Questions about Hyperinsulinemia/Diabetes

[Kumar]

PREVALENCE
In Type 1 diabetic patients, 13% have retinopathy at 5 years and 90% have retinopathy after 10-15 years. Twenty-five percent of Type 1 diabetics develop proliferative retinopathy after 15 years of diabetes.1 Type 2 diabetics taking insulin have a 40% prevalence of retinopathy at 5 years, while those on oral hypoglycemic agents have a 24% prevalence. By 15 -19 years of diabetes, the rates increase to 84% and 53% respectively. Proliferative retinopathy develops in 2% of Type 2 patients with <5 years of diabetes and 25% with 25 or more years of diabetes.2 The prevalence of nephropathy in diabetes has not been determined. Thirty percent with IDDM and 5-10% with NIDDM become uremic.3 The prevalence of neuropathy defined by loss of ankle jerk reflexes is 7% at 1 year increasing to 50% at 25 years4 for both type 1 and type 2 diabetes.
http://www.clevelandclinicmeded.com/diseasemanagement/endocrinology/microvascular/microvascular.htm

Does this link tells comparatively more complication ratio on use of insulin to oral diabetes medicines?

In conclusion, the tubules participate to the catabolism of insulin by two different mechanisms: (1) an uptake from the tubular fluid which can be inhibited by diuretics exerting their main action on the proximal tubules; (2) a direct catabolism from the interstitial fluid resulting from the large permeability of the peritubular capillaries to insulin.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1001004&dopt=Abstract

Does it indicate catabolism/renal loss of insulin, possible?

The walls of small blood vessels act as a microfilter, allowing the passage of water and solutes but blocking that of large molecules and cells . Oxygen, carbon dioxide and some nutrients transfer across the wall by diffusion, but the main transfer of fluid and solutes is by ultrafiltration,
http://medweb.bham.ac.uk/http/mod/3/1/a/permeability.html

Can you tell something about Vascular prermeability to insulin in kidneys & at other sites of body?

This link do indicate but not clear everything as accepted.

 

[Kiless]

It's best to avoid the Hammersmith jink and since I have the 1967 (revised 1978) rule book, I'll apply the simplest triangulation and go

Oxford Circus

 

[MRC_Hans]

Does this link tells comparatively more complication ratio on use of insulin to oral diabetes medicines?

No. You cannot compare insulin and oral medicines, they are for two different conditions.

Does it indicate catabolism/renal loss of insulin, possible?

No, not particularly.

Can you tell something about Vascular prermeability to insulin in kidneys & at other sites of body?

No. Do your own homework.


....
Sorry, back to topic.

Hans

 

[Kumar]

No. You cannot compare insulin and oral medicines, they are for two different conditions.

I am asking, whether complications aggravate when we start/use insulin after or with diabetic oral medicines. That link indicate higher ratio of complications when patient is on insulin.


No, not particularly.


No. Do your own homework.

Let us ignore this important issue or we are ignorant in this issue due to "many wrinkles are there in diabetology-Rolfe".


....
Sorry, back to topic.

Yes, as I don't get satisfactory replies.

 

[MRC_Hans]

I am asking, whether complications aggravate when we start/use insulin after or with diabetic oral medicines. That link indicate higher ratio of complications when patient is on insulin.

I understand your question, but it still does not make sense.

Insulin is given for one problem, oral diabetic medicin for another. Thus you cannot compare them. Type 2 patients become insulin dependent when their disease has progeressed sufficiently, so of course they have more complications by then.They are getting insulin because their complications have increased, not the other way around. Even you should be able to understand this simple logic.

Hans

 

[Badly Shaved Monkey]

Even you should be able to understand this simple logic.

Ever the optimist!

Golders Green

 

[Hellbound]

Not bad, BSM. However, I'm picking up some tricks of my own as we go along.

I'll take advantage of the reflex trump and try

Warren Street

 

[Rolfe]

Morden.

Rolfe.

 

[Goshawk]

I am asking, whether complications aggravate when we start/use insulin after or with diabetic oral medicines. That link indicate higher ratio of complications when patient is on insulin.

Yes, and...what does it have to do with kidneys?



Theydon Bois. And I use my Blue Eyes White Dragon.

 

[Kumar]

I understand your question, but it still does not make sense.

Insulin is given for one problem, oral diabetic medicin for another. Thus you cannot compare them. Type 2 patients become insulin dependent when their disease has progeressed sufficiently, so of course they have more complications by then.They are getting insulin because their complications have increased, not the other way around. Even you should be able to understand this simple logic.

Hans

That I thought but was willing to clarify. Thanks for the clarification.

Can you/Rolfe/anyother explain about vascular preambilities/filteration to insulin-- at renal & other places? Btw, how sugar/carbs are absorbed in intestines?

 

[Badly Shaved Monkey]

Btw, how sugar/carbs are absorbed in intestines?

You've already been told this.

It's almost like you never pay attention to what people have patiently explained to you. But, that can't be true.

Chorleywood

 

[Kiless]

and Bank!

Right, I'm going to restart because of Lindley's law (revised Japanese edition, 1976) and move us sharply using a 'shinkansen' manover. Mind the gap, it'll be a fast round.

Moorgate.

 

[Mojo]

I think I should be able to invoke the North End Rule here, and play:

Bull & Bush.

 

[Goshawk]

 

[Kumar]

You've already been told this.

It's almost like you never pay attention to what people have patiently explained to you. But, that can't be true.

Chorleywood

Means, sugar can also be absorbed/taken by cells during active transport by other means than with insulin.

In the gut, for example, sodium is transported out of the resorbing cell on the blood side via the Na-K pump, whereas, on the resorbing side, the Na-Glucose co-transporter uses the created Na gradient as a source of energy to import both Na and Glucose, which is far more efficient than simple diffusion. Similar processes are located in the renal tubular system.
http://en.wikipedia.org/wiki/NaKATPase

Why/how it happens in gut only?

The electrical and concentration gradient established by the sodium-potassium ATPase supports not only the cell resting potential but the action potentials of nerves and muscles. Export of sodium from the cell provides the driving force for several facilitated transporters, which import glucose, amino acids and other nutrients into the cell.http://en.wikipedia.org/wiki/NaKATPase

Sciene ground or Play ground?

 

[Kumar]

Primary active transport directly uses energy to transport molecules across a membrane. Most of the enzymes that perform this type of transport are transmembrane ATPases. A primary ATPase universal to all cellular life is the sodium-potassium pump, which helps maintain the cell potential...An example is the glucose symporter, which cotransports two sodiums for every molecule of glucose it imports into the cell.
http://en.wikipedia.org/wiki/Active_transport

Whether hormonal is an aid or need, a requirement for normal activity or to metabolize excess sugar? Whether hormones are reqired to create hormony in system or to do everything? Is it evolved for imbalanced/emergency need or also for regular/normal requirement--just think first at concept-Adam & Eve's level, for example?

 

[Ducky]

Whether hormonal is an aid or need, a requirement for normal activity or to metabolize excess sugar?

Speaking of "metabolize excess sugar"

CREME BRULEE

1 pt. heavy cream
6 egg yolks
1/2 c. sugar
Pinch of salt
2 tsp. vanilla
Light brown sugar (granulated)

Heat heavy cream (the heaviest you can get) to the boiling point. Lightly beat egg yolks with sugar and a pinch of salt; pour the hot cream over them, stirring constantly with a wooden spatula or wire whisk until well blended. Add vanilla or a little mace or any other flavoring you desire. Strain the custard into a 1 1/2 quart heat-proof baking dish; stand the dish in a pan of warm water and bake in a 350 degree oven for 25 to 30 minutes or until the custard is completely set but not over cooked. Do not let the water in the pan boil. Remove from the oven; cool and then chill in the refrigerator.
About 1 1/2 to 2 hours before serving, sprinkle the top evenly with fine light brown granulated sugar to a thickness of about 1/4 inch. Put under the broiler (or use a salamander, if you have one) until the sugar is melted and bubbly, watching carefully to see it does not scorch and burn. Remove, cool, and chill again until serving time. You'll have a hard, highly glazed crust on top of an unctuous, voluptuous custard. This will serve about 6. If you have more guests, double the recipe, using 12 egg yolks to a quart of cream.

While you can certainly serve creme brulee alone, it is sometimes fun to gild the lily a bit. I like a little cream with it, either heavy cream or whipped cream, flavored perhaps with a touch of cognac.

 

[Kumar]

Any logic, why we got evolved for insulin need, when it could possible to transport sugar with out it as in intestines?

 

[Ducky]

Any logic, why we got evolved for insulin need, when it could possible to transport sugar with out it as in intestines?

Speaking of intestines:

Traditional Haggis (from Evelyn Hlabse, )
1 sheep's pluck (stomach bag)
2 lb.. dry oatmeal
1 lb. suet
1 lb. lamb's liver
2 1/2 cups stock
1 large chopped onion
1/2 tsp. cayenne pepper, Jamaica pepper and salt
Boil liver and parboil the onion, then mince them together. Lightly brown the oatmeal. Mix all ingredients together. Fill the sheep's pluck with the mixture pressing it down to remove all the air, and sew up securely. Prick the haggis in several places so that it does not burst. Place haggis in boiling water and boil slowly for 4-5 hours. Serves approximately 12.

 

[flume]

Any logic, why we got evolved for insulin need, when it could possible to transport sugar with out it as in intestines?

Have you thought about it? Did you come up with any ideas? Have you read about insulin in evolution? Maybe it would be interesting to you to see how insulin acts and how glucose is transported and stored in a simpler organism than humans.


Turnham Green