Chapter 22. New Approaches to Diabetes

摘要: Publisher Summary Several new mechanisms for the therapy of diabetes show considerable promise expansion clinical options treatment hyperglycemia. As pharmacological classes anti-diabetic agents emerge, optimal non-insulin dependent mellitus (NIDDM) may require combination therapies. These be adjusted to suit individual patient needs, particularly if responsiveness therapies is as heterogeneous it can expected in so large a population. Insulin replacement insulin (IDDM) optimized by development more physiological replacements and correction other secondary hormonal changes. This chapter discusses several promising approaches that represent potential therapeutic breakthroughs hyperglycemia with emphasis on insulin, release, action, counter-regulatory hormones. Therapy IDDM or Type I attempts replace manner mimics physiologic pattern release seen nondiabetic. In addition, used NIDDM II when oral alone fails. characterized abnormal secretion from pancreas, increased basal glucose output liver, resistance peripheral tissue. Peripheral significantly contributes hyperglycemic state NIDDM, proven euglycemic clamp studies marked reduction stimulation disposal. Current data favor post-receptor defect response insulin. A glycemia also alleviates action tissues. act counter insulin's stimulating disposal inhibiting hepatic output. Modulation these regulatory hormones impact glycemic control and/or diabetic patients.