how does being overweight cause diabetes

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Sign Up It''overview''clinical''workup''treatment''medication''s 39–amino acid sequence partially overlaps that of the human incretin GLP-1.

Exenatide is indicated as adjunctive therapy to improve glycemic control in patients with type 2 diabetes who have not achieved glycemic control with metformin or a sulfonylurea. The solution is an immediate-release product administered by SC injection twice daily.

Exenatide injectable suspension (Bydureon, Bydureon BCise)

The injectable suspension is administered SC once weekly. The patient does not need to have undergone treatment with Byetta (short-acting exenatide injectable solution) prior to initiating therapy with the injectable suspension. Treatment with Byetta should be discontinued if it is already being used when Bydureon or Bydureon BCise (autoinjector) therapy is started.

Liraglutide (Victoza, Saxenda)

Liraglutide is a once-daily SC injectable GLP-1 receptor agonist that stimulates G-protein in pancreatic beta cells. It increases intracellular cyclic adenosine monophosphate (cAMP), leading to insulin release in the presence of elevated glucose concentrations. Liraglutide is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. In addition, evidence from the LEADER clinical trial resulted in liraglutide’s approval for risk reduction of major cardiovascular events (cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke) in adults with type 2 diabetes mellitus and established for 1 last update 12 Jul 2020 cardiovascular disease.Liraglutide is a once-daily SC injectable GLP-1 receptor agonist that stimulates G-protein in pancreatic beta cells. It increases intracellular cyclic adenosine monophosphate (cAMP), leading to insulin release in the presence of elevated glucose concentrations. Liraglutide is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. In addition, evidence from the LEADER clinical trial resulted in liraglutide’s approval for risk reduction of major cardiovascular events (cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke) in adults with type 2 diabetes mellitus and established cardiovascular disease.

It is also indicated for children aged 10 years or older with type 2 diabetes mellitus.

The drug has not been studied in combination with prandial insulin.

how does being overweight cause diabetes japan (🔴 and pregnancy) | how does being overweight cause diabetes headachehow to how does being overweight cause diabetes for Liraglutide is not recommended as first-line pharmacologic therapy, because of potential serious adverse effects. Liraglutide is contraindicated in patients with a history or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2, as dose- and duration-dependent thyroid C-cell tumors have occurred in animal studies of liraglutide.

In addition, clinical studies suggest that liraglutide may cause pancreatitis, although conclusive evidence has not been established. Nevertheless, patients should be monitored for unexplained, persistent, severe abdominal pain, with or without vomiting, and liraglutide should be discontinued if pancreatitis is suspected.

Note that the brand Saxenda is not indicated for the treatment of type 2 diabetes mellitus. Used as an adjunct to a reduced-calorie diet and increased physical activity, Saxenda is indicated the 1 last update 12 Jul 2020 for chronic weight management in adults with a BMI of 30 kg/m2 or greater (obesity) or adults with a BMI of 27-29.9 kg/m2 (overweight) and one or more weight-associated conditions (eg, hypertension, type 2 diabetes, dyslipidemia). Saxenda may also be prescribed for persons with overweight and a risk factor for type 2 diabetes. Do not use Saxenda in combination with another GLP-1 agonist or with insulin.Note that the brand Saxenda is not indicated for the treatment of type 2 diabetes mellitus. Used as an adjunct to a reduced-calorie diet and increased physical activity, Saxenda is indicated for chronic weight management in adults with a BMI of 30 kg/m2 or greater (obesity) or adults with a BMI of 27-29.9 kg/m2 (overweight) and one or more weight-associated conditions (eg, hypertension, type 2 diabetes, dyslipidemia). Saxenda may also be prescribed for persons with overweight and a risk factor for type 2 diabetes. Do not use Saxenda in combination with another GLP-1 agonist or with insulin.

Albiglutide (Tanzeum)

Albiglutide is a once-weekly SC injectable GLP-1 receptor agonist indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. It may be used with other antidiabetic agents, although a dose reduction may be needed for insulin secretagogues (eg, sulfonylureas) or insulin if coadministered. GLP-1 receptor agonists augment glucose-dependent insulin secretion.

Dulaglutide (Trulicity)

Dulaglutide is a glucagonlike peptide-1 (GLP-1) agonist that acts as an incretin mimetic. It increases insulin secretion in the presence of elevated blood glucose, delays gastric emptying to decrease postprandial glucose, and decreases glucagon secretion. It is administered as a once-weekly SC injection. It is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. It is also indicated for major adverse cardiovascular (CV) event reduction (with regard to CV death, nonfatal myocardial infarction, and nonfatal stroke) in adults with type 2 diabetes mellitus in whom established CV disease or multiple CV risk factors exist.

Lixisenatide (Adlyxin)

GLP-1 agonist indicated as adjunctive therapy to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. It is administered as a once daily SC injection.

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Antidiabetics, Dipeptidyl Peptidase IV Inhibitors

Class Summary

Incretin hormones are part of an endogenous system involved in the physiologic regulation of glucose homeostasis. They increase insulin release and decrease glucagon levels in the circulation in a glucose-dependent manner. DPP-4 degrades numerous biologically active peptides, including the endogenous incretins GLP-1 and glucose-dependent insulinotropic peptide (GIP). DPP-4 inhibitors prolong the action of incretin hormones.

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Sitagliptin (Januvia)

Sitagliptin demonstrates selectivity for DPP-4 and does not inhibit DPP-8 or DPP-9 activity in vitro at concentrations approximating those from therapeutic doses. Sitagliptin can be used as a monotherapy or in combination with metformin or a thiazolidinedione. It is given once daily and is weight neutral.

Saxagliptin (Onglyza)

Saxagliptin inhibits DPP-4 and thereby increases concentrations of GLP-1 and GIP, which stimulate insulin release in response to increased blood glucose levels following meals. This action enhances glycemic control. Saxagliptin is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.

Linagliptin (Tradjenta)

Linagliptin is a DPP-4 inhibitor that increases and prolongs incretin hormone activity. It is indicated for adults with type 2 diabetes mellitus, along with diet and exercise, to lower blood glucose levels. It may be used as monotherapy or in combination with other common antidiabetic medications, including metformin, sulfonylurea, or pioglitazone; it has not been studied in combination with insulin.

Alogliptin (Nesina)

Selective dipeptidyl peptidase-4 (DPP-4) inhibitor; slows inactivation of incretin hormones (eg, GLP-1, GIP), thereby reducing fasting and postprandial glucose concentrations in a glucose-dependent manner

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Antidiabetics, Amylinomimetics

Class Summary

These the 1 last update 12 Jul 2020 agents mimic endogenous amylin effects by delaying gastric emptying, decreasing postprandial glucagon release, and modulating appetite. These agents mimic endogenous amylin effects by delaying gastric emptying, decreasing postprandial glucagon release, and modulating appetite.

Pramlintide (Symlin, SymlinPen 120, SymlinPen 60)

This agent is a synthetic analogue of human amylin, a naturally occurring hormone made in pancreatic beta cells. It slows gastric emptying, suppresses postprandial glucagon secretion, and regulates food intake because of centrally mediated appetite modulation.

how does being overweight cause diabetes genetic (🔥 nurse teaching) | how does being overweight cause diabetes grocery listhow to how does being overweight cause diabetes for Pramlintide is indicated for the treatment of type 1 or type 2 diabetes in combination with insulin. It is administered before mealtime in patients who have not achieved desired glucose control despite optimal insulin therapy. It helps to achieve lower blood glucose levels after meals, less fluctuation of blood glucose levels during the day, and improvement of long-term control of glucose levels (ie, HbA1C levels), compared with insulin alone. Additionally, less insulin use and a reduction in body weight are observed.

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Selective Sodium-Glucose Transporter-2 Inhibitors

Class Summary

These agents lower the renal glucose threshold.

Canagliflozin (Invokana)

Canagliflozin is an SGLT-2 inhibitor and lowers the renal glucose threshold (ie, the plasma glucose concentration that exceeds the maximum glucose reabsorption capacity of the kidney). Lowering the renal glucose threshold results in increased urinary glucose excretion. Indicated as an adjunct to diet and exercise, canagliflozin therapy is aimed at improving glycemic control in adults with type 2 diabetes. In addition, in adults with type 2 diabetes and diabetic nephropathy with albuminuria of more than 300 mg/day, canagliflozin is indicated to lower the chances of end-stage renal disease, doubling of serum creatinine, cardiovascular death, and hospitalization for heart failure.

Dapagliflozin (Farxiga)

Dapagliflozin reduces glucose reabsorption in the proximal renal tubules and lowers the renal threshold for glucose, thereby increasing urinary glucose excretion. It is indicated as an adjunct to diet and exercise to improve glycemic control in type 2 diabetes mellitus. It is indicated as monotherapy, as initial therapy with metformin, or as an add-on to other oral glucose-lowering agents, including metformin, pioglitazone, glimepiride, sitagliptin, and insulin. It is also indicated to lower the risk of adults with type 2 diabetes and established cardiovascular disease or multiple cardiovascular risk factors being hospitalized for heart failure.

Empagliflozin (Jardiance)

Empagliflozin, an SGLT2 inhibitor, decreases blood glucose by increasing urinary glucose excretion. SGLT-2 is expressed in the proximal renal tubules and is responsible for the majority of the reabsorption of filtered glucose from the tubular lumen. SGLT2 inhibitors reduce glucose reabsorption and lower the renal threshold for glucose.

It is indicated as an adjunct to diet and exercise, empagliflozin therapy is aimed at improving glycemic control in adults with type 2 diabetes. It is also indicated for lowering the cardiovascular death risk in adults with type 2 diabetes and cardiovascular disease.

Ertugliflozin (Steglatro)

An SGLT2 inhibitor, ertugliflozin is indicated for improvement of glycemic control in adults with type 2 diabetes, serving as an adjunct to diet and exercise. It can also be found in the combination products ertugliflozin plus metformin and ertugliflozin plus sitagliptin.

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Bile Acid Sequestrants

Class Summary

Colesevelam is FDA approved as an adjunctive therapy to improve glycemic control in adults with type 2 diabetes mellitus.

Colesevelam (WelChol)

Colesevelam is a high-capacity bile acid sequestrant. It is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. The precise mechanism by which colesevelam improves glycemic control is largely unknown.

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Antidiabetics, Rapid-Acting Insulins

Class Summary

Rapid-acting insulins have a short duration of action and are appropriate for use before meals or when blood glucose levels exceed target levels and correction doses are needed. These agents are associated with less hypoglycemia than regular insulin.

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Insulin aspart (NovoLog, Fiasp)

Insulin aspart has a short onset of action of 5-15 minutes and a short duration of action of 3-5 hours. The peak effect occurs within 30-90 minutes. Insulin aspart is FDA approved for use in insulin pumps.

Fiasp also has a rapid onset of action, with its first measurable effect occurring within 16-20 minutes. The peak effect occurs within 91-133 minutes, and the usual duration of action is 5-7 hours.

Insulin glulisine (Apidra)

Insulin glulisine has a rapid onset of action of 5-15 minutes and a short duration of action of 3-5 hours. The peak effect occurs within 30-90 minutes. Insulin glulisine is FDA approved for use in insulin pumps.

Insulin lispro (Humalog)

Insulin lispro has a rapid onset of action of 5-15 minutes and a short duration of action of 4 hours.

Insulin inhaled (Afrezza)

Orally inhaled rapid-acting insulin in powder form. When 8 units were administered, maximum serum insulin concentration was reached by 12-15 minutes and declined to baseline by about 180 minutes.

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Antidiabetics, Short-Acting Insulins

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Class Summary

Short-acting insulins are commonly used when a slower onset of action or a longer duration of action is desired.

Regular insulin (Humulin R, Novolin R, Myxredlin)

Regular insulin has a rapid onset of action of 0.5-1 hours and duration of action of 4-6 hours. The peak effects are seen within 2-4 hours. Preparations that contain a mixture of 70% neutral protamine Hagedorn (NPH) and 30% regular human insulin (ie, Novolin 70/30, Humulin 70/30) are also available.

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Antidiabetics, Intermediate-Acting Insulins

Class Summary

how does being overweight cause diabetes carb count (🔴 foods to avoid) | how does being overweight cause diabetes in skinny peoplehow to how does being overweight cause diabetes for Intermediate-acting insulins have a slow onset of action and a longer duration of action. These agents are commonly combined with faster-acting insulins to maximize the benefits of a single injection.

Insulin NPH (Humulin N, Novolin N)

Insulin neutral protamine Hagedorn (NPH) has an onset of action of 3-4 hours. The peak effect occurs within 8-14 hours, and its usual duration of action is 16-24 hours. The drug appears cloudy and must be gently mixed and checked for clumping; if clumping occurs, the insulin should be discarded.

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Antidiabetics, Long-Acting Insulins

Class Summary

These insulins provide a longer duration of action, and, when combined with rapid- or short-acting insulins, they provide better glucose control.

Insulin detemir (Levemir)

how does being overweight cause diabetes blood sugar levels (🔴 januvia) | how does being overweight cause diabetes eventshow to how does being overweight cause diabetes for Insulin detemir is indicated for once- or twice-daily dosing in patients with type 1 or 2 diabetes mellitus. The duration of action is up to 24 hours, the result of slow systemic absorption of detemir from the injection site.

Insulin glargine (Lantus, Lantus SoloStar, Toujeo, Toujeo Max, Basaglar)

Insulin glargine stimulates proper utilization of glucose by the cells and reduces blood sugar levels. It has no pronounced peaks of action, because a small amount of insulin is gradually released at a constant rate over 24 hours. The amount of insulin in Toujeo and Toujeo Max is three times greater (300 Units/mL) than in Lantus or Basaglar (100 Units/mL).

Insulin degludec (Tresiba)

Ultralong-acting basal insulin indicated to improve glycemic control in adults with diabetes mellitus who require basal insulin. It is highly protein bound, and following SC, the protein-binding provides a depot effect. The elimination half-life is 25 h and its duration of action is beyond 42 h.

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Dopamine Agonists

Class Summary

Quick-release bromocriptine acts on circadian neuronal activities within the hypothalamus to reset the abnormally elevated hypothalamic drive for increased plasma glucose, triglyceride, and free fatty acid levels in fasting and postprandial states in patients with insulin resistance.

Bromocriptine (Cycloset)

This quick-release formulation is the only bromocriptine product indicated for type 2 diabetes mellitus. It is indicated as an adjunct to diet and exercise to improve for 1 last update 12 Jul 2020 glycemic control.This quick-release formulation is the only bromocriptine product indicated for type 2 diabetes mellitus. It is indicated as an adjunct to diet and exercise to improve glycemic control.

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