Standardized biosynthesis of flavan-3-ols with effects on pancreatic beta-cell insulin secretion

Size: px
Start display at page:

Download "Standardized biosynthesis of flavan-3-ols with effects on pancreatic beta-cell insulin secretion"

Transcription

1 Standardized biosynthesis of flavan-3-ols with effects on pancreatic beta-cell insulin secretion Joseph A. Chemler, Lye T. Lock, Mattheos A. G. Koffas, Emmanuel S. Tzanakakis Applied Microbiology and Biotechnology 77(4): , Speaker: I-Lun Chiang Adviser: Ching-Tsan Huang, PhD Date:

2 Symptoms of Diabetes Eat a lot!! Drink a lot!! Pee a lot!! 2

3 Diabetes: A Global Problem and Epidemic +44% +102% +160% +180% +130% 3 (from WHO)

4 Diabetes Mellitus Type 1 Diabetes - Cannot produce insulin at all - insulin injection Type 2 Diabetes - Lack of insulin production - Insulin resistance -Oral medication 4

5 Diabetes Oral Medications 6 Classes : Sulfonylureas Biguanides Sulfonylureas and biguanide combination drugs Thiazolidinediones Alpha-glycosidase inhibitors Meglitinides 5

6 Sulfonylureas Stimulate pancreatic ß-cell to secrete insulin Side effects Long time hypoglycemia Water retention (edema) Worsening myocardial function Gains in body weight New drugs discovery!! 6

7 Plant-derived Flavonoids Antioxidant Flavonoids Flavan-3-ols protect islets from oxidative stress slow progressive ß-cell dysfunction may be effective against diabetes Natural hypoglycemic compounds Catechins 7

8 The Flavonoids Metabolic Pathway Plant secondary metabolites Flavan-3-ols 8

9 Strategy of Production Metabolic Engineering -The The practice of optimizing genetic and regulatory processes within cells to increase the production of a certain substance. precursor Metabolically Engineered cells Product 9

10 Metabolic Engineering of Flavan-3-ols Advantages Easy to scale up Less expensive starting materials Challenges Involves multiple enzymes in the pathway The target genes are from different plants The vectors must be designed specially The problem of plasmids incompatibility Need to optimize the production yield 10

11 Framework Precursors Metabolic engineering flavan-3-ols Insulin secretion assay Type-2 diabetes drug candidate 11

12 Metabolic engineering Identify the enzymes (b.c) C c= D =d E (e.f) b= =e B F a= A =f (a.d) 12

13 Metabolic engineering Find the genes from plants Petroselinum crispum Pc4CL-2 4CL (a) (a) Petunia hybrida CHS-A CHS (b) (b) Medicago sativa CHI (c) CHI (c) Malus domestica MdF3H (d) FHT (d) flamingo flower DFR DFR (e) (e) Desmodium uncinatum LAR LAR (f) (f) 13

14 Metabolic engineering Construct expression plasmids CHS-A (b) Md3FH (d) DFR (e) (b) (d) (e) CHI (c) Pc4CL (a) LAR (f) (b.c) (a.d) (e.f) 14

15 Metabolic engineering Transform into E. coli cells BL21Star E. coli lack of some proteases reduces degradation of heterologous proteins (e.f) (a.d) (b.c) Antibiotic Kanamycin marker: streptomycin Ampicillin 15

16 Metabolic engineering Supply of precursors c d b C D E e (e.f) (a.d) (b.c) a B A F f f e d Catechins F E Product D c b a C B Precursor A 16

17 Metabolic engineering Production yield control D eriodictyol naringenin d e f E F Catechins (+)-catechin (+)-afzelechin To increase the yield: growth medium oxygen availability enzyme s cofactor vector copy number 17

18 Production yield control Growth medium: M9 vs. LB M9 wins!! Because in LB: D E F (+)-catechin 18

19 Production yield control Production (mg/l) Oxygen availability: 20 ml liquid medium: oxygen-rich cultures 80 ml liquid medium: oxygen-limited cultures (+)-catechin from eriodictyol 20 ml Production (mg/l) (+)-afzelechin from naringenin 80 ml 80 ml 20 ml 20 ml 80 ml 0 20 ml 80 ml Volume (ml) inhibited by O ml 80 ml Volume (ml) Oxygen-limited culture wins!! 19

20 Production yield control Enzyme s cofactor: Fe(II) 80 ml Increased Decreased 20

21 Production yield control Enzyme s cofactor: Fe(II) D Fe(II) eriodictyol naringenin d e f E F Catechins Chelating effect (+)-catechin (+)-afzelechin No chelating effect Because Fe(II) chelating with the catechol groups of eriodictyol, the yield decrease Produce (+)-catechin without FeSO 4 Fe(II) can increase the yield of (+)-afzelechin Produce (+)-afzelechin with FeSO 4 21

22 Production yield control Vector copy number: Hypothesis: replace by yield? (e.f) (e.f) Medium-copy High-copy (d) (e.f) (d) (e.f) BL-FDL BL-FDLb 22

23 Production yield control Vector copy number: Results: did not get higher yield, why? 4 (+)-catechin 0.25 (+)-afzelechin Production (mg/l) Medium-copy High-copy Production (mg/l) Medium-copy High-copy BL-FDL BL-FDLb d might be limiting factor BL-FDL BL-FDLb 23

24 Metabolic engineering Production yield control D eriodictyol naringenin d e f E F Catechins (+)-catechin (+)-afzelechin To increase the yield: growth medium: M9 oxygen availability: oxygen-limited culture enzyme s cofactor: (+)-catechin without FeSO 4 (+)-afzelechin with FeSO 4 vector copy number: unclear 24

25 Results- Standardized Biosynthesis of Flavan-3-ols caffeic acid courmaric acid A B C D E F CatechinsCatechins (+)-catechin (+)-afzelechin Successful! A (+)-catechin Standardized conditions (+)-afzelechin 25

26 Framework Precursors Metabolic engineering flavan-3-ols Insulin secretion assay Type-2 diabetes drug candidate MIN6 ß-cell incubation 2.5 mm glucose 25 mm glucose KRB KRB add (+)-catechin or (+)-afzelechin Insulin secretion Quantify by ELISA 26

27 Results- Insulin secretion assay (+)-catechin can increase the glucose-stimulated insulin secretion of MIN6 β-cells. glucose-stimulated level Base-line level the same Control group KRB (Krebs-Ringer bicarbonate buffer) 27

28 Results- Insulin secretion assay (+)-afzelechin can increase both base-line level and glucose-stimulated level of insulin secretion. glucose-stimulated level Base-line level increased Control group KRB (Krebs-Ringer bicarbonate buffer) 28

29 Summary Oral medication Old drugs have side effects Discovery of new drugs Treating diabetes Precursors Metabolic engineering flavan-3-ols Insulin secretion assay Insulin injection Type-1 diabetes treatment (+)-catechin Type-2 diabetes drug candidate (+)-afzelechin Type-2 diabetes treatment 29

30 Thanks for your attention! 30

Standardized biosynthesis of flavan-3-ols with effects on pancreatic beta-cell insulin secretion

Standardized biosynthesis of flavan-3-ols with effects on pancreatic beta-cell insulin secretion Appl Microbiol Biotechnol (2007) 77:797 807 DOI 10.1007/s00253-007-1227-y BIOTECHNOLOGICAL PRODUCTS AND PROCESS ENGINEERING Standardized biosynthesis of flavan-3-ols with effects on pancreatic beta-cell

More information

ULTRASOUND STIMULATION OF INSULIN RELEASE FROM PANCREATIC BETA CELLS

ULTRASOUND STIMULATION OF INSULIN RELEASE FROM PANCREATIC BETA CELLS ULTRASOUND STIMULATION OF INSULIN RELEASE FROM PANCREATIC BETA CELLS Ivan M. Suarez Castellanos 1, Aleksandar Jeremic 2, and Vesna Zderic 1 1 The George Washington University, Department of Biomedical

More information

Biosynthesis of 5-deoxyflavanones in microorganisms

Biosynthesis of 5-deoxyflavanones in microorganisms DOI 10.1002/biot.200700119 Biotechnol. J. 2007, 2, 1250 1262 Research Article Biosynthesis of 5-deoxyflavanones in microorganisms Yajun Yan 1, Lixuan Huang 2 and Mattheos A. G. Koffas 1 1 Department of

More information

What systems are involved in homeostatic regulation (give an example)?

What systems are involved in homeostatic regulation (give an example)? 1 UNIVERSITY OF PNG SCHOOL OF MEDICINE AND HEALTH SCIENCES DIVISION OF BASIC MEDICAL SCIENCES DISCIPLINE OF BIOCHEMISTRY AND MOLECULAR BIOLOGY GLUCOSE HOMEOSTASIS (Diabetes Mellitus Part 1): An Overview

More information

Chapter 24 Diabetes Mellitus

Chapter 24 Diabetes Mellitus Chapter 24 Diabetes Mellitus Classification of Diabetes Mellitus Acute Effects of Diabetes Mellitus Chronic Complications of Diabetes Mellitus: Early Stages Chronic Complications of Diabetes Mellitus:

More information

A M Metabolics. inventing the future of healthcare

A M Metabolics. inventing the future of healthcare A M Metabolics inventing the future of healthcare Metabolic Disease Control Flavonoid-Based Amelioration of Carbohydrate Dysfunctional Metabolism December 2013 Daryl L. Thompson and M. Joseph Ahrens 2002

More information

22 Emerging Therapies for

22 Emerging Therapies for 22 Emerging Therapies for Treatment of Type 2 Diabetes Siddharth N Shah Abstract: The prevalence of Diabetes is progressively increasing world-wide and the growth of the disease in our country is phenomenal.

More information

UNIVERSITY OF PNG SCHOOL OF MEDICINE AND HEALTH SCIENCES DIVISION OF BASIC MEDICAL SCIENCES DISCIPLINE OF BIOCHEMISTRY AND MOLECULAR BIOLOGY

UNIVERSITY OF PNG SCHOOL OF MEDICINE AND HEALTH SCIENCES DIVISION OF BASIC MEDICAL SCIENCES DISCIPLINE OF BIOCHEMISTRY AND MOLECULAR BIOLOGY 1 UNIVERSITY OF PNG SCHOOL OF MEDICINE AND HEALTH SCIENCES DIVISION OF BASIC MEDICAL SCIENCES DISCIPLINE OF BIOCHEMISTRY AND MOLECULAR BIOLOGY GLUCOSE HOMEOSTASIS An Overview WHAT IS HOMEOSTASIS? Homeostasis

More information

Diabetes: We ve Come a Long Way, Baby! Amy Wachter, MD Christiana Care Endocrinology March 22, 2018

Diabetes: We ve Come a Long Way, Baby! Amy Wachter, MD Christiana Care Endocrinology March 22, 2018 Diabetes: We ve Come a Long Way, Baby! Amy Wachter, MD Christiana Care Endocrinology March 22, 2018 Title of My Talk Ancient Times Diabetes has been affecting lives for thousands of years. Egyptians in

More information

Metabolic Engineering of Anthocyanin Biosynthesis in Escherichia coli

Metabolic Engineering of Anthocyanin Biosynthesis in Escherichia coli APPLIED AND ENVIRONMENTAL MICROBIOLOGY, July 2005, p. 3617 3623 Vol. 71, No. 7 0099-2240/05/$08.00 0 doi:10.1128/aem.71.7.3617 3623.2005 Copyright 2005, American Society for Microbiology. All Rights Reserved.

More information

Type 2 Diabetes: Where Do We Start with Treatment? DIABETES EDUCATION. Diabetes Mellitus: Complications and Co-Morbid Conditions

Type 2 Diabetes: Where Do We Start with Treatment? DIABETES EDUCATION. Diabetes Mellitus: Complications and Co-Morbid Conditions Diabetes Mellitus: Complications and Co-Morbid Conditions ADA Guidelines for Glycemic Control: 2016 Retinopathy Between 2005-2008, 28.5% of patients with diabetes 40 years and older diagnosed with diabetic

More information

Functional expression of a P450 flavonoid hydroxylase for the biosynthesis of plant-specific hydroxylated flavonols in Escherichia coli

Functional expression of a P450 flavonoid hydroxylase for the biosynthesis of plant-specific hydroxylated flavonols in Escherichia coli Metabolic Engineering 8 (2006) 172 181 www.elsevier.com/locate/ymben Functional expression of a P450 flavonoid hydroxylase for the biosynthesis of plant-specific hydroxylated flavonols in Escherichia coli

More information

History of Investigation

History of Investigation Acini - Pancreatic juice (1º) (2º) Secretions- neuronal and hormonal mechanisms 1) Secretin - bicarbonate rich 2) Cholecystokinin - enzyme rich Islets of Langerhans (contain 4 cell types) Alpha cells (α)-

More information

Montri Punyatong 1, Puntipa Pongpiachan 2 *, Petai Pongpiachan 2 Dumnern Karladee 3 and Samlee Mankhetkorn 4 ABSTRACT

Montri Punyatong 1, Puntipa Pongpiachan 2 *, Petai Pongpiachan 2 Dumnern Karladee 3 and Samlee Mankhetkorn 4 ABSTRACT Kasetsart J. (Nat. Sci.) 42 : 676-681 (2008) Cytotoxicity of Crude Proanthocyanidin Extract from Purple Glutinous Rice Bran (Oryza sativa L.) (Kum Doi Saket) Compared with Cyanidin 3-Glucoside on X63 Myeloma

More information

Diabetes Oral Agents Pharmacology. University of Hawai i Hilo Pre-Nursing Program NURS 203 General Pharmacology Danita Narciso Pharm D

Diabetes Oral Agents Pharmacology. University of Hawai i Hilo Pre-Nursing Program NURS 203 General Pharmacology Danita Narciso Pharm D Diabetes Oral Agents Pharmacology University of Hawai i Hilo Pre-Nursing Program NURS 203 General Pharmacology Danita Narciso Pharm D 1 Learning Objectives Understand the role of the utilization of free

More information

The Many Faces of T2DM in Long-term Care Facilities

The Many Faces of T2DM in Long-term Care Facilities The Many Faces of T2DM in Long-term Care Facilities Question #1 Which of the following is a risk factor for increased hypoglycemia in older patients that may suggest the need to relax hyperglycemia treatment

More information

Diabetes Mellitus. Raja Nursing Instructor. Acknowledgement: Badil 09/03/2016

Diabetes Mellitus. Raja Nursing Instructor. Acknowledgement: Badil 09/03/2016 Diabetes Mellitus Raja Nursing Instructor 09/03/2016 Acknowledgement: Badil Objective: Define Diabetes Mellitus (DM) & types of DM. Understand the pathophysiology of Type-I & II DM. List the clinical features

More information

Characterization of dihydroflavonol 4-reductases for recombinant plant pigment biosynthesis applications

Characterization of dihydroflavonol 4-reductases for recombinant plant pigment biosynthesis applications Biocatalysis and Biotransformation, JuneJuly 2008; 26(3): 243251 ORIGINAL ARTICLE Characterization of dihydroflavonol 4-reductases for recombinant plant pigment biosynthesis applications EFFENDI LEONARD

More information

Week 3 The Pancreas: Pancreatic ph buffering:

Week 3 The Pancreas: Pancreatic ph buffering: Week 3 The Pancreas: A gland with both endocrine (secretion of substances into the bloodstream) & exocrine (secretion of substances to the outside of the body or another surface within the body) functions

More information

Changing Diabetes: The time is now!

Changing Diabetes: The time is now! Midwest Cardiovascular Research Foundation Welcomes DANITA HARRISON, ARNP Ms. Harrison discloses speaking relationships with Lilly, Novo Nordisk and Pfizer. Changing Diabetes: The time is now! Danita Harrison

More information

Newer and Expensive treatment of diabetes. Endocrinology Visiting Associate Professor Institute of Medicine TUTH

Newer and Expensive treatment of diabetes. Endocrinology Visiting Associate Professor Institute of Medicine TUTH Newer and Expensive treatment of diabetes Jyoti Bhattarai MD Endocrinology Visiting Associate Professor Institute of Medicine TUTH Four out of every five people with diabetes now live in developing countries.

More information

Case Study: Carbohydrate Metabolism. eating an early dinner the night before and skipping breakfast that morning, Sid goes to the

Case Study: Carbohydrate Metabolism. eating an early dinner the night before and skipping breakfast that morning, Sid goes to the Student Name Biochemistry 4320 Case Study Part I 4 November 2013 Case Study: Carbohydrate Metabolism Sid is a high school student who has decided to start exercising before school. After eating an early

More information

Joslin Diabetes Center Joslin Diabetes Forum 2013: The Impact of Comorbidities on Glucose Control Scenario 2: Reduced Renal Function

Joslin Diabetes Center Joslin Diabetes Forum 2013: The Impact of Comorbidities on Glucose Control Scenario 2: Reduced Renal Function Scenario 2: Reduced Renal Function 62 y.o. white man with type 2 diabetes for 18 years Hypertension and hypercholesterolemia Known proliferative retinopathy Current medications: Metformin 1000 mg bid Glyburide

More information

A factorial randomized trial of blood pressure lowering and intensive glucose control in 11,140 patients with type 2 diabetes

A factorial randomized trial of blood pressure lowering and intensive glucose control in 11,140 patients with type 2 diabetes A factorial randomized trial of blood pressure lowering and intensive glucose control in 11,140 patients with type 2 diabetes Hypotheses: Among individuals with type 2 diabetes, the risks of major microvascular

More information

Glyceamic control is indicated by 1. Fasting blood sugar less than 126 mg/dl 2. Random blood sugar 3. HbA1c less than 6.5 % Good glycaemic control

Glyceamic control is indicated by 1. Fasting blood sugar less than 126 mg/dl 2. Random blood sugar 3. HbA1c less than 6.5 % Good glycaemic control Glyceamic control is indicated by 1. Fasting blood sugar less than 126 mg/dl 2. Random blood sugar 3. HbA1c less than 6.5 % Good glycaemic control can prevent many of early type 1 DM(in DCCT trail ). UK

More information

GLYCATION OF PROTEINS IN ESCHERICHIA COLI: EFFECT OF NUTRIENT BROTH INGREDIENTS ON GLYCATION

GLYCATION OF PROTEINS IN ESCHERICHIA COLI: EFFECT OF NUTRIENT BROTH INGREDIENTS ON GLYCATION Industry GLYCATION OF PROTEINS IN ESCHERICHIA COLI: EFFECT OF NUTRIENT BROTH INGREDIENTS ON GLYCATION R. Dimitrova, R. Mironova, I. Ivanov Institute of Molecular biology, Bulgarian Academy of Sciences

More information

Choosing a Diabetes Strategy Where to Start and Where to Go

Choosing a Diabetes Strategy Where to Start and Where to Go Choosing a Diabetes Strategy Where to Start and Where to Go Erin Keely, MD, FRCPC; and Sharon Brez, RN, BScN, MA(Ed), CDE As presented at the University of Ottawa's 52nd Annual Refresher Course for Family

More information

Expression of a soluble flavone synthase allows the biosynthesis of phytoestrogen derivatives in Escherichia coli

Expression of a soluble flavone synthase allows the biosynthesis of phytoestrogen derivatives in Escherichia coli Appl Microbiol Biotechnol (2006) 70: 85 91 DOI 10.1007/s00253-005-0059-x APPLIED GENETICS AND MOLECULAR BIOTECHNOLOGY Effendi Leonard. Joseph Chemler. Kok Hong Lim. Mattheos A. G. Koffas Expression of

More information

Discussion & Conclusion

Discussion & Conclusion Discussion & Conclusion 7. Discussion DPP-4 inhibitors augment the effects of incretin hormones by prolonging their half-life and represent a new therapeutic approach for the treatment of type 2 diabetes

More information

MOA: Long acting glucagon-like peptide 1 receptor agonist

MOA: Long acting glucagon-like peptide 1 receptor agonist Alexandria Rydz MOA: Long acting glucagon-like peptide 1 receptor agonist Increases glucose dependent insulin secretion Decreases inappropriate glucagon secretion Increases β- cell growth and replication

More information

Glycemic Control IU Health Diabetes Centers

Glycemic Control IU Health Diabetes Centers Glycemic Control IU Health Diabetes Centers Central Nursing Orientation 3/10/2014 1 Objectives Identify laboratory results that diagnosis diabetes and reflect glycemic control Describe glycemic control

More information

Supplementary Information. Statins Improve Long Term Patency of Arteriovenous Fistula for

Supplementary Information. Statins Improve Long Term Patency of Arteriovenous Fistula for Supplementary Information Statins Improve Long Term Patency of Arteriovenous Fistula for Hemodialysis Hao-Hsiang Chang MD, MSc 1,2, Yu-Kang Chang PhD 3, Chia-Wen Lu MD 1, Chi-Ting Huang 3, Chiang-Ting

More information

Galvus the most comprehensively studied DPP-4 inhibitor

Galvus the most comprehensively studied DPP-4 inhibitor Galvus the most comprehensively studied DPP-4 inhibitor! >7 000 patients enrolled in clinical studies! >4 00 patients exposed to Galvus >1 300 patients exposed 2 weeks >300 patients exposed for 104 weeks!

More information

Diabetes, Drugs and Dangerous Discrepancies. Sally Bodenhamer, OD, OT/L, CDE

Diabetes, Drugs and Dangerous Discrepancies. Sally Bodenhamer, OD, OT/L, CDE Diabetes, Drugs and Dangerous Discrepancies Sally Bodenhamer, OD, OT/L, CDE I have no disclosures Disclosures $245 BILLION American DM ASSOC 2012 cost of Diabetes Economic Costs of Diabetes in the U.S.

More information

Cambridge International Examinations Cambridge Ordinary Level

Cambridge International Examinations Cambridge Ordinary Level Cambridge International Examinations Cambridge Ordinary Level *9076754804* BIOLOGY 5090/21 Paper 2 Theory May/June 2016 1 hour 45 minutes Candidates answer on the Question Paper. No Additional Materials

More information

UNIVERSITY OF CAMBRIDGE INTERNATIONAL EXAMINATIONS International General Certificate of Secondary Education. BIOLOGY May/June 2013

UNIVERSITY OF CAMBRIDGE INTERNATIONAL EXAMINATIONS International General Certificate of Secondary Education. BIOLOGY May/June 2013 UNIVERSITY OF CAMBRIDGE INTERNATIONAL EXAMINATIONS International General Certificate of Secondary Education *7604327696* 0610/32 BIOLOGY May/June 2013 Paper 3 Extended 1 hour 15 minutes Candidates answer

More information

Disclosure. Learning Objectives. Case. Diabetes Update: Incretin Agents in Diabetes-When to Use Them? I have no disclosures to declare

Disclosure. Learning Objectives. Case. Diabetes Update: Incretin Agents in Diabetes-When to Use Them? I have no disclosures to declare Disclosure Diabetes Update: Incretin Agents in Diabetes-When to Use Them? I have no disclosures to declare Spring Therapeutics Update 2011 CSHP BC Branch Anar Dossa BScPharm Pharm D CDE April 20, 2011

More information

LifePak Health Benefits. LifePak is optimum supplementation for:

LifePak Health Benefits. LifePak is optimum supplementation for: LifePak What is LifePak? Our comprehensive nutritional wellness program delivering the optimum amounts of all essential and generally beneficial nutrients for long-term health and well-being. LifePak Health

More information

Management of DM in Older Adults: It s not all about sugar! Who needs treatment for DM? Peggy Odegard, Pharm.D., BCPS, CDE

Management of DM in Older Adults: It s not all about sugar! Who needs treatment for DM? Peggy Odegard, Pharm.D., BCPS, CDE Management of DM in Older Adults: It s not all about sugar! Peggy Odegard, Pharm.D., BCPS, CDE Who needs treatment for DM? 87 year old, frail male with moderately severe dementia living in NH with persistent

More information

Objectives. Insulin Resistance. Understanding the Basic Pharmacology of Medications for Type 2 Diabetes

Objectives. Insulin Resistance. Understanding the Basic Pharmacology of Medications for Type 2 Diabetes Understanding the Basic Pharmacology of Medications for Type 2 Diabetes Alan P. Agins, Ph.D. President, PRN Associates, Ltd Continuing Medical Education Tucson, AZ Objectives Describe the pathogenesis

More information

Control of Glucose Metabolism

Control of Glucose Metabolism Glucose Metabolism Control of Glucose Metabolism The pancreas is both an exocrine and endocrine gland. It secretes digestive enzymes into the duodenum (exocrine) and 3 specific hormones into the bloodstream

More information

Figure legends Supplemental Fig.1. Glucose-induced insulin secretion and insulin content of islets. Supplemental Fig. 2.

Figure legends Supplemental Fig.1. Glucose-induced insulin secretion and insulin content of islets. Supplemental Fig. 2. Figure legends Supplemental Fig.. Glucose-induced insulin secretion and insulin content of islets. Insulin secretory responses to.,., and. mm glucose (A) (n = 7-), and the insulin content in the islets

More information

Diabetes Mellitus Aeromedical Considerations. Aviation Medicine Seminar Bucharest, Romania. 11 th to 15 th November 2013

Diabetes Mellitus Aeromedical Considerations. Aviation Medicine Seminar Bucharest, Romania. 11 th to 15 th November 2013 Diabetes Mellitus Aeromedical Considerations Aviation Medicine Seminar Bucharest, Romania. 11 th to 15 th November 2013 Metabolic, Nutritional or Endocrine disorders Applicants with metabolic, nutritional

More information

Functional Properties of Cocoa Products: Health Aspects. Puspo Edi Giriwono SEAFAST Center - IPB

Functional Properties of Cocoa Products: Health Aspects. Puspo Edi Giriwono SEAFAST Center - IPB Functional Properties of Cocoa Products: Health Aspects Puspo Edi Giriwono SEAFAST Center - IPB Theobroma cacao Nutrient content of various cocoa products Colombo et al., Chocolate and Health., 2012 Cocoa

More information

Multiple Factors Should Be Considered When Setting a Glycemic Goal

Multiple Factors Should Be Considered When Setting a Glycemic Goal Multiple Facts Should Be Considered When Setting a Glycemic Goal Patient attitude and expected treatment effts Risks potentially associated with hypoglycemia, other adverse events Disease duration Me stringent

More information

AUSTRALIAN FUNCTIONAL NUTRACEUTICAL

AUSTRALIAN FUNCTIONAL NUTRACEUTICAL Botanical Innovations PURE NATURE AUSTRALIAN FUNCTIONAL NUTRACEUTICAL FLAVOURS, FRAGRANCES & INGREDIENTS Plant Extracts-Naturally Fermented Fruits and Vinegars Cold Pressed Oils-Essential Oils-Phenolic

More information

IMIDIA IMPROVING BETA-CELL FUNCTION AND IDENTIFICATION OF DIAGNOSTIC BIOMARKERS FOR TREATMENT MONITORING IN DIABETES. A. Ktorza, B.

IMIDIA IMPROVING BETA-CELL FUNCTION AND IDENTIFICATION OF DIAGNOSTIC BIOMARKERS FOR TREATMENT MONITORING IN DIABETES. A. Ktorza, B. IMIDIA IMPROVING BETA-CELL FUNCTION AND IDENTIFICATION OF DIAGNOSTIC BIOMARKERS FOR TREATMENT MONITORING IN DIABETES A. Ktorza, B. Thorens DIABETES Definition Diabetes is a metabolic disease characterized

More information

Name: Oasis: Questions EPCP. Professional Development: Diabetes

Name: Oasis: Questions EPCP. Professional Development: Diabetes EPCP Professional Development: Diabetes Name: Oasis: Questions 1) Type 1 diabetes in characterized by which of the following: 1) adult onset, obesity 2) juvenile onset, lean build 3) auto-immune beta cell

More information

Chemistry 5.07 Problem Set

Chemistry 5.07 Problem Set Chemistry 5.07 Problem Set 8 2013 Problem 1. All oxidation steps in the pathway from glucose to CO 2 result in the production of NADH, except the succinate dehydrogenase (SDH) step in the TCA cycle, which

More information

Insulin mrna to Protein Kit

Insulin mrna to Protein Kit Insulin mrna to Protein Kit A 3DMD Paper BioInformatics and Mini-Toober Folding Activity Student Handout www.3dmoleculardesigns.com Insulin mrna to Protein Kit Contents Becoming Familiar with the Data...

More information

YOU HAVE DIABETES. Angie O Connor Community Diabetes Nurse Specialist 25th September 2013

YOU HAVE DIABETES. Angie O Connor Community Diabetes Nurse Specialist 25th September 2013 YOU HAVE DIABETES Angie O Connor Community Diabetes Nurse Specialist 25th September 2013 Predicated 2015 figures are already met 1 in 20 have diabetes:1in8 over 60years old Definite Diagnosis is key Early

More information

Org/Biochem Final Lec Form, Spring 2012 Page 1 of 6

Org/Biochem Final Lec Form, Spring 2012 Page 1 of 6 Page 1 of 6 Missing Complete Protein and Question #45 Key Terms: Fill in the blank in the following 25 statements with one of the key terms in the table. Each key term may only be used once. Print legibly.

More information

AUSTRALIAN FUNCTIONAL NUTRACEUTICAL FLAVOURS, FRAGRANCES & INGREDIENTS

AUSTRALIAN FUNCTIONAL NUTRACEUTICAL FLAVOURS, FRAGRANCES & INGREDIENTS TASTE + FUNCTION RED & APPLE PEEL FLAKES & POWDER CREATE NEW PRODUCTS ENHANCE EXISTING PRODUCTS WITH PHENOLIC RICH POWDERS CONCENTRATED PHENOLIC COMPOUNDS ANTIXODIANTS VITAMIN C VITAMIN E n Botanical Orange

More information

Glucose Control drug treatments

Glucose Control drug treatments Glucose Control drug treatments It should be noted that glitazones are under suspicion of precipitating acute cardiac events and current recommendations contraindicate the use of glitazones in patients

More information

Comparative Effectiveness and Safety of Diabetes Medications for Adults with Type 2 Diabetes

Comparative Effectiveness and Safety of Diabetes Medications for Adults with Type 2 Diabetes Draft Comparative Effectiveness Review Comparative Effectiveness and Safety of Diabetes Medications for Adults with Type Diabetes Prepared for: Agency for Healthcare Research and Quality U.S. Department

More information

GLP 1 agonists Winning the Losing Battle. Dr Bernard SAMIA. KCS Congress: Impact through collaboration

GLP 1 agonists Winning the Losing Battle. Dr Bernard SAMIA. KCS Congress: Impact through collaboration GLP 1 agonists Winning the Losing Battle Dr Bernard SAMIA KCS Congress: Impact through collaboration CONTACT: Tel. +254 735 833 803 Email: kcardiacs@gmail.com Web: www.kenyacardiacs.org Disclosures I have

More information

Strain Improvement of Recombinant Escherichia coli for Efficient Production of Plant Flavonoids

Strain Improvement of Recombinant Escherichia coli for Efficient Production of Plant Flavonoids Strain Improvement of Recombinant Escherichia coli for Efficient Production of Plant Flavonoids Effendi Leonard, Yajun Yan, Zachary L. Fowler, Zhen Li, Chin-Giaw Lim, Kok-Hong Lim, and Mattheos A. G. Koffas*

More information

An Overview of Diabetes

An Overview of Diabetes An Overview of Diabetes What is Diabetes? Diabetes is a disease in which the body is unable to properly use and store glucose (a form of sugar). Glucose backs up in the bloodstream causing a person s blood

More information

Practical Strategies for the Clinical Use of Incretin Mimetics CME/CE. CME/CE Released: 09/15/2009; Valid for credit through 09/15/2010

Practical Strategies for the Clinical Use of Incretin Mimetics CME/CE. CME/CE Released: 09/15/2009; Valid for credit through 09/15/2010 Practical Strategies for the Clinical Use of Incretin Mimetics CME/CE Robert R. Henry, MD Authors and Disclosures CME/CE Released: 09/15/2009; Valid for credit through 09/15/2010 Introduction Type 2 diabetes

More information

What s New in Diabetes Treatment. Disclosures

What s New in Diabetes Treatment. Disclosures What s New in Diabetes Treatment Shiri Levy M.D. Henry Ford Hospital Senior Staff Physician Service Chief, West Bloomfield Hospital Endocrinology, Metabolism, Bone and Mineral Disorders Disclosures None

More information

egfr > 50 (n = 13,916)

egfr > 50 (n = 13,916) Saxagliptin and Cardiovascular Risk in Patients with Type 2 Diabetes Mellitus and Moderate or Severe Renal Impairment: Observations from the SAVOR-TIMI 53 Trial Supplementary Table 1. Characteristics according

More information

Targeted Chemoprevention of Progressive Marrow Failure in Patients with Fanconi Anemia using Quercetin, a Pilot study

Targeted Chemoprevention of Progressive Marrow Failure in Patients with Fanconi Anemia using Quercetin, a Pilot study Targeted Chemoprevention of Progressive Marrow Failure in Patients with Fanconi Anemia using Quercetin, a Pilot study Parinda Mehta, M.D. Division of Bone Marrow Transplantation and Immune Deficiency Cincinnati

More information

Characterization of the DNA-mediated Oxidation of Dps, a Bacterial Ferritin

Characterization of the DNA-mediated Oxidation of Dps, a Bacterial Ferritin SUPPORTING INFORMATION Characterization of the DNA-mediated Oxidation of Dps, a Bacterial Ferritin Anna R. Arnold, Andy Zhou, and Jacqueline K. Barton Division of Chemistry and Chemical Engineering, California

More information

Flavonoids and their contribution to health: a look at the scientific support

Flavonoids and their contribution to health: a look at the scientific support Flavonoids and their contribution to health: a look at the scientific support Frank Hu, MD, PhD Professor of Nutrition and Epidemiology Harvard School of Public Health Professor of Medicine Harvard Medical

More information

Lignin and the General Phenylpropanoid Pathway. Introduction and Importance:

Lignin and the General Phenylpropanoid Pathway. Introduction and Importance: Lignin and the General Phenylpropanoid Pathway 13. Phenolics and Lignin p. 1 Introduction and Importance: Phenolic: a compound consisting of an aromatic ring plus at least one hydroxyl [= phenyl group],

More information

THE PATENT LIST OF BIFIDO

THE PATENT LIST OF BIFIDO THE PATENT LIST OF BIFIDO No Patent No. Patent Name Publication Date Country 1 1001356150000 Bifidobacterium strain without β-glucosidase and its use 1998-01-15 Korea 2 1001357800000 Improved selective

More information

Diabetes Mellitus. Disclaimer. Multimedia Health Education

Diabetes Mellitus. Disclaimer. Multimedia Health Education Disclaimer This movie is an educational resource only and should not be used to manage Diabetes or blood sugar control.all decisions about management of diabetes must be made in conjunction with your Physician

More information

What s New in Diabetes Medications. Jena Torpin, PharmD

What s New in Diabetes Medications. Jena Torpin, PharmD What s New in Diabetes Medications Jena Torpin, PharmD 1 Objectives Discuss new medications in the management of diabetes Understand the mechanism of the medications discussed Understand the side effects

More information

Supplementary Data. Correlation analysis. Importance of normalizing indices before applying SPCA

Supplementary Data. Correlation analysis. Importance of normalizing indices before applying SPCA Supplementary Data Correlation analysis The correlation matrix R of the m = 25 GV indices calculated for each dataset is reported below (Tables S1 S3). R is an m m symmetric matrix, whose entries r ij

More information

Xultophy 100/3.6. (insulin degludec, liraglutide) New Product Slideshow

Xultophy 100/3.6. (insulin degludec, liraglutide) New Product Slideshow Xultophy 100/3.6 (insulin degludec, liraglutide) New Product Slideshow Introduction Brand name: Xultophy Generic name: Insulin degludec, liraglutide Pharmacological class: Human insulin analog + glucagon-like

More information

The information in this guide comes from a government-funded review of research about pills for type 2 diabetes.

The information in this guide comes from a government-funded review of research about pills for type 2 diabetes. effectivehealthcare.ahrq.gov Pills for Type 2 Diabetes: A Guide for Adults Consumer Summary Guide published 5 Dec 2007 1. Introduction What does this guide cover? Type 2 diabetes means the body has a problem

More information

Copyright 2003 How long does it take metformin to lower blood sugar. All rights reserved.

Copyright 2003 How long does it take metformin to lower blood sugar. All rights reserved. How long does it take to see results with invokana on lowering your sugar reading?. Diabetes In Control. A free weekly diabetes newsletter for Medical Professionals. News and information for Medical Professionals.

More information

ADVANCES IN ORAL INSULIN DELIVERY

ADVANCES IN ORAL INSULIN DELIVERY ADVANCES IN ORAL INSULIN DELIVERY Zakieh I. Al-Kurdi, Babur Z. Chowdhry, Nidal A. Qinna, Mahmoud M.H. Al Omari and Adnan A. Badwan 2 ND MENA REGULATORY CONFERENCE ON BIOEQUIVALENCE, BIOWAIVERS, BIOANALYSIS,

More information

Peer Review Report. [long acting insulin analogues glargine and detemir]

Peer Review Report. [long acting insulin analogues glargine and detemir] 21 st Expert Committee on Selection and Use of Essential Medicines Peer Review Report [long acting insulin analogues glargine and detemir] (1) Does the application adequately address the issue of the public

More information

Glucagon Administration. Molalla River School District

Glucagon Administration. Molalla River School District Glucagon Administration Molalla River School District Laws that have were created to allow for administration of epinephrine in the school based setting were revised to include glucagon administration

More information

GLP-1 (glucagon-like peptide-1) Agonists (Byetta, Bydureon, Tanzeum, Trulicity, Victoza ) Step Therapy and Quantity Limit Criteria Program Summary

GLP-1 (glucagon-like peptide-1) Agonists (Byetta, Bydureon, Tanzeum, Trulicity, Victoza ) Step Therapy and Quantity Limit Criteria Program Summary OBJECTIVE The intent of the GLP-1 (glucagon-like peptide-1) s (Byetta/exenatide, Bydureon/ exenatide extended-release, Tanzeum/albiglutide, Trulicity/dulaglutide, and Victoza/liraglutide) Step Therapy

More information

Quick Guide MEDICATIONS 7th Edition Evan Sisson, Pharm.D., MHA, CDE

Quick Guide MEDICATIONS 7th Edition Evan Sisson, Pharm.D., MHA, CDE Quick Guide to MEDICATIONS 7th Edition Evan Sisson, Pharm.D., MHA, CDE Adapted from The Art and Science of Diabetes Self-Management Education Desk Reference 2017, American Association of Diabetes Educators,

More information

A Comparison of Leucine- and Acetoacetate-induced Hypoglycemia in Man *

A Comparison of Leucine- and Acetoacetate-induced Hypoglycemia in Man * Journal of Clinical Investigation Vol. 43, No. 1, 1964 A Comparison of Leucine- and Acetoacetate-induced Hypoglycemia in Man * STEFAN S. FAJANS, JOHN C. FLOYD, JR., RALPH F. KNOPF, AND JEROME W. CONN (From

More information

Bioavailability of dietary (poly)phenols following acute. ingestion of an enriched drink by ileostomists

Bioavailability of dietary (poly)phenols following acute. ingestion of an enriched drink by ileostomists SUPPLEMENTARY MATERIAL Bioavailability of dietary (poly)phenols following acute ingestion of an enriched drink by ileostomists Gina Borges a, Michael E.J. Lean b, Susan A. Roberts c, and Alan Crozier *a

More information

Supplementary Online Content

Supplementary Online Content Supplementary Online Content Lin Y-S, Chen Y-L, Chen T-H, et al. Comparison of Clinical Outcomes Among Patients With Atrial Fibrillation or Atrial Flutter Stratified by CHA 2 DS 2 -VASc Score. JAMA Netw

More information

Society for Ambulatory Anesthesia Consensus Statement on Perioperative Blood Glucose Management in Diabetic Patients Undergoing Ambulatory Surgery

Society for Ambulatory Anesthesia Consensus Statement on Perioperative Blood Glucose Management in Diabetic Patients Undergoing Ambulatory Surgery Society for Ambulatory Anesthesia Consensus Statement on Perioperative Blood Glucose Management in Diabetic Patients Undergoing Ambulatory Surgery Girish P. Joshi, MB BS, MD, FFARCSI Anesthesia & Analgesia

More information

Treating Type 2 Diabetes with Bariatric Surgery. Goal of Treating T2DM. Remission of T2DM with Bariatric

Treating Type 2 Diabetes with Bariatric Surgery. Goal of Treating T2DM. Remission of T2DM with Bariatric Treating Type 2 Diabetes with Bariatric Surgery Number (in Millions) of Persons with Diagnosed Diabetes, United States, 198 25 The number of Americans with diabetes increased from 5.6 to 15.8 million Guilherme

More information

Anne Leake, PhD, APRN, BC-ADM ECHO Diabetes Learning Group 4/4/18. High Sugar / Hyperglycemia: Causes, Complications and Management

Anne Leake, PhD, APRN, BC-ADM ECHO Diabetes Learning Group 4/4/18. High Sugar / Hyperglycemia: Causes, Complications and Management Anne Leake, PhD, APRN, BC-ADM ECHO Diabetes Learning Group 4/4/18 High Sugar / Hyperglycemia: Causes, Complications and Management Case Presentation A 45 year old obese man comes to your clinic with a

More information

Hanyang University Guri Hospital Chang Beom Lee

Hanyang University Guri Hospital Chang Beom Lee Hanyang University Guri Hospital Chang Beom Lee Meal prayer, Van Brekelenkam 17 th C Introduction 2012 ADA/EASD Position Statement Proper Patients for Pioglitazone β-cell Preservation by Pioglitazone Benefit

More information

Hypoglycemia in congenital hyperinsulinism

Hypoglycemia in congenital hyperinsulinism How a normal body works: Our body is constantly at work. Our cells need a source of energy, and this source of energy is called glucose. The process is quite simple; think of it like an assembly line.

More information

Cellular Respiration. May 2017

Cellular Respiration. May 2017 Cellular Respiration May 2017 What is cellular respiration Is the gradual release of energy by the stepwise breakdown of energy-rich fuel molecules, example glucose within a plant or animal cell to keep

More information

Gene therapy: State of the art. Ramon Gomis MD, PhD, MAE. Hospital Clínic. IDIBAPS. University of Barcelona.

Gene therapy: State of the art. Ramon Gomis MD, PhD, MAE. Hospital Clínic. IDIBAPS. University of Barcelona. Gene therapy: State of the art Ramon Gomis MD, PhD, MAE. Hospital Clínic. IDIBAPS. University of Barcelona. Gene Therapy: First Steps Type 1 diabetes: An islet disease Alpha cell Beta cell Pancreatic

More information

Metabolic engineering some basic considerations. Lecture 9

Metabolic engineering some basic considerations. Lecture 9 Metabolic engineering some basic considerations Lecture 9 The 90ties: From fermentation to metabolic engineering Recruiting heterologous activities to perform directed genetic modifications of cell factories

More information

SIOFOR mg film-coated tablets

SIOFOR mg film-coated tablets PACKAGE LEAFLET: INFORMATION FOR THE USER SIOFOR 850 850mg film-coated tablets METFORMIN HYDROCHLORIDE This leaflet is a copy of the Summary of Product Characteristics and Patient Information Leaflet for

More information

T2DM is a global epidemic with

T2DM is a global epidemic with : a new option for the management of type 2 diabetes Marc Evans MRCP, MD, Consultant Diabetologist, Llandough Hospital, Cardiff Incretin-based therapies for the treatment of diabetes mellitus (T2DM) present

More information

Modulating the Incretin System: A New Therapeutic Strategy for Type 2 Diabetes

Modulating the Incretin System: A New Therapeutic Strategy for Type 2 Diabetes Modulating the Incretin System: A New Therapeutic Strategy for Type 2 Diabetes Geneva Clark Briggs, PharmD, BCPS Adjunct Professor at University of Appalachia College of Pharmacy Clinical Associate, Medical

More information

Drug Class Review Newer Diabetes Medications and Combinations

Drug Class Review Newer Diabetes Medications and Combinations Drug Class Review Newer Diabetes Medications and Combinations Final Update 2 Report July 2016 The purpose reports is to make available information regarding the comparative clinical effectiveness and harms

More information

Commonwealth Nurses Federation. Preventing NCDs: A primary health care response Risk factor No 1: Diabetes

Commonwealth Nurses Federation. Preventing NCDs: A primary health care response Risk factor No 1: Diabetes Preventing NCDs: A primary health care response Risk factor No 1: Diabetes DIABETES: Definition Diabetes is a group of heterogeneous disorders with the common elements of hyperglycaemia and glucose intolerance

More information

International Journal of Medicine and Pharmaceutical Research. International Journal of Medicine and Pharmaceutical Research

International Journal of Medicine and Pharmaceutical Research. International Journal of Medicine and Pharmaceutical Research U. Venkatesh et al, IJMPR, 2017, 5(2): 38-42 CODEN (USA): IJMPMW ISSN: 2321-2624 International Journal of Medicine and Pharmaceutical Research Journal Home Page: www.pharmaresearchlibrary.com/ijmpr Research

More information

Finding the sweet spot: Individualized targets for older adults with Type 2 DM

Finding the sweet spot: Individualized targets for older adults with Type 2 DM Finding the sweet spot: Individualized targets for older adults with Type 2 DM Samuel C. Durso, M.D., M.B.A. Mason F. Lord Professor of Medicine Director, Division of Geriatric Medicine and Gerontology

More information

5/21/2013. Welcome. Today. Facts about Diabetes. Living Well with Diabetes Including: Physical Activity. Learn about diabetes and how to manage it

5/21/2013. Welcome. Today. Facts about Diabetes. Living Well with Diabetes Including: Physical Activity. Learn about diabetes and how to manage it Welcome Living Well with Diabetes Including: Physical Activity Today. Learn about diabetes and how to manage it If you or your client have medical questions about diabetes, talk with their doctor, healthcare

More information

Age-adjusted Percentage of U.S. Adults Who Were Obese or Who Had Diagnosed Diabetes

Age-adjusted Percentage of U.S. Adults Who Were Obese or Who Had Diagnosed Diabetes Age-adjusted Percentage of U.S. Adults Who Were Obese or Who Had Diagnosed Diabetes Obesity (BMI 30 kg/m 2 ) 1994 2000 2009 No Data 26.0% Diabetes 1994 2000 2009

More information

Diabetes: Just the Basics

Diabetes: Just the Basics Diabetes: Just the Basics Newly Diagnosed Type 2 Diabetes If you have recently been diagnosed with diabetes, you may be experiencing a range of emotions. You should know that you are not alone. Your healthcare

More information

2017, Pharmapex USA, A Member of Apex Group of Companies

2017, Pharmapex USA, A Member of Apex Group of Companies 2017, Pharmapex USA, A Member of Apex Group of Companies Natural Blood Health Aid uses a proprietary and licensed Virgin Isolate Technology, invented which recreates the Ayurvedic method used in ancient

More information

A Clinical Context Report

A Clinical Context Report Type 2 Diabetes in Practice An Expert Commentary with Silvio E. Inzucchi, MD A Clinical Context Report Clinical Context: Type 2 Diabetes in Practice Expert Commentary Jointly Sponsored by: and Clinical

More information