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High glucose concentrations cause ATP-sensitive potassium channels to close resulting in membrane depolarization and opening of L-type calcium channels.

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Meglitinides (repaglinide) also trigger the release of insulin by stimulating the pancreas.

Selected from data included with permission and copyrighted by First Databank, Inc.

Because it has been established that recurrent hypoglycemia can result in further deficits in counter-regulatory hormone responses, regular nocturnal hypoglycemia can trigger a cycle of hypoglycemia, impaired counter regulatory responses, and decreased awareness of low blood glucose levels while awake or asleep.

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The ASPIRE trial of 247 patients showed that sensor-augmented insulin pump therapy with a low glucose suspend significantly reduced nocturnal hypoglycemia, without increasing A1C levels for those over 16 years of age ().

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The NP reviewed glycemic goals with the patient and his wife and assisted them in deciding on initial short-term goals for weight loss, exercise, and medication.

This hormone causes a person to feel full and satiated; theyve eaten enough, and dont need to eat any more.

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When actually comparing DPP-4 inhibitor with SU therapy, non-inferiority of gliptins has been shown.

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When the agents described herein are administered in combination, both of the agents should be present at dosage levels of between about 1 to 100%, and more preferably between about 5 to 95% of the dosage normally administered in a monotherapy regimen.

However, no studies have demonstrated differences between the effects of repaglinide and SUs on glucose fluctuations based on data obtained from CGM devices.

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Welschen LMC, Bloemendal E, Nijpels G, Dekker JM, Heine RJ, Stalman WAB, Bouter LM: Self-monitoring of blood glucose in patients with type 2 diabetes who are not using insulin: a systematic review.

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If lifestyle, metformin, and a second medication do not result in goal glycemia, the next step should be to start, or intensify, insulin therapy ().

Weight loss is one advantage of treatment with incretin-based agents.

4 Based on the literature, acamprosate is associated with an improved rate of complete abstinence and may have other positive outcomes, such as decreased drinking frequency and rate of relapse.

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One drug in this class, troglitazone (Rezulin), was taken off the market in 2000 after being linked to fatal liver failure.

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