Abstract
Type 2 diabetes is characterized by insulin resistance together with progressive loss of beta-cell function. After recognition of gluco- and lipo-toxicity, attention was focused on the preservation and/or restoration of beta cell function, especially at the early stages of the diabetes, with better beta-cell reserve and in the absence of complications. Early treatment of glucotoxicity with insulin was searched by early insulin treatment studies, and these studies have some promising results, pointing the possibility of “remission” of diabetes in some patients. According to the results of these studies, patients with early diagnosis of diabetes, the ones with better beta cell reserve, patients with low tendency for “insulin-abuse” could make “U”-turn from insulin to pills or even drug-free life. Criteria to turn back to pills could be listed as disappearance of diabetic symptoms, daily insulin need < 0.25 unit/kg, euglycemia in both fasting and postprandial state, and better beta cell function. The main problems in early insulin treatment are the ‘’insulin resistance’’ of both patients and doctors, hypoglycemia, weight gain and increased appetite. Meanwhile, hyperinsulinemia desensitizes receptors and causes worsening of situation in a vicious cycle of insulin resistance and hyperglycemia. Therefore, patients should be selected properly and U-turn could be performed in relevant conditions explained in the text. It could be possible to see early insulin treatment and U-turn strategies in future guidelines for type 2 diabetes.
Keywords: Amylin, beta cell, glucotoxicity, insulin, oral antidiabetics, type 2 diabetes.
Current Vascular Pharmacology
Title:Is there U-turn from Insulin Back to Pills in Diabetes?
Volume: 12 Issue: 4
Author(s): Sibel Ertek and Sevki Cetinkalp
Affiliation:
Keywords: Amylin, beta cell, glucotoxicity, insulin, oral antidiabetics, type 2 diabetes.
Abstract: Type 2 diabetes is characterized by insulin resistance together with progressive loss of beta-cell function. After recognition of gluco- and lipo-toxicity, attention was focused on the preservation and/or restoration of beta cell function, especially at the early stages of the diabetes, with better beta-cell reserve and in the absence of complications. Early treatment of glucotoxicity with insulin was searched by early insulin treatment studies, and these studies have some promising results, pointing the possibility of “remission” of diabetes in some patients. According to the results of these studies, patients with early diagnosis of diabetes, the ones with better beta cell reserve, patients with low tendency for “insulin-abuse” could make “U”-turn from insulin to pills or even drug-free life. Criteria to turn back to pills could be listed as disappearance of diabetic symptoms, daily insulin need < 0.25 unit/kg, euglycemia in both fasting and postprandial state, and better beta cell function. The main problems in early insulin treatment are the ‘’insulin resistance’’ of both patients and doctors, hypoglycemia, weight gain and increased appetite. Meanwhile, hyperinsulinemia desensitizes receptors and causes worsening of situation in a vicious cycle of insulin resistance and hyperglycemia. Therefore, patients should be selected properly and U-turn could be performed in relevant conditions explained in the text. It could be possible to see early insulin treatment and U-turn strategies in future guidelines for type 2 diabetes.
Export Options
About this article
Cite this article as:
Ertek Sibel and Cetinkalp Sevki, Is there U-turn from Insulin Back to Pills in Diabetes?, Current Vascular Pharmacology 2014; 12 (4) . https://dx.doi.org/10.2174/15701611113119990122
DOI https://dx.doi.org/10.2174/15701611113119990122 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
Call for Papers in Thematic Issues
Ischemic Cardiovascular Diseases: Mechanisms, Diagnosis and Therapy
Ischemic cardiovascular disease includes myocardial infarction, coronary atherosclerotic heart disease, angina pectoris, etc., constitute the leading cause of patient mortality by preventing tissues from getting sufficient oxygen and nutrients. Ischemic heart disease, as a clinical condition, is characterized by myocardial ischemia, causing an imbalance between myocardial blood supply and demand, ...read more
TREATMENT OF CARDIOVASCULAR DISEASE IN CHRONIC AND END STAGE KIDNEY DISEASE
Cardiovascular disease still remains the leading cause of death in Chronic and End Stage Kidney Disease, accounting for more than half of all deaths in dialysis patients. During the past decade, research has been focused on novel therapeutic agents that might delay or even reverse cardiovascular disease and vascular calcification, ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
The mTOR Signaling Network: Insights from Its Role During Embryonic Development
Current Medicinal Chemistry Exploring the Role of Gene Therapy for Neurological Disorders
Current Gene Therapy Target Driven Preclinical Screening for New Antimitotic Chemotherapy Agents
Current Topics in Medicinal Chemistry Immune Modulation by Plasmid DNA-mediated Cytokine Gene Transfer
Current Pharmaceutical Design Sulfotransferase 1A1 as a Biomarker for Susceptibility to Carcinogenesis: From Molecular Genetics to the Role of Dietary Flavonoids
Current Drug Metabolism Organ Preservation by the Association of Chemotherapy and Radiotherapy in Invasive Bladder Cancer
Current Drug Therapy Recent Approaches in Chemoprevention of Prostate Cancer
Current Cancer Drug Targets Iontophoresis: Drug Delivery System by Applying an Electrical Potential Across the Skin
Drug Delivery Letters Lycopene Modulation of Molecular Targets Affected by Smoking Exposure
Current Cancer Drug Targets Multimodality Imaging of RNA Interference
Current Medicinal Chemistry Allelic Variations in CYP2D6 Gene and Susceptibility to Cervical Cancer
Drug Metabolism Letters A Review on Defects of Dendritic Cells in Common Variable Immunodeficiency
Endocrine, Metabolic & Immune Disorders - Drug Targets Specific Targeted Therapy: A New Tool for the Destruction of Cancer
Current Drug Therapy Pharmacotherapy for the Metabolic Syndrome
Current Vascular Pharmacology Association of Metronidazole with Cancer: A Potential Risk Factor or Inconsistent Deductions?
Current Drug Metabolism Targeted Therapies in Gynecologic Cancers
Current Cancer Drug Targets Population Diversity and its Relationship with Infectious and Tumor Diseases
Current Immunology Reviews (Discontinued) Diverse Mechanisms of AKT Pathway Activation in Human Malignancy
Current Cancer Drug Targets Abatacept and Glomerular Diseases: The Open Road for the Second Signal as a New Target is Settled Down
Recent Patents on Endocrine, Metabolic & Immune Drug Discovery Cancer Cell Cannibalism: A Primeval Option to Survive.
Current Molecular Medicine