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

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.

2012 ◽  
Vol 15 (4) ◽  
pp. 128-131
Author(s):  
Marina Vladimirovna Shestakova

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.


2019 ◽  
Vol 22 (3) ◽  
pp. 206-216
Author(s):  
Inna V. Misnikova ◽  
Yulia A. Kovaleva ◽  
Mikhail А. Isakov ◽  
Alexander V. Dreval

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.


2021 ◽  
Vol 9 (3) ◽  
pp. 28-33
Author(s):  
S.Yu. Mogilevskyy ◽  
A.S. Hudz ◽  
Yu.O. Panchenko ◽  
O.V. Bushuyeva ◽  
G.E. Zakharevych

Background. According to the International Diabetes Federation, the number of people with diabetes mellitus is going to increase from 366 to 552 million by 2030. More than 1.5 million patients with diabetes are registered in Ukraine, of which 84–95 % have type 2 diabetes. Diabetic retinopathy (DR) is one of the common diabetes complications, being one of the leading causes of blindness and low vision, in particular in people of occupational age. Metabolic disorders, including activation of the polyol pathway of glucose utilization, play an important role in the pathogenesis of DR, with aldose reductase playing a key role, the activity of which is associated with the polymorphism of its gene, AKR1B1. The study of new meta­bolic and genetic mechanisms for the development and progression of DR in type 2 diabetes mellitus in patients from the Ukrainian population is an actual task of modern ophthalmology. Purpose: to investigate and generalize new genetically determined risk factors for diabetic retinopathy in type 2 diabetes mellitus. Materials and methods. The study involved 409 participants, who were divided into four groups: 1 — comparison cohort (98 people without diabetes mellitus type 2); 2 — 76 patients (stage I DR, without fundus chan­ges); 3 — 64 individuals with non-proliferative DR; 4 — 64 patients with proliferative DR; control group for genetic researches included 107 ophthalmologically healthy individuals. All patients underwent blood sampling for molecular genetic research by puncture of the ulnar vein and aspiration of 2.5 ml of blood through a 23G 5.0 ml disposable syringe (Hemoplast, Etalon+, Ukraine), followed by a release into a 3.0 ml container (Vacuette K3E K3EDTA, Greiner Bio-One, Austria). Distribution of polymorphic alleles and genotypes of rs759853 and rs9640883 aldose reductase gene (AKR1B1) in patients with non-proliferative DR, proliferative DR and in the control group and their association with disease and effects on the occurrence, mechanisms of development and progression of DR were studied. Based on the conducted researches, a model of DR development prognosis was developed by construction of multiple regression with sufficient reliability of degree of influence of independent variables on a calculated indicator. Results. As a result of our research, we identified new genetically determined risk factors for the development and progression of the different stages of DR in patients with diabetes mellitus type 2, namely the role of polymorphic alleles and genotypes rs759853 and rs9640883 of the AKR1B1 gene. The deve­loped logistic regression models found that the risk of DR incidence is five times lower in carriers of the G/G and G/A genotypes compared to carriers of the A/A genotype rs759853 polymorphism (p < 0.001). It was found that the risk is twice as high (p = 0.01) for carriers of the G/G genotype rs9640883 compared to the A/A + G/A genotypes. The risk of developing proliferative DR is 3.3 times lower in carriers of the G/G genotype and 2.5 times lower in carriers of the G/A genotype compared to carriers of the A/A genotype rs759853. Conclusions. Therefore, on the basis of our clinical, ophthalmological, molecular genetic and statistical studies we have identified new risk factors for the development and progression of different stages of DR in patients with diabetes mellitus type 2. Mathematical models of development and progression of different stages of DR in patients with diabetes type 2 were built.


2021 ◽  
Vol 13 (2) ◽  
pp. 107-112
Author(s):  
Sarah Grasya Elisabeth Pasaribu ◽  
Ratih Kurniasari

Diabetes Mellitus Type 2 is a chronic non-communicable disease characterized by an increase in blood sugar levels. Typical symptoms of Type 2 Diabetes Mellitus consist of polyuria, polydipsia, polyphagia and weight loss for no apparent reason. Diabetes Mellitus cannot be cured but its severity can be controlled by adopting a good lifestyle such as taking medication regularly, doing physical activity and adhering to a recommended diet such as the 3J diet. One way to increase the compliance of the 3J diet in people with Diabetes Mellitus Type 2 can be done by providing education through both print and audio-visual media. The aim was to determine the level of adherence of the 3J diet to the adherence of the 3J diet. The author collects data or sources related to a particular topic that can be obtained from various sources such as journals, books, the internet, and other libraries. Based on 4 reviewed journals, it was found that people with Type 2 Diabetes Mellitus have the potential to increase knowledge and compliance of patients with Diabetes Mellitus Type 2 to the 3J diet. The use of media, either print media or through applications that can increase the knowledge of Type 2 Diabetes Mellitus sufferers, is very well given and educated to patients with Type 2 Diabetes Mellitus. ABSTRAK Diabetes Mellitus Type 2 merupakan salah satu Penyakit Tidak Menular yang bersifat kronik ditandai dengan peningkatan kadar gula dalam darah. Gejala khas Diabetes Mellitus Tipe 2 terdiri dari poliuria, polidipsia, polifagia dan berat badan menurun tanpa sebab yang jelas. Diabetes Mellitus tidak dapat disembuhkan tetapi tingkat keparahannya dapat dikendalikan dengan menerapkan pola hidup yang baik seperti mengonsumsi obat – obatan secara teratur, melakukan aktifitas fisik dan mematuhi pola diet yang disarankan seperti diet 3J. Salah satu cara untuk meningkatkan kepatuhan diet 3J pada penderita Diabetes Mellitus Type 2 dapat dilakukan dengan memberikan edukasi melalui media baik media cetak maupun melalui media aplikasi. Adapun tujuannya untuk mengetahui tingkat kepatuhan diet 3J terhadap kepatuhan diet 3J.  Penulis mengumpulkan data atau sumber yang berhubunga pada sebuah topik tertentu yang bisa didapat dari berbagai sumber seperti jurnal, buku, internet, dan pustaka lain. Berdasarkan 4 jurnal yang di review, didapatkan hasil bahwa penderita Diabetes Mellitus type 2 memiliki potensi untuk meningkatkan pengetahuan dan kepatuhan pasien penderita Diabetes Mellitus Type 2 terhadap diet 3J. Penggunaan media baik itu media cetak atau melalui aplikasi yang dapat menambah pengetahuan penderita Diabetes Mellitus Type 2 sangat baik diberikan dan diedukasi kepada pasien penderita Diabetes Mellitus Tipe 2.


Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 112-LB ◽  
Author(s):  
RONAN ROUSSEL ◽  
SANTIAGO DURAN-GARCIA ◽  
YILONG ZHANG ◽  
SUNERI SHAH ◽  
CAROLYN DARMIENTO ◽  
...  

2020 ◽  
Vol 16 (6) ◽  
pp. 598-607 ◽  
Author(s):  
Rebeca Barbosa da Rocha ◽  
Cristiano Sales Silva ◽  
Vinícius Saura Cardoso

Background: Self-care is essential for the prevention of complications in patients with diabetes, but several authors report that even with health education programs, the incidence of complications in patients with diabetes continues to increase. Objective: We aimed to examine adherence to self-care strategies and the repercussions of adherence on the clinical profiles of individuals with type 2 diabetes. Methods: We performed a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. We searched for related studies in 4 databases: PubMed, Web of Science, Scopus, and Latin American and Caribbean Health Science Literature (LILACS). We included observational studies in English and Portuguese that evaluated the effects of selfcare in individuals with type 2 diabetes. Results: The search resulted in the identification of 615 articles, of which 34 met all the inclusion criteria. General self-care was considered unsatisfactory. Physical exercise was classified as the self-care activity that was performed less frequently by individuals with type 2 diabetes mellitus; adherence to medication was the most frequent behavior among volunteers. Conclusion: The studies indicated poor adherence of the population to good self-care practices, reflected by the increase in complications related to DM.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Elharram ◽  
A Sharma ◽  
W White ◽  
G Bakris ◽  
P Rossignol ◽  
...  

Abstract Background The timing of enrolment following an acute coronary syndrome (ACS) may influence cardiovascular (CV) outcomes and potentially treatment effect in clinical trials. Using a large contemporary trial in patients with type 2 diabetes mellitus (T2DM) post-ACS, we examined the impact of timing of enrolment on subsequent CV outcomes. Methods EXAMINE was a randomized trial of alogliptin versus placebo in 5380 patients with T2DM and a recent ACS. The primary outcome was a composite of CV death, non-fatal myocardial infarction [MI], or non-fatal stroke. The median follow-up was 18 months. In this post hoc analysis, we examined the occurrence of subsequent CV events by timing of enrollment divided by tertiles of time from ACS to randomization: 8–34, 35–56, and 57–141 days. Results Patients randomized early (compared to the latest times) had less comorbidities at baseline including a history of heart failure (HF; 24.7% vs. 33.0%), prior coronary artery bypass graft (9.6% vs. 15.9%), or atrial fibrillation (5.9% vs. 9.4%). Despite the reduced comorbidity burden, the risk of the primary outcome was highest in patients randomized early compared to the latest time (adjusted hazard ratio [aHR] 1.47; 95% CI 1.21–1.74) (Figure 1). Similarly, patients randomized early had an increased risk of recurrent MI (aHR 1.51; 95% CI 1.17–1.96) and HF hospitalization (1.49; 95% CI 1.05–2.10). Conclusion In a contemporary cohort of T2DM with a recent ACS, early randomization following the ACS increases the risk of CV events including recurrent MI and HF hospitalization. This should be taken into account when designing future clinical trials. Figure 1 Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Takeda Pharmaceutical


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