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- W2022120346 abstract "ACHIEVING normal glycemic control in patients with diabetes mellitus (DM) is important for minimizing the risk of complications. The approach to glycemic control, however, usually depends on the disease type and may change over time. In patients with type 1 DM, pancreatic beta cells have been destroyed, resulting in an insulin deficiency. 1 Atkinson M.A. Eisenbarth G.S. Type 1 diabetes; new perspectives on disease pathogenesis and treatment. Lancet. 2000; 358: 221-229 Abstract Full Text Full Text PDF Scopus (1125) Google Scholar Insulin must be provided exogenously to these patients. On the other hand, patients with type 2 DM may have genetically defective beta cell activity, insulin resistance, or an increase in glucose production. 2 Gerich J.E. Contributions of insulin-resistance and insulin-secretory defects to the pathogenesis of type 2 diabetes. Mayo Clin Proc. 2003; 78: 447-456 Abstract Full Text Full Text PDF PubMed Scopus (147) Google Scholar , 3 Defronzo R.A. Bonadonna R.C. Ferrannini E. Pathogenesis of NIDDM, a balanced overview. Diabetes Care. 1992; 15: 318-366 Crossref PubMed Scopus (1878) Google Scholar In the early stages, insulin secretion increases to overcome insulin resistance. Over time (about 6 years), pancreatic beta cells fail and insulin secretion returns to baseline. 4 UK prospective Diabetes Study GroupUK Prospective Diabetes Study 16: Overview of 6 years’ therapy of type 2 diabetes: A progressive disease. Diabetes. 1995; 44: 1249-1258 Crossref PubMed Scopus (1885) Google Scholar , 5 Cook D.L. Taborsky Jr, G.J. B-cell function and insulin secretion. in: Porte D. Sherwin R.S. Ellenberg and Rifkin’s Diabetes Mellitus. 5th ed. Lippincott-Raven, Philadelphia, PA1997: 49-73 Google Scholar Thus, patients with type 2 DM may be managed with insulin, one or two oral antidiabetic agents, and, possibly, one of two new antidiabetic agents with unique mechanism of action (exenatide and pramlintide). Julie Golembiewski, PharmD, is a Clinical Associate Professor, College of Pharmacy and Department of Anesthesiology, University of Illinois at Chicago, Chicago, IL" @default.
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- W2022120346 date "2006-04-01" @default.
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- W2022120346 title "Insulin and Antidiabetic Agents—The Old and the New" @default.
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