scholarly journals Rational approach to patients treatment with type 2 diabetes and obesity: results of the All-Russian observational program «AURORA»

2019 ◽  
Vol 15 (4) ◽  
pp. 48-58
Author(s):  
Ivan I. Dedov ◽  
Tatiana I. Romantsova ◽  
Marina V. Shestakova

Background: As in many other developed nations, the problem of obesity and type 2 diabetes is acute in Russia. In Russia, the only combination of sibutramine and metformine (ReduxinMet) is authorized to reduce body mass and prevention development of type 2 diabetes mellitus or its complication. The article presents the results of the observational program AVRORA. Aim: Evaluation of the effectiveness and safety of ReduxinMet (sibutramine + microcrystalline cellulose + Metformin) in patients with type 2 diabetes and alimentary obesity in routine clinical practice. Materials methods: The observational program AVRORA was conducted from September 2016 to October 2017 under the auspices of the Endocrinological Scientific Center and the Russian Association of Endocrinologists. The AVRORA program was a multicenter, non-interventional study of patients to whom the attending physicians prescribed ReduxinMet, a set (tablets + capsules), in accordance with the instruction for medical use as part of routine clinical practice. The treated group included patients of both sexes, aged 1865 years, with an established diagnosis of obesity in combination with type 2 diabetes. The duration of the drug usage was determined by the attending physician and was up to 6 months. ReduxineMet was prescribed in addition to the existing glucose-lowering therapy, the dose of metformin was adjusted to the patient's needs. Results: The AVRORA study was attended by 259 doctors and 5,812 patients in 240 medical institutions from 12 cities of the Russian Federation. The average age of patients was 46.6 10.5 years, the ratio of male / female -24% / 76%. The decreasing of BMI during 6 months of the therapy amounted to 5.4 2.3 kg / m2 (on average, 15.1 6.4 kg). After 3 months of the therapy 81.6% of patients achieved clinically significant weight loss of 10.6% or more. The average decrease in waist circumference during 6 months of therapy was 13.8 7.4 cm. A decrease of indicators of glycemic control and lipid metabolism right up to the target values was observed. Conclusions: In AVRORA study it was shown that addition of ReduxineMet (sibutramine+ microcrystalline cellulose+metformine) to the complex therapy of the diabetes in combination with obesity according to approved indications is safe and effective for long-term treatment in regards to weight loss, regulation of lipemic index, glucose profile and quality of life.

2012 ◽  
Vol 29 (2) ◽  
pp. 61-64 ◽  
Author(s):  
Hermione C Price ◽  
Catherine Gorst ◽  
Usha Ayyagari ◽  
Jonathan Levy ◽  
Rury R Holman

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 2143-PUB
Author(s):  
KONSTANTINOS MAKRILAKIS ◽  
GEORGIOS KONSTANTONIS ◽  
AIKATERINI ARIDA ◽  
EVAGGELIA AISSOPOU ◽  
ANTONIOS ARGYRIS ◽  
...  

2020 ◽  
Vol 36 (9) ◽  
pp. 1449-1456
Author(s):  
Silvia Díaz-Cerezo ◽  
Irene Romera ◽  
Antoni Sicras-Mainar ◽  
Flora López-Simarro ◽  
Tatiana Dilla ◽  
...  

2019 ◽  
Vol 104 (9) ◽  
pp. 3647-3660 ◽  
Author(s):  
Akihiro Yoshida ◽  
Yasuhiro Matsubayashi ◽  
Toshiaki Nojima ◽  
Hideki Suganami ◽  
Takahiro Abe ◽  
...  

Abstract Context Although calorie loss from increased urinary glucose excretion continues after long-term treatment with sodium-glucose cotransporter 2 inhibitors (SGLT2is), the mechanisms of the attenuated weight loss due to SGLT2is are not well known. Objective To examine the mechanism of the attenuated weight loss during long-term treatment with an SGLT2i, tofogliflozin, focusing on the antilipolytic effect of insulin on adipose tissue. Design and Participants An integrated analysis was performed using data from two phase 3 studies of 52 weeks of tofogliflozin administration. The antilipolytic effect was evaluated using adipose tissue insulin resistance (Adipo-IR) calculated from the product of the levels of fasting insulin (f-IRI) and fasting free fatty acids (f-FFAs). Results Data from 774 patients with type 2 diabetes (mean age, 58.5 years; glycosylated hemoglobin, 8.1%; body mass index, 25.6 kg/m2; estimated glomerular filtration rate, 83.9 mL/min/1.73m2; 66% men) were analyzed. Weight loss plateaued between weeks 24 and 52 after decreasing significantly. f-IRI levels decreased significantly from baseline to week 24, and the decrease was maintained until Week 52. f-FFA levels significantly increased, peaked at week 24, then declined from weeks 24 to 52. Adipo-IR levels declined progressively throughout the 52 weeks (−3.6 mmol/L·pmol/L and −6.2 mmol/L·pmol/L at weeks 24 and 52, respectively; P < 0.001 baseline vs weeks 24 and 52 and week 24 vs week 52). Higher baseline Adipo-IR levels were independently associated with greater weight loss at week 52. Conclusion The improved antilipolytic effect in adipose tissue may attenuate progressive lipolysis, leading to attenuating future weight loss induced by an SGLT2i in patients with type 2 diabetes.


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