Insulin

English

Insensitivity to insulin and obesity: the underlying cause

In the late 20th century obesity became an epidemic. The importance of obesity as a risk factor for a number of conditions, including type 2 diabetes, cardiovascular disease, hypertension, gallstones and certain cancers, is well documented. Often associated with insensitivity to insulin, obesity is clearly a key factor in the development of the metabolic syndrome – a risk for both diabetes and cardiovascular disease. In this article, Robert Eckel and Scott Grundy explore the underlying causes of obesity and insensitivity to insulin.

Pulmonary insulin: current status

Attempts to develop the lungs as a route for the delivery of insulin began as early as the 1920s. But inhalers that could deliver insulin via the lungs in a clinically viable manner were not developed until the 1990s. The lungs offer a large surface area of 100 m² to 140 m² (roughly the size of a tennis court) for the absorption of inhaled insulin. Moreover, the very thin alveolar-capillary barrier on the surface of the lungs allows for rapid uptake of insulin into the blood, similar to that seen with the rapid-acting insulin analogues – or even faster. Jay Skyler brings us up to date

This is where we stand: the IDF position statements

The International Diabetes Federation (IDF) continues to prepare and release the Federation’s position statements. Requests are received regularly for the opinion of IDF on topics as varied and, at times, controversial as sucrose and alcohol consumption. Martin Silink and Anne Pierson offer us an update on the position of IDF on the current diabetes issues.

Providing care for all people with diabetes in the Netherlands

The health system in the Netherlands is set for an overhaul. In January 2006, new health legislation, which includes important reforms in the provision of diabetes care, comes into effect. Having played an important advisory role in the design of this new legislation, the Dutch Diabetes Association (DVN) predicts signifi cant improvements in diabetes care as a result of the reforms. However, not all the stakeholders in diabetes care are happy with the changes, which were the central issue in several national and regional strikes by primary care doctors. As a

Meal-time blood sugar control in pregnancy

We have known for more than half a century that good control of blood sugar (glucose) is important for the normal development of the unborn baby throughout pregnancy. During those years there has been much progress in advising

Designer insulins and meal-time blood glucose control

After the discovery of insulin in the 1920´s, available insulin was from natural sources (animal pancreas) until human insulin was made available in the early 1980s. None of these insulins was ideal for injection under the skin. Now, new

Socio-economic determinants of the costs of diabetes in India

Diabetes is rapidly emerging as a major health-care problem in India, especially in urban areas where the prevalence of Type 2 diabetes has been reported as 12% of the adult population. Furthermore, there is an equally large pool of people with

The human perspective on health-care reform: coping with diabetes in Kyrgyzstan

Kyrgyzstan is a small mountainous country with a predominantly agricultural economy; it gained independence with the break-up of the Soviet Union in 1991. For a significant sector of the Kyrgyzstani population, economic difficulties at national level translate into high unemployment and widespread impoverishment. Kyrgyzstan inherited an extensive but basic health-care system, with a functioning – albeit fragmented – structure for managing chronic diseases.

Enhancing insulin secretion: novel approaches to glucose control

When we eat, the concentration of glucose in our blood rises due to the uptake of glucose from the digestion of starch and other carbohydrates in the gut. In healthy people, the increase is modest; eating activates other processes that

Meal-time glucose control: the role of oral drugs

As a species, our condition has changed: from prolonged periods of fasting and occasional gorging, to nearly constant feeding with rarely occurring periods of fasting. The constant availability of ‘grazing opportunities’ has contributed to a change in the body build of humans towards increasing body weight, overweight, and obesity. With this change has come a massive increase in the number of people with diabetes and diabetes- and- obesity-related health problems.

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