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Type 2 Diabetes Mellitus

  • Chapter
Hormone Replacement Therapy

Part of the book series: Contemporary Endocrinology ((COE,volume 13))

Abstract

Type 2 diabetes mellitus is a disease characterized by both abnormalities in insulin secretion and target-tissue resistance to the actions of insulin. Therefore, it is not surprising that replacement therapy with insulin alone is not sufficient to control blood glucose and many of the other metabolic abnormalities in patients with type 2 diabetes. Drugs, such as the sulfonylurea agents can enhance insulin secretion. Other agents, such as metformin, decrease hepatic glucose production (glycogenolysis and gluconeogenesis) in patients with type 2 diabetes. The thiazolidinediones act mainly by sensitizing peripheral tissues (e.g., muscle) to the action of insulin. The disaccharidase inhibitors slow down the absorption of starch from the intestine, leading to smaller rises in blood glucose after meals. Nevertheless, deficient secretion of insulin in many patients with type 2 diabetes may require injection of exogenous insulin, just as it does in patients with type 1 diabetes. In fact, the resistance to insulin’ s action in patients with type 2 diabetes often requires the use of large doses of insulin to achieve adequate glycemic control. The goals of insulin therapy in patients with type 2 diabetes are slightly different than in patients with type 1 diabetes and often necessitate some adjustment in the types of insulin preparations that are used, as well as the timing of insulin injections (Table 1).

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Authors
  1. David G. Johnson MD
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  2. Rubin Bressler MD, PhD
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Editors and Affiliations

  1. Division of Endocrinology and Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA

    A. Wayne Meikle MD

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Johnson, D.G., Bressler, R. (1999). Type 2 Diabetes Mellitus. In: Meikle, A.W. (eds) Hormone Replacement Therapy. Contemporary Endocrinology, vol 13. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-700-0_9

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  • DOI: https://doi.org/10.1007/978-1-59259-700-0_9

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61737-092-2

  • Online ISBN: 978-1-59259-700-0

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