scholarly journals Incretin-Based Therapies in Type 2 Diabetes Mellitus

2008 ◽  
Vol 93 (10) ◽  
pp. 3703-3716 ◽  
Author(s):  
Chee W. Chia ◽  
Josephine M. Egan
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Weight Loss ◽  
Type 2 Diabetes Mellitus ◽  
Evidence Synthesis ◽  
Glycosylated Hemoglobin ◽  
Cell Mass ◽  
New Drugs ◽  
Medline Search

Context: Glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide are incretins secreted from enteroendocrine cells postprandially in part to regulate glucose homeostasis. Dysregulation of these hormones is evident in type 2 diabetes mellitus (T2DM). Two new drugs, exenatide (GLP-1 mimetic) and sitagliptin [dipeptidyl peptidase (DPP) 4 inhibitor], have been approved by regulatory agencies for treating T2DM. Liraglutide (GLP-1 mimetic) and vildagliptin (DPP 4 inhibitor) are expected to arrive on the market soon. Evidence Acquisition: The background of incretin-based therapy and selected clinical trials of these four drugs are reviewed. A MEDLINE search was conducted for published articles using the key words incretin, glucose-dependent insulinotropic polypeptide, GLP-1, exendin-4, exenatide, DPP 4, liraglutide, sitagliptin, and vildagliptin. Evidence Synthesis: Exenatide and liraglutide are injection based. Three-year follow-up data on exenatide showed a sustained weight loss and glycosylated hemoglobin (HbA1c) reduction of 1%. Nausea and vomiting are common. Results from phase 3 studies are pending on liraglutide. Sitagliptin and vildagliptin are orally active. In 24-wk studies, sitagliptin reduces HbA1c by 0.6–0.8% as monotherapy, 1.8% as initial combination therapy with metformin, and 0.7% as add-on therapy to metformin. Vildagliptin monotherapy lowered HbA1c by 1.0–1.4% after 24 wk. Their major side effects are urinary tract and nasopharyngeal infections and headaches. Exenatide and liraglutide cause weight loss, whereas sitagliptin and vildagliptin do not. Conclusions: The availability of GLP-1 mimetics and DPP 4 inhibitors has increased our armamentarium for treating T2DM. Unresolved issues such as the effects of GLP-1 mimetics and DPP 4 inhibitors on β-cell mass, the mechanism by which GLP-1 mimetics lowers glucagon levels, and exactly how DPP 4 inhibitors lead to a decline in plasma glucose levels without an increase in insulin secretion, need further research.

Association Between Glycosylated Hemoglobin and Intentional Weight Loss in Overweight and Obese Patients With Type 2 Diabetes Mellitus

2012 ◽  
Vol 38 (3) ◽  
pp. 417-426 ◽  
Author(s):  
Ghanshyam Palamaner Subash Shantha ◽  
Anita Ashok Kumar ◽  
Scott Kahan ◽  
Lawrence J. Cheskin
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Weight Loss ◽  
Type 2 Diabetes Mellitus ◽  
Glycosylated Hemoglobin ◽  
Baseline Body Mass Index ◽  
Study Cohort ◽  
Obese Patients ◽  
Intentional Weight Loss

Purpose The purpose of this study is to assess the relationship between magnitude of weight loss and improvement in percentage A1C (A1C%) among overweight and obese patients with type 2 diabetes mellitus (DM) undergoing weight reduction. Methods Case records of patients enrolled in 2 university-based weight management programs were reviewed. Patients were sampled if they had a diagnosis of DM and had at least 1 documented A1C% reduction from their baseline value. Weight loss treatment was individualized and consisted of a calorie-restricted diet, a behavior modification plan, and a plan for increasing physical activity. Patient weights were measured at bimonthly visits. A1C% was measured every 3 months. Results Seventy-two patients formed the study cohort. Mean baseline body mass index was 35.1 kg/m2, mean age was 52.6 years, and 59% were males. Mean starting A1C% was 8.6. Patients achieved significant mean weight loss (10.7 kg) at study exit. Weight loss of 6.5 kg (4.5% of baseline body weight), 12.2 kg (8.7%), and 15.9 kg (10.3%) was required to reduce A1C% by 0.5, 1, and 1.5, respectively, and it took a mean of 5.6, 8.7, and 10.1 months, respectively, to achieve this. After adjustment for antidiabetic medication intake, for every 10% weight loss, the predicted reduction in A1C% was 0.81. Conclusions Intentional weight loss of 10% can potentially decrease A1C% by 0.81 among patients with type 2 DM. This finding may be clinically useful in encouraging and counseling a patient attempting weight loss.

High HBA1C Level Is Associated With Low Heamoglobin Level

2018 ◽  
Vol 3 (02) ◽  
Author(s):  
Mafooza Rashid ◽  
B. K. Gupta, Vinay Bharat ◽  
Abhishek Gupta ◽  
Zubair Rashid
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycosylated Hemoglobin ◽  
Good Control ◽  
Diabetic Control ◽  
Medical College ◽  
High Hba1c ◽  
Normal Controls

Background: The aim of the study was to compare the hemoglobin levels among normal controls (patients) and patients of TypeII diabetes with HbA1c levels below 7 % & above 7 %.and secondly to identify the undetected cases of anemia in TypeII diabetes. Materials & Methods - 50 patients of type 2 diabetes mellitus with their glycosylated hemoglobin levels less than 7 %, 50 patients of type 2 diabetes mellitus with their glycosylated hemoglobin levels more than 7 % attending the Medicine outpatient department of Subharti Medical College and Hospital will be the subjects for the study.50 age and sex matched controls will be selected randomly from Subharti Medical College and Hospital. Informed written consent will be taken from all the subjects. The study will be conducted from January 2016 to January. Result - We studied 50 cases with HbA1C>7(poor control),50 cases with HbA1C 5.6 to7 (good control) and 50 controls with HbA1C ≤5.6, we observed in cases with HbA1C>7 (poorly control) ,the mean HbA1C is 9.9±2 and mean Hb is 9.8±1.3 as compared to cases with HbA1C 5.6 to 7(good control) where mean HbA1C is 6±0.4 and Hb is 13±0.5,this clearly indicates that in cases HbA1C is more Hb levels are low and when HbA1C is less Hb levels are higher. Conclusion - In the present study we found negative correlation between HbA1c & Hb levels. As the value of HbA1c increases, as in cases of HbA1c >7(poor diabetic control), we found low Hb levels as compared to the cases with HbA1c <7(5.6-7) (good control).

TYPE 2 DIABETES MELLITUS REMISSION AND ITS PREDICTION AFTER TWO-STAGE SURGICAL TREATMENT OF PATIENTS WITH MORBID OBESITY

2019 ◽  
Vol 72 (5) ◽  
pp. 739-743
Author(s):  
Oleksandr Yu. Ioffe ◽  
Mykola S. Kryvopustov ◽  
Yuri A. Dibrova ◽  
Yuri P. Tsiura
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Morbid Obesity ◽  
Weight Loss ◽  
Type 2 Diabetes Mellitus ◽  
Surgical Treatment ◽  
Two Stage ◽  
C Peptide ◽  
Peptide Level

Introduction: Morbid obesity (MO) has a significant impact on mortality, health and quality of life of patients. Type 2 diabetes mellitus (T2DM) is a common comorbidity in patients with MO. The aim is to study T2DM remission and to develop a prediction model for T2DM remission after two-stage surgical treatment of patients with MO. Materials and methods: The study included 97 patients with MO. The mean BMI was 68.08 (95% CI: 66.45 - 69.71) kg/m2. 70 (72,2%) patients with MO were diagnosed with T2DM. The first stage of treatment for the main group (n=60) included the IGB placement, for the control group (n=37) - conservative therapy. In the second stage of treatment the patients underwent bariatric surgery. The study addresses such indicators as BMI, percentage of weight loss, percentage of excess weight loss, ASA physical status class, fasting glucose level, HbA1c, C-peptide. Results: Two-stage treatment of morbidly obese patients with T2DM promotes complete T2DM remission in 68.1% of patients. The risk prediction model for failure to achieve complete T2DM remission 12 months after LRYGB based on a baseline C-peptide level has a high predictive value, AUC = 0.84 (95% CI: 0.69-0.93), OR = 0.23 ( 95% CI: 0.08-0.67). Conclusions: Two-stage treatment of patients with MO promotes improvement of carbohydrate metabolism indicators. With a C-peptide level > 3.7 ng/ml, prediction of complete T2DM remission 12 months after Laparoscopic Roux-en-Y Gastric Bypass is favorable.

scholarly journals In Patients with Type 2 Diabetes Mellitus, Are Glycosylated Hemoglobin Levels Higher for Those withHelicobacter pyloriInfection Than Those without Infection?

2008 ◽  
Vol 47 (1) ◽  
pp. 144-146 ◽  
Author(s):  
Gino G. Fernandini‐Paredes ◽  
Edward Mezones‐Holguin ◽  
Rolando Vargas‐Gonzales ◽  
Eugenio Pozo‐Briceño ◽  
Alfonso J. Rodriguez‐Morales
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycosylated Hemoglobin

scholarly journals Fenofibrate decreased microalbuminuria in the type 2 diabetes patients with hypertriglyceridemia

2020 ◽  
Author(s):  
Xiaomeng Sun ◽  
Jia Liu ◽  
Guang Wang
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Treatment Group ◽  
Glycosylated Hemoglobin ◽  
Fasting Blood Glucose ◽  
Control Group ◽  
Diabetic Patients ◽  
Fenofibrate Treatment

Abstract Background: This study was to research the efficacy of fenofibrate in the treatment of microalbuminuria in the patients with type 2 diabetes mellitus (T2DM) and hypertriglyceridemia. Methods: Type 2 diabetic patients (56) with microalbuminuria and hypertriglyceridemia aged 30 to 75 were randomly divided into the fenofibrate treatment group(n=28) and the control group (n=28) for 180 days. Urinary microalbumin /creatinine ratio (UACR) and other metabolic parameters were compared at baseline, during treatment and after treatment. Results: After 180 days, the reduction of levels of fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1c) in two groups were no differences. In treatment group, uric acid (UA) (296.42 ± 56.41 vs 372.46 ± 72.78), triglyceride (TG) [1.51(1.17, 2.06) vs 3.04(2.21, 3.29)], and UACR [36.45 (15.78,102.41) vs 129.00 (53.00, 226.25)] were significantly decreased compared with the baseline. The high-density lipoprotein cholesterol (HDL-C) levels were significantly increased (1.22 ± 0.26 vs 1.09 ± 0.24) compared with the baseline. The decrease in UACR [-44.05(-179.47, -12.16) vs -8.15(-59.69, 41.94)]in treatment group was significantly higher compared with the control group. The decrease in UACR was positively associated with the decreases in TG ( r = 0.447, P = 0.042) and UA ( r = 0.478, P = 0.024) after fenofibrate treatment. Conclusion: In the patients with hypertriglyceridemia and type 2 diabetes mellitus, fenofibrate can improve microalbuminuria and do not increase the deterioration of glomerular filtration rate

scholarly journals Advantages of therapy with sodium glucose cotransporter type 2 inhibitors in patients with type 2 diabetes mellitus in combination with hyperuricemia and gout

2020 ◽  
Vol 92 (5) ◽  
pp. 110-118 ◽  
Author(s):  
T. S. Panevin ◽  
M. S. Eliseev ◽  
M. V. Shestakova ◽  
E. L. Nasonov
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Type 2 Diabetes Mellitus ◽  
New Drugs ◽  
Positive Effects ◽  
The Metabolic Syndrome ◽  
Sodium Glucose Cotransporter ◽  
The Russian Federation

Currently, only two drugs for reducing uric acid (UA), allopurinol and febuxostat, are registered in the Russian Federation, but their use does not allow to achieve the target level of UA in all cases. According to the results of numerous randomized trials, hyperuricemia and gout are associated with the corresponding components of the metabolic syndrome, including diabetes mellitus. The influence of factors is due to the need to search for new drugs that have a complex effect on several components of metabolic syndrome at once. Potentially attractive in this regard is a new group of drugs for the treatment of type 2 diabetes mellitus inhibitors of the sodium-glucose cotransporter of type 2, which, in addition to the main hypoglycemic actions, showed positive effects on the cardiovascular system, kidneys, as well as lowering UA.

scholarly journals COMPARISON OF THE EFFECT OF DAPAGLIFLOZIN ON CONTRAST TO STANDARD THERAPY OF THE PATIENTS WITH TYPE 2 DIABETES MELLITUS AND CONCOMITANT OBESITY, THEIR EFFECT ON LABORATORY AND ANTHROPOMETRIC PARAMETERS

2020 ◽  
Vol 73 (3) ◽  
pp. 457-461
Author(s):  
Taras I. Griadil ◽  
Ivan V. Chopey ◽  
Kristian O. Debreceni ◽  
Mykhaylo M. Hechko ◽  
Yaroslav O. Mykhalko ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Clinical Laboratory ◽  
Glycosylated Hemoglobin ◽  
Anthropometric Parameters ◽  
Metformin Monotherapy ◽  
Effect Of Glucose ◽  
Standard Treatment Regimen

The aim: Evaluate clinical and laboratory parameters of the patients with type 2 diabetes mellitus and concomitant obesity after a course of dapagliflozin treatment and compare with a standard treatment regimen. Materials and methods: Conducted a comprehensive clinical laboratory examination and measurement of the anthropometric parameters of the patients with type 2 diabetes mellitus and concomitant obesity, with subsequent statistical calculations. Results: The data obtained at different stages of the study revealed a statistically significant effect of glucose treatment and glycosylated hemoglobin (HbA1c). Since the 6th month of dapagliflozin treatment, we have shown a tendency to lose weight compared to baseline in this group of patients and controls. Conclusions: Type 2 diabetes mellitus and obesity significantly increase the risk of developing a number of complications. Complex control and effects on clinical laboratory and anthropometric parameters can statistically significantly influence the development of the complications, and in this context, dapaglifloflozin showed statistically better results than standard metformin monotherapy.

scholarly journals STUDY OF HBA1C, LIPID PROFILE AND CYCLOPHILIN-A IN DIABETES MELLITUS

2019 ◽  
Vol 3 (12) ◽  
Author(s):  
Rakesh Kumar Jha ◽  
Badade ZG ◽  
Sandeep Rai ◽  
Badade VZ
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Lipid Profile ◽  
Glycosylated Hemoglobin ◽  
General Medicine ◽  
Cyclophilin A ◽  
The Body ◽  
Glucose Levels

Introduction: Diabetes is a chronic disease that occurs when not enough insulin is produced by the pancreas or the body does not use the insulin produced. Because of increased blood glucose levels in the body, serious heart, kidneys, blood vessels, nerves and eyes damage are caused. Report says about 400 million people suffer from diabetes. Therefore present study is aimed to assess levels of HbA1c, Lipid profile and Cyclophilin A in diabetic patient. Material and Methods: The present study includes total 126 subjects comprising of 66 type 2 Diabetes Mellitus patients and 60 healthy individual. Blood samples are collected from the all subjects were processed for HbA1c, Lipid Profile and Cyclophilin A estimation, from OPD and General Medicine Wards. HbA1c is estimated by HPLC, lipid Profile by AU480 and the Cyclophilin A by ELISA method using commercially available Qayee-bio ELISA kit. Conclusion: Present study showed significantly increased levels of HbA1c, Lipid Profile and Cyclophilin A in T2DM patients. The elevated lipid profile may be due to the complication of Diabetic mellitus. CyA is increased as an inflammation marker. Keywords: T2DM: Type 2 diabetes mellitus, HbA1c: Glycosylated Hemoglobin, CyA: Cyclophilin-A

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