Use of the oral glucose tolerance test to assess insulin release and insulin sensitivity.
Predicting insulin sensitivity and insulin release with reasonable accuracy from simple demographic parameters and values obtained during an OGTT is possible and should be used in various clinical settings in which the use of clamps or the minimal model would be impractical.
The treat-to-target trial: randomized addition of glargine or human NPH insulin to oral therapy of type 2 diabetic patients.
Systematically titrating bedtime basal insulin added to oral therapy can safely achieve 7% HbA(1c) in a majority of overweight patients with type 2 diabetes, thus reducing a leading barrier to initiating insulin.
Efficacy and Safety of the Human Glucagon-Like Peptide-1 Analog Liraglutide in Combination With Metformin and Thiazolidinedione in Patients With Type 2 Diabetes (LEAD-4 Met+TZD)
Liraglutide combined with metformin and a thiazolidinedione is a well-tolerated combination therapy for type 2 diabetes, providing significant improvements in glycemic control and C-peptide and homeostasis model assessment of β-cell function.
Metabolic effects of metformin in non-insulin-dependent diabetes mellitus.
- M. Stumvoll, N. Nurjhan, G. Perriello, G. Dailey, J. Gerich
- Medicine, BiologyNew England Journal of Medicine
- 31 August 1995
Metformin acts primarily by decreasing hepatic glucose output, largely by inhibiting gluconeogenesis, and also seems to induce weight loss, preferentially involving adipose tissue.
Role of the kidney in normal glucose homeostasis and in the hyperglycaemia of diabetes mellitus: therapeutic implications
- J. Gerich
- Medicine, BiologyDiabetic Medicine
- 1 February 2010
Diabet. Med. 27, 136–142 (2010)
Renal gluconeogenesis: its importance in human glucose homeostasis.
Early work in animals and humans is summarized, methodological problems in assessing renal glucose release in vivo are discussed, and results of recent human studies are presented that provide evidence that the kidney may play a significant role in carbohydrate metabolism under both physiological and pathological conditions.
Role of reduced suppression of glucose production and diminished early insulin release in impaired glucose tolerance.
Impaired glucose tolerance, the precursor of NIDDM, results primarily from reduced suppression of hepatic glucose output due to abnormal pancreatic islet-cell function.
Hierarchy of glycemic thresholds for counterregulatory hormone secretion, symptoms, and cerebral dysfunction.
It is concluded that there is a distinct hierarchy of responses to decrements in plasma glucose, such that the threshold for activation of counterregulatory hormone secretion occurs at higher plasma glucose levels than that for initiation of autonomic warning symptoms, which in turn occurs for onset of neuroglycopenic symptoms and deterioration in cerebral function.
The genetic basis of type 2 diabetes mellitus: impaired insulin secretion versus impaired insulin sensitivity.
- J. Gerich
- MedicineEndocrine reviews
- 1 August 1998
The literature better supports the case of impaired insulin secretion being the initial and main genetic factor predisposing to type 2 diabetes, especially the studies in people at high risk to subsequently develop type 1 diabetes and the studies demonstrating compete alleviation of insulin resistance with weight loss.
Dose-response characteristics for effects of insulin on production and utilization of glucose in man.
The above dose-response relationships indicate that in man glucose production is more sensitive to changes in plasma insulin concentration than is glucose utilization; both hepatic and peripheral tissues may contain "spare" insulin receptors; and relatively minor changes in Plasma insulin concentration or insulin receptor function can cause appreciable alterations in glucose metabolism.