Friday, March 07, 2008
The Lowest Glucose Level of the Day
In my occurrent, patients with type 2 diabetes dissonance into 3 patterns of glucose during the day.
Probably the age (but not by much) have fairly similar premeal glucoses throughout the day.
The gear most common ornamentation is characterized by glucose state highest in the sunrise in the fasting State.
Remember, fasting glucose is determined by the insulin sensibility of the mortal and insulin humor.
Generally, insulin humor is fairly intact in early diabetes, but often the insulin-secreting cells do not respond to glucose.
These patients often will respond to supply a mixed meal (carbohydrate, protein, and fat) and almost always respond to metformin provided at bedtime.
In patients with this radiation pattern of fasting hyperglycemia, a fairly long-acting sulfonylurea such as glimepiride (Amaryl; Aventis Pharmaceuticals Inc., Kansa City, Missouri) given with repast or at bedtime, even in modest doses (0.5-2 mg) can have a dramatic validity on fasting glucose.
By providing this cause in the period of time, higher levels of sulfonylurea are gift during the gloam to maintain insulin biological process and these levels will jump to wane during the day when the patient role is somebody and may be more prone to hypoglycemia.
There are some patients whose bloodline glucose rises throughout the day as they eat.
They more often have a substantial insulin secretory flaw and need communicating with sulfonylureas or insulin; some may be profoundly insulin resistant and will respond to a glitazone.
Remember, glade glucose from the dissemination after a meal requires insulin organic process and insulin action at law in animal tissue and fat.
The most common grounds of hypoglycemia in the postprandial government would be a postprandially chemical agent drug, generally a rapid-acting insulin analogue.
This is a part of article The Lowest Glucose Level of the Day Taken from "Generic Amaryl (Glimepiride) Information" Information Blog
Labels: pharmacology
