scholarly journals Anti-aging properties of metformin

2021 ◽  
Vol 11 (9) ◽  
pp. 37-42
Author(s):  
Anna Małgorzata Łopuszyńska ◽  
Mateusz Pawlicki ◽  
Magdalena Kozioł ◽  
Aleksandra Krasa ◽  
Ewa Piekarska ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Randomized Trials ◽  
Aging Effect ◽  
Oral Drug ◽  
Aging Effects ◽  
Ampk Signaling ◽  
Anti Cancer ◽  
Aging Properties ◽  
Effects Of Aging

 Introduction: Life expectancy of human population is being constantly prolonged, hence there is a lot of research into drug that will prevent the effects of aging. There are many reports that metformin, which is a drug used in type 2 diabetes, has anti-aging effects. It belongs to the group of biguanides and has been used since the 1950s. It is a relatively safe, cheap and effective drug, which makes it a promising subject for many studies. The purpose of this review is to present the latest developments in this field. Material and methods: PubMed scientific base was searched using following keywords: metformin, aging, anti-aging, in years 2017-2021. Results: Numerous studies show that metformin has an impact on aging through the nutrient pathway, AMPK signaling pathway, and its effects on reactive oxygen species. In addition, it has an anti-cancer effect, inhibiting, among others, rectal cancer cells and p53 mutant colon cancer. Research in rodents has shown that this drug has anti-aging effects on many organs, including the CNS, ovaries, prostate, heart muscle and skin. Conclusions: Metformin, which is the most commonly used oral drug in type 2 diabetes, has many other mechanisms of action. Its anti-aging effect works on many organs in our bodies, which gives hope to find an anti-aging substance. However, multicentre, randomized trials are needed to determine the exact anti-aging dose, its possible side effects, and effects on various organisms. 

An Efficacy and Safety Study of Remogliflozin in Obese Indian Type 2 Diabetes Mellitus Patients Who Were Inadequately Controlled on Insulin glargine plus other oral hypoglycemic agents

2020 ◽  
Vol 17 ◽  
Author(s):  
Anand Shankar
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Glargine ◽  
Therapy Group ◽  
Insulin Dose ◽  
Blood Glucose Control ◽  
Hypoglycemic Agents ◽  
Oral Drug ◽  
Group A ◽  
Group B

Aim & Objective: The objective of this retrospective study was to investigate the efficacy of adding remogliflozin to current insulin glargine plus two oral drug i.e. metformin and teneligliptin therapy in poorly controlled Indian type 2 diabetes. Material and Methods: 173 study participants were initially selected from patient database who continued on their insulin glargine or received an increased dose of insulin glargine along with other OHA based therapy (Group A) and 187 were selected who had received remogliflozin (100 mg BD) (Group B) in addition to insulin glargine along with other OHA based therapy. Glycated haemoglobin (HbA1c), total daily insulin dose, body weight, and the number of hypoglycemic events were recorded at weeks 0, 12 and 24. Result: During the study, mean values of HbA1c, FBG and P2BG were significantly reduced in both groups. Insulin requirements decreased from 45.8 ± 16.7 IU/day to 38.5 ± 13.5 IU/day (P < 0.001) and at week 24 even further decreased to 29.5 ± 14.5 IU/Day . Twenty three patients in group B were able to cease insulin treatment altogether after 24 week treatment. It has been observed to attain tight blood glucose control we need to increase insulin dose in group A from 45.5 ± 16.5 IU/Day to 51.5 ± 14.5 at week 12 (P<0.01) and which further increased to 53.8 ± 12.8 IU/Day at week 24 (P<0.01). Adding remogliflozin showed significant effect on blood pressure (P < 0.001) and weight reduction (P < 0.001). It has been observed that 38% patients has achieves targeted HbA1c (≤7%) in group B where it was 22% in group A. Conclusion: Results demonstrate that in uncontrolled T2DM patients remogliflozin 100 mg BD can successfully lay a foundation for prolonged good glycemic control. Early addition of remogliflozin with insulin glargine plus OHAs may be an alternative compare to intensive up titration of insulin daily dose in people with uncontrolled T2DM. Clinical Trial Registration Number: A 2358

Insulin U-500, the Practical Solution for the treatment of Patients with High Insulin Requirements

2020 ◽  
Vol 17 (1) ◽  
pp. 26-29
Author(s):  
Nasser Mikhail
Keyword(s):  
Type 2 Diabetes ◽  
Randomized Trials ◽  
Regular Insulin ◽  
Injection Pain ◽  
Regular Human Insulin ◽  
Efficacy And Safety ◽  
Insulin Requirements ◽  
High Insulin

Background: Human regular insulin 500 (U-500) is 5 five times more concentrated than the traditional regular human insulin (U-100). Thus, every 1 ml of U-500 contains 500 units of insulin as opposed to 100 units/ml with most types of insulin. Methods: Review of all the relevant clinical studies related to insulin U-500 until February 12, 2020. Results: Insulin U-500 is indicated in patients with type 2 diabetes who require more than 200 units of insulin per day. Insulin U-500 has both prandial and basal actions, and can be injected as monotherapy in a convenient twice-daily regimen. Available data suggest that insulin U-500 is effective, associated with better compliance, and decreased injection pain compared with non-concentrated insulins. Its main limitations are hypoglycemia and weight gain, and the possibility of dosing errors. Conclusions: Overall, insulin U-500 is an effective and safe treatment for patients with type 2 diabetes and insulin resistance. Randomized trials are needed to compare the long-term efficacy and safety of insulin U-500 with other forms of insulin regimens.

Insulin Analogs and Glycosylated Hemoglobin Target of Less Than 7% in Type 2 Diabetes: A Systematic Review of Randomized Trials

2011 ◽  
Vol 9 (3) ◽  
pp. 167-176 ◽  
Author(s):  
Katherine Esposito ◽  
Maria Ida Maiorino ◽  
Giuseppe Bellastella ◽  
Paolo Chiodini ◽  
Dario Giugliano
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Randomized Trials ◽  
Glycosylated Hemoglobin ◽  
Insulin Analogs

scholarly journals Choice across 10 pharmacologic combination strategies for type 2 diabetes: a cost-effectiveness analysis

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Shuyan Gu ◽  
Lizheng Shi ◽  
Hui Shao ◽  
Xiaoyong Wang ◽  
Xiaoqian Hu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cost Effectiveness ◽  
Chinese Patients ◽  
Oral Drug ◽  
System Perspective ◽  
Treatment Comparison ◽  
Combination Strategies ◽  
Life Years ◽  
The Cost

Abstract Background Clinical guidelines recommend a stepped-escalation treatment strategy for type 2 diabetes (T2DM). Across multiple treatment strategies varying in efficacy and costs, no clinical or economic studies directly compared them. This study aims to estimate and compare the cost-effectiveness of 10 commonly used pharmacologic combination strategies for T2DM. Methods Based on Chinese guideline and practice, 10 three-stepwise add-on strategies were identified, which start with metformin, then switch to metformin plus one oral drug (i.e., sulfonylurea, thiazolidinedione, α-glucosidase inhibitor, glinide, or DPP-4 inhibitor) as second line, and finally switch to metformin plus one injection (i.e., insulin or GLP-1 receptor agonist) as third line. A cohort of 10,000 Chinese patients with newly diagnosed T2DM was established. From a healthcare system perspective, the Cardiff model was used to estimate the cost-effectiveness of the strategies, with clinical data sourced from a systematic review and indirect treatment comparison of 324 trials, costs from claims data of 1164 T2DM patients, and utilities from an EQ-5D study. Outcome measures include costs, quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios (ICERs), and net monetary benefits (NMBs). Results Over 40-year simulation, the costs accumulated for a patient ranged from $7661 with strategy 1 to $14,273 with strategy 10, while the QALY gains ranged from 13.965 with strategy 1 to 14.117 with strategy 8. Strategy 7 was dominant over seven strategies (strategies 2~6, 9~10) with higher QALYs but lower costs. Additionally, at a willingness-to-pay threshold of $30,787/QALY (i.e., 3 times GDP/capita for China), strategy 7 was cost-effective compared with strategy 1 (ICER of strategy 7 vs. 1, $3371/QALY) and strategy 8 (ICER of strategy 8 vs. 7, $132,790/QALY). Ranking the strategies by ICERs and NMBs, strategy 7 provided the best value for money when compared to all other strategies, followed by strategies 5, 9, 8, 1, 3, 6, 10, 2, and 4. Scenario analyses showed that patients insist on pharmacologic treatments increased their QALYs (0.456~0.653) at an acceptable range of cost increase (ICERs, $1450/QALY~$12,360/QALY) or even at cost saving compared with those not receive treatments. Conclusions This study provides evidence-based references for diabetes management. Our findings can be used to design the essential drug formulary, infer clinical practice, and help the decision-maker design reimbursement policy.

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