scholarly journals Metformin prevents metabolic side effects during systemic glucocorticoid treatment

2017 ◽  
Vol 176 (3) ◽  
pp. 349-358 ◽  
Author(s):  
Eleonora Seelig ◽  
Stefanie Meyer ◽  
Katharina Timper ◽  
Nicole Nigro ◽  
Martina Bally ◽  
...  
Keyword(s):  
Side Effects ◽  
Glucose Tolerance Test ◽  
Controlled Trial ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Diabetic Patients ◽  
Oral Glucose Tolerance ◽  
Glucocorticoid Treatment ◽  
Metabolic Complications ◽  
Systemic Glucocorticoid

Objectives Patients receiving glucocorticoid treatment are prone to develop metabolic complications. In preclinical studies, metformin prevented the development of the metabolic syndrome during glucocorticoid excess. We herein investigated the metabolic effect of metformin during glucocorticoid treatment in non-diabetic patients. Methods In a double-blind, placebo-controlled trial, patients starting glucocorticoid treatment (prednisone, prednisolone or methylprednisolone) for four weeks were randomised to concomitantly receive metformin (850 mg once daily for one week followed by 850 mg twice daily for three weeks) or placebo. All patients underwent a standardised oral glucose tolerance test at baseline and after four weeks. The primary endpoint was change in the 2-h area under the curve (AUC) of glucose during the oral glucose tolerance test between baseline and four weeks. Results 29 of 34 randomised non-diabetic patients completed the trial (17 metformin and 12 placebo). In patients allocated to placebo, median glucose 2-h AUC increased from baseline to four weeks (836 (IQR 770–966) to 1202 (1009–1271) mmol/L per min; P = 0.01). In contrast, glucose levels remained similar to baseline in the metformin group (936 (869–1003) to 912 (825–1011) mmol/L per min; P = 0.83). This change within four weeks was different between both groups (P = 0.005). Glucocorticoid equivalent doses were similar in both groups (placebo: 980.0 (560.0–3259.8) mg/28 days; metformin: 683.0 (437.5–1970.5) mg/28 days; P = 0.26). Conclusions In this first randomised controlled trial of metformin targeting metabolic complications in patients needing glucocorticoid therapy, we observed a beneficial effect of metformin on glycaemic control. Metformin thus seems to be a promising drug for preventing metabolic side effects during systemic glucocorticoid treatment.

scholarly journals Antidiabetic Effects of Add-OnGynostemma pentaphyllumExtract Therapy with Sulfonylureas in Type 2 Diabetic Patients

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
V. T. T. Huyen ◽  
D. V. Phan ◽  
P. Thang ◽  
P. T. Ky ◽  
N. K. Hoa ◽  
...  
Keyword(s):  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Diabetic Patients ◽  
Oral Glucose Tolerance ◽  
Type 2 Diabetic Patients ◽  
Drug Naïve ◽  
Type 2 Diabetic ◽  
Antidiabetic Effects

Aims.To investigate the antidiabetic effect of the traditional Vietnamese herbGynostemma pentaphyllum(GP) together with sulfonylurea (SU) in 25 drug-naïve type 2 diabetic patients.Methods.After 4-week treatment with gliclazide (SU), 30 mg daily, all patients were randomly assigned into 2 groups to add on GP extract or placebo extract, 6 g daily, during eight weeks.Results.After 4-week SU treatment, fasting plasma glucose (FPG) and HbA1Cdecreased significantly (P<0.001). FPG was further reduced after add-on therapy with 2.9 ± 1.7 and 0.9 ± 0.6 mmol/L in the GP and placebo groups, respectively (P<0.001). Therapy with GP extract also reduced 30- and 120-minute oral glucose tolerance test postload values. HbA1Clevels decreased approximately 2% units in the GP group compared to 0.7% unit in the placebo group (P<0.001).Conclusion.GP extract in addition to SU offers an alternative to addition of other oral medication to treat type 2 diabetic patients.

scholarly journals Food intake regulating hormones in adult craniopharyngioma patients

2014 ◽  
Vol 170 (4) ◽  
pp. 627-635 ◽  
Author(s):  
J Roemmler-Zehrer ◽  
V Geigenberger ◽  
S Störmann ◽  
M Losa ◽  
V Crippa ◽  
...  
Keyword(s):  
Glucose Tolerance Test ◽  
Peptide Yy ◽  
Fasting Glucose ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Metabolic Complications ◽  
X Ray ◽  
Total Ghrelin ◽  
Hypothalamic Pituitary Axis

IntroductionPatients with craniopharyngioma (CP) have disturbances of the hypothalamic–pituitary axis and serious comorbidities such as obesity. We hypothesized that the secretion of hormones regulating the nutritional status is altered in adult patients with CP compared with patients with non-functioning pituitary adenoma (NFPA).MethodsWe included 40 CP (50% males, mean age: 49.6±14.3 years) and 40 NFPA (72.5% males, mean age: 63.4±9.8 years) patients. We measured glucose, insulin, leptin, total ghrelin, peptide-YY (PYY) and cholecystokinin (CCK) during oral glucose tolerance test (OGTT). Fat mass (FM) was determined by dual X-ray absorptiometry.ResultsGender distribution was not significantly different, but CP patients were significantly younger (P<0.001). CP patients had significantly higher BMI and FM than NFPA patients (BMI 32±8 vs 28±4 kg/m2, P=0.009 and FM 37±9 vs 33±9%, P=0.02). Fasting glucose level (84±12 vs 78±11 mg/dl, P=0.03), leptin (27.9±34.2 vs 11.9±11.6 μg/l, P=0.008) and leptin levels corrected for percentage FM (0.66±0.67 vs 0.32±0.25 μg/l%, P=0.005) were significantly higher in CP than in NFPA patients, whereas ghrelin was significantly lower (131±129 vs 191±119 ng/l, P=0.035). Insulin, PYY and CCK did not differ significantly between groups. After glucose load, leptin decreased significantly in CP patients (P=0.019). In both groups, ghrelin decreased significantly during OGTT (both P<0.001). The percentage decline was significantly smaller for CP. PYY and CCK increased equally after glucose in both groups.ConclusionOur patients with CP have more metabolic complications than our patients with NFPA. The levels of leptin and ghrelin at fasting status and after glucose seem to be altered in CP, whereas changes in insulin, PYY and CCK do not seem to be responsible for the metabolic changes in these patients.

Conformance of the diagnostic criteria for diabetes mellitus estimated from the results of the oral glucose tolerance testsand glycated hemoglobin (HbA1c) level

2014 ◽  
Vol 60 (1) ◽  
pp. 36-38
Author(s):  
E A Shestakova
Keyword(s):  
Diabetes Mellitus ◽  
Glucose Tolerance ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Diabetic Patients ◽  
Oral Glucose Tolerance ◽  
Study Population ◽  
Hba1c Measurement

The study population of 127 patients with type 2 diabetes mellitus (T2DM) risk factors underwent oral glucose tolerance test (OGTT) and HbA1c measurement for diagnostic reasons. HbA1c revealed less diabetic patients than OGTT (31% vs 43%). HbA1c >7% and OGTT were similar in confirming diabetes, but HbA1c <7% suggests the need for OGTT performance to validate the diagnosis.

scholarly journals Effect of Correction of Hyperthyroidism with Anti-thyroid Drugs on the Glycated Hemoglobin in Non-diabetic Patients with Primary Hyperthyroidism

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Dasari Mani Deepthi ◽  
Suresh Vaikkakara ◽  
Avinash Patil ◽  
Sandeep Ganta ◽  
Alok Sachan ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Plasma Glucose ◽  
Glucose Tolerance Test ◽  
Glycated Hemoglobin ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Diabetic Patients ◽  
Oral Glucose Tolerance ◽  
Significant Change

Background: Glycated hemoglobin (HbA1c) levels are dependent not only on the average blood glucose levels over the preceding 2 - 3 months but also on the turnover of erythrocytes. Hyperthyroidism is known to be associated with an increase in erythrocyte turnover that may falsely lower the HbA1c in relation to the level of glycemia. Objectives: To assess the impact of medical correction of hyperthyroidism on HbA1c, independent of changes in the fasting plasma glucose and 2-hour post-oral glucose tolerance test plasma glucose. Methods: Adult patients with overt hyperthyroidism (n = 36) were tested for their hemoglobin, reticulocyte percentage, HbA1c and fasting and post-oral glucose tolerance test (OGTT) 2-hour plasma glucose, both at baseline and following at least three months of near normalization of serum thyroxin on Carbimazole treatment. Results: Correction of hyperthyroidism in 36 patients was associated with an increase in the hemoglobin (P = 0.004) and a rise in HbA1c (P = 0.025), even though no significant change was observed in both the fasting (P = 0.28) and post OGTT two-hour plasma glucose (P = 0.54). Also, the proportion of patients with HbA1c ≥ 5.7% rose from 3/36 to 10/36; P = 0.016, while the proportion of patients with either abnormal fasting or abnormal post OGTT 2-hour plasma glucose or both did not show any significant change (P = 0.5). The sensitivity of HbA1c to diagnose prediabetes increased from 20% to 50% post- treatment. Conclusions: Glycated hemoglobin is falsely low in relation to glycemia in patients with untreated hyperthyroidism.

scholarly journals Plant Based Foods to Improve Metabolic Health in Prediabetics – Protocol for a Randomized Controlled Trial

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 1278-1278
Author(s):  
Sumanto Haldar ◽  
Long Hui Wong ◽  
Alvin Suriya Tjahyo ◽  
Farhana Osman ◽  
Shia Lyn Tay ◽  
...  
Keyword(s):  
Weight Loss ◽  
Randomized Controlled Trial ◽  
Dietary Intervention ◽  
Glucose Tolerance Test ◽  
Controlled Trial ◽  
Tolerance Test ◽  
Metabolic Health ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Randomized Controlled

Abstract Objectives The study will investigate the effectiveness of an Asian food based intervention to improve metabolic health, notably glucose homeostasis in a prediabetic population. Methods A parallel design randomized controlled trial will be conducted in Chinese prediabetics aged 45–75 years, BMI 19.5–32 kg/m2. Prediabetes defined according to the American Diabetes Association guideline: fasting blood glucose 5.6–6.9 mmol/l or hemoglobin A1c 5.7–6.4% or 2-hr oral glucose tolerance test 7.8–11.0 mmol/l. Major exclusion criteria were: smoking, food allergies or intolerances to common food ingredients, dietary restrictions, sustained hypertension (&gt;160/95 mmHg), history of metabolic, cardiac, liver or kidney disorders, thyroid dysfunction and recent weight loss. The dietary intervention will last for 16 weeks, where volunteers will consume 2 specially formulated main meals per day, provided as pre-cooked, frozen, ready-meals (approximately 400 kcal each). The treatment group (TG) meals will be prepared with legumes, low GI rice or noodles, blended vegetable oil and added mixed herbs and spices. The control group (CG) meals, isocaloric, will consist of a portion of chicken, a portion of vegetables, medium to high GI rice or noodles and negligible herbs and spices. The male volunteers will be provided additional 100 kcal snacks containing either wholegrain cereals and nuts/seeds (TG) or refined cereal snack products (CG). The daily meals and snacks for rest of the day will be chosen freely, while a dietitian limits the total average calorie consumption to ensure around 5% weight loss in both groups. The effects of dietary interventions on metabolic health will be assessed at every 4 week intervals. The primary outcome measures will include several markers of glucose homeostasis (including HbA1c, fasting glucose, fasting insulin and a 2-hr oral glucose tolerance test [OGTT]). The secondary outcomes will include lipid profile, fructosamine, adiponectin, markers of oxidative stress and chronic inflammation. Results The recruitment for the study has been completed (n = 256 screened, n = 123 suitable). The dietary intervention will commence in March 2021 and expected to be completed in July 2021. Conclusions N/A. Funding Sources Jointly funded by the National University of Singapore, Agency of Science Technology and Research, Singapore, and Wilmar International Limited.

scholarly journals Acceptance and tolerability of 75 g Pregnancy Oral Glucose Tolerance Test in Pregnancy

2019 ◽  
Author(s):  
Santosh Kumar Chaubey ◽  
Henrik Falhammar
Keyword(s):  
Side Effects ◽  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Diagnostic Methods ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Pregnant Females ◽  
Fasting Duration

Abstract Background: Gestational diabetes mellitus (GDM) is increasing in prevalence but there are various debatable issues around the diagnostic methods and criteria. Universal screening and 2-hour 75 g pregnancy oral glucose tolerance test (POGTT) is now widely accepted in Australia barring a few places.A questionnaire based study was planned to determine the acceptance and tolerability of 75 g POGTT in pregnant females and compare with 50 g glucose challenge test (GCT).Methods: A questionnaire based prospective study was conducted of the pregnant females attending the combined endocrine and obstetrics antenatal clinic at Gosford Hospital, NSW. The questionnaire tried to analyse the issues encountered by patients with regard to requirement of fasting, duration of the test as well as gastrointestinal and other side effects experienced during the test. Moreover, the respondents were also asked to rate their experience with 75 g POGTT vs. 50 g GCT if they had this in previous or current pregnancy. The attitude of the respondents towards various side effects was explored as well.Results: The completed questionnaire was received from 98 pregnant females attending the clinic. The most inconvenient factors during the POGTT were the taste of Glucogel (54%, 53/98) and duration of the test (45%, 44/98) , followed nausea (42%, 41/98) and requirement for fasting (18 %, 18/98). Almost half (46%, 45/98) had had a 50 g GCT previously. Of those, more had no issues with 50 g GCT compared to 75 g POGTT (76% vs. 47%, P=0.006) and there was a tendency of less issues of the duration of the test (20% vs. 40%, P=0.065).Conclusions: This study, reassuringly found that in spite its complexity and longer duration of test, 75 g POGTT was reasonably well accepted and tolerated.

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