Endocrine disorders

Glulisine (ApidraTM) is a rapid acting recombinant insulin analogue which differs from regular human insulin (RHI) by the substitution of lysine for asparagine at position B3 and glutamic acid for lysine at position B29. The chemical name is 3B-Lys-29- B-Glu-human insulin. The amino acid substitutions of glulisine and other rapid...

Background: Combination oral glucose-lowering drug therapy is often required to maintain glycemic control in patients with type 2 diabetes. Single-tablet fixed-dose combinations of oral glucose-lowering agents provide one means to increase adherence, which may improve metabolic and clinical outcomes. A new fixed-dose combination of pioglitazone and extended-release metformin has recently...

Reductions in fasting serum fructose or erythrocyte sorbitol have been proposed as markers for early proof of mechanism in clinical development of aldose reductase (AR) inhibitors. However fructose is significantly impacted by meals and evaluation of erythrocyte sorbitol poses technical challenges. To more accurately assess the performance of these markers...

The fat mass and obesity associated (FTO) gene has an important genetic effect on body mass index (BMI) and risk of obesity, and obesity contributes to the progression of renal diseases, including diabetic nephropathy. We thus conducted a genetic association study to evaluate whether the FTO gene confers the...

Type 2 diabetes mellitus (T2DM) is a major public health problem that affects an increasingly larger number of individuals worldwide. Metformin, unless contraindicated, is the recommended first line pharmacological treatment as it can achieve good glycemic control without weight gain or hypoglycemia and with evidence for cardioprotection. T2DM is a...

Parathyroid hormone (PTH) seems to affect the risk of cardiovascular disease. The aim of the present study was to investigate PTH’s acute effect on endothelial vasodilatory function in forearm resistance vessels. Ten healthy subjects underwent forearm venous occlusion plethysmography. We measured forearm blood flow at baseline and at a stable,...

Background: Increased protein proportions in the diet combined with energy restriction has been shown to enhance weight loss during dietary intervention. It is not known if the beneficial effect of dietary protein exists in the general population under normal living conditions without a negative energy balance. Methods: A total...

Type 2 diabetes mellitus (T2DM) is a complex multifactorial disease which affects the length and quality of life by severe chronic complications. Chronic hyperglycemia, which is the main alteration in T2DM, is strictly related to microvascular complications (such as retinopathy and nephropathy) and neuropathy, whereas large vessel atherosclerosis is also...

Pegaptanib sodium is a polyethylene-glycolated, 28-nucleotide RNA aptamer that binds selectively to vascular endothelial growth factor (VEGF)165 but not smaller isoforms. Preclinical studies identified VEGF165 as an especially potent promoter of ocular neo-vascularization and inflammation. Following the pivotal clinical trials demonstrating the efficacy of intravitreal pegaptanib in treating all angiographic...

Liraglutide—a once-daily human glucagon-like peptide-1 receptor agonist for treatment of Type 2 diabetes—provides effective glycemic control with a lower incidence of hypoglycemia than therapies such as glimepiride and exenatide, and reduces body weight and systolic blood pressure. This article briefly discusses efficacy and safety results from the Liraglutide Effect and...

Cortisol concentrations in hair collected from young male and female adults were assayed and compared for differences along shaft length and between body sites. No significant differences were found between hair shaft sites, supporting a model of the hair shaft as “alive” and responsive to environmental demand in terms of...

Cortisol concentrations in hair and saliva collected from male and female adults over a 15-hour period were compared for differences in overall level and cyclic pattern. Typical diurnal fluctuations were noted for both salivary and hair cortisol, with some individual differences that are congruent with the previous literature. Issues of...

Background: Chronic hepatitis C virus (HCV) infection is not a simple viral infection; it has many metabolic and autoimmune complications. Objective: To investigate the impacts of chronic HCV infection on glucose and lipid metabolism and its correlation-if any-with body mass index (BMI) and hepatosteatosis in chronic HCV patients. Patients and Methods: One...

Background: Statins are recommended as first line therapy for the prevention of cardiovascular disease. Some individuals are statin intolerant or may need additional cholesterol lowering to achieve their cholesterol targets. Purpose: To review the pharmacology, clinical efficacy and safety of colesevelam mono- and combination therapy in patients with hypercholesterolemia. Data source: English-language...

Obesity is a common problem that can lead to numerous comorbid conditions, including Type 2 diabetes. Currently, there are few pharmacologic options available to help obese patients lose weight. Pramlintide is an injectable, amylin analogue that is indicated in patients with Type 1 and Type 2 diabetes for use...

Introductory Editorial by Dr Karna Dev Bardhan

Twenty-eight patients with diabetes who screened positive for at-risk drinking were assigned to brief alcohol intervention (BAI) (n = 14) or standard care (SC) (n = 14) treatment conditions. All participants completed a baseline interview and one-, three, and six-month follow-up interviews. Across the six-month follow-up period, there was a...

Among the new therapeutic options for type 2 diabetes care, the incretin-based treatments are considered particularly promising. Two classes of drugs have been developed, GLP-1 receptor agonists and DPP-IV inhibitors, that respectively mimic or prolong the action of the human GLP-1, key-hormone in the glucose homeostasis maintenance. Liraglutide is a GLP-1...

A new lancet with an extremely small needle (0.15 mm diameter and 0.75 mm length) mounted on a small pedestal was tested in diabetic patients for blood glucose measurement in a randomized clinical study. A total of 37 diabetic patients were enrolled for the study. A pain scale categorized from...

Background: The aim of this study is to evaluate the prevalence of chronic complications in type 2 diabetic patients in Basrah (Southern Iraq). Methods: This was a longitudinal descriptive study for patients with diabetes registered in Al-Faiha Diabetes and Endocrine Centre in Basrah (Southern Iraq) for the period from...

In this commentary to the paper by Donadon V. et al (Clinical Medicine: Endocrinology and Diabetes. 2009;2:25–33.) the association and significance of insulin resistance with chronic liver disease are shortly reviewed and the molecular mechanisms underlying the diabetogenic and oncogenic potentials of advanced liver disease are summarized. Literature studies demonstrate...

The antidiabetic effect of the dipeptidyl peptidase 4 (DPP-4) inhibitors depends on the prolongation of action of the 2 incretin hormones: glucagon like peptide-1 (GLP-1) and gastric inhibitory polypeptide (GIP) by preventing their rapid degradation by the enzyme DPP-4. The use of the DPP-4 inhibitor vildagliptin is associated with mean...

Objective: The aim of the present study was to determine differences between male and female type 2 diabetic patients concerning body weight, metabolic control, insulin requirement and prevalence of vascular diseases during the first year insulin therapy. Patients and Methods: We investigated 102 newly insulin-treated type 2 diabetic patients (60 female)...

The incidence of hepatocellular carcinoma (HCC) is increasing world wide. The risk factors for the development of HCC include liver cirrhosis, chronic alcohol intake, and chronic viral hepatitis. These conditions are associated with inflammation, liver cell injury, and oxidative stress. The signaling pathways that contribute to liver cell injury have...

Glycogen synthase kinase 3β (GSK3β) was discovered as a major factor in glucose homeostasis. GSK3β is a pivotal regulator of glycogen synthesis by altering the activity of glycogen synthase and perturbation in this process have been linked to at least some sub-entities of insulin resistance and diabetes mellitus. However, GSK3β...

Common variable immunodeficiency (CVID) is a heterogeneous group of primary immunodeficiency disorders characterized by defective antibody production, low levels of serum immunoglobulins and increased susceptibility to infection. The patient was a 39-year-old male who was admitted to the gastroenterology department with a two week history of diarrhea, blunt abdominal pain...

A number of studies have suggested that homocysteine may be a contributing factor to development of retinopathy in diabetic patients based on observed correlations between elevated homocysteine levels and the presence of retinopathy. The significance of such a correlation remains to be determined, and potential mechanisms by which homocysteine might...

Objectives: There is an established causal link between obesity and cardiovascular outcomes. The aim of this review was to determine whether an independent relationship exists between anthropometric measurements of weight (typically body mass index [BMI]) and cardiovascular outcomes (e.g. angina, myocardial infarction, congestive heart failure, stroke, and mortality due to...

GISTs are rare neoplasms, which were recently identified to be a distinct pathologic entity. They can develop in patients with neurofibromatosis type 1 (NF1) or may be sporadic. NF1 is one of the most common inherited diseases and is a complex disease, with patients having an increased prevalence of benign...

Metformin is now the most widely prescribed oral hypoglycemic agent. This review outlines its use in the treatment of type 2 diabetes. The main mechanisms of action include reduction of appetite and of intestinal carbohydrate absorption, inhibition of hepatic gluconeogenesis, and increased glucose uptake by peripheral tissues. Metformin has been...