scholarly journals The experience with the use of the GLP-1 analog liraglutide (Victoza) for the optimization of metabolic control and correction of the body mass in the patients with type 2 diabetes mellitus

2012 ◽  
Vol 58 (5) ◽  
pp. 75-79
Author(s):  
T V Saprina ◽  
T K Gudkova ◽  
V A Stoliarova ◽  
S Iu Martynova ◽  
N G Dudar'kova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Body Weight ◽  
Risk Factor ◽  
Combined Therapy ◽  
The Body ◽  
Hypoglycemic Agents ◽  
Cardiovascular Risks

The optimal control of diabetes mellitus (DM) should ensure not only the achievement and maintenance of the targeted blood glucose level but also the reduction of other cardiovascular risks. Obesity is a key risk factor of the development of type 2 diabetes mellitus (DM2) and an independent risk factor of cardiovascular complications. The agonists of glucagon-like peptide-1 (GLP-1) are currently considered to be the sole hypoglycemic agents that not only effectively correct hyperglycemia but also reduce the excessive body weight. Liraglutide (Victoza, Novo Nordisk) is the first long-acting analog of human GLP-1 approved for the application in the treatment of DM2 at the early stages of the disease in the form of both mono- and combined therapy. We present the literature review of the results of randomized clinical studies and our own experience with the use of Victoza for glycemic control and correction of the body weight in the patients presenting with type 2 diabetes mellitus.

scholarly journals Influence of Bromocriptine Plus Metformin Treatment on Glycaemia and Blood Pressure in Patients with Type 2 Diabetes Mellitus

2018 ◽  
Vol 25 (1) ◽  
pp. 59-66
Author(s):  
Alfredo Briones-Aranda ◽  
Javier Ramírez-Carballo ◽  
Bernardo Alfredo Romero Gómez ◽  
Victor Manuel Vega Villa ◽  
Manuela Castellanos Pérez ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Controlled Trial ◽  
Combined Therapy ◽  
The Body ◽  
Open Label ◽  
D2 Agonist

Abstract Background and aims: Bromocriptine is a dopaminergic (D2) agonist that has shown hypoglycemic and normotensive activity in preclinical and clinical studies. The main objective of this study was to investigate the effect of bromocriptine plus metformin on glycaemia and blood pressure in patients with type 2 diabetes mellitus (T2DM). Material and methods: An open-label randomised controlled trial was conducted for three months. It involved two groups (n=10), each containing 2 women and 8 men with an average age of 50 years. One group was given monotherapy (MT) with metformin (850 mg every 12 h) and the other combined therapy (CT) with the same dose of metformin plus an increasing dose of bromocriptine (from 1.25 mg per day to 2.5 mg per day). The parameters monitored were glycaemia, glycated hemoglobin (HbA1c), serum creatinine, blood pressure, and the body mass index. Results: CT was able to significantly decrease the level of glycaemia, HbA1c and diastolic blood pressure, whereas MT had no effect on any of the measured variables. Conclusions: The ability of CT with bromocriptine and metformin to control glycaemia and produce a normotensive effect reaffirms its advantages for controlling T2DM. Further research is needed to improve this therapeutic strategy.

The effectiveness and safety of the supplementation of therapy with oral hypoglycemic agents by basal insulin in the patients with type 2 diabetes mellitus. Results of the SOLOS observational program

2013 ◽  
Vol 59 (4) ◽  
pp. 65-68
Author(s):  
M G Pavlova ◽  
I V Glinkina
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Insulin Glargine ◽  
Hba1c Level ◽  
Combined Therapy ◽  
Fasting Blood Glucose ◽  
Hypoglycemic Agents ◽  
The Mean

The results of numerous clinical investigations carried out during the last years provide convincing evidence of the high effectiveness and safety of early initiation of insulin therapy. Of special interest are the studies conducted under conditions of real clinical practice. One of them is the Russian SOLOS observational program designed to evaluate the influence of intensification of the treatment of type 2 diabetes mellitus with oral hypoglycemic agents (OHA) supplemented by using insulin glargine in the patients who failed to be adequately compensated by OHA therapy alone. Another objective of this program was to find out the opinion of the patients and physicians about the SoloStar pen employed for injecting insulin glargine. The data concerning 1309 patients at the mean age of 59.5±8.8 years with type 2 diabetes mellitus and the mean duration of the disease 6.9±5.0 years were available for the analysis. The overwhelming majority of the patients presented with severe decompensation of carbohydrate metabolism, the mean fasting blood glucose level being 10.7±2.4 mmol/l and the HbA1c level varying from 7.2 to 18.2% (mean 9.6±1.5%). Supplementation of OHA therapy with insulin glargine caused the significant reduction of the HbA1c level to 8.1±1.0% (p<0.001) within 3 months after the onset of the combined treatment. The HbA1c level fell down to 7.2±0.9% (p<0.001) after 6 months 40.6% of the patients had HbA1c at the level below 7%. Fasting blood glucose levels decreased to 7.4±1.4 mmol/l and 6.3±1.0 mmol/l (p<0.001) at 3 and 6 months after the onset of insulin administration respectively. The number of daytime and nocturnal hypoglycemic episodes under effect of insulin glargine injections significantly decreased by the end of the study. Severe hypoglycemic episodes suffered initially by 8 (0.5%) patients totally disappeared 6 months after the initiation of the combined therapy. Most patients did not need hospitalization after supplementation of OHA treatment with insulin. The results of combined therapy with the use of disposable SoloStar pens were positively assessed by the overwhelming majority of both the patients and the physicians involved in the study.

scholarly journals Association of metformin monotherapy or combined therapy with cardiovascular risks in patients with type 2 diabetes mellitus

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Tian Li ◽  
Rui Providencia ◽  
Nan Mu ◽  
Yue Yin ◽  
Mai Chen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cardiovascular Mortality ◽  
Combined Therapy ◽  
Cardiovascular Effects ◽  
Cardiovascular Risks ◽  
All Cause Mortality ◽  
Hypoglycemic Drug

Abstract Background Metformin is a first-line drug in type 2 diabetes mellitus (T2DM) treatment, yet whether metformin may increase all-cause or cardiovascular mortality of T2DM patients remains inconclusive. Methods We searched PubMed and Embase for data extracted from inception to July 14, 2020, with a registration in PROSPERO (CRD42020177283). This study included randomized controlled trials (RCT) assessing the cardiovascular effects of metformin for T2DM. This study is followed by PRISMA and Cochrane guideline. Risk ratio (RR) with 95% CI was pooled across trials by a random-effects model. Primary outcomes include all-cause mortality and cardiovascular mortality. Results We identified 29 studies that randomly assigned patients with 371 all-cause and 227 cardiovascular death events. Compared with untreated T2DM patients, metformin-treated patients was not associated with lower risk of all-cause mortality (RR: 0.98; 95%CI: 0.69–1.38; P = 0.90), cardiovascular mortality (RR: 1.13; 95% CI: 0.60, 2.15; P = 0.70), macrovascular events (RR: 0.87; 95%CI: 0.70–1.07; P = 0.19), heart failure (RR: 1.02; 95% CI:0.61–1.71; P = 0.95), and microvascular events (RR: 0.78; 95% CI:0.54–1.13; P = 0.19). Combination of metformin with another hypoglycemic drug was associated with higher risk of all-cause mortality (RR: 1.49; 95% CI: 1.02, 2.16) and cardiovascular mortality (RR: 2.21; 95% CI: 1.22, 4.00) compared with hypoglycemic drug regimens with no metformin. Conclusion The combination of metformin treatment may impose higher risk in all-cause and cardiovascular mortality. This finding, at least in part, shows no evidence for benefits of metformin in combination in terms of all-cause/cardiovascular mortality and cardiovascular events for T2DM. However, the conclusion shall be explained cautiously considering the limitations from UK Prospective Diabetes Study (UKPDS).

scholarly journals Вплив ураження ацетамінофеном на тлі цукрового діабету типу 2 на зміни показників глутатіонової системи

2018 ◽  
Author(s):  
O. B. Furka
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Body Weight ◽  
Antioxidant System ◽  
The Body ◽  
Intraventricular Injection ◽  
Control Group ◽  
Starch Solution

Introduction. The most important function of the liver in the body is neutralization and destruction of toxic substances. Metabolism and utilization of chemical and biological toxins are carried out by neutralizing the hepatocyte system, followed by the removal of harmful products from the body.The aim of the study – to investigate the effect of acetaminophen on the background of type 2 diabetes mellitus on the main parameters of the glutathione unit of the antioxidant system in rat liver homogenate in time dynamics.Research Methods. The experiments were carried out on white mature rats weighing 180–220 g, contained on a standard ration of the vivarium and free access to water. We conducted 2 series of experiments. In the first, toxic acetaminophen was caused by a single intraventricular injection of acetaminophen in 2 % starch solution at a dose of 1250 mg/kg body weight (1/2 LD50), in the second suspension of acetaminophen in a 2 % starch solution at a dose of 55 mg/kg, which corresponds to the highest therapeutic dose for 7 days. The non-genetic form of experimental type 2 diabetes mellitus was modeled according to the method of Islam S., Choi H. (2007) by a single intraperitoneal injection of a streptozotocin solution (“Sigma”, USA) at a body weight (200±20) g at a rate of 65 mg/kg, which diluted with citrated buffer (pH 4.5) with a preliminary (within 15 minutes) intraperitoneal administration of nicotinamide in a dose of 230 mg/kg. For the control group, rats with the same body weight were administered with a similar volume of solvent (citrate buffer pH 4.5).Results and discussion. Activation of lipid peroximation reactions is one of the fundamental biological mechanisms of damage to biostructures and the development of cellular pathology for the actions of damaging factors of various genesis, especially under the conditions of xenobiotics.Conclusion. Acetaminophen poisoning against type 2 diabetes mellitus causes a significant disruption of compensatory mechanisms, especially the state of the enzyme and non-enzyme links of the antioxidant system.

scholarly journals Effects of metformin on body weight in patients with type 2 diabetes mellitus,receiving insulin analogue treatment

2013 ◽  
Vol 16 (1) ◽  
pp. 48-51 ◽  
Author(s):  
Tatiana Ivanovna Romantsova ◽  
T Sh Dzhavakhishvili ◽  
O V Roik
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Body Weight ◽  
Weight Gain ◽  
Waist Circumference ◽  
Insulin Analogue ◽  
Combined Therapy ◽  
Insulin Analogues

Aims. To study the dynamics of body weight, waist circumference, blood lipid and insulin demand in patients with type 2 diabetes mellitus (T2DM) during first year of combined treatment with metformin and insulin analogues, compared with insulin analogue monotherapy. Materials and Methods. We examined 78 patients with T2DM on newly initiated insulin therapy, including 54 females and 24 males. Median age was 56 [51.0; 64.0] years, median disease duration ? 9 [6.8;14.0] years. Participants were subdivided in two groups. First group was comprised of 48 subjects (33 females and 15 males), who received monotherapy with insulin analogues (glargine, de- temir, biphasic Aspart 30 and Humalog Mix 25 or rapid-acting lispro and aspart). Second group included 30 patients (18 females and12 males), who were treated with combined therapy (insulin analogues plus metformin). We measured HbA1c, plasma lipid composition, BMI, waist circumference and insulin demand initially and after one year of follow-up. Results. We showed that combined therapy vs. insulin monotherapy allows better glycemic compensation while reducing insulin demand and lowering risks for weight gain. Conclusions. Combined insulin analogue plus metformin treatment delivers better metabolic control in patients with T2DM and is as- sociated with lower risks for body weight gain and increase in insulin demand against monotherapy with insulin analogues.

scholarly journals Efficacy of GLP-1 analog to achieve metabolic control and correction of body weight in patients with type 2 diabetes mellitus

2011 ◽  
Vol 10 (6) ◽  
pp. 114-119
Author(s):  
T. V. Saprina ◽  
T. K. Gudkova ◽  
V. A. Stolyarova ◽  
S. Yu. Martynova ◽  
N. G. Dudarkova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Body Weight ◽  
Metabolic Control ◽  
Hypoglycemic Agents ◽  
Incretin Mimetics ◽  
Reduce Body Weight ◽  
Weight Correction

Obesity associated with the enhanced risk of cardiovascular disorders plays a key role in the evolvement and progression of type 2 diabetes mellitus (DM2). Incretin mimetics are the sole class of hypoglycemic agents that not only effectively correct hyperglycemia but also reduce body weight. Exenatide (Byetta, Eli Lilly, USA) is the first drug of this class approved for the use as monotherapy. This paper presents data of clinical studies and owns data on the effectiveness of the drug Byetta in achieving metabolic control and weight correction in patients with type 2 diabetes.

scholarly journals The effects of Metformin Use on Body Mass Index: A Prospective Study

2015 ◽  
Vol 1 (1) ◽  
pp. 16-20 ◽  
Author(s):  
Sanjeev Tiwari ◽  
Aseem Bhattarai ◽  
Ramesh Prasad Acharya ◽  
Pratap Narayan Prasad
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Body Mass Index ◽  
Type 2 Diabetes Mellitus ◽  
Body Weight ◽  
Body Mass ◽  
Hypoglycemic Agents ◽  
Metformin Group ◽  
First Choice

BACKGROUND: Limited number of studies has compared metformin with other Oral Hypoglycemic agents (OHAs) for reducing BMI and few of the results are controversial. Perhaps, this is of clinical importance because the Nepalese population presents different dietary habits in comparison with the European population. The objective of this study was to study the comparative evaluation of metformin with other OHAs influence on Body Mass Index (BMI) in Nepalese patients with diagnosed type 2 Diabetes Mellitus (T2DM)). METHODS: A prospective cross sectional database of patients treated at diabetic clinic, TUTH, was analysed. Patients (N = 115) with type 2 Diabetes Mellitus and with complete BMI and HbA1c and treated with metformin and other OHAs, for at least three visits were included. Analysis of BMI and the type of oral agent was performed. Individuals were categorized as ideal weight, overweight, or obese (BMI <25, 25–29.9, and >30 kg/m2, respectively). RESULTS: There were differences between the values of BMI at presentation, the third, the sixth and the ninth months, between the metformin-treated groups compared to other OHAs treated groups. Metformin was given to 48 patients and OHAs to other 57 patients. In the metformin group, mean BMI decreased significantly during the treatment time, from 29.93±5.7 to 28.95±5.2 (<0.001). The obese the patients, the lower their BMI levels at the end of the analysis period. The mean BMI dropped by 0.9±1.18 in metformin group (from 29.93±5.7 to 24.83±3.6kg/m2; p<0.001). It was found that the patients who had BMI higher than 30 kg/m2 were significantly more likely to lose weight during the metformin therapy (p<0.05). However, the baseline change in body weight observed during metformin treatment correlated with the baseline metabolic control or its improvement during the analysis period. CONCLUSION: Metformin use is associated with a significant decrease in body weight and BMI over long periods of time and it should remain a first choice drug for newly diagnosed T2DM patients, even more so for patients that are overweight or obese. DOI: http://dx.doi.org/10.3126/acclm.v1i1.12309 Ann. Clin. Chem. & Lab. Med. 1(1) 2015: 16-20

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