scholarly journals Effectiveness prediction of Evogliptin treatment in type 2 diabetes mellitus in russian-korean population

2018 ◽  
Vol 21 (5) ◽  
pp. 333-343
Author(s):  
Anna A. Mosikian ◽  
Alina Y. Babenko ◽  
Yulia A. Sevastyanova ◽  
Roman V. Drai ◽  
Evgenij V. Shlyakhto
Keyword(s):  
Hba1c Level ◽  
Statistical Power ◽  
Clinical Care ◽  
Statin Treatment ◽  
Linear Regression Models ◽  
South Korean ◽  
Effectiveness Prediction ◽  
The Difference ◽  
Phosphorous Concentration

Background: Individualized treatment has already become a part of a routine clinical care. Many data on the effectiveness prediction of commercially available DPP-4 inhibitors had been published, but not on the effectiveness prediction of evogliptin. Aim: To reveal the clinical characteristics and metabolic predictors of better hypoglycemic response to evogliptin. Matherials and methods: We have conducted a retrospective study, based on the data of a randomized clinical trial comparing effectiveness and safety of evogliptin and sitagliptin in Russian and Korean subpopulations. We provide univariate linear regression models for separate subpopulations and a multivariate stepwise regression model for the combined subpopulation. HbA1c change after 24 weeks of evogliptin treatment was a primary endpoint and a dependent variable in the analysis. Results: The decrease of HbA1c after 24 weeks of treatment with evogliptin in Russian subpopulation negatively correlates with triglycerides/HDL level (p = 0,046). In South Korean subpopulation it correlates positively with HbA1c level at baseline (p 0,0001). In order to increase the statistical power of the analysis the data of both populations were combined. According to the combined data, the decrease of HbA1c after 24 weeks of treatment with evogliptin positively correlates with HbA1c level at baseline (p0.0001) and log(HOMA-B) (p=0.0042), and it negatively correlates with log(triglycerides/HDL) (p=0.0057), blood phosphorous concentration (p=0.014) and statin treatment (p=0.044). No correlation of HbA1c change at week 24 was observed with body mass index, diabetes duration and blood C-peptide concentration. Patients able to achieve HbA1c7,0 % had higher HOMA-B (53.22 36.95 и 39.67 24.74, respectively, р=0.033) and were tend to have higher HDL concentration (1.36 0.28 и 1.26 0.26 mmol/l, respectively, р=0.076) and lower triglycerides to HDL ratio (0.87 0.70 и 1.48 0.95, respectively, р=0.079). Conclusion: A patient, who benefits more when treated with evogliptin, has higher HOMA-B, lower triglycerides to HDL ratio and phosphorous concentration in the 1-2 quartiles of the normal range. Triglycerides to HDL ratio is, probably, a specific effectiveness predictor for Russian, but not for Korean subpopulation. These data prove the difference in effectiveness prediction for different drugs of DPP-4 inhibitors group and reveal the need of further investigation.

P1050THE EFFICACY AND RENAL SAFETY OF SWITCHING FROM DAPAGLIFLOZIN TO EMPAGLIFLOZIN IN PATIENTS WITH TYPE 2 DIABETES

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
AI-YU YANG ◽  
Hung-Chun Chen
Keyword(s):  
Type 2 Diabetes ◽  
Hba1c Level ◽  
Adverse Reactions ◽  
Primary Outcome Measure ◽  
Glucose Reabsorption ◽  
Before And After ◽  
The Difference ◽  
Effective Group ◽  
Renal Safety

Abstract Background and Aims Both dapagliflozin (DPG) and empagliflozin (EPG) are highly selective sodium-glucose cotransporter-2 (SGLT-2) inhibitors that inhibit glucose reabsorption and increase its excretion in urine. Previously, DPG was limited to patients with an estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m2, while EPG can be used for those with an eGFR ≥ 45 mL/min/1.73 m2. Therefore DPG was switched to EPG in many patients when eGFR decreased. However, the clinical efficacy and safety of these switches are not clear. In this study, we compared the efficacy and renal safety between patients switching from DPG to EPG and those continuing DPG in patients with type 2 diabetes mellitus (T2DM). Method This retrospective observational study included patients with T2DM who were treated with DPG for more than 6 months. This study included patients who switched to EPG and those who continued using DPG. All other hypoglycemic drugs were maintained at the same dosage before and after the study period. The primary outcome measure was the change in hemoglobin A1c (HbA1c) level after 6 months. The EPG group was evaluated for whether the hypoglycemic effect remain effective after drug switching. Patients with HbA1c levels at or lower than the baseline value after 6 months were defined as effective and patients with levels higher than the baseline were defined as invalid. Safety was evaluated by comparing the difference of eGFR between the baseline value and six months after treatment. Results This study included 169 patients. Among them, 72 patients continued DPG and 97 patients switched to EPG. HbA1c level decreased significantly only in EPG group. In EPG group, 59 patients belong to the effective group (60.8%) and 38 patients were invalid (39.2%). There was no significant change in eGFR after treatment in both groups. Ten patients in DPG group develop adverse reactions (three patients felt uncomfortable and seven patients had urinary tract symptoms), but all continued treatment. In EPG group, five patients lacked follow-up records during the study period and it was difficult to determine whether the patient’s willingness to continue treatment was affected by adverse reactions. Conclusion Our study showed that switching from DPG to EPG in patients with T2DM was effective for blood glucose maintenance and caused no significant changes in renal function. In addition, no severe drug-related adverse reactions were found.

Polymorphisms of the Plasminogen Activator Inhibitor- 1 Gene in Type 1 and Type 2 Diabetes, and in Patients with Diabetic Retinopathy

1994 ◽  
Vol 71 (06) ◽  
pp. 731-736 ◽  
Author(s):  
M W Mansfield ◽  
M H Stickland ◽  
A M Carter ◽  
P J Grant
Keyword(s):  
Diabetic Retinopathy ◽  
Plasminogen Activator Inhibitor ◽  
Allelic Frequency ◽  
Repeat Sequence ◽  
Dinucleotide Repeat ◽  
Plasminogen Activator Inhibitor 1 ◽  
The Difference ◽  
Pai 1

SummaryTo identify whether genotype contributes to the difference in PAI-1 levels in type 1 and type 2 diabetic subjects and whether genotype relates to the development of retinopathy, a Hind III restriction fragment length polymorphism and two dinucleotide repeat polymorphisms were studied. In 519 Caucasian diabetic subjects (192 type 1, 327 type 2) and 123 Caucasian control subjects there were no differences in the frequency of the Hind III restriction alleles (type 1 vs type 2 vs control: allele 1 0.397 vs 0.420 vs 0.448; allele 2 0.603 vs 0.580 vs 0.552) nor in the allelic frequency at either dinucleotide repeat sequence. In 86 subjects with no retinopathy at 15 years or more from diagnosis of diabetes and 190 subjects with diabetic retinopathy there was no difference in the frequency of Hind III restriction alleles (retinopathy present vs retinopathy absent: allele 1 0.400 vs 0.467; allele 2 0.600 vs 0.533) nor in the allelic frequencies at either dinucleotide repeat sequence. The results indicate that there is no or minimal influence of the PAI-1 gene on either PAI-1 levels or the development of diabetic retinopathy in patients with diabetes mellitus.

Clinical Experience with Insulin Detemir: Results from the Bangladesh Cohort of Global A1chieve Study

2013 ◽  
Vol 3 (1) ◽  
pp. 11-18 ◽  
Author(s):  
Zafar Ahmed Latif ◽  
Md. Faruque Pathan ◽  
Md. Nazrul Islam Siddiqui ◽  
MA Mannan ◽  
SM Ashrafuzzaman ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Weight ◽  
Glycaemic Control ◽  
Insulin Therapy ◽  
Hba1c Level ◽  
Insulin Detemir ◽  
Entire Cohort ◽  
Baseline Visit ◽  
Effective Option

Objective: To present results from the Bangladesh cohort of the A1chieve study receiving insulin detemir (Levemir) ± oral anti diabetic drugs. Methods: Out of 1093 patients recruited from 49 sites in Bangladesh, 370 were initiated on insulin detemir (Levemir).Study visits were defined as baseline, interim (around 12 weeks from baseline) and final (around 24 weeks from baseline) visit. Results: Glycaemic control was poor in all the groups at baseline. In the entire cohort at 24 weeks, significant reductions from baseline were observed in mean HbA1c (from 10.0 % to 7.2%, p<0.001), FPG (from 10.5 to 6.7 mmol/L, p<0.001) and PPPG (from 15.3 to 8.9 mmol/L, p<0.001) levels. Overall 45.5% of the participants achieved target HbA1c level of < 7% after 24 weeks. The rate of all hypoglycaemic events in the entire cohort reduced from 1.34 (baseline) to 0.12 events/person year after 24 weeks of insulin detemir therapy (p<0.0001). There was no clinically relevant change in body weight in insulin naïve or prior insulin users groups after 24 weeks of insulin detemir therapy. Conclusions: The current study suggests that insulin detemir may be considered as a safe and effective option for initiating insulin therapy for type 2 diabetes in Bangladesh. Birdem Med J 2013; 3(1): 11-18 DOI: http://dx.doi.org/10.3329/birdem.v3i1.17121

Glucagon-like peptide-1 agonist therapy in patients with diabetes mellitus and obesity

2020 ◽  
Vol 98 (3) ◽  
pp. 210-217
Author(s):  
A. Yu. Babenko ◽  
Yu. A. Kononova ◽  
M. V. Martjanova ◽  
A. V. Simanenkova ◽  
M. A. Kokina ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Hba1c Level ◽  
High Efficiency ◽  
Receptor Agonists ◽  
Predictors Of Response ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1 ◽  
Lipids Metabolism

Due to the high efficiency of glucagon-like peptide-1 (GLP-1) receptor agonists therapy in only a part of patients, the search for predictors of response to the treatment is a relevant problem. Purpose. The purpose is to compare the efficacy of liraglutide and exenatide therapy in obese patients with type 2 diabetes mellitus (T2DM) and to evaluate the predictors of response to glycated hemoglobin (HbA1c), weight and lipids reduction. Material and methods. The study included 47 patients with type 2 diabetes and obesity who received GLP-1 receptor agonists therapy. 26 patients were treated with liraglutide, 21 patients were treated with exenatide. We measured the parameters of carbohydrate and lipid metabolism, the levels of hormones involved in glucose and lipids metabolism and in appetite regulation. Blood pressure was measured. These parameters were evaluated at baseline and after 24 weeks of treatment. Results. Patients receiving exenatide therapy showed a tendency towards more frequent HbA1c level reduction by 1% or more (60% versus 30.4%, p = 0.07). The effects of liraglutide and exenatide on weight and waist circumference were comparable. When assessing the predictors of response to the therapy, a more pronounced decrease in HbA1c level (by 1% or more) was in the patients with a higher initial HbA1c level (8.7 (8.2; 9.7) versus 8.2 (6.9; 8.7)%, p = 0.04), as well as with a higher initial GLP-1 level (0.12 (0.05; 0.17) versus 0.040 (0.01; 0.09) ng/ml.) A more significant decrease in the triglycerides (TG) level was detected in patients with a higher level of glucose-dependent insulinotropic peptide (GIP) before therapy (409 (316.0; 431.4) pg/ml in patients who reduced TG level by 30% or more and 331.5 (324.9; 367.1) pg/ml in patients with a lower decrease in TG level). Among the studied parameters, no predictors of body mass reduction were revealed. Conclusion. Measurement of HbA1c, GLP-1, GIP level may be useful to predict the efficacy of GLP-1 receptor agonists therapy.

Evaluation of Salivary Antioxidants and Oxidative Stress Markers in Type 2 Diabetes Mellitus: A Retrospective Cohort Study

2020 ◽  
Vol 20 (4) ◽  
pp. 584-590 ◽  
Author(s):  
Shima Fathi ◽  
Shiva Borzouei ◽  
Mohammad Taghi Goodarzi ◽  
Jalal Poorolajal ◽  
Fatemeh Ahmadi-Motamayel
Keyword(s):  
Oxidative Stress ◽  
Diabetes Mellitus ◽  
Control Group ◽  
Oxidative Stress Markers ◽  
Stress Markers ◽  
Type 2 Dm ◽  
Patients With Diabetes ◽  
The Difference ◽  
And Oxidative Stress

Background: Diabetes Mellitus (DM) is a progressive metabolic disorder. Objective: The aim of this study was to investigate the relationship between antioxidant and oxidative stress markers in the saliva of patients with type 2 DM and a healthy control group. Methods: In this study, 20 patients with diabetes and 20 healthy individuals were evaluated. Salivary antioxidants markers consisted of total antioxidant capacity (TAC), uric acid (UA), peroxidase and catalase. Oxidative stress markers included total oxidant status (TOS), malondealdehyde (MDA) and total thiol (SH). Sialochemical analysis was performed with spectrophotometric assay. All the statistical analyses were conducted using STATA software. Results: TAC decreased significantly in patients with diabetes. Although salivary UA and peroxidase were lower in patients with diabetes compared to the control group, the difference was not significant. Salivary catalase in patients with diabetes was significantly lower than that in the control group. MDA and TOS exhibited significantly higher levels in type 2 DM. SH levels were slightly higher in DM. Conclusions: According to the results of the present study, there were some changes in the salivary levels of some antioxidants and oxidative stress markers in patients with type 2 DM and could be measured as an indicator of serum changes..

Immunoassay or LC-MS/MS for the measurement of salivary cortisol in children?

2016 ◽  
Vol 54 (5) ◽  
Author(s):  
Yoon Ju Bae ◽  
Alexander Gaudl ◽  
Sonia Jaeger ◽  
Stephanie Stadelmann ◽  
Andreas Hiemisch ◽  
...  
Keyword(s):  
Salivary Cortisol ◽  
Social Stress ◽  
Statistical Power ◽  
Stress Test ◽  
Externalizing Disorders ◽  
Cross Reactivity ◽  
Trier Social Stress Test ◽  
Healthy Children ◽  
Kinetic Assay ◽  
The Difference

AbstractBackground:Dysregulation of the adrenal cortex has been assessed with measurement of salivary cortisol. So far salivary cortisol is routinely measured with immunoassay (IA). However, liquid chromatography-tandem mass spectrometry (MS) is known to offer better specificity. We compared the concentrations of salivary cortisol measured by MS and IA at basal and stress induced conditions and evaluated reasons for the difference in method-dependent cortisol results.Methods:Saliva samples (n=2703) were collected from 169 children (age range: 8–14 years; 81 healthy children; 55 with internalizing and 33 with externalizing disorders) under circadian conditions and during the Trier Social Stress Test for Children (TSST-C). Biochemical analyses were performed with MS for cortisol and cortisone, IA (IBL, RE62011) for cortisol, and enzyme kinetic assay for α-amylase.Results:MS and IA showed mostly comparable results for circadian activity and TSST-C response with similar statistical power. However, IA measured cortisol concentrations about 2.39-fold higher than MS. We found that this difference in measured values between MS and IA was mainly due to different standardization of IA compared to MS. In addition, at cortisol IA concentration below 5 nmol/L, cross-reactivity with cortisone was found to contribute to the lower concordance between MS and IA.Conclusions:Immunoassay and LC-MS/MS were largely comparable in the interpretation of salivary cortisol dynamics in stress research. But the IA method revealed a restricted accuracy in the measuring range below 5 nmol/L.

scholarly journals Associations between multimorbidity and glycaemia (HbA1c) in people with type 2 diabetes: cross-sectional study in Australian general practice

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039625
Author(s):  
Jason I Chiang ◽  
John Furler ◽  
Frances Mair ◽  
Bhautesh D Jani ◽  
Barbara I Nicholl ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
General Practice ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Linear Regression Models ◽  
Sectional Study ◽  
Cross Sectional ◽  
Long Term Conditions ◽  
Australian General Practice

ObjectivesTo explore the prevalence of multimorbidity as well as individual and combinations of long-term conditions (LTCs) in people with type 2 diabetes (T2D) attending Australian general practice, using electronic health record (EHR) data. We also examine the association between multimorbidity condition count (total/concordant(T2D related)/discordant(unrelated)) and glycaemia (glycated haemoglobin, HbA1c).DesignCross-sectional study.SettingAustralian general practice.Participants69 718 people with T2D with a general practice encounter between 2013 and 2015 captured in the MedicineInsight database (EHR Data from 557 general practices and >3.8 million Australian patients).Primary and secondary outcome measuresPrevalence of multimorbidity, individual and combinations of LTCs. Multivariable linear regression models used to examine associations between multimorbidity counts and HbA1c (%).ResultsMean (SD) age 66.42 (12.70) years, 46.1% female and mean (SD) HbA1c 7.1 (1.4)%. More than 90% of participants with T2D were living with multimorbidity. Discordant conditions were more prevalent (83.4%) than concordant conditions (69.9 %). The three most prevalent discordant conditions were: painful conditions (55.4%), dyspepsia (31.6%) and depression (22.8%). The three most prevalent concordant conditions were hypertension (61.4%), coronary heart disease (17.1%) and chronic kidney disease (8.5%). The three most common combinations of conditions were: painful conditions and hypertension (38.8%), painful conditions and dyspepsia (23.1%) and hypertension and dyspepsia (22.7%). We found no associations between any multimorbidity counts (total, concordant and discordant) or combinations and HbA1c.ConclusionsMultimorbidity was common in our cohort of people with T2D attending Australian general practice, but was not associated with glycaemia. Although we did not explore mortality in this study, our results suggest that the increased mortality in those with multimorbidity and T2D observed in other studies may not be linked to glycaemia. Interestingly, discordant conditions were more prevalent than concordant conditions with painful conditions being the second most common comorbidity. Better understanding of the implications of different patterns of multimorbidity in people with T2D will allow more effective tailored care.

scholarly journals Metabolomics-based multidimensional network biomarkers for diabetic retinopathy identification in patients with type 2 diabetes mellitus

2021 ◽  
Vol 9 (1) ◽  
pp. e001443
Author(s):  
Jingjing Zuo ◽  
Yuan Lan ◽  
Honglin Hu ◽  
Xiangqing Hou ◽  
Jushuang Li ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Permutation Test ◽  
Linear Regression Models ◽  
Characteristic Analysis ◽  
Network Biomarkers ◽  
Validation Set

IntroductionDespite advances in diabetic retinopathy (DR) medications, early identification is vitally important for DR administration and remains a major challenge. This study aims to develop a novel system of multidimensional network biomarkers (MDNBs) based on a widely targeted metabolomics approach to detect DR among patients with type 2 diabetes mellitus (T2DM) efficiently.Research design and methodsIn this propensity score matching-based case-control study, we used ultra-performance liquid chromatography-electrospray ionization-tandem mass spectrometry system for serum metabolites assessment of 69 pairs of patients with T2DM with DR (cases) and without DR (controls). Comprehensive analysis, including principal component analysis, orthogonal partial least squares discriminant analysis, generalized linear regression models and a 1000-times permutation test on metabolomics characteristics were conducted to detect candidate MDNBs depending on the discovery set. Receiver operating characteristic analysis was applied for the validation of capability and feasibility of MDNBs based on a separate validation set.ResultsWe detected 613 features (318 in positive and 295 in negative ESI modes) in which 63 metabolites were highly relevant to the presence of DR. A panel of MDNBs containing linoleic acid, nicotinuric acid, ornithine and phenylacetylglutamine was determined based on the discovery set. Depending on the separate validation set, the area under the curve (95% CI), sensitivity and specificity of this MDNBs system were 0.92 (0.84 to 1.0), 96% and 78%, respectively.ConclusionsThis study demonstrates that metabolomics-based MDNBs are associated with the presence of DR and capable of distinguishing DR from T2DM efficiently. Our data also provide new insights into the mechanisms of DR and the potential value for new treatment targets development. Additional studies are needed to confirm our findings.

scholarly journals Ability of radiofrequency echographic multispectrometry to identify osteoporosis status in elderly women with type 2 diabetes

2021 ◽  
Author(s):  
Carla Caffarelli ◽  
Maria Dea Tomai Pitinca ◽  
Antonella Al Refaie ◽  
Elena Ceccarelli ◽  
Stefano Gonnelli
Keyword(s):  
Type 2 Diabetes ◽  
Lumbar Spine ◽  
Elderly Women ◽  
Fragility Fractures ◽  
Dual Energy ◽  
Healthy Controls ◽  
Diagnosis Of Osteoporosis ◽  
X Ray ◽  
The Difference

Abstract Background Patients with type 2 diabetes (T2DM) have an increased or normal BMD; however fragility fractures represent one of the most important complications of T2DM. Aims This study aimed to evaluate whether the use of the Radiofrequency Echographic multi spectrometry (REMS) technique may improve the identification of osteoporosis in T2DM patients. Methods In a cohort of 90 consecutive postmenopausal elderly (70.5 ± 7.6 years) women with T2DM and in 90 healthy controls we measured BMD at the lumbar spine (LS-BMD), at femoral neck (FN-BMD) and total hip (TH-BMD) using a dual-energy X-ray absorptiometry device; moreover, REMS scans were also carried out at the same axial sites. Results DXA measurements were all higher in T2DM than in non-T2DM women; instead, all REMS measurements were lower in T2DM than in non T2DM women. Moreover, the percentage of T2DM women classified as “osteoporotic”, on the basis of BMD by REMS was markedly higher with respect to those classified by DXA (47.0% vs 28.0%, respectively). On the contrary, the percentage of T2DM women classified as osteopenic or normal by DXA was higher with respect to that by REMS (48.8% and 23.2% vs 38.6% and 14.5%, respectively). T2DM women with fragility fractures presented lower values of both BMD-LS by DXA and BMD-LS by REMS with respect to those without fractures; however, the difference was significant only for BMD-LS by REMS (p < 0.05). Conclusions Our data suggest that REMS technology may represent a useful approach to enhance the diagnosis of osteoporosis in patients with T2DM.

scholarly journals Profile of the Change in Depression during Proton-Pump Inhibitor Therapy in Patients with Gastroesophageal Reflux Disease: Influence of the Mucosal Break

2021 ◽  
Vol 18 (11) ◽  
pp. 5964
Author(s):  
Chia-Liang Wu ◽  
Chien-Lin Chen ◽  
Shu-Hui Wen
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Proton Pump ◽  
Reflux Disease ◽  
Proton Pump Inhibitor Therapy ◽  
Linear Regression Models ◽  
Independent Variable ◽  
The Difference ◽  
Mucosal Break ◽  
The Impact

Given the frequent concomitance between depression and gastroesophageal reflux disease (GERD), it is important to evaluate the change of depression in patients with GERD, especially considering the presence of esophageal mucosal breaks (MB). This study aimed to examine the change in the levels of depression in patients with GERD during proton-pump inhibitors (PPI) therapy. We designed a prospective cohort study to explore the profile of the alteration in depression with respect to the impact of esophageal MB. This study recruited 172 eligible patients with GERD between February 2016 and May 2018. The change in depression was defined as the difference between the respective Taiwanese Depression Questionnaire (TDQ) scores obtained at baseline and after PPI therapy. Multivariate linear regression models were used to estimate the factors associated with the change in depression. The results revealed statistically significant improvements in the TDQ score (mean score: baseline = 13.2, after PPI therapy = 10.9, p < 0.01, Cohen’s d = 0.30) during PPI therapy for GERD. Moreover, the MB was an independent variable associated with changes in the TDQ score [B = 3.31, 95% confidence interval (CI): (1.12, 5.51), p < 0.01] and the improvement in depression [odds ratio = 0.38, 95% CI: (0.17, 0.86), p = 0.02]. Our findings revealed that depressive symptoms improved slightly following PPI therapy. Moreover, MB was an unfavorable prognostic factor for the improvement in depression.

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