Use of Insulin to Improve Glycemic Control in Diabetes Mellitus

Dandona, Paresh; Chaudhuri, Ajay; Ghanim, Husam; Mohanty, Priya

doi:10.1007/s10557-008-6101-3

Cited by 12 publications

(6 citation statements)

References 121 publications

(126 reference statements)

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“…Hypoglycemic effects of metformin correlated to a higher insulin release. Some studies indicate that insulin may exert an anti-inflammatory response, independent of its effects on glycemia by mechanisms of NO release, and inhibition of NFκB signaling thus decreasing ICAM-1 and MCP-1 expression (Dandona et al, 2008;Sun et al, 2014). Our study showed pro-hyperglycemic effects by BTE as indicated by increased levels of fasted and fed glucose as well as lesser glucose tolerance, whereas levels of insulin were not changed significantly.…”

Section: Discussionsupporting

confidence: 45%

Anti-diabetic effects of a theaflavin-enriched black tea extract in the obese ZDF rat model

Gosslau¹,

Zachariah²,

Li³

et al. 2018

Journal of Food Bioactives

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Effects of a theaflavin-enriched black tea extract (BTE) against type 2 diabetes (T2D) were analyzed using the obese ZDF model. ZDF rats were hyperglycemic, dyslipidemic and express pro-inflammatory markers. BTE was well tolerated and caused an elevation of fasted and fed glucose as well as lower glucose tolerance in contrast to hypoglycemic effects by metformin. However, the BTE group showed decreased levels of LDL and triacylglycerols which corresponded to an increase in free fatty acids. Positive effects against dyslipidemia of BTE corresponded to a significant decrease in weight gain. The impact on inflammatory pathways was analyzed by expression analysis of inflammatory mediators in whole blood and epididymal adipose tissue using TaqMan PCR and ELISA. Whole blood analysis revealed a significant down-regulation of ICAM-1 and TNF-α, whereas IL-4, IL-6, IL-10, IL-13 and IFN-γ were elevated to higher levels as compared to ibuprofen. In adipose tissue, BTE treatment induced an upregulation of COX-2 and IL-6. Thus, BTE treatment showed strong effects against systemic inflammation and caused a reduction of weight gain with positive effects against dyslipidemia. The complexity of signaling pathways leading to complications in diabetes suggest a treatment of BTE in combination with antidiabetic therapeutics as promising strategy against T2D.

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Section: Discussionsupporting

confidence: 45%

Anti-diabetic effects of a theaflavin-enriched black tea extract in the obese ZDF rat model

Gosslau¹,

Zachariah²,

Li³

et al. 2018

Journal of Food Bioactives

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“…Studies using surrogate clinical measures of atherosclerosis showed that pioglitazone significantly slowed progression of carotid intima–media thickness and prevented progression of coronary atherosclerosis vs glimepiride [79, 80]. Insulin may exert anti-inflammatory actions that could be anti-atherogenic/cardioprotective, although this remains controversial [81]. Insulin may also lower LDL-cholesterol and triacylglycerol levels [82, 83].…”

Section: Other Important Pathophysiological and Clinical Effectsmentioning

confidence: 99%

Is the ADA/EASD algorithm for the management of type 2 diabetes (January 2009) based on evidence or opinion? A critical analysis

et al. 2010

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The ADA and the EASD recently published a consensus statement for the medical management of hyperglycaemia in patients with type 2 diabetes. The authors advocate initial treatment with metformin monotherapy and lifestyle modification, followed by addition of basal insulin or a sulfonylurea if glycaemic goals are not met (tier 1 recommendations). All other glucose-lowering therapies are relegated to a secondary (tier 2) status and only recommended for selected clinical settings. In our view, this algorithm does not offer physicians and patients the appropriate selection of options to individualise and optimise care with a view to sustained control of blood glucose and reduction both of diabetes complications and cardiovascular risk. This paper critically assesses the basis of the ADA/EASD algorithm and the resulting tiers of treatment options.

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“…Diabetes induces oxidative and inflammatory stress, vasoconstrictor responses, thrombotic phenomena and pro-apoptotic effects on endothelial cells (22).…”

Section: Discussionmentioning

confidence: 99%

Impact of previous insulin therapy on the prognosis of diabetic patients with acute coronary syndromes

António

Soares²,

Lourenco

et al. 2010

Arq Bras Endocrinol Metab

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Objective: To determine whether previous insulin treatment independently influences subsequent outcomes in diabetic patients with ACS (acute coronary syndromes). Subjects and methods: 375 diabetic patients with ACS, divided in 2 groups: Group A (n = 69) -previous insulin and Group B (n = 306) -without previous insulin. Predictors of 1-year mortality and major adverse cardiac events (MACE) were analyzed by Cox regression analysis. Results: Group A had more previous stroke (17.4% vs. 9.2%, p = 0.047) and peripheral artery disease (13.0% vs. 3.6%, p = 0.005). They had significantly higher admission glycemia and lower LDL cholesterol. There were no significant differences in the type of ACS, in 1-year mortality (18.2% vs. 10.4%, p = 0.103) or MACE (32.1% vs. 23.0%, p = 0.146) between groups. In multivariate analysis, insulin treatment was neither an independent predictor of 1-year mortality nor of MACE. Conclusion: Despite the more advanced atherosclerotic disease, diabetics under insulin had similar outcomes to those without insulin. Insulin may protect diabetics from the expected poor adverse outcome of an advanced atherosclerotic disease. Arq Bras Endocrinol Metab. 2010;54(7):612-9 Keywords Insulin; diabetes; acute coronary syndromes; outcomes RESUMO Objectivo: Avaliar se a insulinoterapia prévia influencia de forma independente o prognóstico de diabéticos após uma síndrome coronária aguda (SCA). Sujeitos e métodos: 375 doentes diabéti-cos com SCA, divididos em 2 grupos: Grupo A (n = 69) -sob insulinoterapia prévia e Grupo B (n = 306) -sem insulinoterapia prévia. Os preditores de mortalidade a um ano e de eventos cardíacos adversos maiores (MACE) foram determinados pela regressão de Cox. Resultados: Verificou-se maior proporção de acidente vascular cerebral prévio (17,4% vs. 9,2%, p = 0,047) e doença arterial periférica (13,0% vs. 3,6%, p = 0,005) no Grupo A. Esses doentes apresentaram glicemia na admissão significativamente mais elevada e LDL inferior. Não houve diferenças estatisticamente significativas no tipo de SCA, na mortalidade (18,2% vs. 10,4%, p = 0,103) e MACE (32,1% vs. 23,0%, p = 0,146) em um ano entre os 2 grupos. Na análise multivariada, a insulinoterapia prévia não foi preditor independente nem de mortalidade, nem de MACE em 1 ano. Conclusão: Apesar da doença aterosclerótica mais avançada, os diabéticos previamente insulino-tratados têm um prognóstico semelhante aos não insulino-tratados. A insulinoterapia crônica poderá proteger os diabéticos da evolução desfavorável própria da doença aterosclerótica avançada. Arq Bras Endocrinol Metab. 2010;54(7):612-9 Descritores Insulina; diabetes; síndromes coronárias agudas; prognóstico Copyright © ABE&M todos os direitos reservados. 613Arq Bras Endocrinol Metab. 2010;54/7Insulin and acute coronary syndromes

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Use of Insulin to Improve Glycemic Control in Diabetes Mellitus

Cited by 12 publications

References 121 publications

Anti-diabetic effects of a theaflavin-enriched black tea extract in the obese ZDF rat model

Anti-diabetic effects of a theaflavin-enriched black tea extract in the obese ZDF rat model

Is the ADA/EASD algorithm for the management of type 2 diabetes (January 2009) based on evidence or opinion? A critical analysis

Impact of previous insulin therapy on the prognosis of diabetic patients with acute coronary syndromes

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