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Insulin treatment of post‐prandial hyperglycemia
Author(s) -
Rendell Marc S.
Publication year - 2008
Publication title -
drug development research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.582
H-Index - 60
eISSN - 1098-2299
pISSN - 0272-4391
DOI - 10.1002/ddr.20237
Subject(s) - insulin , medicine , endocrinology , diabetes mellitus , post prandial , ingestion , basal (medicine) , type 2 diabetes , basal insulin , drug , carbohydrate , meal , pharmacology
With evidence that elevated post‐prandial glucose (PPG) is a major risk factor for cardiovascular disease, there is increasing emphasis on primary treatment of PPG in diabetes. The carbohydrate content of a meal is the principal contribution to PPG, so efforts to reduce carbohydrate ingestion are an important dietary approach to management. Although all oral hypoglycemics reduce PPG, newer agents including disaccharidase inhibitors and meglitinides act more selectively to lower PPG. GLP‐1 agonists and pramlintide act primarily on post‐meal glucose. DPP‐IV inhibitors are oral agents that raise GLP‐1 levels. Unquestionably, exogenous insulin is the most potent agent to lower PPG levels. Long‐acting basal insulin has much less effect on PPG than rapid‐acting insulin taken at the time of a meal. Inhaled insulin is no more effective than injectable insulin but is much more acceptable to most patients and may thus lead to administration of insulin earlier in the course of type II diabetes. Drug Dev Res 69:124–129, 2008. © 2008 Wiley‐Liss, Inc.