Téma: Overview works

Therapeutic influencing of the defect of insulin secretion in type 2 diabetes mellitus

Zbynek Schroner

Insulin resistance and the defect of insulin secretion are two basic pathogenic mechanisms in the development of type 2 diabetes mellitus. The presence both of these defects is necessary for clinical manifestation of type 2 diabetes mellitus. Due to progressive loss of function and number of B-cells insulin secretion is declined. Treatment should be focused on influencing both of these pathogenic mechanisms. Biguanids and thiazolidinediones mainly decrease insulin resistance. Therapeutic influencing of the defect of insulin secretion is also irreplaceable. Sulphonylurea derivates reduce blood glucose level by augmenting insulin release from B-cells of islets of Langerhans. Derivates of meglitinides stimulate secretion of insulin during meals. They don´t stimulate insulin in late postprandial and fasting period. Enhancement of incretin effect (glucagon like peptid-1 analogs and inhibitors of dipeptidylpeptidase-4) is a new therapeutic approach in the treatment of type 2 diabetes mellitus. Beside the physiological stimulation of insulin secretion these drugs supress postprandial glucagon secretion, delay gastric emptying and reduce food intake. Analogs of amylin also supress postprandial glucagon secretion. Approximately in the period 5 - 10 years since the diagnosis of type 2 diabetes mellitus, majority of type 2 diabetics will require exogenous insulin treatment for achieving the goals for glycemic control as replacement of the defect of endogenous insulin secretion.

Ročník 2008  Témy časopisu Internal medicine 1 / 2008

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MUDr. Viera Fedelešová, CSc.
prof. MUDr Martin Haluzík, CSc.
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prof. MUDr. Peter Mitro, PhD.
doc. MUDr. Viliam Mojto, CSc., MHA
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2. Stenestrand U, Wallentin L. Swedish Register of Cardiac Intensive Care (RIKS-HIA): Early statin treatment following acute myocardial infarction and 1-year survival. JAMA 2001; 285(4): 430-436.
3. LIPID Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med 1998; 339: 1349-1357.
4. Jurkovičová O, Spitzerová H, Cagáň S. Komorové arytmie a náhla srdcová smrť pri akútnom infarkte myokardu. Bratisl Lek Listy 1997; 98: 379-389.
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