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Chapter 25

Insulin and Hypoglycemic Drugs

Glucose Homeostasis: Regulation of Blood Glucose
Glucose Homeostasis: Regulation of Blood Glucose
Carbohydrates consumed through foods are converted into glucose, a crucial energy source for the body. In the prandial state, high blood glucose levels ...
Glucose Homeostasis: Pancreatic Islets and Insulin Secretion
Glucose Homeostasis: Pancreatic Islets and Insulin Secretion
The pancreas comprises highly vascularized and innervated pancreatic islets, encompassing α, β, δ, PP, and ε endocrine cells. Amongst ...
Insulin: The Receptor and Signaling Pathways
Insulin: The Receptor and Signaling Pathways
The insulin receptor belongs to the receptor tyrosine kinase family. It comprises disulfide-linked α/β dimers, forming a transmembrane ...
Pathophysiology of Diabetes
Pathophysiology of Diabetes
Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The two most common types of diabetes mellitus are type 1 and type 2. ...
Diabetes: Symptoms, Diagnosis, and Complications
Diabetes: Symptoms, Diagnosis, and Complications
Diabetes can be initially identified based on symptoms. Hyperglycemic patients may present common symptoms, including polyuria, polydipsia, fatigue, and ...
Diabetes: Management and Pharmacotherapy
Diabetes: Management and Pharmacotherapy
The goals of diabetes therapy include glycemic control, alleviating hyperglycemia-related symptoms, and preventing or reducing chronic end-organ ...
Insulin: Biosynthesis, Chemistry, and Preparation
Insulin: Biosynthesis, Chemistry, and Preparation
The pancreatic β-cell's endoplasmic reticulum synthesizes preproinsulin comprising a signal peptide, B and A chains, and a C-peptide. The ...
Insulin Formulations: Types and Delivery
Insulin Formulations: Types and Delivery
Insulin preparations, based on their duration of action, are categorized as short-acting and long-acting. Short-acting regular insulin forms hexamers, ...
Insulin: Dosing Regimen and Adverse Effects
Insulin: Dosing Regimen and Adverse Effects
Insulin dosage regimens generally include a mixture of analogs given as daily injections. Typically, most patients are prescribed long and short-acting ...
Oral Hypoglycemic Agents: Sulfonylureas
Oral Hypoglycemic Agents: Sulfonylureas
Sulfonylureas are a class of insulin secretagogues. They are used as oral hypoglycemic agents for managing Type 2 diabetes. Structurally, these drugs ...
Oral Hypoglycemic Agents: Biguanides and Glitazones
Oral Hypoglycemic Agents: Biguanides and Glitazones
Biguanides are insulin sensitizers that enhance glucose uptake, reducing insulin resistance. Unlike sulfonylureas, they do not stimulate insulin ...
Oral Hypoglycemic Agents: Glinides
Oral Hypoglycemic Agents: Glinides
Glinides are insulin secretagogues that trigger insulin release from β cells by inhibiting KATP channels and controlling potassium efflux. They share ...
Oral Hypoglycemic Agents: α-Glucosidase Inhibitors
Oral Hypoglycemic Agents: α-Glucosidase Inhibitors
α-glucosidase inhibitors impede intestinal α-glucosidase enzymes, delaying the digestion of starch and disaccharides. This effectively curtails ...
Glucagon-like Receptor Agonists
Glucagon-like Receptor Agonists
Oral glucose intake triggers gut hormones like GLP-1 and GIP called incretins, which stimulate insulin secretion. Both GLPs and glucagon originate from ...
Dipeptidyl Peptidase 4 Inhibitors
Dipeptidyl Peptidase 4 Inhibitors
Dipeptidyl peptidase 4, or DPP-4 inhibitors, called gliptins inhibit incretin hormone inactivation. These drugs bind to DPP-4,  increasing the levels ...
Hypoglycemia and Glucagon
Hypoglycemia and Glucagon
Without prolonged fasting, healthy individuals maintain blood glucose levels >80 mg/dL due to a well-adapted neuroendocrine system. However, ...
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