Therefore, deficiency of insulin or the insensitivity of its receptors play a
central role in all forms of diabetes mellitus.
• The body obtains glucose from three main sources: the intestinal absorption
of food; the breakdown of glycogen (glycogenolysis), the storage form of
glucose found in the liver; and gluconeogenesis, the generation of glucose
from non-carbohydrate substrates in the body.
• Insulin plays a critical role in regulating glucose levels in the body.
• Insulin can inhibit the breakdown of glycogen or the process of
gluconeogenesis.
Contd.
15. HYPOGLYCAEMIA,
• Its also known as low blood sugar, is a fall in blood sugar to levels below
• This may result in a variety of symptoms including clumsiness, trouble
confusion, loss of consciousness, seizures or death. A feeling of hunger,
shakiness and weakness may also be present. Symptoms typically come on
quickly.
HYPERGLYCAEMIA
• Its a condition in which an excessive amount of glucose circulates in
plasma.
• This is generally a blood sugar level higher than
symptoms may not start to become noticeable until even higher values
13.9–16.7 mmol/l (~250–300 mg/dl). A subject with a consistent range
~5.6 and ~7 mmol/l (100–126 mg/dl) (American Diabetes
is considered slightly hyperglycaemic, and above 7 mmol/l (126 mg/dl) is
generally held to have diabetes. Contd
16. MATERIAL & METHODS
• For carrying out above assessment the following materials are required and
the project will be carried out by collecting sample of 50 individuals &
their reports data.
• Material for Blood Collection
• Syringe with Needle
• Collection vial especially EDTA, Fluoride-grey top, Yellow top and Green
• top for Insulin.
• Tourniquet
• Alcohol Swab or cotton swab
• 70% Alcohol for cleaning of ante cubital fossa.
• Bandage
• Needle Burner or Needle destroyer
Contd
17. • Material for Hormonal Screening and
Diabetes Screening
• Reagent or chemical for glucagon & Insulin
• Test Tubes
• Micropipettes or Auto Pipettes (10-1000ul)
• GOD-POD Kit
• Centrifuge
• Tissue Paper
• Timer
Contd
19. SAMPLE PROCESSING / METHODS
METHODS USED FOR GLUCOSE
ESTIMATION
• GOD-POD Method
Reaction :
D-glucose + O2+ H2O
𝑮𝑶𝑫
𝒈𝒍𝒖𝒄𝒐𝒏𝒊𝒄 𝒂𝒄𝒊𝒅 + 𝑯2O + phenol +
4-aminoantipyrine
𝑷𝑶𝑫
quinonimine
(red Color complex) + H2O.
• Normal values: -
• Fasting blood glucose – 70-110 mg/dl
• Postprandial (pp)- 110-140 mf/dl
METHOD OF GLYCATED HAEMOGLOBIN
• Using kit of Glycated Haemoglobin an
its measurement by semi
autoanalyzer.
Expected range of HbA1c
Sugar – 90-150 5-0% to 7.0%
Sugar – 150-180 7.0% to 8.0%
Sugar – 180-360 9.0% to 14.0%.
20. METHODS FOR HORMONES
• Method For Insulin
– Chemiluminescent Micro particle immunoassay.
• Insulin Test Preparation
• Insulin blood test or Fasting insulin test as the name suggests requires
fasting of minimum 8 hours or more as advised by the doctor.
• Insulin normal range: averages between 2.6 - 24.9 mcIU/mL
21. METHOD FOR GLUCAGON ESTIMATION
• A glucagon blood test measures the amount of a hormone called
glucagon in your blood. Glucagon is produced by cells in the pancreas.
It helps control your blood sugar level by increasing blood sugar when
it is too low.
• Method: RIA (Radio Immuno Assay)
• Normal Value: Normal levels are 150 to 200 pg./mL; in patients with
glucagonomas, levels usually (>90%) are higher than 1000 pg./mL.
However, in some recent studies, up to 40% of patients had plasma
glucagon values of 500 to 1000 pg./mL.
22. RESULTS & DISCUSSION
Total No. of
Samples N
Minimu
m
Maxim
um Mean
Std.
Deviati
on
Statist
ic
Statisti
c
Statisti
c
Statis
tic
Statisti
c
Fasting Blood
Glucose (
90-110 mg/dl) 50 85 250
131.
66 42.499
HbA1C
(4.5 - 5.6%) 50 5 9 6.06 1.219
Insulin
(2.6 - 24.9
mcIU/Ml) 50 4 50
19.3
4 10.497
Glucagon
(50 to 100
pg/ml) 50 51 190
88.9
8 38.682
NON
DIABETIC
N
Minim
um
Maxim
um
Me
an
Std.
Deviati
on
Stati
stic
Statis
tic
Statist
ic
Sta
tist
ic
Statisti
c
Fasting
Blood
Glucose
( 90-110
mg/dl) 22 85 120 97 8.106
HbA1C
(4.5 -
5.6%) 22 5 5 5 0
Insulin
(2.6 - 24.9
mcIU/Ml) 22 6 22
13.
36 4.583
23. DIABETIC
N Minimum Maximum Mean Std. Deviation
Statistic Statistic Statistic Statistic Statistic
Fasting Blood Glucose ( 90-110
mg/dl) 28 110 250 158.89 38.456
HbA1C (4.5 - 5.6%) 28 6 9 6.89 1.031
Insulin (2.6 - 24.9
mcIU/Ml) 28 4 50 24.04 11.475
Glucagon (50 to 100 pg/ml) 28 55 190 108.5 42.19
SUMMARY & CONCLUSION
In order to ensure normal body function, the human body is dependent on a tight
control of its blood glucose levels.
This is accomplished by a highly sophisticated network of various hormones and
neuropeptides released mainly from the brain, pancreas, liver, intestine as well as
adipose and muscle tissue.
Within this network, the pancreas represents a key player by secreting the blood
sugar-lowering hormone insulin and its opponent glucagon.
24. SUMMARY & CONCLUSION
• However, disturbances in the interplay of the hormones and peptides involved
may lead to metabolic disorders such as type 2 diabetes mellitus (T2DM) whose
prevalence, comorbidities and medical costs take on a dramatic scale.
• Therefore, it is of utmost importance to uncover and understand the
mechanisms underlying the various interactions to improve existing anti-
diabetic therapies and drugs on the one hand and to develop new therapeutic
approaches on the other.
• This review summarizes the interplay of the pancreas with various other organs
and tissues that maintain glucose homeostasis. Furthermore, anti-diabetic
drugs and their impact on signalling pathways underlying the network will be
discussed.
• In order to ensure normal body function, the human body is dependent on a
tight control of its blood glucose levels. This is accomplished by a highly
sophisticated network of various hormones and neuropeptides released mainly
from the brain, pancreas, liver, intestine as well as adipose and muscle tissue.
Within this network, the pancreas represents a key player by secreting the
blood sugar-lowering hormone insulin and its opponent glucagon.
25. • The conclusion of the study suggested that the ratio of samples was suggested that
the pancreatic hormones plays vital role in glucose storage and utilization. In type-
2 diabetes, both insufficient insulin and excessive glucagon secretion contribute to
hyperglycaemia. We compared insulin, glucagon and somatostatin stores in
pancreas obtained from different categories of patient such as obese non-diabetic
(ND), and 18 type-2 diabetic (T2D) subjects. From concentrations and pancreas
weight, total content of hormones was calculated. Insulin content was 35% lower in
T2D than ND subjects (7.4 versus 11.3 mg), whereas glucagon content was similar
(0.76 versus 0.81 mg). The higher ratio of glucagon/insulin contents in T2D was
thus explained by the decrease in insulin.
• To normalize metabolic control of glucose in the treatment of T2D, support has
increased for targeting not only abnormalities in insulin secretion but also
dysfunctional glucagon secretion. Glucagon is a key regulator of normal fuel
metabolism, and both fasting and postprandial hyperglucagonemia make
substantial contributions to the fasting hyperglycaemia and postprandial glucose
excursions that characterize T2D. Because patients with T2D have defects in
glucagon control, improved restoration of metabolic control by therapies that also
suppress glucagon, including DPP-4is and GLP-1RAs, would be beneficial. Future
studies should focus on how novel strategies such as glucagon antagonism,
glucagon/GLP-1 receptor coagonism, or combining DPP-4is or GLP-1RAs with
SGLT2is can best control both insulin and glucagon in patients with T2D.
Editor's Notes
(ketones are a by-product of the breakdown of muscle and fat that happens when there's not enough available insulin)