Initiating oral glucose-lowering therapy with metformin in tyape 2 diabetic patients: an evidence-based strategy to reduce the burden of late-developing diabetes complications

2004 ◽  
Vol 30 (6) ◽  
pp. 509-516 ◽  
Author(s):  
A Consoli ◽  
R Gomis ◽  
S Halimi ◽  
PD Home ◽  
H Mehnert ◽  
...  
Keyword(s):  
Diabetes Complications ◽  
Oral Glucose ◽  
Diabetic Patients ◽  
Evidence Based ◽  
Glucose Lowering ◽  
Lowering Therapy ◽  
Glucose Lowering Therapy

scholarly journals MON-668 The Content of Serum Clusterin in Patients with Diabetic Macular Edema Depending on the Kind of Glucose Lowering Therapy

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Mykhailo L Kyryliuk ◽  
Sviatoslav A Suk
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Therapy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Neurovascular Unit ◽  
Oral Glucose ◽  
Glucose Lowering ◽  
Lowering Therapy ◽  
Glucose Lowering Therapy

Abstract Relevance. Insight into the pathophysiology of diabetic macular edema (DME) has led to novel treatments, including anti-VEGF, corticosteroid-based treatment strategies and novel therapies, such as a clusterin blood retina barrier (BRB) cytoprotection. It has been shown the protective effect of clusterin on oxidative stress-induced cell death and its emerging roles in reduction of both BRB breakdown and neural retina damage. Goal. To assess the content of serum clusterin in patients with type 2 diabetes (T2D) and diabetic macular edema depending on the type of glucose lowering therapy. Material and methods. This study was conducted in 82 patients with T2D and DME. The average age of patients was 65.25 ± 10.85 years (±SD) [25; 84], the average duration of diabetes was 14.0 ± 7.05 years (±SD) [1; 35], the average level of HbA1c was 8.40 ± 1.58% (±SD). The criteria for inclusion in the open study was voluntary informed consent, age 18 years and more, the presence of T2DM. Non-inclusion criteria were the presence of endocrine diseases, which can lead to type 2 diabetes, T1D, acute infectious diseases, cancer, decompensation of comorbid pathology, mental disorders, antipsychotics, antidepressants, neurodegenerative diseases of the central nervous system, proteinuria, damage to the optic nerve, glaucoma and mature cataracts. 43 patients received oral glucose lowering drugs (OGLD: sulfonylureas, biguanides), 39 patients received insulin therapy. All patients had instrumental ophthalmological examinations. The concentration of serum clusterin was measured by «Human Clusterin ELISA» kits. Statistical analysis was performed by one-way ANOVA analysis. Results. A study of level variability of blood clusterin in patients with DME showed its dependence from the type of glucose lowering therapy. Comparison of mean values of strum clusterin in patients with DME and T2DM revealed the following statistically significant differences: OGLD 87,08 ± 3,15 mcg/ml [95% CI 82,63 - 91,54 mcg/ml]; insulin therapy 74,79±2,98 mcg/ml [95% CІ 70,58 - 78,99 mcg/ml] (р=0,006). Apparently, clusterin is involved in the pathogenesis of DME and may have a potential in reducing of the pathogenic effect of diabetes on the neurovascular unit. The data obtained make it possible to discuss the neuroprotective role of clusterin in DME with the use of voiced oral hypoglycemic drugs, which usually prescribe for patients with mild form of T2D or for the patients with moderate severity T2D (i. e. at the initial stages of development of diabetes). Conclusion. Against the background of glucose lowering drugs in patients with type 2 diabetes and diabetic macular edema statistically significant (р=0,006) increases the content of serum clusterin compared to insulin therapy.

Combined use of polypill components in patients with type 2 diabetes mellitus

2018 ◽  
Vol 25 (14) ◽  
pp. 1523-1531 ◽  
Author(s):  
Vivi E Janssen ◽  
Frank L Visseren ◽  
Anthonius de Boer ◽  
Diederick E Grobbee ◽  
Jan Westerink ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Vascular Disease ◽  
Antiplatelet Agent ◽  
Patient Characteristics ◽  
Oral Glucose ◽  
Glucose Lowering ◽  
Lowering Therapy ◽  
Combined Use ◽  
Glucose Lowering Therapy

Objectives A polypill containing aspirin, a statin and blood pressure (BP)-lowering agents has been proposed for the prevention of cardiovascular disease. To increase adherence and reduce the gaps between indicated and used therapy, a polypill might be of interest for patients with type 2 diabetes (T2DM). Our aim was to assess the prevalence of the combined use of polypill components in patients with T2DM over time. Methods The combined use of polypill components was assessed between 1996 and 2015 in patients with T2DM in the prospective SMART cohort ( n = 1828). The results were dichotomized into patients without ( n = 568) and with ( n = 1260) vascular disease. The patient characteristics associated with the use of polypill components were evaluated. Results In total, 19% of patients with T2DM without vascular disease received a statin and ≥2 BP-lowering agents (‘cardiovascular polypill’) and 13% received additional oral glucose-lowering therapy (‘diabetic polypill’). Of the patients with T2DM with vascular disease, 42% received the combination of an antiplatelet agent, a statin and ≥2 BP-lowering agents (‘cardiovascular polypill’) and 30% received additional glucose-lowering therapy (‘diabetic polypill’). The prevalence of the use of the cardiovascular and diabetic polypill combination has substantially increased between 1996 and 2015 to 36 and 32% in patients without vascular disease and to 67 and 57% in patients with vascular disease. Conclusions Patients with T2DM frequently use polypill components, often together with oral glucose-lowering agents, and this rate of use has increased steadily between 1996 and 2015. Introducing a cardiovascular or diabetic polypill for patients with T2DM seems to be highly relevant.

scholarly journals Priorities of self-monitoring of blood glucose in a treatment of diabetes mellitus

2019 ◽  
Vol 10 (1) ◽  
pp. 36-41
Author(s):  
Elena V. Biryukova ◽  
Mikhail V. Shinkin ◽  
Catherine S. Ganekova
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Glycated Hemoglobin ◽  
Point Of View ◽  
Diabetic Patients ◽  
Self Monitoring ◽  
Glucose Lowering ◽  
Lowering Therapy ◽  
Treatment Of Diabetes ◽  
Glucose Lowering Therapy

Aim. To describe a role of self-monitoring of glycemia in a treatment of diabetes mellitus (DM) and in a prevention of vascular complications of DM. Materials and methods. Data of 57 scientific sources from Russian and foreign literature published within 2005-2017 are considered. Results and conclusions. DM is a chronic disease associated with a development of micro- and macrovascular complications and to prevent them is an important task of modern medicine. In patients with DM an incidence of cardiovascular diseases is 2-3 times higher compared with the general population. Hyperglycemia is among the major damaging factors for the cardiovascular system. Clinical studies have clearly demonstrated that programs of therapeutic management of diabetic patients which include regular self-monitoring of glycemia lead to a better reduction of glycated hemoglobin levels compared to programs without self-monitoring as well as they help many patients to avoid late complications. СКГ rate is correlated with glycated hemoglobin levels. Regular self-monitoring allows you to avoid sudden and dangerous fluctuations in glycemia, including hypoglycemia, which contribute to high cardiovascular risk. The use of self-monitoring of glycemia in combination with structured patient education is associated with improving the quality of life of patients with DM. Current view on self-monitoring implies a certain frequency of blood glucose systematic measurement (varies depending on the type of glucose-lowering therapy and the degree of diabetes compensation) and is an important reference point used by both the doctor and the patient to assess a treatment outcome and to correct it if necessary. An availability of modern glucometers and skills of their correct and regular use turn a patient into an active and valuable participant in a management of DM. Achieving and maintaining the target glycemia levels depends largely on an accuracy of the glucometer since measurement results provide the basis for changing a glucose-lowering therapy if necessary. From the physician's point of view, the most important criterion for selecting a glucometer is compliance with the accuracy standards, and from the patient’s point of view this is convenience and ease of use. Thanks to improving technologies that increases an accuracy of blood glucose measurements, the procedure for self-monitoring of glycemia is simplified, which contributes to glucose-lowering therapy effectiveness and treatment compliance.

scholarly journals Emergence of SGLT2 Inhibitors as Powerful Antioxidants in Human Diseases

Antioxidants ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 1166
Author(s):  
Kai-Fan Tsai ◽  
Yung-Lung Chen ◽  
Terry Ting-Yu Chiou ◽  
Tian-Huei Chu ◽  
Lung-Chih Li ◽  
...  
Keyword(s):  
Liver Diseases ◽  
Redox Homeostasis ◽  
Sglt2 Inhibitors ◽  
Human Diseases ◽  
Oral Glucose ◽  
Diabetic Patients ◽  
Protective Effects ◽  
Glucose Lowering ◽  
Therapeutic Benefits ◽  
Neural Disorders

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a new class of oral glucose-lowering agents. Apart from their glucose-lowering effects, large clinical trials assessing certain SGLT2 inhibitors have revealed cardiac and renal protective effects in non-diabetic patients. These excellent outcomes motivated scientists and clinical professionals to revisit their underlying mechanisms. In addition to the heart and kidney, redox homeostasis is crucial in several human diseases, including liver diseases, neural disorders, and cancers, with accumulating preclinical studies demonstrating the therapeutic benefits of SGLT2 inhibitors. In the present review, we aimed to update recent advances in the antioxidant roles of SGLT2 inhibitors in common but debilitating human diseases. We anticipate that this review will guide new research directions and novel therapeutic strategies for diabetes, cardiovascular diseases, nephropathies, liver diseases, neural disorders, and cancers in the era of SGLT2 inhibitors.

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