scholarly journals The Effects of Exenatide Once Weekly (EXQW) and Exenatide Twice a Day (EXBID) on Beta-Cell Function in Type 2 Diabetes: A Systematic Review and Network Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Jie Wang ◽  
Xinye Jin ◽  
Ping An ◽  
Songyan Yu ◽  
Yiming Mu
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Cell Function ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Diabetic Patients ◽  
Antidiabetic Agents ◽  
Significant Difference ◽  
Glucagon Like Peptide 1

Background. In patients with type 2 diabetes mellitus (T2DM) and poor glycemic control receiving metformin (MET), glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are recommended as the adjunctive therapy. However, there are only a few studies involving the comparative effects of exenatide twice a day (EXBID) and exenatide once weekly (EXQW) on HOMA-β. This meta assessed the comparative effects of EXQW and EXBID on HOMA-β among T2DM patients. Materials and Methods. PubMed, Cochrane Library, and Embase databases were searched to collect randomized controlled trials (RCTs). Network meta-analysis was performed, and network diagrams were constructed to evaluate the effects. The primary outcome is HOMA-β, and the secondary outcomes are fasting blood glycose (FBG), glycated hemoglobin (HbA1c), and weight loss. Results. A total of 8 studies with 3506 subjects were included. Compared with other antidiabetic agents, EXQW has a greater improvement in HOMA-β than EXBID (weight mean difference WMD=‐0.46, 95% confidence interval (CI) [-0.64, -0.28], P=0.001). The effect of EXQW on HbA1c is superior to that of sitagliptin (SITA) (WMD=0.51, 95% CI [0.03, 0.99], P=0.037). The significant reduction of weight was detected for EXBID in comparison with EXQW (WMD=‐0.73, 95% CI [-1.13, -0.33], P=0.001), and no significant difference was found between EXQW and MET. Conclusions. EXQW shows a greater improvement in HOMA-β than EXBID. Moreover, the efficacy of EXQW on glycemic control is similar to other antidiabetic agents including EXBID. It is an advisable treatment for diabetic patients to improve HOMA-β and has an advantage of fewer number of injections compared with EXBID, to increase patients’ adherence and quality of life.

scholarly journals Glucagon-like peptide-1 receptor agonists in type 2 diabetes: a meta-analysis of randomized clinical trials

2009 ◽  
Vol 160 (6) ◽  
pp. 909-917 ◽  
Author(s):  
Matteo Monami ◽  
Niccolò Marchionni ◽  
Edoardo Mannucci
Keyword(s):  
Type 2 Diabetes ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Relevant Information ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Receptor Agonists ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

ObjectiveThe role of glucagon-like peptide-1 (GLP-1) receptor agonists in the treatment of type 2 diabetes is debated; many recent trials, which were not included in previous meta-analyses, could add relevant information.Design and methodsAll available randomized controlled trials (RCTs), either published or unpublished, performed in type 2 diabetic patients with GLP-1 receptor agonists (exenatide and liraglutide), with a duration>12 weeks were meta-analysed for HbA1c, body mass index, hypoglycaemia and other adverse events.Results and conclusionsA total of 21 RCTs (six of which unpublished), enrolling 5429 and 3053 patients (with GLP-1 receptor agonists and active comparator or placebo respectively), was retrieved and included in the analysis. GLP-1 receptor agonists determine a significant improvement of HbA1c in comparison with placebo (−1.0 (−1.1, −0.8),P<0.001), with a low risk of hypoglycaemia. There is no evidence of increased cardiovascular risk with the use of GLP-1 receptor agonists. GLP-1 receptor agonists, which induce weight loss, are associated with gastrointestinal side effects. GLP-1 receptor agonists are effective in reducing HbA1c and postprandial glucose. In patients failing to sulphonylureas and/or metformin, GLP-1 receptor agonists are similarly effective as insulin. Available data suggest that the efficacy and tolerability of the novel agent, liraglutide, which is adequate for once-a-day administration, are comparable with those of exenatide bis in die.

scholarly journals Glycemic Control in Diabetes Type 2 Patients in Foster Families of Brod-Posavina County During the COVID-19 Pandemic

2021 ◽  
Vol 45 (2) ◽  
pp. 95-102
Author(s):  
Blaženka Miškić ◽  
Vesna Čosić ◽  
Marijana Knezević Praveček ◽  
Daniel Rahelić ◽  
Blaženka Kljaić Bukvić ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Medical Care ◽  
Chronically Ill ◽  
Medical Documentation ◽  
Diabetic Patients ◽  
Adequate Treatment ◽  
Foster Families ◽  
Significant Difference

COVID-19 pandemic has changed everyday life and medical supervision of chronically ill patients. Epidemiological measures, social distancing, and limited access to medical care impair glycemic control in patients with diabetes. Also, type 2 diabetes is a risk factor for more severe form of coronavirus disease. A large proportion of diabetic patients are placed in foster families who also adapt to the new situation. The purpose of this study was to examine the manner and frequency of glycemic control in patients with type 2 diabetes who are placed in foster families in the region of Brod- Posavina County. We established contact with patients suffering from type 2 diabetes situated in foster families and their caregivers. Measurement of glycemia was performed several times a day with regular notes and the data were supplemented by an insight into the medical documentation of patients in the hospital information system. The study included 33 patients with type 2 diabetes. The relationship between HbA1C with fasting and postprandial glycemia was linear. There were no statistically significant differences in HbA1C regulation by type of therapy. There was a significant difference in the number of complications according to the level of HbA1C (Hi square test = 25.982, p &lt;.001). The number of complications generally increased as HbA1C regulation was poorer. During current COVID-19 pandemic, care for patients with type 2 diabetes is significantly limited. Improved medical care for patients can be achieved by establishing cooperation and daily communication between caregivers, family physicians and, if necessary, diabetologists, especially through the use of online platforms and telephone communication, all with the aim of early detection of diabetes complications and adequate treatment of patients in current conditions.

Circulating Meteorin-like Levels in Patients with Type 2 Diabetes Mellitus: A Meta-Analysis

2020 ◽  
Vol 26 (44) ◽  
pp. 5732-5738
Author(s):  
Qian Wu ◽  
Yi-Lin Dan ◽  
Yi-Sheng He ◽  
Kun Xiang ◽  
Yu-Qian Hu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Sample Size ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Sample Type ◽  
Significant Difference ◽  
Circulating Levels

Background: Meteorin-like (Metrnl) is a newly identified adipokine implicated in the pathogenesis of type 2 diabetes mellitus (T2DM), yet data on the circulating levels of Metrnl in patients with T2DM are controversial. To derive a more precise estimation on circulating Metrnl levels in T2DM patients, we conducted this meta-analysis. Methods: The existing studies on the circulating levels of Metrnl in patients with T2DM published up to 16 January 2020 were comprehensively retrieved from PubMed, Web of Science, EMBASE, and The Cochrane library database. Pooled standard mean difference (SMD) with 95% confidence interval (CI) was calculated using random-effects model. Heterogeneity was assessed and quantified by Cochrane’s Q and I2 statistic. All statistical analyses were performed using Stata 12.0 software. Results: Nine studies with 867 T2DM patients and 831 normal glucose tolerance (NGT) controls were included in the final analysis according to the inclusion criteria. No significant difference in circulating Metrnl levels was found between T2DM patients and NGT individuals (pooled SMD = -0.429, 95% CI = -1.077 to 0.219). Compared to controls, circulating Metrnl levels were significantly higher in the subgroups with BMI <25 kg/m2, using plasma sample and patient sample size ≥100, while circulating Metrnl levels were significantly lower in subgroups with age ≤50 years and homeostatic model assessment for insulin resistance (HOMA-IR) ≥4. Conclusions: This meta-analysis indicates no significant change in circulating Metrnl levels in T2DM patients. However, this result may be influenced by age, BMI, sample type, HOMA-IR and patients sample size. Further longitudinal studies are warranted to offer more insights into the relationship between Metrnl and T2DM.

Fighting Type-2 Diabetes: Present and Future Perspectives

2019 ◽  
Vol 26 (10) ◽  
pp. 1891-1907 ◽  
Author(s):  
Cai-Guo Yu ◽  
Ying Fu ◽  
Yuan Fang ◽  
Ning Zhang ◽  
Rong-Xin Sun ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Secretion ◽  
Glycemic Control ◽  
Clinical Results ◽  
Diabetic Patients ◽  
Β Cells ◽  
Receptor Agonists ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

Background: Type-2 diabetes mellitus accounts for 80-90% of diabetic patients. So far, the treatment of diabetes mainly aims at elevating insulin level and lowering glucose level in the peripheral blood and mitigating insulin resistance. Physiologically, insulin secretion from pancreatic β cells is delicately regulated. Thus, how insulin-related therapies could titrate blood glucose appropriately and avoid the occurrence of hypoglycemia remains an important issue for decades. Similar question is addressed on how to attenuate vascular complication in diabetic subjects. Methods: We overviewed the evolution of each class of anti-diabetic drugs that have been used in clinical practice, focusing on their mechanisms, clinical results and cautions. Results: Glucagon-like peptide-1 receptor agonists stimulate β cells for insulin secretion in response to diet but not in fasting stage, which make them superior than conventional insulinsecretion stimulators. DPP-4 inhibitors suppress glucagon-like peptide-1 degradation. Sodium/ glucose co-transporter 2 inhibitors enhance glucose clearance through urine excretion. The appearance of these new drugs provides new information about glycemic control. We update the clinical findings of Glucagon-like peptide-1 receptor agonists, DPP-4 inhibitors and Sodium/glucose cotransporter 2 inhibitors in glycemic control and the risk or progression of cardiovascular disease in diabetic patients. Stem cell therapy might be an alternative tool for diabetic patients to improve β cell regeneration and peripheral ischemia. We summarize the clinical results of mesenchymal stem cells transplanted into patients with diabetic limb and foot. Conclusion: A stepwise intensification of dual and triple therapy for individual diabetic patient is required to achieve therapeutic target.

scholarly journals The Effects of Exercise Interventions on Balance Capacity in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 58 ◽  
pp. 004695802110182
Author(s):  
Jiawei Qin ◽  
Kaize Zhao ◽  
Yannan Chen ◽  
Shuai Guo ◽  
Yue You ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Exercise Intervention ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Significant Difference

The effect of exercise intervention on balance capacity among type 2 diabetes mellitus (T2DM) patients has not been evaluated. The objective of this systematic review and meta-analysis is to investigate the effect of exercise intervention on balance capacity among T2DM patients compared to the control group (usual care, waitlist, no-treatment, education). We conducted a comprehensive literature search through PubMed, EMBASE, Physiotherapy Evidence Database (PEDro), Cochrane library, Web of Science (WOS) from inception to August 2020. The literature language was limited to English. Randomized controlled trials (RCTs) or quasi-experimental (Q-E) trials that examined the effect of exercise intervention on balance capacity among T2DM patients were included. We used the standard methods of meta-analysis to evaluate the outcomes of exercise intervention for balance capacity of T2DM patients. A total of 14 trials (11 RCTs and 3 Q-E trials) involving 883 participants were eligible. The meta-analysis of some studies demonstrated that exercise intervention could significantly improve Berg Balance Scale (BBS) (MD = 2.56; 95%CI [0.35, 4.77]; P = .02), SLST (Single Leg Stance Test) under the eyes-open (EO) condition (MD = 3.63; 95%CI [1.79, 5.47]; P = .0001) and eyes-close (EC) condition (MD = 0.41; 95%CI [0.10, 0.72]; P = .01) compared to control group. There was no significant difference in Time Up and Go Test (TUGT) (MD = −0.75; 95%CI [−1.69, 0.19]; P = .12) and fall efficacy (SMD = −0.44; 95%CI [−0.86, −0.01]; P = .05). Narrative review of some studies indicated that exercise intervention could improve postural stability measured by Sensory Organization Test (SOT) and Center of Pressure (COP) variables, etc. This systematic review and meta-analysis summarized that exercise intervention could improve balance capacity in T2DM patients. However, further studies with high quality are required to evaluate its effect.

scholarly journals A Meta-Analysis of a Cohort Study on the Association between Sleep Duration and Type 2 Diabetes Mellitus

2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Huapeng Lu ◽  
Qinling Yang ◽  
Fang Tian ◽  
Yi Lyu ◽  
Hairong He ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Publication Bias ◽  
Sleep Duration ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Short Sleep Duration ◽  
Significant Difference

Objective. To study the association between sleep duration and the incidence of type 2 diabetes mellitus (T2DM) and to provide a theoretical basis for the prevention of T2DM through a meta-analysis. Methods. PubMed, Web of Science, Scopus, Embase, Cochrane Library, ProQuest, CNKI, Wanfang, VIP, and SINOMED were searched from their inception until May 2020. All cohort studies on the relationship between sleep duration and T2DM in adults were included. According to the inclusion and exclusion criteria, two authors independently assessed the literature and extracted the data. Metaregression and publication bias were evaluated, and sensitivity and meta-analyses were conducted with RevMan 5.3. Results. A total of 17 studies were collected, involving 737002 adults. The incidence of T2DM was 4.73% in short sleep duration (SSD) ( t ≤ 6   h ), 4.39% in normal sleep duration (NSD) ( 6   h < t < 9   h ), and 4.99% in long sleep duration (LSD) ( t ≥ 9   h ). The meta-analysis demonstrated that SSD increased the risk of T2DM compared with NSD ( RR = 1.22 , 95% CI: 1.15-1.29, P < 0.001 ), LSD increased the risk of T2DM compared with NSD ( RR = 1.26 , 95% CI: 1.15-1.39, P < 0.001 ), and the risk of T2DM has no significant difference between SSD and LSD ( RR = 0.97 , 95% CI: 0.89-1.05, P = 0.41 ). The sensitivity of each study was robust and the publication bias was weak. Conclusion. SSD or LSD can increase the risk of T2DM.

scholarly journals Antidiabetic Agents for Treatment of Parkinson’s Disease: A Meta-Analysis

2020 ◽  
Vol 17 (13) ◽  
pp. 4805
Author(s):  
Shu-Yi Wang ◽  
Shey-Lin Wu ◽  
Ta-Cheng Chen ◽  
Chieh-Sen Chuang
Keyword(s):  
Type 2 Diabetes ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Large Sample Size ◽  
Antidiabetic Agents ◽  
Updrs Part

Background: Clinical and epidemiological studies suggest that two of the most common geriatric diseases, type 2 diabetes and Parkinson’s disease (PD), are linked. These studies notably suggest that treatment of insulin resistance in type 2 diabetes may beneficially modify the pathophysiology of PD and help to maintain motor and nonmotor function. In this meta-analysis, we evaluate the efficacy of new antidiabetic agents in the treatment of PD. Methods: We systematically searched PubMed, Medline, ProQuest, ScienceDirect, ClinicalKey, and Cochrane Library from the date of their inception until 15 March 2020. Multiple efficacy parameters were compared between treatment groups. The results are expressed as mean differences with 95% confidence intervals (CIs) in a random-effects model. Results: A meta-analysis of the data extracted from three randomized control trials revealed that treatment with exenatide yielded significant improvements in scores on the Unified Parkinson’s Disease Rating Scale Part I (UPDRS-I) (−0.438, 95% CI, −0.828 to −0.048, p = 0.028), UPDRS Part IV (UPDRS-IV) (−0.421, 95% CI, −0.811 to −0.032, p = 0.034) and the Mattis Dementia Rating Scale (MDRS) (−0.595, 95% CI, −1.038 to −0.151, p = 0.009). At the 12-month follow-up, the UPDRS Part III (UPDRS-III) scores in the off-medication phase revealed significant improvements in patients using exenatide (−0.729; 95% CI, −1.233 to −0.225, p = 0.005). Treatment with pioglitazone did not yield significant improvements in UPDRS, MDRS, or Parkinson’s Disease Questionnaire scores. Conclusion: This meta-analysis suggests that exenatide use is associated with the alleviation of cognitive, motor and nonmotor symptoms. However, long-term studies with a large sample size of patients with PD of varying severity are required.

scholarly journals Systematic review and meta-analysis for prevention of cardiovascular complications using GLP-1 receptor agonists and SGLT-2 inhibitors in obese diabetic patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kazushi Uneda ◽  
Yuki Kawai ◽  
Takayuki Yamada ◽  
Sho Kinguchi ◽  
Kengo Azushima ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Indirect Comparison ◽  
Cardiovascular Complications ◽  
Cochrane Library ◽  
Major Adverse Cardiovascular Events ◽  
Diabetic Patients ◽  
Receptor Agonists ◽  
Sodium Glucose Cotransporter ◽  
Significant Difference ◽  
Glucagon Like Peptide 1

AbstractPatients with type 2 diabetes mellitus (T2DM) and obesity are at high risk of developing cardiovascular disease (CVD). Both glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter (SGLT-2) inhibitors have been shown to prevent CVD in T2DM patients. Additionally, the two drugs reduce body mass. However, it is unknown which drug is more effective at reducing the risk of CVD in such patients. We searched Medline, EMBASE, and Cochrane Library records to February 20, 2021 and performed a network meta-analysis to compare the efficacy with which the drugs reduced the risk of major adverse cardiovascular events (MACE). We included 102,728 patients in 12 studies containing data of obesity subgroup analyses. In T2DM patients with obesity, GLP-1 RAs significantly reduced the risk of MACE versus placebo (relative risk, RR [95% confidence interval, CI]: 0.88 [0.81–0.96]), whereas SGLT-2 inhibitors showed a tendency (RR [95% CI]: 0.91 [0.83–1.00]). In an indirect comparison, GLP-1 RAs were not associated with a significant difference in MACE compared with SGLT-2 inhibitors (RR [95% CI]: 0.97 [0.85–1.09]). Thus, GLP-1 RAs are effective at preventing MACE than placebo in T2DM patients with obesity, although further studies are warranted to conclude their superiority to SGLT-2 inhibitors.

Sign in / Sign up

Export Citation Format

Share Document