Comparative Impact of Hypoglycemic Agents on Severity and Extent of Myocardial Ischemia in Patients With Type 2 Diabetes Mellitus Undergoing Myocardial Perfusion Scintigraphy

: Meglitinides are a group of oral hypoglycemic medications currently approved for the treatment of type 2 diabetes mellitus (T2DM). Two meglitinide molecules, Repaglinide and Nateglinide,are presently in use. Repaglinide is preferred because of its superior glycemic efficacy.They have modest efficacy with a mean decrement of glycosylated haemoglobin (HbA1c) ranging between -0.2 to -1.50% with individual therapy. Additional HbA1c reduction can occur with combination therapy with other oral hypoglycemics. This class of drugs is effective in controlling postprandial hyperglycemia with minimal risk of hypoglycemia.It is also useful in patients in with variable meal timings, especially in the elderly, and in patients with renal failure. There are is a dearth of long-term studies on meglitinides to assess cardiovascular outcomes or mortality in T2DM,although the Nateglinide and Valsartan in Impaired Glucose ToleranceOutcomes Research (NAVIGATOR) study showed no difference between Nateglinide and placebo with regard to the core composite cardiovascular outcomes. Based on a PubMed literature search using key words: ‘meglitinides’, ‘repaglinide’, ‘nateglinide’, ‘HbA1c’, ‘glycated haemoglobin’, ‘cardiovascular safety’, ‘cardiovascular events’, ‘cardiovascular outcome trials’, ‘type 2 diabetes mellitus’ and heart failure, and combining the search terms using Boolean operators ‘AND’, ‘OR’ and ‘NOT’ as needed we compiled current evidence for use of these oral hypoglycemic agents in clinical use. This article is an attempt to review the efficacy and cardiovascular (CV) safety of Meglitinides to help clinicians to use this class of oral hypoglycaemic agents prudently.

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Insertion/insertion genotype of α2B-adrenergic receptor gene polymorphism is associated with silent myocardial ischemia in patients with type 2 diabetes mellitus

Clinical Biochemistry ◽

10.1016/j.clinbiochem.2010.07.023 ◽

2010 ◽

Vol 43 (15) ◽

pp. 1201-1204 ◽

Cited By ~ 2

Author(s):

Qiu Jing Chen ◽

Lin Lu ◽

Cao Jin ◽

Ling Jie Wang ◽

Rui Yan Zhang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Myocardial Ischemia ◽

Adrenergic Receptor ◽

Receptor Gene ◽

Silent Myocardial Ischemia ◽

Receptor Gene Polymorphism ◽

Adrenergic Receptor Gene

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Characteristics of patients with type 2 diabetes mellitus grouped by 5 classes of oral hypoglycemic agents based on assessment of treatment satisfaction

Diabetology International ◽

10.1007/s13340-013-0149-4 ◽

2013 ◽

Vol 5 (2) ◽

pp. 134-143 ◽

Cited By ~ 1

Author(s):

Hitoshi Ishii ◽

Eisei Oda

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Treatment Satisfaction ◽

Hypoglycemic Agents ◽

Oral Hypoglycemic Agents

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Nephrolithiasis against type 2 diabetes mellitus: on the effect of hypoglycemic therapy on lithogenesis

Terapevticheskii arkhiv ◽

10.26442/terarkh201890104-64 ◽

2018 ◽

Vol 90 (10) ◽

pp. 60-64

Author(s):

S K Yarovoy ◽

E N Kareva ◽

O V Djalilov

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Negative Impact ◽

Stone Formation ◽

Hypoglycemic Agents ◽

Control Group ◽

City Hospital ◽

Increased Risk

Aim. To study the effects of oral hypoglycemic agents that can affect the probability of recurrence of nephrolithiasis. Materials and methods. The article is based on the results of examination and treatment of 315 patients suffering from recurrent nephrolithiasis and medically compensated type 2 diabetes mellitus treated at the N.A. Lopatkin Institute of Urology and Interventional Radiology - the branch of the SMRC of Radiology, Ministry of Health of Russia and D.D. Pletnev City Hospital Moscow Healthcare Department in 2012-2017. The patients were divided into three groups according to the applied tool antidiabetic: metformin, glibenclamide, canagliflozin. The control group consisted of patients receiving insulin therapy. Results and discussion. The propensity of Metformin to reduce the pH of urine, which has a negative impact in the conditions of urate nephrolithiasis, which is most common in the population of patients with type 2 diabetes mellitus. Glibenclamide, on the contrary, somewhat latches urine. But changes in the reaction of urine under the influence of the drug do not go beyond normal values and are not clinically significant. Canagliflozin increases diuresis due to medication induced glycosuria and stimulates renal excretion of uric acid and its salts. However canagliflozin does not cause significant shifts in the pH of urine that may somewhat negates the increased risk of recurrence of urate stone formation in the background of the uricosuric effect of the drug. Conclusion. Drug therapy of type 2 diabetes mellitus significantly affects the properties of urine from patients with nephrolithiasis.

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The importance and advantages of the timely prescription of insulin to the patients with type 2 diabetes mellitus

Problems of Endocrinology ◽

10.14341/probl201258356-60 ◽

2012 ◽

Vol 58 (3) ◽

pp. 56-60

Author(s):

I R Iarek-Martynova

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Insulin Therapy ◽

Clinical Situation ◽

Hypoglycemic Agents ◽

Negative Consequences ◽

Oral Hypoglycemic Agents ◽

Adequate Treatment

The onset of insulin therapy is an important stage in the treatment of type 2 diabetes mellitus. Its timely beginning ensures better control of glycemia and reduces the negative consequences of chronic glucose cytotoxicity and lipotoxicity. The achievement and maintenance of the stable compensation of the disease are the indispensable conditions for successful prophylaxis and adequate treatment of chronic complications of diabetes mellitus. The ADA guidelines recommend to initiate insulin therapy at the early stages of the disease provided it is dictated by the clinical situation or combine it with the use of oral hypoglycemic agents if the targeted HbA1c levels fail to be reached despite the intake of one or more tableted preparations.

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