scholarly journals The association of antidiabetic medications and Mini-Mental State Examination scores in patients with diabetes and dementia

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Juraj Secnik ◽  
Hong Xu ◽  
Emilia Schwertner ◽  
Niklas Hammar ◽  
Michael Alvarsson ◽  
...  
Keyword(s):  
Mental State ◽  
Mini Mental State Examination ◽  
Dipeptidyl Peptidase 4 ◽  
Patient Dropout ◽  
Random Intercept ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
Dementia Registry ◽  
Patients With Diabetes ◽  
State Examination

Abstract Background The effect of antidiabetic medication on cognitive function is unclear. We analyzed the association between five antidiabetic drugs and change in Mini-Mental State Examination (MMSE) scores in patients with diabetes and dementia. Methods Using the Swedish Dementia Registry and four supplementary Swedish registers/databases, we identified 1873 patients (4732 observations) with diagnosis of type 2 diabetes (diabetes) and Alzheimer’s disease or mixed-pathology dementia who were followed up at least once after dementia diagnosis. Use of metformin, insulin, sulfonylurea, thiazolidinediones (TZD), and dipeptidyl-peptidase-4 inhibitors (DPP-4i) was identified at baseline. Prevalent-user, incident-user, and drug-drug cohorts were sampled, and propensity-score matching was used to analyze comparable subjects. Beta coefficients with 95% confidence intervals (CI) from the random intercept and slope linear mixed-effects models determined the association between the use of antidiabetic medications and decline in MMSE score points between the follow-ups. Inverse-probability weighting was used to account for patient dropout. Results Compared to non-users, prevalent users of metformin (beta 0.89, 95% CI 0.44; 1.33) and DPP-4i (0.72, 0.06; 1.37) experienced a slower cognitive decline with time. Secondly, compared to DPP-4i, the use of insulin (−1.00, −1.95; −0.04) and sulfonylureas (−1.19; −2.33; −0.04) was associated with larger point-wise decrements in MMSE with annual intervals. Conclusions In this large cohort of patients with diabetes and dementia, the use of metformin and DPP-4i was associated with a slower decline in MMSE scores. Further examination of the cognitive effects of metformin and incretin-based medications is warranted.

scholarly journals Effect of Astaxanthin supplementation on cognitive function and depression in Patients with Type 2 Diabetes Mellitus

2020 ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cognitive Function ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Mmse Score ◽  
Beneficial Effects ◽  
State Examination

Background: The oral administration of Astaxanthin may decrease depression symptoms and improved cognitive function through its beneficial effects on inflammation, and oxidative stress. Objective: This study was designed to assess whether Astaxanthin supplementation can reduce symptoms of depression and increase MMSE score in patients with Type 2 Diabetes Mellitus. Methods: This randomized, double-blind, placebo-controlled clinical trial was performed in 44 patients between 30 and 60 y of age with a diagnosis of type 2 diabetes. Patients were randomly assigned to receive either a single capsule of 8 mg of Astaxanthin /day (n = 22) or placebo (n = 22) for 8 wk. The primary [Beck Depression Inventory (BDI), which examines depressive symptoms] and secondary (Mini-Mental State Examination (MSSE) score, which evaluates cognitive function) outcomes were assessed. Results: After 8 week of intervention, Mini-Mental State Examination baseline score was significantly improved only in the group treated with Astaxanthin, during study (p < 0.01). But no significant reduction in the Beck Depression Inventory (BDI) was observed in both group. Conclusion: Overall, Astaxanthin supplementation of patients with diabetes for 8 weeks had beneficial effects on the MMSE score. Key words: Astaxanthin, Cognitive function Depression

Cardivascular Risk Profile in Patients with Diabetes and Acromegaly or Cushing’s Disease – Analysis from the DPV Database

2018 ◽  
Vol 128 (02) ◽  
pp. 104-110 ◽  
Author(s):  
Katharina Warncke ◽  
Sebastian Kummer ◽  
Peter Herbert Kann ◽  
Dominik Bergis ◽  
Esther Bollow ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Cushing’S Disease ◽  
Cushing's Disease ◽  
Dipeptidyl Peptidase 4 ◽  
Number Of Patients ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
Patients With Diabetes

Abstract Background Although diabetes is a common complication of acromegaly or Cushing´s disease, there are only few detailed studies with a focus on cardiovascular risk, metabolic control or diabetes therapy. Here, we provide a comprehensive characterization from the longitudinal DPV (Diabetes Patienten Verlaufsdokumentation) registry. Methods Patients from the registry≥18 years of age with diabetes and acromegaly or Cushing´s disease were compared to patients with type 1 diabetes or type 2 diabetes using the statistical software SAS 9.4. Results Patients with diabetes and acromegaly (n=52) or Cushing’s disease (n=15) were significantly younger at diabetes onset (median age 50.1 and 45.0 vs. 59.0 years in type 2 diabetes; both p<0.05). Dyslipidemia was common in both diseases (71.0% and 88.9% vs. 71.8% in type 2 diabetes; n.s.), while hypertension was most frequent in acromegaly (56.8% vs. 20.9% in type 1 diabetes, p<0.00001). 36.5% of patients with acromegaly and 46.7% with Cushing´s disease receive insulin, compared to 50.4% with type 2 diabetes. Oral antidiabetic drugs were used in 36.5% of patients with acromegaly and 40% with Cushing´s disease, with a predominance of biguanides and dipeptidyl peptidase-4 inhibitors. HbA1c was well controlled in both groups (median 7.0% and 6.5%; vs. 7.2% in type 2 diabetes). Conclusion Patients with acromegaly are at a high risk for cardiovascular disease, reflected by dyslipidemia and hypertension. A high proportion of patients with diabetes in acromegaly or Cushing´s disease receives insulin. Based on a multicenter register, a sufficient number of patients with rare forms of diabetes can be analyzed.

scholarly journals Diabetes prescription patterns in Costa Rica and Panama among patients switching to a second-line medication. Evidence from the DISCOVER real-world diabetes registry.

2020 ◽  
Author(s):  
Chih Hao Chen-Ku ◽  
Pilar Grimaldo de Sucre ◽  
Mary Vinocour-Fournieri ◽  
Luis Ramírez-Zamora ◽  
Fernando Andrés-Jiménez ◽  
...  
Keyword(s):  
Costa Rica ◽  
Latin American ◽  
Second Line ◽  
Dipeptidyl Peptidase 4 ◽  
Diabetes Registry ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
Patients With Diabetes ◽  
Latin American Countries ◽  
Medication Choice

Abstract Aims: to describe the prescriptions patters of second line medications in patients with diabetes in Costa Rica and Panama.Methods: DISCOVER is a registry of patients with type 2 diabetes that are switching from first- to second-line medications. We analyzed medication choice and reasons to switch by country. Results: 219 patients were included, 127 in Costa Rica and 92 in Panama. The most frequently prescribed first-line medication was metformin, followed by sulphonylureas in Panama and a combination of metformin and dipeptidyl peptidase-4 inhibitors (iDPP4) in Costa Rica. DPP4 inhibitors plus metformin was the most commonly prescribed second line medication in both countries, followed by metformin combined with SGLT2 inhibitors in Costa Rica and iDPP4 in monotherapy in Panama. The main reason to switch was efficacy. When choosing the second-line medication, the main reasons were efficacy, weight loss, and hypoglycemia risk in both countries (tolerability was also common in Panama). Conclusions: In these two Latin American countries the main reason to switch to second line medication was efficacy and the most prescribed agent was metformin plus iDPP4.

Association between SGLT2 Inhibitors vs DPP-4 Inhibitors and Risk of Pneumonia Among Patients with Type 2 Diabetes

2021 ◽  
Author(s):  
Philip C M Au ◽  
Kathryn C B Tan ◽  
Bernard M Y Cheung ◽  
Ian C K Wong ◽  
Ying Wong ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Real World ◽  
Medical Database ◽  
Similar Reduction ◽  
Dipeptidyl Peptidase 4 ◽  
Incidence And Mortality ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
User Design ◽  
Patients With Diabetes

Abstract Context Patients with diabetes are at a higher risk of pneumonia and pneumonia mortality. Sodium-glucose co-transporter 2 inhibitors (SGLT2is), the latest class of glucose-lowering agents, were shown to reduce the risk of pneumonia in clinical trials. However, the real-world effectiveness of SGLT2is on the risk of pneumonia is largely unknown. Objective To investigate the associations between SGLT2is use and the risk of pneumonia and pneumonia mortality compared to dipeptidyl peptidase-4 inhibitors (DPP4is) using an electronic medical database in Hong Kong. Design A retrospective cohort study. The “prevalent new-user” design was adopted to account for the previous exposure to the study drugs being compared. Propensity score (PS) matching (1:4) was used to balance the baseline characteristics of the two groups. Setting and participants Electronic health data of type 2 diabetes patients using SGLT2is and DPP4is between 2015 and 2018 was collected from the Clinical Data Analysis and Reporting System (CDARS). Main Outcome Measures Pneumonia incidence and mortality. Results The PS-matched cohort consisted of 6,664 users of SGLT2is and 26,656 users of DPP4is, with a mean follow-up of 3.8 years. Poisson regression showed that SGLT2is use was associated with lower risk of pneumonia compared to DPP4is with an absolute rate difference of 4.05 per 1000 person-years (95% CI: 2.61-5.51). The corresponding IRR was 0.71 (95% CI: 0.62-0.81). Similar reduction in risk of pneumonia death was observed (HR: 0.57; 95% CI: 0.42-0.77). Conclusion Compared to DPP4is, SGLT2is use was associated with a reduced risk of pneumonia and pneumonia mortality in a real-world setting.

Adverse Effects Associated With Newer Diabetes Therapies

2016 ◽  
Vol 30 (2) ◽  
pp. 238-244 ◽  
Author(s):  
Oluwaranti F. Akiyode ◽  
Adebola A. Adesoye
Keyword(s):  
Type 2 Diabetes ◽  
Adverse Effects ◽  
Dipeptidyl Peptidase 4 ◽  
Health Care Practitioners ◽  
Sodium Glucose Cotransporter ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
Patients With Diabetes ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

The increasing number of newer type 2 diabetes therapies has allowed providers an increased armamentarium for the optimal management of patients with diabetes. In fact, these newer agents have unique benefits in the management of type 2 diabetes. However, they are also associated with certain adverse effects. This review article aims to describe the notable adverse effects of these newer antidiabetic therapies including the glucagon-like peptide 1 receptor agonists, dipeptidyl peptidase-4 inhibitors, and the sodium-glucose cotransporter 2 inhibitors. The adverse effects reviewed herein include pancreatitis, medullary thyroid carcinoma, heart failure, gastrointestinal disturbances, renal impairment, and genitourinary infections. More clinical data are necessary to solidify the association of some of these adverse effects with the newer diabetes agents. However, it is important for health care practitioners to be well informed and prepared to properly monitor patients for these adverse effects.

Mini-Mental-State

2009 ◽  
Vol 22 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Andreas Kaiser ◽  
Renate Gusner-Pfeiffer ◽  
Hermann Griessenberger ◽  
Bernhard Iglseder
Keyword(s):  
Mental State ◽  
Mini Mental State Examination ◽  
Oder Nicht ◽  
State Examination

Im folgenden Artikel werden fünf verschiedene Versionen der Mini-Mental-State-Examination dargestellt, die alle auf der Grundlage des Originals von Folstein erstellt wurden, sich jedoch deutlich voneinander unterscheiden und zu unterschiedlichen Ergebnissen kommen, unabhängig davon, ob das Screening von erfahrenen Untersuchern durchgeführt wird oder nicht. Besonders auffällig ist, dass Frauen die Aufgaben «Wort rückwärts» hoch signifikant besser lösten als das «Reihenrechnen». An Hand von Beispielen werden Punkteunterschiede aufgezeigt.

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