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By H.P.T. Ammon, H.U. Häring, M. Kellerer, H. Laube, L. Mosthaf, E.J. Verspohl and M.A. Wahl (Eds.)

Quantity 27, the 1st thematic quantity within the sequence, presents an outline of current wisdom in regards to the pharmacological and medical features of antidiabetic medications. It goals to stimulate additional attention of attainable strategies within the improvement of latest antidiabetic medications.

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The median survival is about 10 years, which is determined by diastolic blood pressure, dietary protein intake and the severity of diabetes exposure. A family history of longevity, however, may be helpful and also regular clinical contact. The complication risk in Type-I diabetes is related not only to duration of the disease but also to the degree of glycaemic control, blood pressure and genetic susceptibility (Hanssen, 1991). The most frequent chronic complication in Type-I diabetes is diabetic background retinopathy, with a near-100% occurrence rate after 15 years diabetes duration.

These results suggest that elevated rates of lipid oxidation contribute to the defect in glucose oxidation and, to a lesser extent, glucose storage in insulin-resistant diabetics. In normal-weight NIDDM patients, however, lipid oxidation is not significantly increased. The treatment of obese NIDDM patients should primarily aim at a reduction in insulin resistance by hypocaloric diet (reducing hyperglycaemia), weight reduction (reducing hyperinsulinaemia) and a reduction in hyperlipidaemia (with interruption of the fatty acid cycle).

1991, 1992). , 1987). , 1991b). , 1991b). It is believed that this association leads to activation of PI 3-kinase which results in phosphorylation of phosphatidylinositol molecules (Cantley et al. , 1991). , 1993). Although some functional properties of IRS-1 have been defined, we can presume that not all of the functions of IRS-1 have been discovered. The role of IRS-1 is probably not restricted to its function as a docking protein for PI 3-kinase; it might rather play a multifunctional role as a signalling element for growth-promoting and metabolic effects.

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