scholarly journals Early insulin therapy Coordination Council

2012 ◽  
Vol 15 (4) ◽  
pp. 128-131
Author(s):  
Marina Vladimirovna Shestakova
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Insulin Secretion ◽  
Insulin Therapy ◽  
Microvascular Complications ◽  
Glucose Lowering ◽  
Endogenous Insulin

Coordination Council has denoted the importance of adherence to Russian and international guidelines and prominent role of insulin therapy in management of type 2 diabetes mellitus (T2DM). Insulin therapy in T2DM preserves endogenous insulin secretion, prevents or decelerates development of microvascular complications and is known to be the most effective glucose-lowering treatment.

scholarly journals Role of insulin in management of type 2 diabetes mellitus

2017 ◽  
Vol 5 (6) ◽  
pp. 2282
Author(s):  
Sujay S. Patil ◽  
Manthan Mehta ◽  
Vaishali Thakare ◽  
Shrikrishna Shende ◽  
Prashant A. Shirure ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Insulin Therapy ◽  
Treatment Guidelines ◽  
Patient Adherence ◽  
Microvascular Complications ◽  
Advantages And Disadvantages

The prevalence of type 2 diabetes mellitus and its resultant morbidity and mortality is rapidly increasing. An important factor in reducing the microvascular complications of diabetes is strict glycemic control. Most patients require additional insulin therapy in spite of regularly taking oral anti-diabetic drugs. Though classically used later in the natural course of the disease, newer treatment guidelines suggest early initiation of insulin analogues. The discovery of insulin has been hailed as one of the most dramatic events in the history of diabetes, improving the life-span of most diabetics. Replacement insulin therapy should mimic physiological insulin release patterns. Modern insulin and its analogues have been developed to serve as an ideal replacement therapy. There are various insulin preparations available in the market and each of them has their own advantages and disadvantages. The modern insulin’s have been developed to overcome certain side effects of the older preparations. A range of insulin products are under development that aim to increase absorption prolong action and provide alternative delivery methods. Greater patient adherence is important since most patients are reticent about insulin therapy.  This review describes the role of insulin in the management of type 2 diabetes mellitus.

scholarly journals The Role of Insulin Therapy in Correcting Hepcidin Levels in Patients with Type 2 Diabetes Mellitus

2017 ◽  
Vol 32 (3) ◽  
pp. 195-200 ◽  
Author(s):  
Driton Vela ◽  
Jovica Leshoski ◽  
Elizabeta S. Gjorgievska ◽  
Nikola Hadzi-Petrushev ◽  
Muharrem Jakupaj ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Insulin Therapy

Influence of insulin therapy for type 2 diabetes mellitus on cancer incidence.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e13036-e13036
Author(s):  
Oyeon Cho ◽  
Young-Taek Oh ◽  
Mison Chun ◽  
O Kyu Noh ◽  
Jaesung Heo
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cancer Risk ◽  
Insulin Therapy ◽  
Microvascular Complications ◽  
Time Interval ◽  
Start Date

e13036 Background: This study aimed to investigate the influence of insulin therapy for type 2 diabetes mellitus (T2D) on cancer development. Methods: We evaluated 4780 patients with T2D, treated at our institution, from 1994-2006, after excluding patients with 1) preexisting cancer or cancer within 1 year after T2D registration, 2) renal transplantation, and 3) follow-up period of < 5 years. The following information was collected from the patients’ electronic medical records: age; sex; registered date of T2D and cancer; last visit; use of metformin, insulin, and medications for microvascular complications; and start date of using insulin in the first year after cohort entrance. Insulin users were stratified according to insulin start date and complication as follows: < 3 months with (462 patients) or without complications (526 patients), ≥3 months with complications (852 patients) or without complications (1249 patients). The standardized incidence ratio (SIR) was calculated using the expected age-standardized incidence rate in Korea. The adjusted hazard ratio (AHR) of insulin was estimated for evaluation of all-year cancer risk and time interval of 3 years from cohort entrance. Results: SIR was > 1 in all cancer types except laryngeal and esophageal cancers. The median follow-up was 12 years (interquartile range: 9–15 years), and 679 events occurred. Insulin users had a significantly higher risk of all-time cancer. The patients with insulin use for ≥3 months without complications had a continuously increasing cancer risk 2–3, 4–6, 7–9, 10–12, and 13–15 years from cohort start (AHR [95% confidence interval {CI}]: 2.2 [0.91–5.3], P= 0.081; 2.39 [1.07–5.32], P= 0.0335; 1.98 [1.35–2.9], P= 0.0005; 2.41 [1.52–3.81], P= 0.0002; and 1.6 [0.6–2.83], P= 0.1077, respectively), while the rest did not. This was significantly associated with stomach, colorectal, lung, liver, pancreatic, and bladder cancers (AHR [95% CI]: 6.09 [2.58–14.4], P= 00001; 2.49 [1.22–5.07], P= 01188; 3.36 [1.18–9.51], P= 0.02265; 14.8 [1.97–110], P= 0.0088; 14.6 [1.88–113], P= 0.0103; and 10.4 [2.38–45.6], P= 0.00186, respectively). Conclusions: Incidences of gastrointestinal, lung, and bladder cancers could be increased in new insulin users without complications.

scholarly journals Intensification of glucose-lowering treatment in patients with diabetes mellitus type 2 on insulin therapy: Perspectives of dapagliflozin

2016 ◽  
Vol 19 (1) ◽  
pp. 72-79
Author(s):  
Olga Yuryevna Sukhareva ◽  
Marina Vladimirovna Shestakova
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Clinical Trials ◽  
Type 2 Diabetes Mellitus ◽  
Insulin Therapy ◽  
Diabetes Mellitus Type 2 ◽  
Glucose Lowering ◽  
Patients With Diabetes ◽  
Difficult Issue

Intensification of antihyperglycaemic treatment in patients with poorly controlled type 2 diabetes mellitus who were on insulin therapy remains a difficult issue. Results from clinical trials with the sodium-glucose linked transporter (SGLT-2) inhibitor dapagliflozin as add-on therapy in patients with type 2 diabetes mellitus using insulin are summarised and discussed in the article.

scholarly journals The glucose-lowering therapy structure in special groups of type 2 diabetes mellitus patients based on data from the Moscow region register

2019 ◽  
Vol 22 (3) ◽  
pp. 206-216
Author(s):  
Inna V. Misnikova ◽  
Yulia A. Kovaleva ◽  
Mikhail А. Isakov ◽  
Alexander V. Dreval
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Insulin Therapy ◽  
Sglt2 Inhibitors ◽  
Moscow Region ◽  
Glucose Lowering ◽  
Lowering Therapy ◽  
Glucose Lowering Therapy

BACKGROUND: Data of real clinical practice in diabetes mellitus (DM) register allow to evaluate features and trends in structure of glucose-lowering therapy (GLT). AIM: Тo analyze of structure of GLT received by patients with type 2 diabetes mellitus (T2DM) in Moscow region for 2018 and to evaluate its dynamics over 15 years. METHODS: Analysis of GLT structure was carried out on basis of data from register of patients with DM in Moscow region, which is part of National register of diabetes mellitus in Russian Federation. In March 2018 it contained data on 211,792 T2DM patients of Moscow region. Structure of GLT administration was evaluated according T2DM duration, patients age and presence of cardiovascular diseases (CVD). Dynamics of GLT is analyzed from 2004 to 2018 yrs. RESULTS: In 2018 non-insulin glucose-lowering drugs (NIGD) prescription prevailed (78.3%), insulin therapy was prescribed in 18.5% of patients, 3.2% of patients did not receive drug therapy. Most commonly prescribed NIGD were metformin (69.3%) and sulfonylurea (51.3%). Older patients more often than younger did not use GLT at all and less frequently received insulin therapy and iDPP-4. Insulin therapy was prescribed twice as often in patients with CVD compared with patients without CVD (29.6% and 15.5%). NIGD monotherapy has been less commonly used in patients with CVD (67.3% and 81.2%). Glucagon-like peptide-1 receptor agonists (GLP-1 RA) were prescribed to patients with CVD GLP-1 RA in 0.1% of cases, without CVD in 0.3% of cases, and sodium-glucose cotransporter 2 (SGLT2) inhibitors in 1.1% and 0.6%. correspondently. CONCLUSION: Metformin was most commonly prescribed drug in GLT structure for T2DM patients in the Moscow region in 2018 yr. Percentage of new drugs in the structure of GLT increased mainly due to iDPP-4, and secondly due to SGLT2 inhibitors. New classes of GLT were more often prescribed to patients of younger age, with diabetes duration up to 10 years, overweight or obese. Administration of NIGD with proven cardiovascular protection in presence of CVD is almost two times less than for those without CVD.

scholarly journals Exendin-4 as a Versatile Therapeutic Agent for the Amelioration of Diabetic Changes

2021 ◽  
Author(s):  
Hadi Rajabi ◽  
Mahdi Ahmadi ◽  
Somayeh Aslani ◽  
Shirin Saberianpour ◽  
Reza Rahbarghazi
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Insulin Secretion ◽  
Signaling Pathways ◽  
Diabetic Patients ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

Type 2 diabetes mellitus is a chronic metabolic abnormality leading to microvascular and macrovascular complications. Non-insulin Incretin mimic synthetic peptide exendin-4 was introduced as an anti-diabetic drug which helped diabetic patients with triggering insulin secretion; further researches have revealed an effective role of exendin-4 in treatment of type 2 diabetes mellitus related diseases. Exendin-4 is approximately similar to Glucagon-like peptide, thus it can bind to the glucagon-like peptide-1 receptor and activated different signaling pathways that are involved in various bioactivities such as apoptosis, insulin secretion and inactivation of microglial. In this review, we investigated the interesting role of exendin-4 in various kinds of type 2 diabetes mellitus related disorders through the activation of different signaling pathways.

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