Author: Sanjay Kalra
Publisher: JP Medical Ltd
ISBN: 9350256487
Category : Medical
Languages : en
Pages : 194

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Book Description
Incretins are a group of gastrointestinal hormones that cause an increase in the amount of insulin released from cells in the pancreas after eating. Incretin based drugs are used to control blood sugar levels in the management of diabetes. This book is a concise guide to incretin based therapy. Beginning with an introduction to the history and physiology of incretins, the following sections examine the clinical pharmacology of GLP-1 Analogues and DPP-4 Inhibitors, the pleiotrophic effects of incretins and comparative pharmacology. Each section integrates science with practical therapeutic guidance for clinicians involved in the management of diabetes. The final chapter discusses the future of incretin therapies, including non-diabetic usage and combination therapy. Key Features Concise overview of incretin based therapy for the management of diabetes Guides clinicians step by step through the history and pharmacology of various molecules Integrates science with practical therapeutic guidance Includes chapter on the future of incretin therapy

Author: Stephen Gough
Publisher: Springer
ISBN: 331908982X
Category : Medical
Languages : en
Pages : 97

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Book Description
This concise handbook provides an overview of incretin-based therapies and guidance for incorporating them into the treatment of type 2 diabetes. Chapters include landmark clinical trials and international treatment guidelines in order to update readers with all major advances in the field. An ideal resource for medical professionals that treat patients with type 2 diabetes in hospital and clinical settings.

Author: Adrian Vella
Publisher: Wiley-Blackwell
ISBN: 9781405169288
Category : Medical
Languages : en
Pages : 170

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Book Description
Clinical Dilemmas in Diabetes provides evidence-based clinical guidance on the most common and problematic areas of concern encountered in diagnosing, treating and managing patients with diabetes. Each chapter is highly topical and has been selected due to current interest, specific recent developments, and areas of controversy. This valuable guide provides assistance in managing the life-long treatment of diabetes and the complications that often develop in patients. Clinical Dilemmas in Diabetes guides the medical team in their decision-making, particularly when there are conflicts in the treatment for the disease and the complications. Part of the Clinical Dilemmas series, the well-focused chapter structure allows for quick retrieval of information, and each opens with a “Learning Points” box to aid easy assimilation of the main issues. With a leading team of contributors and editors, Professor Robert A. Rizza is the immediate Past-President of the American Diabetes Association. This book is perfect for use on the wards and clinics as well as for self-study by diabetologists, diabetes specialist nurses, endocrinologists, GPs and cardiologists.

Author: Carl Erik Mogensen
Publisher: Springer Science & Business Media
ISBN: 0387697373
Category : Medical
Languages : en
Pages : 283

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Book Description
Diabetes is a huge and growing healthcare worry, especially in Western countries. The treatment of both types – 1 and 2 – of this disease has changed radically over the past few years. This work provides an overview of all the changes that will come to be implemented in clinical practice. Summarizing all aspects of treatment, this book delineates the large amount of research work that has been completed over the last few years into the relief of complications in diabetes and vascular medicine in general.

Author: Laurence Kennedy
Publisher:
ISBN:
Category :
Languages : en
Pages : 47

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Book Description

Author: Joel Rodriguez-Saldana
Publisher: Springer
ISBN: 3030118150
Category : Medical
Languages : en
Pages : 1040

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Book Description
Diabetes has become a worldwide health problem, the global estimated prevalence approaches ten percent and the burden of this disease in terms of morbidity and mortality is unprecedented. The advances acquired through the knowledge of the mechanisms of the disease and the variety of therapeutic approaches contrast with the inability of private and public health systems in underdeveloped and even developed countries to achieve the goals of treatment. This paradox has been described in many sources: the surge of scientific advances contrast with an unprecedented amount of human suffering. Thus, a patient centered and an evidence based approach with the capacity to produce measurable clinical and economic outcomes is required. The purpose of this textbook is multiple: to offer a comprehensive resource covering all aspects of outpatient management; to address diabetes as a health problem from an epidemiological, economic and clinical perspective; to discuss the role of social determinants of health on the worldwide increase in diabetes; to highlight the challenges and obstacles in providing adequate care; and to outline a multidisciplinary approach to management in which medical visits retain their importance as part of a team comprising the patient, his or her family and a multidisciplinary group of health professionals who are able to move beyond the traditional approach of diabetes as a disease and greatly improve outcomes.

Author: M. Wabitsch
Publisher: Karger Medical and Scientific Publishers
ISBN: 3318059749
Category : Medical
Languages : en
Pages : 200

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Book Description
The gut not only represents the largest endocrine organ of the human body but is also profoundly involved in the control of metabolism through peptide hormones. Therefore, gastrointestinal hormones are acting via autocrine, paracrine, and classical endocrine pathways and regulate e.g. digestion, hunger, and satiety. Furthermore, they are important regulators of body weight, growth, and glucose metabolism, as well as of mood and behavior. Physicians and scientists in the field of pediatric endocrinology and diabetes, as well as in pediatric gastroenterology, require an extensive understanding of the origin of enteroendocrine cells, factors controlling their differentiation, hormone gene expression, secretion, function and, finally, the complex interaction with other organs, especially the central nervous system. In order to meet these needs, experts in the field have written up-to-date, comprehensive, and illustrated reviews presenting the current knowledge in the field of gastrointestinal endocrinology with a pediatric view. Those reviews comprise this latest volume of Endocrine Development.

Author:
Publisher:
ISBN:
Category :
Languages : en
Pages : 36

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Book Description

Author: Matthew P. Coghlan
Publisher: Elsevier Inc. Chapters
ISBN: 0128061960
Category : Science
Languages : en
Pages : 29

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Book Description
The increasing global prevalence of type 2 diabetes represents a significant burden of disease for afflicted patients and for health care systems. In the developed world poorly controlled diabetes is the leading cause of non-traumatic amputation, blindness and end-stage renal disease requiring dialysis and kidney transplant. Additionally, diabetes represents a significant risk factor for the development of cardiovascular disease with its associated morbidity and premature death. Currently available glucose lowering drugs used to treat type 2 diabetes do not impede progression of the disease. Therefore, as the disease progresses these agents rapidly lose efficacy, first as monotherapy and then in combination, resulting in poorly controlled disease. Clearly, there is a significant need for novel glucose lowering drugs for type 2 diabetes that will deliver sustained efficacy over several years by impeding disease progression. Such agents would reduce the risk of developing the microvascular complications of diabetes that ultimately result in amputation, blindness and kidney transplant. Novel glucose lowering drugs should ideally also exhibit a positive impact on the increased cardiovascular risk associated with diabetes. The incretin-based therapies first entered the market in the mid 2000’s and were heralded for their potential to impede progression of type 2 diabetes and to reduce cardiovascular risk. Through mimicking the actions of the gut incretin hormone GLP-1, these drugs had been shown to lower blood glucose in clinical trials by potentiating glucose stimulated insulin secretion from pancreatic β-cells. Moreover, data from preclinical rodent disease models and isolated human pancreatic islets suggested that these novel agents could preserve pancreatic β-cell function and thus impede disease progression. Further preclinical and clinical data supported the notion that these drugs could also aid blood glucose control by suppressing glucagon secretion, slowing gastric emptying and by suppressing appetite. The incretin-based drugs have potential to reduce cardiovascular risk through their ability to reduce body weight, blood pressure and atherogenic blood lipids. This chapter will review the incretin-based therapies and consider what impact these new drugs have made to date in the pharmacotherapy of type 2 diabetes. The incretin-based therapies are of particular relevance to this book as this class of drugs is composed of two sub-classes, injectable peptide drugs and oral small molecule drugs. The similarities and differences between these small molecule and peptide drugs are described.

Author: Barry Kerr
Publisher:
ISBN:
Category :
Languages : en
Pages :

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Book Description
Gut peptides including glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide-l (GLP-I), and oxyntomodulin (Oxm) act to regulate glucose homeostasis, insulin secretion, bodyweight and satiety. However, clinical development has been hindered by rapid enzymatic degradation followed by renal clearance. This thesis evaluates the biological activities of these peptides, and exploits various chemical modifications / approaches to generate novel mimetics with therapeutic potential for type 2 diabetes and obesity. Acylation of Lys37 in GIP with C-14 fatty acid (myristate) afforded dipeptidylpeptidase-IV (DPP-IV) resistance and significantly enhanced in vitro cAMP production and insulin secretion. Furthermore, administration of N- AcGIP(Lys37 MYR) resulted in markedly improved glucose homeostasis and insulin-release in obese diabetic (ob/ob) mice. Once-daily administration of the DPP- IV resistant GIP analogue, GIP[mPEG], decreased non-fasting plasma glucose concentrations, increased insulin concentrations and improved glycaemic and insulin responses to a glucose load in mice with age-related glucose intolerance. These data clearly demonstrate the utility of stable analogues of GIP for treatment of obesity- diabetes. The GLP-l mimetic, Liraglutide, lacking the y-glutamyl linker (Lira-yGlu) demonstrated equi-potent DPP-IV resistance, cAMP production and insulin secretion compared with Liraglutide. In vivo, Lira-yGlu and Liraglutide significantly lowered plasma glucose in fasted mice. Twice-daily administration of either GLP-l analogue decreased food intake and plasma glucose concentrations, whilst increasing plasma insulin, and improving glucose tolerance and insulin sensitivity. These data indicate lack of requirement of y-glutamyl linker together with acylation for generation of long-acting incretin mimetics. Evaluating the effects of a an overnight preparation of Liraglutide and N- AcGIP(Lys37Myr) (Lira-AcGIP - mixed together and incubated for 12h) revealed improved acute glucose tolerance and insulin responses compared to a simple combination (immediate mixture). Furthermore, daily administration of the Lira- AcGIP preparation lowered bodyweight, decreased food intake, plasma glucose and insulin concentrations in ob/ob mice, as well as enhancing glucose tolerance, insulin response to glucose and insulin content. These data indicate the possibility of using combination therapy with stable GLP-l and GIP mimetics for treatment of type 2 diabetes. Oxm analogues, (0-Ser2)Oxm and (0-Ser2)Oxm[mPEG-PAL] exhibited DPP- IV stability, with equi-potent in vitro cAMP production and insulin secretion. In the presence of specific antagonists, cAMP production was reduced in GLP-l and glucagon receptor transfected cells, consistent with actions of dual receptor agonism. In acute studies, (0-Ser2)Oxm and (0-Ser2)Oxm[mPEG-PAL] exhibited glucoregulatory and anorexigenic properties with (0-Ser2)Oxm[mPEG-PAL] demonstrating more potent actions. Once-daily administration of (0- Ser2)Oxm[mPEG-PAL] decreased food intake, bodyweight and plasma glucose concentrations and increased insulin concentrations in ob/ob mice whilst improving glucose tolerance, insulin response to glucose and plasma lipid profiles. The N-terminal domain of GIP plays an important role in regulating its biological activity. Examining several novel N-terminally truncated forms of GIP revealed that GIP(8-42) exhibited reduced cAMP levels compared to native hormone whilst inhibiting GIP-induced cAMP production. In ob/ob mice, GIP(8-42) increased plasma glucose concentrations compared to the glucose-lowering action of native GIP. When GIP(8-42) was co-administered with GIP it countered the ability of the native hormone to lower plasma glucose and increase insulin concentrations. These data demonstrate the importance of the N-terminal of GIP in regulating bioactivity. Collectively, these data illustrate chemical modifications / approaches to improve the biological efficacy of GIP, GLP-l and Oxm. The use of smaller moieties to offset enzymatic degradation and renal clearance offer improved efficacy potentially due to reduced steric hindrance compared to currently available incretin therapies. In addition, incretin preparations and the dual role of Oxm may offer targeted 'smart therapy' for both obesity and type 2 diabetes. Hopefully this thesis will aid the development of pharmaceutical agents and subsequent clinical studies that will ultimately improve the lives of people suffering from type 2 diabetes and obesity.