tailieunhanh - Báo cáo y học: "The therapeutic potential of a venomous lizard: the use of glucagon-like peptide-1 analogues in the critically ill"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: The therapeutic potential of a venomous lizard: the use of glucagon-like peptide-1 analogues in the critically ill. | Deane et al. Critical Care 2010 14 1004 http content 14 5 1004 CRITICAL CARE COMMENTARY L__ The therapeutic potential of a venomous lizard the use of glucagon-like peptide-1 analogues in the critically ill Adam M Deane - 2-3 Marianne J Chapman -2-3 and Michael Horowitz3-4 See related research by Mecott et http content 4 4 R 53 Abstract Glucagon-like peptide- GLP-1 - a principal mediator of the postprandial insulinotropic response in health-has a half-life of minutes. The saliva of the Gila monster contains exendin-4- a structural analogue of human GLP-1- but with a much longer half-life. A synthetic preparation of exendin-4- exenatide- is suitable for human use and effectively lowers glucose in ambulant type 2 diabetic patients. When compared with insulinexenatide therapy is associated with a reduction in hypoglycaemic episodes and postprandial glycaemic excursions in this group. Accordingly- GLP-1 analogues are appealing therapies for hyperglycaemia in the critically ill patient and warrant further study. In the previous issue of Critical Care Mecott and colleagues report the effects of a glucagon-like peptide-1 GLP-1 analogue exenatide on glycaemia in severely burned paediatric patients 1 . The incretin hormones GLP-1 and glucose-dependent polypeptide GIP mediate 70 of the insulin response to a meal 2 . While GIP is potently insulinotropic in health its effect is markedly attenuated in type 2 diabetic patients such that even pharmacological doses have little effect on glycaemia 3 . In contrast physiological replacement or pharmacological administration of GLP-1 lowers glycaemia substantially in this group 3 . Accordingly studies in ambulant type 2 diabetic patients have focused on the therapeutic potential administration of GLP-1 rather than GIP. Significantly the glucose-lowering effects of Correspondence Discipline of Acute Care Medicine- University of Adelaide- North Terrace- Adelaide-South .

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