Figure 2 Evidence for the incretin effect and

Slides:

Advertisements

Similar presentations

GLP-1 Effectiveness, Mechanisms of Action and Potential Part 1.

Advertisements

Mechanisms of Glucose Lowering of Dipeptidyl Peptidase-4 Inhibitor Sitagliptin When Used Alone or With Metformin in Type 2 Diabetes A double-tracer study.

GLP-1 Effectiveness, Mechanisms of Action and Potential Part 2.

JANUVIA is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. JANUVIA Tablets contain sitagliptin.

Diabetes Mellitus 101 for Cardiologists (and Alike): 2015

Glucose Metabolism Dr Lenon T Gwaunza MBChB, BSc (Hons), MSc (UCL)

GLP-1 agonists Ian Gallen Consultant Community Diabetologist

Glucagon-Like Peptide-1 Receptor (GLP-1R) Agonists and Dipeptidyl Peptidase-4 (DPP-4) Inhibitors: How Do They Exert Their Metabolic Actions?

GLP-1 Modulates Numerous Functions in Humans

Glucose tolerance testing. A

Fig. 1. Intravenous glucose infusion rates during an isoglycemic intravenous glucose infusion (IIGI) study in subjects with (A) normal glucose tolerance.

6.Fat- increased lipolysis, inc FFA

A comparison of acute insulin responses to 5 g i. v

Plasma insulin concentrations (A) and insulin secretion rates (B) in response to molar increments of plasma glucose concentration during the graded glucose.

From: Effect of a Low-Carbohydrate Diet on Appetite, Blood Glucose Levels, and Insulin Resistance in Obese Patients with Type 2 Diabetes Ann Intern Med.

Incretins Daniel J. Drucker, MD Professor of Medicine Director, Banting and Best Diabetes Centre.

Figure 1 Disruption of phosphate homeostasis in chronic kidney disease (CKD) Figure 1 | Disruption of phosphate homeostasis in chronic kidney disease (CKD).

Nat. Rev. Nephrol. doi: /nrneph

Figure 2 Pathophysiology of hyperglycaemia in T2DM

with undiagnosed diabetes mellitus by three diagnostic criteria

Figure 3 Energy metabolism regulation, cardiovascular and bone disease in CKD Figure 3 | Energy metabolism regulation, cardiovascular and bone disease.

Figure 6 Differences in glycaemic control with the study drug

Figure 2 Proinflammatory mechanisms in CKD

Figure 1 Role of the kidney in glucose homeostasis

Figure 4 Effect of dapagliflozin on HbA1c and body weight

Nat. Rev. Nephrol. doi: /nrneph

Nat. Rev. Nephrol. doi: /nrneph

Volume 83, Issue 5, Pages (May 2013)

Figure 3 Putative actions of glucagon-like peptide 1 (GLP-1)

Figure 5 Risk factor control in the intensive treatment group

Figure 2 Glucose handling by the kidney

Figure 2 The network of chronic diseases and their mutual influences

Figure 1 The sensory and secretory function of the L cell

Nat. Rev. Nephrol. doi: /nrneph

Figure 8 4D magnetic resonance imaging patterns

Figure 4 Effects of glucagon-like peptide 1 (GLP-1) and

Figure 5 Potential roles of phosphate and fibroblast growth factor 23 (FGF-23) in the development of cardiovascular disease in patients with chronic kidney.

GLP-1 Agonists and DPP-4 Inhibitors How do they work?

Glucose Tolerance Test Physiology lab-3 February, 2018

Nat. Rev. Nephrol. doi: /nrneph

Pharmacokinetics and pharmacodynamics of oral tolvaptan in patients with varying degrees of renal function Susan E. Shoaf, Patricia Bricmont, Suresh.

Figure 3 Clinical algorithms in the management of NASH and diabetes mellitus Figure 3 | Clinical algorithms in the management of NASH and diabetes mellitus.

Dieter A. Häberle, Wolfgang Biller, Takuyuki Ise, Christian J. Metz

Nat. Rev. Nephrol. doi: /nrneph

cardiovascular and renal systems

Nat. Rev. Endocrinol. doi: /nrendo

Figure 3 Serum phosphate level is associated with

Nat. Rev. Nephrol. doi: /nrneph

Figure 1 The relationship between health fitness and pathogen load

James F. List, Jean M. Whaley Kidney International

Figure 3 Pharmacodynamic action profiles of long-acting insulins

Dandan Wang et al. BTS 2018;3: Down-Regulation of miR-24 in Response to Insulin Infusion in Human Plasma Human plasma insulin (A), glucose (B),

Figure 1 Sites of action of glucose-lowering agents

GLP-1 Agonists and DPP-4 Inhibitors How do they work?

Volume 130, Issue 1, Pages (January 2006)

Volume 83, Issue 5, Pages (May 2013)

Pharmacology, Physiology, and Mechanisms of Incretin Hormone Action

Incretin Physiology in Type 2 Diabetes Mellitus

The underlying physiological basis of the HOMA model.

Intracerebroventricular (ICV) insulin infusion increases TG secretion.

Metabolic parameters in the three groups of patients during l-arginine infusion. Metabolic parameters in the three groups of patients during l-arginine.

Figure 3 Within-group comparisons (before–after)‏

Glucagon-Like Peptide-1 Receptor (GLP-1R) Agonists and Dipeptidyl Peptidase-4 (DPP-4) Inhibitors: How Do They Exert Their Metabolic Actions? Part 7.

(A) Mean glucose concentrations (standard error) over a 3-hour period in 21 placebo- and 15 pramlintide-treated patients with type 1 diabetes treated for.

Plasma glucose (A), serum insulin (B), serum C peptide (C) and plasma GLP-1 level (D) during the 2-hour OGTT among subjects with normal glucose tolerance.

Postprandial glucose, insulin and glucagon-like peptide-1 (GLP-1) levels following carbohydrate-first (CF), carbohydrate-last (CL) and sandwich (S) meal.

(A) Twenty-four-hour plasma profiles of insulin and amylin in healthy subjects. (A) Twenty-four-hour plasma profiles of insulin and amylin in healthy subjects.

Glucagon-Like Peptide-1 Receptor (GLP-1R) Agonists and Dipeptidyl Peptidase-4 (DPP-4) Inhibitors: How Do They Exert Their Metabolic Actions? Part 5.

Horacio J. Adrogué, Nicolaos E. Madias

Presentation transcript:

Figure 2 Evidence for the incretin effect and the putative gastrointestinal regulation of urinary sodium excretion Figure 2 | Evidence for the incretin effect and the putative gastrointestinal regulation of urinary sodium excretion. a,b | Incremental pancreatic β-cell secretory responses (assessed using C-peptide, which is a marker of endogenous insulin secretion) to an oral glucose load (50 g in 400 ml) or isoglycaemic intravenous (IV) glucose infusion in (part a) healthy individuals (n = 8) and (part b) patients with type 2 diabetes mellitus (T2DM; n = 14). In both groups, the isoglycaemic glucose infusion mimicked plasma glucose concentration profiles after glucose ingestion. The incretin effect — defined as the difference in the area under the curve of the C-peptide response to oral versus IV glucose — is, however, markedly reduced or absent in patients with T2DM. c,d | An equivalent sodium load is more rapidly excreted by the kidneys when given orally than when given by IV infusion. Relative urinary sodium excretion after an oral compared to IV load of 300 mmol sodium in 2 l volume over 60 min in healthy men (n = 8) who were in normal sodium balance with an intake of 150 mmol sodium per day86 (part c). Cumulative urinary sodium excretion during a balanced 10 mEq constant sodium intake 24 h before and following a 100 mEq oral or IV sodium load in healthy men (n = 8) (part d). Similar to C-peptide, these findings indicate a stimulatory contribution of the gastrointestinal tract to regulation of urinary sodium excretion — the gut–renal axis. *Denotes statistical significance (P <0.05). Parts a and b reproduced with permission from Springer © Nauck, M. et al. Diabetologia 29, 46–52 (1986). Part d reproduced with permission from Wolters Kluwer Health, Inc © Carey, R. M. Circ. Res. 43, 19–23 (1978). Parts a and b reproduced with permission from Springer © Nauck, M. et al. Diabetologia 29, 46–52 (1986). Part d reproduced with permission from Wolters Kluwer Health, Inc © Carey, R. M. Circ. Res. 43, 19–23 (1978). Muskiet, M. H. A. et al. (2017) GLP-1 and the kidney: from physiology to pharmacology and outcomes in diabetes Nat. Rev. Nephrol. doi:10.1038/nrneph.2017.123