scholarly journals NEW ASPECTS OF ERADICATIVE ANTI-HELICOBACTER PYLORI IN TYPE 2 DIABETIC PATIENTS WITH CHRONIC GASTRODUODENAL DISORDERS

2018 ◽  
Vol 1 (67) ◽  
pp. 70-76
Author(s):  
Марина Мартынюк ◽  
Marina Martynuk ◽  
Юрий Федорченко ◽  
Yuri Fedorchenko
Keyword(s):  
Helicobacter Pylori ◽  
Combined Therapy ◽  
Randomized Study ◽  
Positive Influence ◽  
Diabetic Patients ◽  
Bacterial Antigen ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic ◽  
Gastroduodenal Disorders

The aim of the study was to analyze the effectiveness of different regimens of anti-Helicobacter pylori therapy and their influence on the small intestinal overgrowth syndrome (SIBOS) in type 2 diabetic patients with chronic gastroduodenal disorders. For this purpose an open comparative randomized study was performed in 138 type 2 diabetic patients with chronic gastroduodenal disorders, aged 54.4±5.2 on average. Gastroduodenal pathology was confirmed by gastroduodenoscopy, the H.pylori contamination by use of the unease method or finding bacterial antigen in excrements. The SIBOS was recognized by a respiratory hydrogen method with lactulose. Depending on the type of anti-H.pylori regimen all the patients were divided into 3 groups. Optimization 14-days triple therapy by use of Rabeprazol instead of Omeprazol was found to be effective with 80.6% of H.pylori eradication. Addition of both vismuth and probiotic resulted in increased eradication up to 94.1%, while the optimized triple regimen with Metronidazol and probiotic (intensified combined therapy) proved to be the most effective (97.2%) in H.pylori eradication. All 3 regimens of anti-H.pylori therapy resulted in the decreased number of SIBOS cases, but the best results in comparison with the initial data were obtained in the groups on the triple optimized and intensive combined therapy – up to 60 and 78.3%, respectively. The positive influence of anti-H.pylori therapy on SIBOS seen in the study allows the authors to propose one more indication for anti-H.pylori therapy.

scholarly journals Prospective randomized study for optimal insulin therapy in type 2 diabetic patients with secondary failure

2008 ◽  
Vol 7 (1) ◽  
pp. 16 ◽  
Author(s):  
Yumi Miyashita ◽  
Rimei Nishimura ◽  
Masami Nemoto ◽  
Toru Matsudaira ◽  
Hideaki Kurata ◽  
...  
Keyword(s):  
Insulin Therapy ◽  
Randomized Study ◽  
Prospective Randomized Study ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Secondary Failure ◽  
Type 2 Diabetic

scholarly journals Preventing microalbuminuria with benazepril, valsartan, and benazepril–valsartan combination therapy in diabetic patients with high-normal albuminuria: A prospective, randomized, open-label, blinded endpoint (PROBE) study

PLoS Medicine ◽  
2021 ◽  
Vol 18 (7) ◽  
pp. e1003691
Author(s):  
Piero Ruggenenti ◽  
Monica Cortinovis ◽  
Aneliya Parvanova ◽  
Matias Trillini ◽  
Ilian P. Iliev ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Angiotensin Receptor Blockers ◽  
Combined Therapy ◽  
Accelerated Failure Time Model ◽  
Diabetic Patients ◽  
Open Label ◽  
Type 2 Diabetic Patients ◽  
Link Type ◽  
Type 2 Diabetic

Background Angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) prevent microalbuminuria in normoalbuminuric type 2 diabetic patients. We assessed whether combined therapy with the 2 medications may prevent microalbuminuria better than ACE inhibitor or ARB monotherapy. Methods and findings VARIETY was a prospective, randomized, open-label, blinded endpoint (PROBE) trial evaluating whether, at similar blood pressure (BP) control, combined therapy with benazepril (10 mg/day) and valsartan (160 mg/day) would prevent microalbuminuria more effectively than benazepril (20 mg/day) or valsartan (320 mg/day) monotherapy in 612 type 2 diabetic patients with high-normal albuminuria included between July 2007 and April 2013 by the Istituto di Ricerche Farmacologiche Mario Negri IRCCS and 8 diabetology or nephrology units in Italy. Time to progression to microalbuminuria was the primary outcome. Analyses were intention to treat. Baseline characteristics were similar among groups. During a median [interquartile range, IQR] follow-up of 66 [42 to 83] months, 53 patients (27.0%) on combination therapy, 57 (28.1%) on benazepril, and 64 (31.8%) on valsartan reached microalbuminuria. Using an accelerated failure time model, the estimated acceleration factors were 1.410 (95% CI: 0.806 to 2.467, P = 0.229) for benazepril compared to combination therapy, 0.799 (95% CI: 0.422 to 1.514, P = 0.492) for benazepril compared to valsartan, and 1.665 (95% CI: 1.007 to 2.746, P = 0.047) for valsartan compared to combination therapy. Between-group differences in estimated acceleration factors were nonsignificant after adjustment for predefined confounders. BP control was similar across groups. All treatments were safe and tolerated well, with a slight excess of hyperkalemia and hypotension in the combination therapy group. The main study limitation was the lower than expected albuminuria at inclusion. Conclusions Risk/benefit profile of study treatments was similar. Dual renin–angiotensin system (RAS) blockade is not recommended as compared to benazepril or valsartan monotherapy for prevention of microalbuminuria in normoalbuminuric type 2 diabetic patients. Trial registration EudraCT 2006-005954-62; ClinicalTrials.gov NCT00503152.

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