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At least 433 records · Page 24Linked to original sources
PubMed2005

Low incidence of vascular complications in patients with diabetes mellitus associated with liver cirrhosis as compared with type 2 diabetes mellitus.

We compared clinical features and vascular complications of patients with diabetes mellitus associated with liver cirrhosis versus patients with type 2 diabetes mellitus. Subjects were 19 patients (LC-DM group) in whom diabetes was diagnosed after development of liver cirrhosis. Control consisted of 38 patients with type 2 diabetes (T2DM group) matched for sex, age, duration of diabetes, body mass index, treatment, and degree of glycemic control, which was determined by glycoalbumin. The LC-DM group had significantly more smokers, higher serum insulin levels, more insulin resistance calculated by homeostasis model assessment, lower blood counts (white and red blood cells, hemoglobin, and platelets), and lower serum levels of total cholesterol, triglyceride, low density lipoprotein cholesterol and lipoprotein (Lp)(a) than the T2DM group. The incidence of diabetic retinopathy and cerebrovascular disease was significantly lower in the LC-DM group compared to the T2DM group. Logistic regression analysis indicated that Lp(a) and the diabetes duration were significant predictors for the retinopathy, while Lp(a) was a significant predictor for the cerebrovascular complication. In diabetes associated with liver cirrhosis, the incidence of diabetic retinopathy and cerebrovascular disease is lower than in type 2 diabetes mellitus in this study, probably because of lower levels of serum Lp(a).

Aged↗
PubMed2006

What are incretins, and how will they influence the management of type 2 diabetes?

OBJECTIVE: To review the pathophysiology of type 2 diabetes (T2DM), the role of incretins, the potential of incretin-based therapies to address unmet therapeutic needs in T2DM, and the potential impact this will have on the contribution of managed care pharmacy to diabetes therapy. SUMMARY: Diabetes, the fifth leading cause of death by disease in the United States, costs approximately $132 billion per year in direct and indirect medical expenses. According to the Centers for Disease Control and Prevention.s National Health and Nutrition Examination Survey, a majority of diabetes patients do not achieve target A1C levels with their current treatment regimens. Advances in understanding the pathophysiologic abnormalities underlying the metabolic dysfunctions associated with T2DM are leading to the development of new treatment approaches and new therapeutic classes of drugs. Novel incretin-based therapies currently available, and in late-stage development, are among those showing the greatest promise for addressing the unmet needs of traditional therapies.

Adenosine Deaminase↗
PubMed2002

Applications of economic models in healthcare: the introduction of pioglitazone in Sweden.

Type 2 diabetes mellitus (T2DM) is a common disorder that is estimated to affect approximately 100 million people worldwide. Forecasts have suggested a substantial increase in incidence, mainly in Asia, Africa and North America. Thus, an increasing number of people with diabetes-related complications will have to be cared for in the future. This development will be a major health problem for the people affected, as well as a major health economic challenge for many countries. Thiazolidinediones represent a new class of drugs with a novel mechanism of action that addresses the root cause of T2DM. Their mode of action targets the core defect of T2DM, namely, insulin resistance. One of these drugs, pioglitazone, was recently approved by the Swedish authorities. To evaluate the cost effectiveness of this new drug, a published mathematical simulation model was used. This model was adapted to Swedish conditions, and local Swedish unit costs were put into the model. Modelling is necessary when performing economic evaluations in diabetes because of the complexity of the disease and its long time horizon. The cost-effectiveness analyses showed that the cost per life-year gained with pioglitazone combination therapy compared with current treatment ranged from 37,000 Swedish kronor (SEK) to SEK149,000. Although there is no threshold value for cost effectiveness in Sweden, the values presented would normally be regarded as cost effective in the Swedish healthcare system. Modelling studies are a good starting point, but long-term naturalistic studies are needed to establish the cost effectiveness of these new drugs.

Diabetes Mellitus, Type 2↗
PubMedDate not supplied

Incretin mimetics and DPP-IV inhibitors: new paradigms for the treatment of type 2 diabetes.

Incretin mimetics are a new class of pharmacological agents with multiple antihyperglycemic actions that mimic several of the actions of incretin hormones originating in the gut, such as glucagon-like peptide (GLP)-1. Dipeptidyl peptidase-IV (DPP-IV) inhibitors suppress the degradation of many peptides, including GLP-1, thereby extending their bioactivity. These agents seem to have multiple mechanisms of action for the treatment of type 2 diabetes mellitus (T2DM), including some or all the following: enhancement of glucose-dependent insulin secretion, suppression of inappropriately elevated glucagon secretion, slowing of gastric emptying, and decreased food intake. Exenatide (BYETTA) is the first incretin mimetic approved for clinical use by the US Food and Drug Administration. In phase 3 clinical trials, exenatide reduced HbA(1c) by approximately 1% and body weight by approximately 2 kg in T2DM patients failing to achieve glycemic control with metformin and/or a sulfonylurea, with mild-to-moderate nausea the most common side effect. Several GLP-1 analogues and DPP-IV inhibitors are in late-stage clinical testing and may soon become available for treating T2DM patients. The use of these agents may provide an opportunity to bring about new improvements in diabetes care.

Aged↗
PubMed2004

Effects of low-dose continuous combined HRT on vascular function in women with type 2 diabetes.

BACKGROUND: Improvement in vascular endothelial function is widley cited as a beneficial effect of hormone replacement therapy (HRT). Women with type 2 diabetes (T2DM) are at increased cardiovascular risk and have impaired endothelial function. Any benefits of HRT on endothelial function in this group are of particular interest. OBJECTIVES: We assessed effects on vascular function of oral 17beta oestradiol (1 mg) and norethisterone (0.5 mg) in postmenopausal women with T2DM. DESIGN: Double-blind, randomised, placebo-controlled trial. ASSESSMENTS: Twenty-eight women had pulse wave velocity (PWV) and adhesion molecules VCAM-1 and ICAM-1 assessed before and after three months' treatment. Twenty-four women also had gluteal fat biopsy for assessment of resistance vessel function (using wire myography). RESULTS: HRT did not affect PWV, VCAM-1, ICAM-1 or carbachol response. Effects of L-NAME and indomethacin on carbachol sensitivity were similar in both groups. CONCLUSIONS: This HRT preparation had no detectable effect on these measures of endothelial function in women with T2DM.

Arteries↗
PubMed2006

Risk factors for stroke in type 2 diabetes mellitus.

Stroke is a serious complication of diabetes but the risk factors for stroke in these patients are not fully defined. The aim of this retrospective study was to investigate the risk factors for stroke in patients with type 2 diabetes mellitus (T2DM). The group comprised 208 patients with T2DM, and the mean duration of follow-up was seven years (range 4-11 years). The incidence of stroke was investigated according to lymphocyte proliferation in response to insulin. Using cimetidine to inhibit cells with histamine receptors and indometacin to inhibit prostaglandin-synthesising cells, a higher incidence of stroke was found in patients with indirect cell-mediated immunity to insulin. Therefore, one of the risk factors for stroke in patients with T2DM is high activity of cells with histamine receptors and prostaglandin-synthesising cells. These cells suppress cell-mediated immunity to insulin and may have a role in promoting the development of insulin resistance.

Aged↗
PubMed2006

[Relationship between adiponectin and beta-cell function in abdominal visceral obesity women].

OBJECTIVE: To investigate the relationship between adiponectin and beta-cell function in abdominal visceral obesity women. METHODS: Nine abdominal visceral obesity women (VO), 9 normal subjects (C) and 7 patients with type 2 diabetes mellitus (T2DM) were enrolled in the study. Beta-cell function and insulin sensitivity were determined by hyperglycemic clamp, fasting serum adiponectin was assayed by ELISA and regional body fat was measured by MRI. RESULT: The levels of first phase insulin release (FPIR), glucose disposal rates (GDR), insulin sensitivity index (ISI) and adiponectin were significantly elevated in control group compared with VO group and T2DM group. As compared with T2DM group, the levels of adiponectin, FPIR, second phase insulin release (SPIR) and maximum insulin release (INS(max)) increased significantly in VO group. Multiple stepwise regression analysis showed that age, FPIR and GDR were positively correlated to adiponectin (B=0.145, 0.194, 0.277 respectively, all P<0.05), while waist-hip ratio was negatively correlated with adiponectin (B=-7.424, P<0.05). CONCLUSION: The visceral obesity women have lower adiponectin levels, and hyperadiponectinemia may be the link with insulin secretion.

Abdominal Fat↗
PubMed1999

Maternal effect of Type 2 diabetes mellitus on insulin sensitivity and metabolic profile in healthy young Mexicans.

UNLABELLED: The objective of this study was to identify the maternal effect of Type 2 diabetes mellitus (T2DM) on insulin sensitivity and metabolic profiles of young healthy, Mexican people (n=15). A cross-sectional study was performed in these subjects with a family history of T2DM in both first and second degree relatives on the maternal side and 15 control subjects. The following tests were carried out: insulin tolerance test and metabolic profile. Systolic blood pressure and serum uric acid were significantly higher in probands than controls. Insulin sensitivity was not different between either group studied (4.7+/-0.9 in probands vs 4.5+/-0.8%/min in controls; p=0.52). IN CONCLUSION: family history of T2DM on the maternal side increased both systolic blood pressure and serum uric acid level in probands, without modification in their insulin sensitivity. Triglycerides concentration had a tendency to be higher in probands than controls.

Adult↗
PubMed2000

Attitudes of Italian physicians towards intensive metabolic control in Type 2 diabetes. The QuED Study Group-Quality of Care and Outcomes in Type 2 Diabetes.

AIMS: To investigate attitudes and expectations of Italian physicians relative to intensive metabolic control in Type 2 diabetes (T2DM) and to compare them with the recent results of the UK Prospective Diabetes Study (UKPDS). METHODS: Before the results of the UKPDS were published, a postal questionnaire was sent to 284 diabetologists practising in 237 outpatient diabetes clinics and 107 general practitioners (GPs) to explore their attitudes toward a tight metabolic control and target fasting blood glucose (FBG) level used. We also investigated clinicians' preferences for an aggressive policy in specific patient subgroups and their expectations about the impact of a strict metabolic control on some of the major end-points included in the UKPDS study. RESULTS: The questionnaire was filled in by 199 diabetologists and 94 GPs (response rate=75%). Although 54% of the respondents declared to seek a strict metabolic control, only 15% of them used target FBG levels < or = 110 mg/dl, while 38% pursued values > 130 mg/dl. GPs declared significantly less often than diabetologists to adopt an aggressive policy (35% vs 65%, p=0.001), and chose more often a target for FBG > 130 mg/dl (44% vs 36%, p=0.02). Only 62% of doctors favouring a strict metabolic control for the average T2DM patient would recommend it for women and 36% for subjects with low educational level. Diabetologists were significantly more likely than GPs to pursue an aggressive policy in obese subjects (70% vs 61%, p=0.03), women (55% vs 18%, p=0.001) and patients with other cardiovascular risk factors (92% vs 81%, p=0.02). The vast majority of respondents did expect a positive impact of a tight metabolic control on micro- and macrovascular complications and on overall mortality. CONCLUSIONS: Italian doctors have extremely heterogeneous attitudes and too optimistic expectations relative to intensive metabolic control in T2DM patients. To facilitate the adoption of UKPDS findings, clear guidelines are needed, providing specific recommendations about subgroups of patients showing a higher risk of complications as well as of inappropriate care.

Attitude of Health Personnel↗
PubMed2000

Fibronectin and lipoprotein(a) are inversely related to plasminogen activator inhibitor type-1 levels in Type 2 diabetic patients without complications.

Plasminogen activator inhibitor type-1 (PAI-1), the most important physiological fibrinolysis inhibitor, is considered an independent factor of cardiovascular risk in Type 2 diabetes mellitus (T2DM). In previous papers we demonstrated that a T2DM population without complications presents: 1) PAI-1 not increased with respect to a control group; and 2) a negative correlation between PAI-1 and lipoprotein(a) [Lp(a)], suggesting that in these subjects PAI-1 levels could be modulated by the "endothelial stress" induced by Lp(a) and diabetes. This work has been performed in order to better verify this intriguing hypothesis, and the endothelial stress has been evaluated through a marker of endothelial damage, fibronectin (FNC). For this purpose we chose a T2DM population without complications (n=73) and a control group (n=46). Plasma concentrations of FNC, Lp(a), PAI-1 antigen and activity, and the main parameters of lipo- and glycometabolic balance were determined. Fibronectin was significantly higher in diabetics with respect to controls (p<0.01). As expected, significant correlation between PAI-1 antigen, PAI-1 activity and Lp(a) (r=-0.54,p<0.01 and r=-0.39,p<0.01, respectively) was found only in diabetic patients. In the same group FNC showed a significant correlation with PAI-1 antigen and activity (r=-0.49,p<0.01 and r=-0.47; p<0.01, respectively), while no relationship was found between Lp(a) and FNC. Multiple regression analysis showed statistically significant correlation between PAI-1 antigen and PAI-1 activity with FNC and Lp(a) in diabetic patients without complications (p<0.05). These data suggest that in absence of complications, the endothelium is able to modulate PAI-1 levels, favouring in that way the fibrinolytic pathway and, subsequently, the recovery of the endothelial integrity. This modulation seems to be related to parameters such as Lp(a) and FNC, although the mechanisms of the endothelial stress of these two molecules seem to be different.

Blood Glucose↗
PubMed2001

Clinical features of insulin resistance and beta cell dysfunction and the relationship to type 2 diabetes.

Type 2 diabetes mellitus is a heterogeneous disorder characterized by varying degrees of impaired insulin secretion and insulin resistance. The metabolic manifestations of insulin resistance include (1) reduced insulin-stimulated glucose uptake, (2) reduced insulin-suppression of endogenous glucose production, and (3) reduced antilipolysis. All of these mechanisms contribute to the hyperglycemis of T2DM, both post-absorptively and postprandially. In addition, insulin resistance is involved in decreaswed insulin-induced vasodilation, dyslipidemia, and platelet hyperaggregability. The pathogenesis of T2DM involves a combination of genetic and environmental factors. Monogenic causes account for only a minority of insulin resistance and beta cell dysfunction. Among environmental factors the most important are obesity, reduced physical activity, and age. Obesity-associated insulin resistance is thought to be mediated mainly by FFAs whose clearance is reduced in subjects with T2DM. A number of clinical tests have been developed to assess insulin sensitivity and beta cell function in vivo. The euglycemic hyperinsulinemic clamp and the hyperglycemic clamp, respectively, represent the gold standard procedures. Recently, indices calculated parameters of the OGTT have been proposed as surrogates for assessing both insulin sensitivity and beta cell function in clinical situations and epidemiologic studies.

Diabetes Mellitus, Type 2↗
PubMedDate not supplied

From "thrifty genotype" to "hefty fetal phenotype": the relationship between high birthweight and diabetes in Saskatchewan Registered Indians.

BACKGROUND: Intrauterine factors have been implicated in the pathogenesis of Type 2 diabetes mellitus (T2DM). METHODS: In a 1:1 matched pairs case-control study, high and low birthweight (HBW, LBW) rates in Saskatchewan Registered Indian (RI) diabetic cases were compared with corresponding rates in RI without diabetes, and non-RI people with and without diabetes. RESULTS: Birthweights were available for 73% of the 1,366 cases and 3 x 1,366 controls. A greater proportion of RI diabetics were born with HBW (> 4000 grams) compared to RI non-diabetics (16.2% vs 10.7%; p < 0.01). There was a significant association between HBW (but not LBW [< 2500 grams]) and diabetes for RI people (OR 1.63 [95% CI 1.20, 2.24]), which was stronger for RI females and strengthened progressively from mid to late 20th century. INTERPRETATION: Certain causes of HBW may predispose to subsequent development of T2DM in Canadian Aboriginal people ("hefty fetal phenotype" ["hefty fetal type"] hypothesis). Programs that optimize healthy pregnancies could reduce T2DM incidence in future generations.

Adolescent↗
PubMed2001

[The impact of calpain-10 gene combined-SNP variation on type 2 diabetes mellitus and its related metabolic traits].

OBJECTIVE: To investigate the impact of calpain-10 gene (CAPN-10) combined single nucleotide polymorphism (SNP) variation on type 2 diabetes mellitus (T2DM) and its related clinical metabolic traits in Chinese. METHODS: The study population consisted of 268 Chinese residents in Shanghai. Among them, 144 were subjects with normal glucose tolerance (NGT) and 124, with T2DM. Plasma glucose (PG), insulin (INS), c-peptide (CP) and free fatty acids (FFA) levels were measured at fasting and 30, 60, 120, and 180 minutes after oral 75 g glucose challenge. The islet beta-cell insulin secretion and tissue insulin sensitivity were assessed. CAPN-10 UCSNP44,-43,-19 and -63 were genotyped. RESULTS: (1) In Chinese NGT subjects, the major allele of UCSNP-44 was allele T (frequency=91%), of UCSNP43 was G(89%), of UCSNP-19 was I (3 repeats of a 32 bp sequence) (67%) and of UCSNP-63 was C allele (79%). Significant differences were observed in comparison of these allele frequencies in Chinese to those in other ethnic groups reported in the literature. (2) 14 genotype combinations of these four SNPs were observed in Chinese NGT subjects. 69% of the NGT population was composed of four genotype combinations, in the order of UCSNP44,-43,-19 and -63, i.e., combination A:TT-GG-DI-CC(haplotype combination was 1121/1111) (frequency=10%), combination B:TT-GA-II-CC(1121/1221)(10%), combination C:TT-GG-II-CC(1121/1121)(26%) and combination D:TT-GG-DI-CT(1121/1112)(22%).(3) The frequencies of the above mentioned SNP in single or in combinations were not different significantly between NGT and T2DM groups. (4) The variation of clinical metabolic parameter levels shifted from completely normal towards abnormal glucose intolerance among genotype combination subgroups. In comparison between combination A and combination D, subjects in the former subgroups had: higher PG levels with delayed peak after glucose challenge; less and lower decrement of FFA levels after challenge with no rising in late stage; higher insulin levels with delayed peak after challenge; and the tendency of decreased insulin sensitivity. More than half of the comparisons remained statistically significant after adjusted with age, gender, body mass index and waist circumference. CONCLUSION: The variation of calpain-10 gene has impact on the variation of clinical metabolic parameter levels related to type 2 diabetes mellitus. Such impact depends upon the haplotypes as well as the haplotype combination of calpain-10 gene variations.

Alleles↗
PubMed2002

Sulfonylurea receptor -1 (SUR1): genetic and metabolic evidences for a role in the susceptibility to type 2 diabetes mellitus.

The pancreatic B-cell ATP-sensitive potassium channel (K(ATP)) is composed of two distinct subunits, an inwardly rectifying ion channel forming the pore (Kir6.2), and a regulatory subunit, namely the sulfonylurea receptor-1 (SUR1), which binds this widely used class of insulin-secreting drugs. Mutations in the genes encoding Kir6.2 and SUR1 may result in familial persistent hyperinsulinemic hypoglycaemia of infancy, demonstrating their role in the regulation of insulin secretion. Studies in various populations with different ethnic background provided evidence that various alleles of single nucleotide polymorphisms (SNPs) in the SUR1 gene, and to a less extent in the Kir6.2 gene, confer a significantly increased risk for the development of type 2 diabetes mellitus (T2DM). Allelic variations of these SNPs were shown to modulate insulin secretion and insulin sensitivity in vivo, thus providing a pathophysiological background to explain their contribution to the genetic susceptibility to T2DM. The aim of this review is to summarise and discuss the significant results of recent literature on the implication of K(ATP), and particularly of SUR1, in the genetic and pathopysiological mechanisms of T2DM.

ATP-Binding Cassette Transporters↗
PubMed2002

Cardiovascular disease in adolescents with type 2 diabetes mellitus.

Type 2 diabetes mellitus (T2DM) in persons less than 20 years of age is increasing dramatically due to increasing obesity and inactivity, particularly in young African Americans. Risk factors for cardiovascular disease (CVD) in this population are similar to those observed in adults with T2DM, including hypertension, dyslipidemia, hyperglycemia and proteinuria. Accordingly, it seems prudent to pursue therapeutic strategies proven to reduce CVD in adult patients with DM soon after the diagnosis of T2DM in young persons.

Adolescent↗
PubMed2002

Insulin effect on leucine kinetics in type 2 diabetes mellitus.

Insulin-induced glucose disposal is impaired in Type 2 diabetes mellitus (T2DM). To determine whether insulin-induced suppression of protein breakdown also is impaired, we measured leucine flux (an index of protein breakdown) in diabetic and nondiabetic subjects during a hyperinsulinemic euglycemic clamp. To avoid the confounding effects of a difference in baseline glucose, glucose concentration in the diabetic subjects was normalized by means of an overnight insulin infusion. Despite higher plasma insulin levels (33.5+/-0.05 vs 132+/-2.7 pmol/l, p<01) diabetic subjects had similar amino acid concentrations and leucine flux (96.9+/-5.8 vs 93.4+/-3.7 micromol/kg/h) as nondiabetic subjects. Infusion of insulin (0.5 mU/kg/min) increased insulin levels (p<0.01) to identical levels in both groups (218+/-16 vs 222+/-19), but the glucose infusion required to maintain euglycemia was higher (p<0.01) in nondiabetic than in diabetic subjects, indicating insulin resistance to glucose disposal in the diabetic subjects. In contrast, leucine flux (81.3+/-4.8 vs 81.6+/-3.4 micromol/kg/h) reached identical levels in both groups. The individual and total amino acid levels also were comparable in both groups. We conclude that suppression of whole body protein turnover in response to an acute increase in insulin is normal in people with T2DM. However, chronic adaptation to high insulin levels occurs, thereby enabling protein breakdown and amino acid concentration to remain within the normal range in people with T2DM.

Blood Glucose↗
PubMed2002

Silybin-beta-cyclodextrin in the treatment of patients with diabetes mellitus and alcoholic liver disease. Efficacy study of a new preparation of an anti-oxidant agent.

BACKGROUND AND AIMS: In patients with non-insulin dependent diabetes mellitus (T2DM) and associated chronic liver disease, plasma levels of glucose, insulin and triglycerides are high, lipid peroxidation is increased and natural antioxidant reserves are reduced. Thus, we hypothesised that the re-balancing of cell redox levels and amelioration of liver function could result in a better glucose and lipid metabolism. To study this, we assessed the effect of a new oral formulation of an antioxidant agent - silybin-beta-cyclodextrin (named IBI/S) - in patients with chronic alcoholic liver disease and concomitant T2DM. METHODS: Sixty outpatients were enrolled in a three-centre, double blind, randomised, IBI/S vs placebo study. Forty-two (21 in the group IBI/S - 135 mg/d silybin per os - and 21 in the placebo group) concluded the 6-month treatment period. The efficacy parameters included fasting and mean daily plasma glucose levels, glycosylated hemoglobin (HbA1c), basal, stimulated C-peptide and insulin levels, total-, HDL-cholesterol and triglycerides levels in addition to conventional liver function tests. Insulin sensitivity was estimated by HOMA-IR. Malondialdehyde (MDA) was also measured before and after treatment as an index of oxidative stress. RESULTS: Fasting blood glucose levels, which were similar at baseline in IBI/S group and in the placebo group (173.9 mg/dl and 177.1 mg/dl, respectively), decreased to 148.4 mg/dl (-14.7% vs baseline; p = 0.03) in the IBI/S group while they were virtually unchanged in the placebo group. The comparison between the groups at mo 6 (T6) also showed a significant reduction of glucose levels in the IBI/S group (p = 0.03). The same trend was observed in mean daily blood glucose levels, HbA1c and HOMA-IR, although differences were not significant. Basal and stimulated C-peptide values showed that only a few changes had occured in both groups. Such results indicate that insulin secretion was virtually unaffected, as confirmed also by the insulinemia data. Plasma triglycerides concentrations dropped from a baseline value of 186 mg/dl to 111 mg/dl (T6) in the IBI/S group, with significant differences at all instances with respect to baseline values. By contrast, triglycerides increased from 159 mg/dl at entry to 185 mg/dl (T6) in the placebo group. The difference between the groups at T6 was highly significant (p < 0.01). Total and HDL cholesterol as well as liver function tests did not change significantly during the study in both groups. MDA decreased significantly only in the group receiving IBI/S. No clinically relevant side effects were observed in either group. CONCLUSIONS: Oral administration silybin-beta-cyclodextrin in patients with T2DM and compensated chronic alcoholic liver disease causes a significant decrease in both glucose and triglyceride plasma levels. These effects may be due to the recovery of energy substrates, consistent with a reduced lipid peroxidation and an improved insulin activity.

Antioxidants↗
PubMed2002

Glucagon receptor antagonists for the treatment of type II diabetes: current prospects.

As the incidence of Type II diabetes (T2DM) will increase to 200 million cases worldwide by 2010, the search for new, effective agentsfor its treatment has been pushed into overdrive. According to Unger's bihormonal hypothesis, elevated levels of circulating glucagon in T2DM patients results in increased rates of hepatic glucose synthesis and glycogen metabolism, translating to excessive plasma glucose levels. In this context, considerable efforts have been made to identify glucagon antagonists for the treatment of T2DM. This review reflects research in this area from 1999 to 2002.

Amino Acid Sequence↗