Detail of "151126-32-8"

Reference

Insulin therapy in type 2 diabetes

Insulin therapy in type 2 diabetes. Davis, Trent; Edelam, Steven V. (Section of Diabetes/Metabolism, Veterans Affairs San Diego HealthCare System, San Diego, CA 92161, USA). Medical Clinics of North America, 88(4), 865-895 (English) 2004 Elsevier Inc. CODEN: MCNAA9. ISSN: 0025-7125. DOCUMENT TYPE: Journal; General Review CA Section: 2 (Mammalian Hormones) Section cross-reference(s): 1, 3 A review. Type 2 diabetes is a common disorder often accompanied by numerous metabolic abnormalities leading to elevated rates of cardiovascular morbidity and mortality. Improved glycemia will delay or prevent the development of microvascular disease and reduce many or all of the acute and subacute complications that worsen the quality of daily life. Exogenous insulin is usually the last line of treatment used to normalize glycosylated Hb in patients with type 2 diabetes who have failed other therapeutic modalities. In selected patients, combination therapy with insulin and oral antidiabetic medications can be an effective method for normalizing glycemia without the need for rigorous insulin regimens. Bedtime intermediate- and long acting-insulin are administered and progressively increased until the fasting blood glucose concn. is normalized. Addnl. benefits of combination therapy include ease of administration, excellent patient compliance and safety, and lower exogenous insulin requirements with less peripheral hyperinsulinemia and wt. gain. 151126-32-8 and 9004-10-8 which are cas registry numbers are also used here. If combination therapy is not successful, a split-mixed regimen of an intermediate- and a fast-acting insulin equally divided between the pre-breakfast and pre-dinner periodos can be effective esp. in obese patients. For patients who do not achieve glucose control on combination or split-mixed regimens, an intensive basal bolus multiple-injection regimen is indicated. Continuous s.c. insulin infusion pumps can be particularly useful in treating patients with type 2 diabetes mellitus who do not respond satisfactorily to more conventional treatment strategies. The use of fast-acting insulin analogs should be used in the majority of insulin-requiring diabetics because of its more physiol. pharmacokinesis. Inhaled insulin and the amylin analog pramlintide also hold promise to intensively control glycemia in patients with insulin-requiring type 2 diabetes. The glycemic objectives for patients with type 2 diabetes should be similar to those for patients with type 1 diabetes, namely, to normalize glycemia and glycosylated Hb without causing undue wt. gain or hypoglycemia or adversely affecting the quality of daily life. This is best achieved in a multidisciplinary setting using complementary therapeutic modalities that include a combination of diet, exercise, and pharmacol. therapy. Emphasis should be placed on diet and exercise initially, and throughout the course of management as well, since even modest success with these therapies will enhance the glycemic response to both oral antidiabetic agents and insulin. .

Pramlintide reduces postprandial glucose excursions when added to regular insulin or insulin lispro in subjects with type 1 diabetes: a dose-timing study

Pramlintide reduces postprandial glucose excursions when added to regular insulin or insulin lispro in subjects with type 1 diabetes: a dose-timing study. Weyer, Christian; Gottlieb, Alan; Kim, Dennis D.; Lutz, Karen; Schwartz, Sherwyn; Gutierrez, Maria; Wang, Yan; Ruggles, James A.; Kolterman, Orville G.In this study， 133107-64-9 and 151126-32-8 are also used.; Maggs, David G. (Amylin Pharmaceuticals, Inc., San Diego, CA, USA). Diabetes Care, 26(11), 3074-3079 (English) 2003 American Diabetes Association, Inc. CODEN: DICAD2. ISSN: 0149-5992. DOCUMENT TYPE: Journal CA Section: 2 (Mammalian Hormones) OBJECTIVE: To assess the postprandial glucose-lowering effect of the human amylin analog pramlintide when given with either regular insulin or insulin lispro in subjects with type 1 diabetes, with an emphasis on the optimal dose timing relative to meals. RESEARCH DESIGN AND METHODS: In this randomized, single-blind, placebo-controlled, five-way crossover study, 19 subjects with type 1 diabetes using regular insulin and 21 subjects with type 1 diabetes using insulin lispro underwent five consecutive mixed meal tests. In randomized order, subjects received s.c. injections of placebo at -15 min or 60 mg pramlintide at -15, 0, +15, or +30 min relative to the meal after an overnight fast. Regular insulin or insulin lispro was injected at -30 and 0 min, resp., at doses that were adjusted appropriately for both the content of the standardized meal and the anticipated effects of pramlintide. Plasma glucose concns. were measured before and during the 4-h post-meal period. RESULTS: In both the regular insulin and insulin lispro groups, pramlintide injections at all four time points lowered the postprandial glucose excursion (36 to > 100% redn. in incremental area under the concn. time curve from 0 to 4 h (AUC0-4 h) compared with placebo). However, only preprandial injections of pramlintide (-15 and 0 min) were able to prevent the initial postprandial surge in glucose. The optimal time for pramlintide injection was 0 min, which reduced the postprandial glucose excursion by >100% compared with regular insulin plus placebo (incremental AUC0-4 h: -0.6±2.5 vs. 11.0±2.9 mmol × h-1 × l-1, P < 0.0007) and by 75% compared with insulin lispro plus placebo (incremental AUC0-4 h: 2.5±2.1 vs. 10.0±2.5 mmol × h-1 × l-1, P < 0.0098). No serious adverse events were reported. CONCLUSIONS: Pramlintide, given at or just before a meal, reduces the postprandial glucose excursion in subjects with type 1 diabetes, regardless of whether added to regular insulin or a rapid-acting insulin analog. .