Achieving goal glycosylated hemoglobin levels in type 2 diabetes mellitus: Practical strategies for success with insulin therapy

Evaluation of antioxidant efficacy of vanadium-3-hydroxyflavone complex in streptozotocin-diabetic rats

Since 1985, when Heyliger et al., first demonstrated that oral administration of sodium orthovanadate (0.8mg/ml) to STZ induced diabetic rats resulted in normoglycemia, numerous extensive studies have been reported on the antidiabetic actions of vanadium. The acceptance of vanadium compounds as promising therapeutic antidiabetic drugs has been slowed due to the concern for chronic toxicity associated with vanadium accumulation. In order to circumvent the toxic effects of vanadium, a combinational approach wherein a novel V3HF complex was synthesized, characterized and its toxic as well as antidiabetic potential were evaluated in STZ diabetic rats. Experimental and clinical studies suggest that hyperglycemia-induced oxidative stress primarily contributes to the pathogenesis and progression of both primary as well as secondary complications of diabetes. It is possible to reduce the risks caused by excessive generation of free radicals by either enhancing the body's natural antioxidant defenses or by supplementing with proven antioxidants. The present study was aimed to study the role of V3HF complex on hyperglycemia mediated oxidative stress in STZ-diabetic rats and the results indicate that the complex improves pancreatic beta cell function. Histological and ultrastructural studies also evidenced that the complex protect the beta cells from hyperglycemia-induced oxidative stress.

A novel insulin mimetic vanadium-flavonol complex: synthesis, characterization and in vivo evaluation in STZ-induced rats

Since 1985, when Heyliger et al., first demonstrated a serendipitous discovery that oral administration of 0.8 mg/ml of sodium orthovanadate in drinking water to streptozotocin-induced diabetic rats resulted in normoglycemia, numerous extensive studies have been pursued on the anti-diabetic and insulinomimetic actions of vanadium. The acceptance of vanadium compounds as promising therapeutic antidiabetic agents has been slowed due to the concern for chronic toxicity associated with vanadium accumulation. In order to circumvent the toxic effects of vanadium, we have taken up a combinational approach wherein a novel vanadium-flavonol complex was synthesized, characterized and its toxic as well as insulin mimetic potential was evaluated in STZ-induced experimental diabetes in rats. The results indicate that the complex is non-toxic and possess anti-diabetic activity.

Initiating and intensifying insulin therapy for type 2 diabetes: why, when, and how

With the exception of insulin, all diabetes medications have limited glucose-lowering capacity. Therefore, as type 2 diabetes progresses, insulin is often needed to achieve near-normal glycemic targets and avoid complications. Concerns about the initiation of insulin by both clinicians and patients play a major role in poor glycemic control. This article discusses current guidelines for treating type 2 diabetes, exploring when and how insulin therapy should be initiated and intensified, and how barriers to insulin use may be overcome. Advances include the development of novel long-acting, premixed, and rapid-acting insulin analogues and delivery devices. These agents have near-physiological time-action profiles that allow safer, flexible, and more convenient dosing. Many patients find using an insulin pen device easier, more convenient, and more discreet than using a vial and syringe. Nurses and medical assistants can be trained to understand the glucose-lowering capacities and limitations of each class of diabetes medications, including recognizing when insulin therapy is necessary. In addition, by showing patients how easy insulin pens are to use, clinic staff can help empower, educate, and encourage patients with type 2 diabetes to optimize their glycemic control with insulin once oral antidiabetic agents alone have become inadequate.