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INTRODUCTION

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This chapter will be most useful after having a basic understanding of the material in Chapter 43, Endocrine Pancreas and Pharmacotherapy of Diabetes Mellitus and Hypoglycemia in Goodman & Gilman’s The Pharmacological Basis of Therapeutics, 12th Edition. In addition to the material presented here, the 12th Edition includes:

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  • A detailed discussion of the regulation of blood glucose

  • A description of pancreatic islet cell physiology and the synthesis and processing of insulin

  • A discussion of the signaling pathway that is activated by insulin resulting in its effects on target cells

  • A description of the pathogenesis of type 1 and type 2 diabetes

  • Drugs that are in development for type 2 diabetes

  • Table 43-5 Properties of Insulin Preparations

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LEARNING OBJECTIVES

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  • Understand the mechanisms of action of insulin and the oral antidiabetic drugs.

  • Describe the components for management of the diabetic patient including the goals of therapy.

  • Describe the pharmacotherapeutic options for the treatment of patients with type 1 or type 2 diabetes.

  • Learn about the adverse effects of insulin and the oral antidiabetic drugs.

  • Understand the treatment of hypoglycemia.

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DRUGS INCLUDED IN THIS CHAPTER

Acarbose (PRECOSE, others)

Alogliptin (NESINA)

Bromocriptine (CYCLOSET, not yet available in the United States for treatment of diabetes)

Colesevelam (WELCHOL)

Diazoxide (PROGLYCEM)

Exenatide (BYETTA)

Gliclazide (DIAMICRON, others, unavailable in the United States)

Glimepiride (AMARYL)

Glipizide (GLUCOTROL, others)

Glucagon

Glyburide (Glibenclamide; MICRONASE, DIABETA, others)

Insulin aspart (NOVOLOG)

Insulin determir (LEVEMIR)

Insulin glargine (LANTUS)

Insulin glulisine (APIDRA)

Insulin lispro (HUMALOG)

Insulin protamine hagedorn (NPH, insulin isophane)

Liraglutide (VICTOZA)

Metformin (GLUCOPHAGE, others)

Miglitol (GLYSET)

Nateglinide (STARLIX)

Pioglitazone (ACTOS)

Pramlintide (SYMLIN)

Repaglinide (PRANDIN)

Rosiglitazone (AVANDIA)

Saxagliptin (ONGLYZA)

Sitagliptin (JANIVIA)

Vidagliptin (GALVUS, ZOMELIS, JAIRA, not available in the United States)

Voglibose (VOGLIB, not available in the United States)

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Table Graphic Jump Location
MECHANISMS OF ACTION INSULIN AND ORAL ANTIDIABETIC DRUGS

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