Insulin

Gestational Diabetes A transient, self-limiting, hyperglycaemia, which occurs during pregnancy due to maternal endocrine changes. Glucose Control Insulin cause…  

This presentation descibes to the listener the eating disorders that can occur in type 1 diabetes mellitus. I have focused on 'Diabulimia', a disorder where diabetics omit their insulin in order to lose weight leading to drastic complications. The presentation looks at evidence based medicine and potential methods of treatment for these highly specialised patients.  

• Type 1 diabetes – a primary deficiency of insulin, β- cell destruction leads to failure of insulin secretion. May be due to an autoimmune reaction against th…  

Acromegaly Growth hormone stimulates the production of insulin-like growth factor-I (IGF-I), which is produced in the liver and many other tissues. IGF-I is th…  

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A overview of the main groups of drugs used in diabetes with some side effects  

Resistance to insulin is a normal physiological response in pregnancy, thought to be induced by maternal hormones.  However, in some women, this is severe enough to result in gestational diabetes. In these women, there is reduced ability of the pancreas to produce enough insulin to overcome the insulin resistance.   Gestation diabetes is defined as - Any hyperglycaemia with first onset or presentation during pregnancy    

The Basics 98% is intracellular Serum range 3.5 – 5 mmol/L K+ and H+ tend to vary together Most body secretion is in urine – from distal tubules   Shifts K+ INSIDE cells: Insulin Aldosterone β-adrenergic stimulation  

The patient is a 63 year old freelance editor with type 2 diabetes diagnosed about five years ago that is relatively well controlled with insulin. He has early signs of retinopathy, with normal kidney function and electrocardiogram. Lipid values are normal with diet and atorvastatin 20 mg/day. He developed autonomic and peripheral neuropathy a few months ago, and now experiences postural hypotension and burning pain and clumsiness in his feet. His pain makes concentration and falling asleep difficult. He asks his general practitioner for painkillers to help him continue working.  

Mid Staffordshire NHS Foundation Trust has been fined £200 000 (€243 000; $336 000) and ordered to pay more than £27 000 in costs after it was prosecuted by the Health and Safety Executive over the “wholly avoidable” death of Gillian Astbury, a diabetic patient who died after nurses failed to give her insulin.  

Professor Fink explains the intra-cellular manufacture, storage and secretion of Insulin by Pancreatic Islet Cells. Profess...  

Managing my health has, and always will be, a partnership. I had type 1 diabetes diagnosed at age 18 months and I am now 27. Along the way my diabetes has been managed in a partnership between family (mainly my mother), friends, school, college, the workplace, the charity sector, health professionals, drug companies (who provide insulin, test strips, etc), the patient community (through peer support and online resources), and, most importantly, me, the person at the centre. - currently located behind a paywall. Your institution may have access through Athens/Elservier or similar.  

A 41 year old patient with insulin dependent diabetes presented with a one month history of progressively worsening pain, numbness, and weakness of his right shoulder and arm. His history included peripheral vascular disease, chronic renal failure, and chronic pancreatitis. He was also a smoker with a 60 pack year history.  

When IGF-1 binds to insulin receptors does it have the same or opposite effect of insulin?  

The secretion of glucagon by pancreatic α-cells plays a critical role in the regulation of glycaemia. This hormone counteracts hypoglycaemia and opposes insulin actions by stimulating hepatic glucose synthesis and mobilization, thereby increasing blood glucose concentrations. During the last decade, knowledge of α-cell physiology has greatly improved, especially concerning molecular and cellular mechanisms. In this review, we have addressed recent findings on α-cell physiology and the regulation of ion channels, electrical activity, calcium signals and glucagon release. Our focus in this review has been the multiple control levels that modulate glucagon secretion from glucose and nutrients to paracrine and neural inputs. Additionally, we have described the glucagon actions on glycaemia and energy metabolism, and discussed their involvement in the pathophysiology of diabetes. Finally, some of the present approaches for diabetes therapy related to α-cell function are also discussed in this review. A better understanding of the α-cell physiology is necessary for an integral comprehension of the regulation of glucose homeostasis and the development of diabetes.  

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High dose insulin given to children at risk of developing type 1 diabetes resulted in an immune response without hypoglycaemia, a double blind, placebo controlled pilot study has found.  

A simple education and patient review programme for GPs reduced the proportion of patients with type 2 diabetes not treated with insulin who were inappropriately self monitoring their blood glucose by 20% over four years, a UK general practice study has shown.1