What does ominous octet mean?
The Ominous Octet of type 2 diabetes mellitus was proposed by Ralph DeFronzo in 2008. It encompasses 8 pathophysiologic perturbations underlying the onset and persistence of hyperglycemia in type 2 diabetes mellitus. The appetite suppressing effects of insulin are significantly impaired in T2DM.
What is ominous octet diabetes?
In his 2008 Banting lecture to the American Diabetes Association 68th Scientific Sessions, Prof Ralph DeFronzo proposed an “ominous octet” of eight factors that contributed to the pathophysiology of type 2 diabetes: decreased insulin secretion, decreased incretin effect, increased lipolysis, increased glucose …
What drugs are TZDS?
There are two thiazolidinediones, rosiglitazone, and pioglitazone, currently approved by the FDA as monotherapy or combined with metformin or sulfonylureas to manage type 2 diabetes mellitus.
What are the core defects of diabetes?
Insulin resistance in muscle and liver and impaired insulin secretion represent the core defects in type 2 diabetes (1).
Who coined the term ominous octet?
This was finally defined by DeFronzo[29] in 2009 under the term “ominous octet”.
What is Flatbush diabetes?
Ketosis prone type 2 diabetes/atypical diabetes/flatbush diabetes. is a widespread, emerging, heterogeneous syndrome characterised by patients who present with diabetic ketoacidosis (DKA) or unprovoked ketosis with hyperglycaemia but do not necessarily have the typical phenotype of autoimmune type 1 diabetes.
Are TZDs still used?
In a large US database of outpatients with T2D, we found that thiazolidinediones are currently used in ≈8% of patients with T2D who are not diet-controlled, making it the fourth most used class of oral glucose-lowering medication after metformin, sulfonylureas, and dipeptidyl peptidase-4 inhibitors.
How do TZDs work?
How do TZDs work? TZDs work by binding to a protein in cells (called the peroxisome proliferator-activated receptor gamma, or PPAR gamma) to activate genes and create new proteins that reduce insulin resistance.
What does low C peptide mean?
C-peptide level is based on blood sugar level. C-peptide is a sign that your body is producing insulin. A low level (or no C-peptide) indicates that your pancreas is producing little or no insulin. A low level may be normal if you have not eaten recently. Your blood sugar and insulin levels would naturally be low then.
What is an incretin hormone?
Incretins are hormones that are released from the gut into the bloodstream in response to ingestion of food, and they then modulate the insulin secretory response to the products within the nutrients in the food.
What is a Type 1.5 diabetic?
INTRODUCTION. Latent autoimmune diabetes of adults (LADA), also known as type 1.5 diabetes,[1] is adult onset autoimmune diabetes which shares features of both type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM).
Why is it called Flatbush diabetes?
Why “Flatbush” Diabetes? The term “Flatbush” Diabetes was first applied to the African Americans residing in the ethnically diverse, Brooklyn, New York neighborhood of Flatbush, who presented in DKA at the time of their diabetes diagnosis.
Why do TZDs cause weight gain?
However, TZDs cause weight gain, which has been thought to be a class effect of TZDs. TZD-associated weight gain may result mainly from increased fat mass and fluid retention and may be in part congruent to the mechanism of action of TZD.
Is metformin a TZD drug?
TZDs help with blood sugar control and insulin resistance. Actos is the only TZD that is currently available in the U.S. It is sometimes prescribed alone, but more commonly is prescribed in addition to another diabetes medication, such as metformin. Actos is used in combination with diet and exercise.
How long do TZDs take to work?
Thiazolidinediones lower hemoglobin AIc levels by as much as 1.0% to 1.5%. Effects can be seen in as little as 4 weeks, but full lowering takes 6 to 12 weeks. When used in combination with other diabetic agents, such as sulfonylureas and biguanides, TZDs’ hypoglycemic effects appear to be complementary.
Does metformin make you gain weight?
Metformin has two advantages over other diabetes drugs: There’s less risk of your blood sugar level falling too low. It doesn’t cause weight gain.
What C-peptide level is when diabetic?
C-peptide levels are associated with diabetes type and duration of disease. Specifically a c-peptide level of less than 0.2 nmol/l is associated with a diagnosis of type 1 diabetes mellitus (T1DM).
What is the C-peptide range in type 2 diabetes?
A normal C-peptide range is 0.5 to 2.0 nanograms per milliliter. These levels can be high when your body makes more insulin than usual.
Is insulin an incretin?
Incretins are gut-derived peptide hormones that are rapidly secreted in response to a meal. The two main incretins in humans are glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 (GLP-1). They stimulate pancreatic β-cells postprandially, to secrete insulin.
What exactly does metformin do to your body?
Metformin works by helping to restore the body’s response to insulin. It decreases the amount of blood sugar that the liver produces and that the intestines or stomach absorb.
What is the 500 rule in diabetes?
To calculate the ICR the 500 rule is sometimes used. You take the number 500 and divide it by the current total daily dose (TDD) of insulin. For example, if you usually have 20 units of Lantus and 10 units of Novorapid with each of your three meals then your TDD is 50.
Do Type 2 diabetics have ketones?
People with type 2 diabetes can also develop DKA. DKA develops when your body doesn’t have enough insulin to allow blood sugar into your cells for use as energy. Instead, your liver breaks down fat for fuel, a process that produces acids called ketones.
What is Type 3 diabetes diagnosis?
type 3 diabetes is a condition which can follow after initially being diagnosed with type 2 diabetes. In type 3 diabetes, the neurons lack glucose, a key element needed for the neurons to function effectively in body however more specifically the hippocampus and the cerebral cortex.
Does insulin cause belly fat?
Insulin: The Key Player in Belly Fat
Numerous hormones contribute to belly fat, but none proves more powerful than insulin, your fat storage hormone. High levels of insulin tell your body to gain weight around the belly, and you become more apple-shaped over time.
Is metformin hard on the kidneys?
Metformin doesn’t cause kidney damage. The kidneys process and clear the medication out of your system through your urine. If your kidneys don’t function properly, there’s concern that metformin can build up in your system and cause a condition called lactic acidosis.