By Bernard Testa, Urs A. Meyer
Quantity 27, the 1st thematic quantity within the sequence, presents an outline of current wisdom in regards to the pharmacological and medical facets of antidiabetic medicines. It goals to stimulate additional attention of attainable techniques within the improvement of latest antidiabetic medicines.
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Extra resources for Antidiabetic Agents: Recent Advances in their Molecular and Clinical Pharmacology, Volume 27
Adaptor proteins are able to form complexes with G D P - G T P exchanger proteins (Sos in Drosophila and mSos 1,2 in mammalian cells). These proteins catalyse the exchange of GDP for GTP in Ras which at the same time activates Ras function. GTP-Ras is then able to activate serine kinases such as Raf. Ras contains an endogenous GTPase activity which inactivates the complex to Ras-GDP. This endogenous GTPase activity is again modulated by other proteins like GTPase-activating protein (GAP) or NF1.
In patients over the age of 75 at the time of diagnosis, mortality from diabetes is similar to that of age-matched non-diabetics. Coronary heart disease is the main cause of death in 58% of all Type-II diabetics (WHO, 1985b), followed by cerebrovascular accidents in 12%. Nephropathy is the cause of death in only 3%. Microvascular complications are far less prominent in Type-II than in Type-I diabetes mellitus. Retinopathy is present in only 17%, and cataracts in 14% of patients. 5% at the time of diagnosis to 50% after 25 years and seems to be directly related to the duration of diabetes.
Hyperglycaemia, ketonaemia, hypertriglyceridaemia and other metabolic complications, however, may continue in view of a still imperfect unphysiological insulin-application regimen. Next to the insulin pump, intensified conventional insulin therapy is the most effective way of imitating the homoeostatic regulation of blood glucose levels by means of several daily injections of clear insulin before meals and basal insulin to suppress gluconeogenesis during the night. 19 C L I N I C A L ASPECTS OF D I A B E T E S M E L L I T U S TABLE l a Symptoms of insulin-dependent diabetes Major symptoms Thirst Polyuria Weight loss Fatigue Minor symptoms Features of ketoacidosis Cramps Constipation Blurred vision Candidiasis Skin sepsis Nausea Vomiting Drowsiness Abdominal pain "Source: Gill (1991).