scholarly journals Pharmacogenetics of hypoglycemic agents

2015 ◽  
Vol 18 (4) ◽  
pp. 28-34 ◽  
Author(s):  
Irina Vladimirovna Kononenko ◽  
Aleksandr Yuryevich Mayorov ◽  
Ekaterina Olegovna Koksharova ◽  
Marina Vladimirovna Shestakova
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Genetic Heterogeneity ◽  
Hypoglycemic Agents ◽  
Therapeutic Effectiveness ◽  
Patients With Diabetes ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1 ◽  
The Individual ◽  
Heterogeneity Of Diabetes

Despite the increase in the number of hypoglycemic agents, 35%–40% of patients with diabetes are unable to achieve adequate glycemic control. One of the reasons is the genetic heterogeneity of diabetes mellitus, requiring different treatment approaches; however, the individual metabolic features and sensitivity to drugs also affect the therapeutic effectiveness. The review presents the main results of pharmacogenetic research of several antidiabetic drugs: metformin, sulfonylurea, agonists of glucagon-like peptide-1 and thiazolidinediones.

Pharmacotherapy for Type 2 Diabetes Mellitus: What’s Up and Coming in the Glucagon-Like Peptide-1 (GLP-1) Pipeline?

2021 ◽  
pp. 089719002110490
Author(s):  
Mary J. Elder ◽  
Emily J. Ashjian
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Glucagon Secretion ◽  
New Drugs ◽  
Beneficial Effects ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

Glucagon-like peptide-1 (GLP-1), an incretin hormone, is known to lower glucose levels, suppress glucagon secretion, and slow gastric emptying. These properties make GLP-1 an ideal target in treating type 2 diabetes mellitus (T2DM). There are many FDA-approved GLP-1 agonists on the market today, several of which have demonstrated benefit beyond improving glycemic control. Given the beneficial effects of GLP-1 agonists in patients with T2DM, new drugs are in development that combine the mechanism of action of GLP-1 receptor agonism with novel mechanisms and with drugs that promote GLP-1 secretion. These agents are designed to improve glycemic control and target greater body weight reduction. This article discusses new GLP-1 drugs in the pipeline for the treatment of T2DM.

scholarly journals Clinical and Radiographic Variables Around Implant With Simultaneous Graft Among Type 2 Diabetic Patients Treated With Different Hypoglycemic Medications: A Retrospective Study.

2020 ◽  
Author(s):  
Shaojie Shi ◽  
Feng Ding ◽  
Xiangdong Liu ◽  
Lei Wang ◽  
Xingxing Wang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Bone Loss ◽  
Hypoglycemic Agents ◽  
Marginal Bone Loss ◽  
Insulin Group ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

Abstract Background: The clinical and radiographic variables around dental implants in type 2 diabetes mellitus patients with different hypoglycemic agents still remained unclear.Methods: This retrospective cohort study collected the dental records and digital periapical radiographs of type 2 diabetes mellitus patients and implants. These patients were grouped according to their medication: insulin, metformin, and glucagon-like peptide-1 drugs. The radiographic marginal bone loss around implants and clinical parameters, including peri-implant bleeding on probing and probing depth, were compared among groups using the Kruskal-Wallis test.Results: A total of 150 patients with 308 implants (101 in insulin group, 121 in metformin group and 86 in glucagon-like peptide-1 drugs group) were assessed. The peri-implants marginal bone loss in insulin group (P<0.05) and metformin group (P<0.01) were significantly higher than glucagon-like peptide-1 drug group. The radiographic bone loss in metformin was higher than insulin group (P<0.05). While there was no statistical difference of clinical peri-implant parameters among groups(P>0.05).Conclusions: The radiographic variables were not exactly the same among type 2 diabetes mellitus patients with different hypoglycemic agents. glucagon-like peptide-1 drugs might be more beneficial to bone tissue around implants. More studies are needed to verify the direct effect of these drugs on peri-implant bone.Clinical trial registration number: ChiCTR2000034211 (retrospectively registered)

Glucose-lowering therapies in patients with type 2 diabetes and cardiovascular diseases

2019 ◽  
Vol 26 (2_suppl) ◽  
pp. 73-80 ◽  
Author(s):  
Francesco Prattichizzo ◽  
Lucia La Sala ◽  
Lars Rydén ◽  
Nikolaus Marx ◽  
Marc Ferrini ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Receptor Agonist ◽  
Glucose Lowering ◽  
Patients With Diabetes ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

Type 2 diabetes mellitus is a major risk factor for developing cardiovascular disease, and many patients with diabetes have prevalent cardiovascular complications. Recent cardiovascular outcome clinical trials suggest that certain new glucose-lowering drugs are accompanied by additional cardioprotective properties. Indeed, selected glucagon-like peptide-1 receptor agonists have a proved cardiovascular benefit in terms of a reduced incidence of ischaemic events, while sodium/glucose co-transporter-2 inhibitors have also shown significant protection, with a striking effect on heart failure and renal endpoints. These findings have been integrated in recent guidelines which now recommend prescribing (when initial metformin monotherapy fails) a glucagon-like peptide-1 receptor agonist or a sodium/glucose co-transporter-2 inhibitor with clinical trial-confirmed benefit in patients with diabetes and atherosclerotic cardiovascular disease, and a sodium/glucose co-transporter-2 inhibitor in such patients with heart failure or chronic kidney disease at initial stages. Furthermore, the new 2019 European Society of Cardiology guidelines in collaboration with the European Association for the Study of Diabetes recommend a glucagon-like peptide-1 receptor agonist or a sodium/glucose co-transporter-2 inhibitor in treatment-naive patients with type 2 diabetes mellitus with pre-existing cardiovascular disease or at high cardiovascular risk. Future research will disentangle the mechanisms underpinning these beneficial effects and will also establish to what extent these results are generalisable to the whole diabetes population. In the meantime, available evidence should prompt a wide diffusion of these two classes of drugs among patients with diabetes and cardiovascular disease. Here, we briefly summarise recent findings emerging from cardiovascular outcome clinical trials, discuss their impact on treatment algorithms and propose new possible approaches to improve our knowledge further regarding the cardiovascular effect of glucose-lowering medications.

Glucagon-like peptide 1 receptor agonists in type 1 diabetes mellitus

2019 ◽  
Vol 76 (21) ◽  
pp. 1739-1748
Author(s):  
Justinne Guyton ◽  
Michelle Jeon ◽  
Amie Brooks
Keyword(s):  
Diabetes Mellitus ◽  
Weight Loss ◽  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Type 1 Diabetes Mellitus ◽  
Alpha Cell ◽  
Cell Dysfunction ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

Abstract Purpose The role of glucagon-like peptide 1 receptor agonists (GLP-1 RAs) in the treatment of type 1 diabetes mellitus (T1DM), including efficacy and safety evidence, is reviewed. Summary Currently approved treatment options for glycemic control in T1DM include insulin, which combats insulin deficiency but does not effectively target disease progression or alpha cell dysfunction; and pramlintide, whose use requires multiple daily doses and involves a high likelihood of gastrointestinal side effects. GLP-1 RAs have a unique mechanism of action in T1DM, addressing alpha cell dysfunction and thereby suppressing inappropriate glucagon secretion. GLP-1 RA dosing varies from once weekly to twice daily, and the class is well tolerated in patients with type 2 diabetes. Among the GLP-1 RAs, exenatide and liraglutide have been studied in patients with T1DM, with published evidence consistently demonstrating weight loss, decreases in total daily insulin requirements, and modest improvements in glycemic control. GLP-1 RA therapy appears to be well tolerated in patients with T1DM and is associated with nonsignificant increases in hypoglycemia risk. Conclusion GLP-1 RA therapy represents an important add-on therapy option for achieving decreased insulin doses, weight loss, and modest improvements in HbA1c levels without significantly increasing hypoglycemia risk in patients with T1DM. Patients who have detectable C-peptide and/or are overweight or cannot achieve glycemic goals without hypoglycemia have been found to benefit the most from GLP-1 RA therapy. Further studies are warranted to evaluate these agents’ potential impact on clinical outcomes such as microvascular and macrovascular complications.

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