scholarly journals Successful Use of a GLP-1 Receptor Agonist as Add-on Therapy to Sulfonylurea in the Treatment of KCNJ11 Neonatal Diabetes

2021 ◽  
Author(s):  
Morten Hindsø ◽  
Christoffer Martinussen ◽  
Maria Saur Svane ◽  
Simon Veedfald ◽  
Birthe Gade-Rasmussen ◽  
...  
Keyword(s):  
Glycaemic Control ◽  
Hba1c Level ◽  
Receptor Agonist ◽  
Standard Treatment ◽  
Neonatal Diabetes ◽  
Permanent Neonatal Diabetes ◽  
Good Glycaemic Control ◽  
First Time

Sulfonylurea monotherapy is the standard treatment for patients with the most common form of permanent neonatal diabetes, KCNJ11 neonatal diabetes, but it is not always sufficient. For the first time, we present a case of successful use of a GLP-1 receptor agonist as add-on therapy in the treatment of a patient with KCNJ11 neonatal diabetes and insufficient effect of sulfonylurea monotherapy. Good glycaemic control was maintained with a HbA1c level of 48 mmol/mol (6.5%) at the end of 26 months’ follow-up.

scholarly journals Glycated Hemoglobin and short-term Prognosis in Patients with Acute Coronary Syndrome with Diabetes Mellitus: A Prospective Cohort Study

2021 ◽  
Vol 17 (2) ◽  
pp. 108-113
Author(s):  
Fysal Faruq ◽  
Syed Ali Ahsan ◽  
Manzoor Mahmood ◽  
MRM Mandal ◽  
Kamruzzaman Siddiki ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cohort Study ◽  
Glycaemic Control ◽  
Clinical Outcomes ◽  
Prospective Cohort ◽  
Diabetic Patients ◽  
Poor Glycaemic Control ◽  
Coronary Syndrome ◽  
Good Glycaemic Control

Background: Data on the association between glycemic control after percutaneous coronary intervention (PCI) and clinical outcomes are limited and controversial in diabetic patients. Objective:The aim of the study was to assess the impact of good glycaemic control on three months clinical outcomes in diabetic acute coronary syndrome (ACS) patients undergoing PCI, from a Bangladesh health service perspective. Materials and methods:This prospective cohort study which was conducted in UCC, BSMMU included 346 consecutive diabetic ACS patients who underwent PCI at department of cardiology, BSMMU. Diabetic patients were categorized into two groups based on their 3 months HbA1c levels: 169 (48.84%) diabetics with good glycaemic control (HbA1c < 7%) and 177 (51.16%) diabetics with poor glycaemic control (HbA1c ≥7%).The outcome was major adverse cardiovascular events (MACEs), defined as cardiac death, myocardial infarction (MI), definite stent thrombosis, target vessel revascularization and stroke. Results: At 3 months follow up, patients with poor glycaemic control had a significantly higher incidence of MI (6.2% vs 1.2%; p=0.021). No other adverse events were found significantly different between the groups at 3 months of PCI. Conclusion:Good glycaemic control to obtain HbA1c level <7% in diabetic ACS patients undergoing coronary artery stenting may be beneficial in reducing the risk of MACEs and improvement of clinical outcome after PCI during 3 months follow up. University Heart Journal Vol. 17, No. 2, Jul 2021; 108-113

scholarly journals Long-term Follow-up of Glycemic and Neurological Outcomes in an International Series of Patients With Sulfonylurea-Treated ABCC8 Permanent Neonatal Diabetes

Diabetes Care ◽  
2020 ◽  
Vol 44 (1) ◽  
pp. 35-42
Author(s):  
Pamela Bowman ◽  
Frances Mathews ◽  
Fabrizio Barbetti ◽  
Maggie H. Shepherd ◽  
Janine Sanchez ◽  
...  
Keyword(s):  
Neonatal Diabetes ◽  
Permanent Neonatal Diabetes ◽  
Neurological Outcomes ◽  
Long Term Follow Up

scholarly journals Long-Acting Glucagon-Like Peptide-1 Receptor Agonist-Induced Rheumatoid Arthritis in a Patient with Type 2 Diabetes Mellitus

2021 ◽  
pp. 1-4
Author(s):  
Koji Kikkawa ◽  
Hiroto Hoshi ◽  
Atsushi Isoda ◽  
Kazuya Okada ◽  
Junichi Okada ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Shoulder Pain ◽  
Hba1c Level ◽  
Receptor Agonist ◽  
Normal Range ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1 ◽  
Long Acting

<b><i>Case Presentation:</i></b> We report a case of a male patient with rheumatoid arthritis (RA) diagnosed during treatment with a long-acting glucagon-like peptide-1 (GLP-1) receptor agonist (once-weekly dulaglutide injection). At 3 months after dulaglutide initiation, he began experiencing left shoulder pain that continued despite treatment by an acupuncturist, indicating that the pain was not due to periarthritis scapulohumeralis. His HbA1c level was 7.3% at the 3-month follow-up. At the 6-month follow-up visit, the HbA1c level was 8.2%, the low-density lipoprotein cholesterol level was 132 mg/dL, and he expressed right shoulder pain. After 3 months, the HbA1c level was 9.0%, and his bilateral shoulder pain worsened, due to which he could not use his arms well. Routine laboratory testing revealed no other abnormalities at that time. However, several inflammatory and serological RA markers were detected, including an erythrocyte sedimentation rate of 73 (normal range, &#x3c;10) mm/h, a C-reactive protein level of 1.89 (normal range, 0.0–0.14) mg/dL, a rheumatoid factor level of 26 (normal range, 0–15) IU/mL, and an anti-cyclic citrullinated protein antibody level of 195 (normal range, &#x3c;4.5) U/mL. However, tests for antinuclear antibodies, anti-SS-A/Ro antibodies, and anti-RNP antibodies showed negative results. He was diagnosed with RA, and salazosulfapyridine (500 mg/day) was started. At 1 month after RA treatment initiation, his shoulder pain began showing improvement and improved HbA1c levels from 9.0% to 8.0%. <b><i>Discussion:</i></b> Thus, this case report suggests an association between RA and GLP-1. Based on a literature search in PubMed, we believe that this case report is the first to demonstrate that a patient with type 2 diabetes mellitus treated with a long-acting GLP-1 receptor agonist had RA. However, further research is needed to determine whether RA is one of the adverse effects of long-acting GLP-1 receptor agonists. <b><i>Conclusion:</i></b> During treatment with long-acting GLP-1 receptor agonists, it is necessary to consider the possibility of RA as a differential diagnosis when patients complain of persistent joint pain.

scholarly journals Changes in Carotid Intimal Medial Thickness (CIMT) With Glycaemic Control in Patients of T2DM

2019 ◽  
Vol 4 (06) ◽  
Author(s):  
Dr. Sanjay Sud
Keyword(s):  
Risk Factors ◽  
Glycaemic Control ◽  
First Year ◽  
Cvd Risk ◽  
Good Glycaemic Control ◽  
Number Of Patients ◽  
Linear Probe ◽  
Group A ◽  
Group B

A real world long term (10 years) prospective randomized observational study to monitor changes in CIMT of T2DM patients who achieved the target glycaemic goal of HbA1c ≤ 7%, with those who did not achieve it. CIMT is a marker of subclinical atherosclerosis associated with CVD risk factors. Hence any progression or regression of CIMT could be considered as increased or decreased risk of CVD as the case might be. This study was to ascertain if (keeping all other risk factors under control and at par in each group) a good glycaemic control could lead to a lower CIMT – leading to a lowering of CVD risk The inclusion criteria was Non – pregnant Adults (Age >18 years) T2DM with HbA1c ≥ 8% at recruitment Those who remained normotensive (B.P. ≤130/80 mm of Hg) Those who maintained a normal Lipid profile Those who had eGFR ≥ 60mL /min/1.73m2(CKD-EPI) CIMT measurements done at recruitment and then once every year Exclusions Any requirement for hospitalization throughout the entire 10 year duration The total number of patients who completed the follow up for the full ten years was 62. CIMT of the CCAs were scanned with 7-10 MHz linear probe transducer under real time B mode imaging. The patients included in the study were divided into (Group A n = 32 and Group B n = 30) Group A were those who could achieve the glycaemic target of HbA1c ≤ 7% by the end of the first year and were able to maintain the target for the major duration of the study. Group B were those who did not achieve the glycaemic target of HbA1c ≤ 7% by the end of the first year of the study and had an average HbA1c of ≥ 7.5% for the major duration of the study Results: The data at the end of ten year follow up showed that patients from Group A had a mean CIMT of 0.79 mm at baseline and at the end of the study it was 0.75 mm Group B had a mean CIMT of 0.81 mm at baseline at baseline and at the end of study period was 1.17 mm. (p<0.05) A good glycaemic control can reduce the burden of CVD as an independent entity.

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