Insulin Promoter Factor 1
IPF1 is a homeodomain-containing transcription factor that was originally isolated as a transcriptional regulator of the insulin and somatostatin genes. It also plays a central role in the development of the pancreas and in regulation of the expression of a variety of pancreatic islet genes, including the genes encoding glucokinase, islet amyloid polypeptide, and glucose transporter 2. IPF1 also appears to mediate glucose-induced stimulation of insulin gene transcription.46
A child born with pancreatic agenesis was shown to have a mutation in IPF1 that lacked the homeodomain required for DNA binding and nuclear localization. Heterozygous carriers of an IPF1 mutation from the same kindred developed an early-onset autosomal dominant form of diabetes caused by dominant negative inhibition of transcription of the insulin gene and other beta cellspecific genes regulated by the mutant IPF1.47 Additional IPF1 mutations have been discovered in pedigrees with late-onset T2DM.48 Therefore, mutations in IPF1 can cause a range of phenotypic manifestations, depending on whether the subjects have homozygous or heterozygous mutations and the severity of the functional effects.
George S. Eisenbarth, in, 2013
What Causes Gestational Diabetes Mellitus
Although the cause of GDM is not known, there are some theories as to why the condition occurs.
The placenta supplies a growing fetus with nutrients and water, and also produces a variety of hormones to maintain the pregnancy. Some of these hormones can have a blocking effect on insulin. This is called contra-insulin effect, which usually begins about 20 to 24 weeks into the pregnancy.
As the placenta grows, more of these hormones are produced, and the risk of insulin resistance becomes greater. Normally, the pancreas is able to make additional insulin to overcome insulin resistance, but when the production of insulin is not enough to overcome the effect of the placental hormones, gestational diabetes results.
The Interaction Of Insulin And Pituitary Hormone Syndromes
- Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
Pituitary hormone axes modulate glucose metabolism and exert direct or indirect effects on insulin secretion and function. Cortisol and growth hormone are potent insulin-antagonistic hormones. Therefore impaired glucose tolerance, elevated fasting glucose concentrations and diabetes mellitus are frequent in Cushings disease and acromegaly. Also prolactinomas, growth hormone deficiency, hypogonadism and hypothyroidism might be associated with impaired glucose homeostasis but usually to a lesser extent. Therefore glucose metabolism needs to be closely monitored and treated in patients with pituitary adenomas. Correction of the pituitary dysfunction is frequently followed by improvement of glucose homeostasis.
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Disposal Of Used Insulin Syringes
Used syringes, pen needles, cannulas and lancets must be disposed of in an Australian Standards-approved sharps container, which is puncture-proof and has a secure lid. These containers are usually yellow and are available through pharmacies, local municipal councils and state or territory diabetes organisations such as Diabetes Victoria.;Procedures to dispose of sharps containers vary from state to state.For sharps disposal information and help, you can contact:
- state or territory diabetes organisations, such as Diabetes Victoria
- state department of health
Insulin needs to be stored correctly. This includes:
- storing unopened insulin on its side in a fridge
- keeping the fridge temperature between 2 and 8°C
- making sure that insulin does not freeze
- once opened, keeping it at room temperature for not more than one month and then disposing of it safely
- avoiding keeping insulin in direct sunlight.
Extreme temperatures can damage insulin so it doesn’t work properly. It must not be left where temperatures are over 30 °C. In summer your car can get this hot so don’t leave your insulin there.
There are various insulated insulin carry bags available for transporting insulin.
How Is Type 2 Diabetes Treated
People with type 2 diabetes have to pay a little more attention to what they’re eating and doing than people who don’t have diabetes. They may need to:
- Eat a healthy diet, as determined by the care team.
- Get regular physical activity to achieve a healthy weight and allow insulin to work more effectively.
- Check their blood sugar levels on a regular basis.
- Get treatment for other health problems that can happen more often in people with type 2 diabetes, like high blood pressure or problems with the levels of fats in their blood.
- Have regular checkups with doctors and other people on their diabetes health care team so they can stay healthy and get treatment for any diabetes problems.
People with type 2 diabetes might have to eat smaller food portions and less salt or fat, too. Those who eat healthy foods, stay active, and get to a healthy weight may bring their blood sugar levels into a healthier range. Their doctors may even say they don’t need to take any medicines at all.
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Which Insulin To Choose
The choice of insulin and the dosage required is made by the health care provider. Premixed formulations are also available which reduce the number of injections.
Combinations currently available include insulin lispro plus neutral protamine lispro, insulin aspart plus neutral protamine aspart, and NPH and regular insulin.
Combination With Other Antidiabetic Drugs
A combination therapy of insulin and other antidiabetic drugs appears to be most beneficial in people who are diabetic, who still have residual insulin secretory capacity. A combination of insulin therapy and sulfonylurea is more effective than insulin alone in treating people with type 2 diabetes after secondary failure to oral drugs, leading to better glucose profiles and/or decreased insulin needs.
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Sleep And Sleep Deprivation
Acute sleep deprivation in healthy young adults has been reported to raise fasting blood glucose concentrations in association with altered diurnal cortisol secretion and reduced heart rate variability. These effects suggest increased counter-regulatory hormone secretion via hyper-arousal with activation of the hypothalamo-pituitary adrenal axis. There is also accumulating evidence that chronic sleep deprivation may impact on insulin and insulin resistance. Recent epidemiological studies report that reduced sleep duration is associated with increased BMI. Sleep deprivation is associated with decreased plasma concentrations of leptin, the adipocyte peptide hormone regulating fat mass and appetite, and increased concentrations of ghrelin, which increases appetite. Growth hormone is secreted during slow wave sleep, sleep declines with age and growth hormone deficiency in adults has been associated with central adiposity and insulin resistance, but whether sleep deprivation acts through these mechanisms is not clearly established. Obstructive sleep apnoea , where sleep disturbance results from obstruction to breathing during sleep, is associated with impaired glucose tolerance independent of adiposity, and improves with continuous positive airway pressure treatment but whether this is due to resolution of hypoxia and hypercapnia, or to effects on sleep quality, is unclear.
Evolution And Species Distribution
Insulin may have originated more than a billion years ago. The molecular origins of insulin go at least as far back as the simplest unicellular eukaryotes. Apart from animals, insulin-like proteins are also known to exist in the Fungi and Protista kingdoms.
Insulin is produced by beta cells of the pancreatic islets in most vertebrates and by the Brockmann body in some teleost fish.Cone snailsConus geographus and Conus tulipa, venomous sea snails that hunt small fish, use modified forms of insulin in their venom cocktails. The insulin toxin, closer in structure to fishes’ than to snails’ native insulin, slows down the prey fishes by lowering their blood glucose levels.
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Sites Of Insulin Action And Manifestations Of Insulin Resistance
The effects of insulin, insulin deficiency and insulin resistance vary according to the physiological function of the tissues and organs concerned, and their dependence on insulin for metabolic processes. Those tissues defined as insulin dependent, based on intracellular glucose transport, are principally adipose tissue and muscle. However, insulins actions are pleotropic and widespread, as are the manifestations of insulin resistance and the associated compensatory hyperinsulinaemia.
Structural Analysis And Synthesis
Purified animal-sourced insulin was initially the only type of insulin available for experiments and diabetics. John Jacob Abel was the first to produce the crystallised form in 1926. Evidence of the protein nature was first given by Michael Somogyi, Edward A. Doisy, and Philip A. Shaffer in 1924. It was fully proven when Hans Jensen and Earl A. Evans Jr. isolated the amino acids phenylalanine and proline in 1935.
The amino acid structure of insulin was first characterized in 1951 by Frederick Sanger, and the first synthetic insulin was produced simultaneously in the labs of Panayotis Katsoyannis at the University of Pittsburgh and Helmut Zahn at RWTH Aachen University in the mid-1960s.Synthetic crystalline bovine insulin was achieved by Chinese researchers in 1965. The complete 3-dimensional structure of insulin was determined by X-ray crystallography in Dorothy Hodgkin‘s laboratory in 1969.
Two other Nobel Prizes have been awarded for work on insulin. British molecular biologist Frederick Sanger, who determined the primary structure of insulin in 1955, was awarded the 1958 Nobel Prize in Chemistry.Rosalyn Sussman Yalow received the 1977 Nobel Prize in Medicine for the development of the radioimmunoassay for insulin.
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Regulation Of Blood Glucose Levels By Insulin And Glucagon
Glucose is required for cellular respiration and is the preferred fuel for all body cells. The body derives glucose from the breakdown of the carbohydrate-containing foods and drinks we consume. Glucose not immediately taken up by cells for fuel can be stored by the liver and muscles as glycogen, or converted to triglycerides and stored in the adipose tissue. Hormones regulate both the storage and the utilization of glucose as required. Receptors located in the pancreas sense blood glucose levels, and subsequently the pancreatic cells secrete glucagon or insulin to maintain normal levels.
What Are The Signs & Symptoms Of Type 2 Diabetes
People who have type 2 diabetes may not know it because the symptoms aren’t always obvious and they can take a long time to develop. Some people don’t have any symptoms at all.
But when a person gets type 2 diabetes, he or she may:
- pee a lot because the body tries to get rid of the extra blood sugar by passing it out of the body in the urine
- drink a lot to make up for all that peeing
- feel tired all the time because the body can’t use sugar for energy properly
Also, people whose bodies are having problems using insulin or who are overweight may notice something called acanthosis nigricans. This can cause a dark ring around the neck that doesn’t wash off, as well as thick, dark, velvety skin under the arms, in between fingers and toes, between the legs, or on elbows and knees. This skin darkening can lighten over time with improvement in insulin resistance.
In addition, girls with insulin resistance may have polycystic ovary syndrome . In PCOS, the ovaries get bigger and develop fluid-filled sacs called cysts. Girls with this condition often have irregular periods or may stop having periods, and they might have excess facial and body hair.
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What Are The Different Types Of Insulin
The American Diabetes Association characterizes insulin by how fast it works. But everyones body is different. If you have diabetes, you should expect deviations in the amount of time any medication takes to reach your bloodstream.;
Here are 8 different types of Insulin and how they work.
- Onset;is defined as the length of time before insulin hits your bloodstream and begins to lower blood glucose.
- Peak;is the time during which insulin is at its maximum effectiveness at lowering your blood glucose levels.
- Duration;is the length of time insulin continues to lower your blood glucose levels.
- Rapid-acting insulin begins to affect blood glucose approximately 15 minutes after injection. It peaks in about an hour, and then continues to work for a few more.
- Short-acting insulin reaches your bloodstream within 30 minutes of injection. It peaks in the 2-3-hour range and stays effective for 3-6 hours.
- Intermediate-acting insulin includes NPH insulin which helps control glucose for 10-12 hours.;A;protamine;is a type of protein that slows the action of this insulin.
- Long-acting insulin enters the bloodstream 1-2 hours after injection and may be effective for as long as 24 hours. An advantage to long-acting insulin is there is no pronounced peak, and it works more like typical pancreatic insulin.
- Premixed/combination insulin contains a mix of rapid- or short-acting insulin combined with an intermediate-acting insulin. This eliminates the need to draw insulin from more than one bottle.
Understanding Insulin And Diabetes
- The pancreas maintains the bodys blood glucose balance.
- Primary hormones of the pancreas include insulin and glucagon, and both regulate blood glucose.
- Diabetes is the most common disorder associated with the pancreas.
Anatomy of the Pancreasspineislets of LangerhansHormones of the Pancreas
- Gastrin: This hormone aids digestion by stimulating certain cells in the stomach to produce acid.
- Glucagon: Glucagon helps insulin maintain normal blood glucose by working in the opposite way of insulin. It stimulates your cells to release glucose, and this raises your blood glucose levels.
- Insulin: This hormone regulates blood glucose by allowing many of your bodys cells to absorb and use glucose. In turn, this drops blood glucose levels.
- Somatostatin: When levels of other pancreatic hormones, such as insulin and glucagon, get too high, somatostatin is secreted to maintain a balance of glucose and/or salt in the blood.
- Vasoactive intestinal peptide : This hormone helps control water secretion and absorption from the intestines by stimulating the intestinal cells to release water and salts into the intestines.
Diseases and Disorders of the Pancreas
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Where Can I Find Help Acquiring Or Paying For Insulin
The ADA has a dedicated page for helping people who need insulin get it, regardless of finances: .
JRDF has a page with a variety of links to organizations who also supply insulin assistance:
What Else Can I Do To Control My Blood Glucose Levels
Food, sleep, and exercise are all of vital importance for regulating your blood sugar when you have diabetes.
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Pcos Symptoms And Diagnosis
When your body doesnt ovulate, you cant produce progesterone. This causes an imbalance in your body that leads to a host of unsavory symptoms. The most common symptoms I hear women describe are:
- Irregular menstrual cycles
If you identify with these symptoms, it may warrant an investigation into the possibility of PCOS. But these can also be caused by other things, which leads many women to be misdiagnosed.In order to have an accurate PCOS diagnosis, you need to have at least two of these things:
Despite what you may have heard, you can have PCOS even if you have regular periods. The key is whether or not your body ovulates because that is where the hormonal dysfunction occurs.What you need to figure out is this: Why in YOUR unique case do you not ovulate? Symptoms and causes are very individual, so theres no one-size-fits-all treatment. Thats why advocating for yourself and investigating root causes is so important!But hear this: a PCOS diagnosis doesnt mean your quality of life will decrease. It is possible to still conquer your symptoms and heal your body!
Which Cells Of Pancreas Secrete Somatostatin
The -cells of the pancreatic islets secrete somatostatin, a powerful paracrine inhibitor of both insulin and glucagon secretion from islet -cells and -cells. -Cells are electrically excitable, and glucose stimulates action potential firing and somatostatin secretion by both metabolic and non-metabolic effects.
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What Is Insulin Resistance
The role of insulin is to allow cells of the body to take in glucose to be used as fuel or stored as body fat.
It also means that glucose is more likely to build up in the blood and this can lead to too high blood sugar levels
When the body becomes resistant to insulin, it tries to cope by producing more insulin. People with insulin resistance are often producing too more insulin than healthy people.
Producing too much insulin is known as hyperinsulinemia
Talk With Your Doctor
Knowing how your body works can help you stay healthy. Insulin and glucagon are two critical hormones your body makes to keep your blood sugar levels balanced. Its helpful to understand how these hormones function so you can work to avoid diabetes.
If you have more questions about insulin, glucagon, and blood glucose, talk to your doctor. Questions you have might include:
- Is my blood glucose at a safe level?
- Do I have prediabetes?
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