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- December 1, 2008 |
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"Oral anti-diabetic action on the beta cell"Dr. Sof Andrikopoulos (biography)
English - 2008-04-17 - 39 minutes
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 | (39 slides) |
Summary :
Dr. Andrikopoulos first explains that type-2 diabetes results from the failure of beta cells to secrete amounts of insulin sufficient to compensate for the impact of muscle insulin resistance, obesity, and a glucose-rich diet. He then goes on to describe some of the main oral anti-diabetic agents used today.
The first of these is sulfonylurea, which acts on the pancreas to stimulate insulin secretion. Dr. Andrikopoulos warns that the chronic use of this agent, however, causes a decrease in its activity due to what experimental data has shown to be increased beta cell death.
GLP-1 is produced in the gut in response to carbohydrates and fat. Its has several anti-diabetic roles, such as increasing the production and secretion of insulin. Several agents have been developed to increase its half-life in diabetic patients, and Dr. Andrikopoulos discusses the efficacy of these, and their effect on beta cell mass.
Though the mechanism of Metformin is currently unclear, it is a known insulin sensitizer and inhibitor of hepatic glucose production. Its effect on beta cells may be indirect through increased insulin sensitivity, or direct, perhaps by decreasing fructose bisphosphatase.
Lastly, Dr. Andrikopoulos discusses thiazolidinediones (TZDs), which improve beta cell function and increase its mass through both direct and indirect mechanisms. They are insulin sensitizers and PPARgamma agonists, and they improve the lipid profile.
Copyright © 2008 E-MedHosting.com Inc.
Learning objectives :
Learning objectives
After viewing this presentation the participant will be able to discuss the role the beta cell in type-2 diabetes and the effect of the following oral anti-diabetic agents on the beta cell:
-Sulfonylureas
-GLP-1
-Metformin
-TZDs
Bibliographic references :
Kahn SE, Hull RL, Utzschneider KM Mechanisms linking obesity to insulin resistance and type 2 diabetes Nature. 2006 Dec 14;444(7121):840-6.
Aston-Mourney K, Proietto J, Morahan G, Andrikopoulos S Too much of a good thing: why it is bad to stimulate the beta cell to secrete insulin Diabetologia 2008 Apr;51(4):540-5. Epub 2008 Feb 2.
Lupi R, Mancarella R, Del Guerra S, Bugliani M, Del Prato S, Boggi U, Mosca F, Filipponi F, Marchetti P S Effects of exendin-4 on islets from type 2 diabetes patients Diabetes Obes Metab. 2008 Jun;10(6):515-9. Epub 2008 Jan 14.
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