Hemostasis effects of various glucose-lowering medications and angiopathy prevention

Aim. To assess hemostasis effects of various glucose-lowering medications (GLM), such as sulphanilamides, biguanides, and insulin, in regard to micro- and microangiopathy progression over 5 years in patients with Type 2 diabetes mellitus (DM-2). Material and methods. The study included 72 patients with DM-2 (47 women, 25 men; median age 54,0 years (49,0-59,0 years); mean DM-2 duration 4,0 years (0,5-8,0 years)), receiving one of the following GLMs for 5 years: glibenclamide, gliclazide, metformin, insulin, or the combination of glibenclamide and metformin. Results. Various GLMs had different effects on platelet activity. In the gliclazide group, aggregant activity was decreased, compared to the glibenclamide and insulin groups. In the metformin group, aggregant activity and platelet disaggregation were similar to that in the gliclazide group. The microangiopathy progression over 5 years was related to GLM therapy, being minimal in the DM-2 patients receiving metformin, and maximal among participants administered glibenclamide. The microangiopathy progression was minimal in the metformin and gliclazide groups, and maximal — in the glibenclamide group. Conclusion. Carbohydrate and lipid metabolism compensation is not the only condition of angiopathy prevention. The latter should be based on the complex intervention, aimed at the complete metabolic compensation and hemostasis balance. The need for taking pleiotropic activity of specific agents into consideration when choosing GLM therapy is emphasized by protective effects of metformin (micro- and microangiopathy prevention) and gliclazide (microangiopathy prevention), but not glibenclamide.

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Metformin improves the outcomes in Chinese invasive breast cancer patients with type 2 diabetes mellitus

Scientific Reports ◽

10.1038/s41598-021-89475-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Tianli Hui ◽

Chao Shang ◽

Liu Yang ◽

Meiqi Wang ◽

Ruoyang Li ◽

...

Keyword(s):

Breast Cancer ◽

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Cancer Patients ◽

Invasive Breast Cancer ◽

Breast Cancer Patients ◽

Diabetes Group ◽

Metformin Group

AbstractEarly reports indicate that metformin, a clinical drug administered to treat type 2 diabetes mellitus (T2DM), was found to be associated with a better prognosis of cancer. The objective of this study was retrospectively analyzed the effect of metformin on the outcomes of Chinese breast cancer patients with T2DM. A total of 3757 primary invasive breast cancer patients who underwent surgery from January 2010 to December 2013 were enrolled. According to the medication treatment, all the patients were divided as non-diabetes group, metformin group and insulin group. The follow-up data for disease-free survival (DFS) and overall survival (OS) were obtained from 3553 patients (median follow up of 85 months) and estimated with the Kaplan–Meier method followed by a log-rank test. Multivariate Cox proportional hazards regression model was applied. The results showed that there was a significant survival difference among non-diabetes group, metformin group and insulin group, 5-year DFS was 85.8%, 96.1%, 73.0%, and 5-year OS was 87.3%, 97.1%, 73.3% respectively (P < 0.05). Prognostic analysis showed metformin was significantly associated with better DFS and OS. Our results suggested that metformin may have a good effect on the survival of invasive breast cancer patients with T2DM.

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The Cardiovascular Events in Metabolic Surgery Compared to the New Classes of Glucose-Lowering Agents in Patients with T2DM

Journal of Endocrinology and Metabolism Research ◽

10.37191/mapsci-2582-7960-2(2)-019 ◽

2021 ◽

Author(s):

Najla Shamsi

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Metabolic Surgery ◽

Cardiovascular Events ◽

Controlled Trials ◽

Glucose Lowering ◽

Randomized Controlled ◽

History Of

Type 2 Diabetes Mellitus is a prevalent chronic disease with several macrovascular and microvascular complications. Cardiovascular diseases including coronary artery disease and stroke are common macrovascular complication that reduces the quality of life and lead to early mortality. Additionally, they pose enormous socioeconomic burden on the societies and the governments. Therefore, any intervention that reduces the cardiovascular events in patients with diabetes will have positive impact of the patients and the society. Thus, this systematic review aimed to evaluate the cardiovascular events after metabolic surgery in comparison with the new classes of glucose lowering agents in patients with type 2 diabetes mellitus. The review included 11 randomized controlled trials to both GLP-1 RA and SGLT-2 i groups. It also included 7 metabolic surgery studies, 2 of these are randomized controlled trials and the other 5 are observational studies. These studies were the most relevant studies to the research question. The results revealed different baseline demographic and clinical characteristics between the medication trials and metabolic surgery studies. Moreover, it revealed significant reduction in cardiovascular events in metabolic surgery studies when compared to medication trials. It also showed significant HbA1c and weight reduction in the metabolic surgery group. The remission of diabetes was very high in the metabolic surgery group while none of medication trials accomplished diabetes recovery. However, both medication and surgery groups had adverse events. In conclusion, the review is consistent with previous literature. It suggests that metabolic surgery is more effective than medical therapy in reducing cardiovascular events. Although this conclusion should be interpreted with caution due to the differences in baseline characteristics between studies. In general, the review recommends younger adult diabetic patients with obesity and history of established cardiovascular diseases to undergo metabolic surgery. Whereas, older patients with history of cardiovascular disease should be advised to take one of the medications that has been proved to reduce cardiovascular events. Future studies that compare metabolic surgery and the new classes of the glucose lowering agents is recommended to confirm the findings in this review.

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Postprandial glucose-lowering effect of premeal consumption of protein-enriched, dietary fiber-fortified bar in individuals with type 2 diabetes mellitus or normal glucose tolerance

Journal of Diabetes Investigation ◽

10.1111/jdi.12831 ◽

2018 ◽

Vol 9 (5) ◽

pp. 1110-1118 ◽

Cited By ~ 10

Author(s):

Jae Hyun Bae ◽

Lee Kyung Kim ◽

Se Hee Min ◽

Chang Ho Ahn ◽

Young Min Cho

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Glucose Tolerance ◽

Postprandial Glucose ◽

Normal Glucose Tolerance ◽

Glucose Lowering ◽

Normal Glucose ◽

Glucose Lowering Effect

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Renoprotective opportunities of Lespedeza capitata in patients with chronic kidney disease and type 2 diabetes mellitus

KIDNEYS ◽

10.22141/2307-1257.10.3.2021.239594 ◽

2021 ◽

Vol 10 (3) ◽

pp. 162-168

Author(s):

S.V. Kushnirenko ◽

D.D. Ivanov ◽

S.A. Rotova ◽

О.V. Kushnirenko

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Antihypertensive Therapy ◽

Glucose Lowering ◽

Type 2 Dm ◽

Group I ◽

Ckd Stage ◽

Lespedeza Capitata ◽

Group Ii

Background. Today, issues of renoprotection have gone beyond the use of antihypertensive therapy alone. Stable glucose-lowering and urate-lowering therapy are integral parts of modern renoprotection, which improve the functional state of the kidneys by increasing the glomerular filtration rate (GFR) and reducing the albumin excretion rate (AER) and the albumin-to-creatinine ratio (ACR). Nevertheless, hypoazotemic therapy aimed at reducing the content of nitrogenous wastes remains the leading component of the treatment of patients with chronic kidney disease (CKD). The aim of the study is the assessment of the renoprotective potential of the drug Libera (Lespedeza capitata) in patients with CKD stages 2–3 on the background of type 2 diabetes mellitus (DM). Materials and methods. The study included 107 patients with type 2 DM, aged 19 to 75 years (female — 41.1 %, male — 58.9 %), CKD stages 2–3, micro- and macroalbuminuria (category A2 and A3). The patients were divided into two groups: group I — traditional stable glucose-lowering and antihypertensive therapy (n = 50) and group II — traditional stable glucose-lowering and antihypertensive therapy in combination with Libera (Lespedeza capitata) (n = 57), which was prescribed 1 capsule t.i.d. regardless of food intake for 3 months. The criteria for the effectiveness of treatment were dynamics of GFR, AER/ACR in daily urine. The observation period for the patients was 3 months. Results. The renoprotective potential of Lespedeza capitata (Libera) was demonstrated after 3 months of treatment in the form of a significant increase in GFR in patients with CKD stage 2 in group II up to 79.0 ± 1.4 ml/min/1.73 m2 in comparison with the initial data (p < 0.01) and the results obtained in group I after 3 months of using only traditional stable glucose-lowering and antihypertensive therapy (p < 0.05). The use of Libera in the complex treatment of patients of the II group with CKD stage 3 against the background of type 2 DM for 3 months had a positive effect on nitrogen and water excretory kidney function, which manifested itself in an improvement in GFR to 56.6 ± 2.1 ml/min/1.73 m2 in comparison with the initial data (p < 0.05) and the results obtained in group I — 50.8 ± 1.9 ml/min/1.73 m2 (p < 0.05). In group I with traditional stable glucose-lowering and antihypertensive therapy, only 3 patients (9.1 %) transferred from category A2 to category A1 (normoalbuminuria) after 3 months and 2 patients (11.8 %) from category A3 to category A2. In group II, the appointment of Lespedeza capitata (Libera) in combination with stable glucose-lowering and antihypertensive therapy facilitated the transfer of 10 patients (27.8 %) from category A2 to A1 and 7 patients (33.3 %) from category A3 to A2 (p < 0.001). Conclusions. Lespedeza capitata (Libera) in combination with traditional stable glucose-lowering and antihypertensive therapy contributes to the preservation and improvement of the filtration function of the kidneys, a decrease in AER/ACR in patients with CKD stage 2–3 (3a і 3b) against the background of type 2 DM and proves renoprotective efficiency and safety.

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Metabolic and hemostatic characteristics of patients with type 2 diabetes mellitus differing in the severity of angiopathy

Problems of Endocrinology ◽

10.14341/probl201056215-19 ◽

2010 ◽

Vol 56 (2) ◽

pp. 15-19 ◽

Cited By ~ 1

Author(s):

G G Petrik ◽

S A Pavlishchuk

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Early Period ◽

Vascular Pathology ◽

Diabetic Patients ◽

Platelet Disaggregation ◽

Aggregation Activity

The objective of the present study was to identify risk factors of developing vascular disorders in patients at different stages of type 2 diabetes mellitus (DM2) by comprehensive analysis of metabolic parameters, hemograms, thrombocytic and plasma hemostasis. The study involved 75 patients (22 men and 53 women of mean age 57,3±9,7 years) having angiopathies of different severity. The data obtained confirmed the presence of risk factors of vascular pathology in different phases of DM2. All the examined patients including those without angiopathies in the early period of diabetes showed triglyceridemia, cholesterolemia, enhanced platelet aggregation activity, and shortened activated partial thromboplastin time. Patients with diabetic nephropathy at the stage of microalbuminuria and with non-proliferative retinopathy were distinct from the remaining ones in that they had significantly higher blood alpha-2 globulin and fibrinogen levels. Diabetic patients with micro- and macrovascular problems were characterized by marked dysproteinemia and abnormal platelet disaggregation.

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SEX DIFFERENCES OF CARBOHYDRATE AND LIPID METABOLISM IMPAIRMENT IN RATS WITH TYPE 2 DIABETES MELLITUS

PROBLEMS OF ENDOCRINE PATHOLOGY ◽

10.21856/j-pep.2018.2.06 ◽

2018 ◽

Vol 64 (2) ◽

pp. 39-45 ◽

Cited By ~ 1

Author(s):

Nataliia Gorbenko ◽

Oleksii Borikov ◽

Olha Ivanova ◽

K. V. Taran ◽

T. S. Litvinova ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Body Weight ◽

Lipid Metabolism ◽

Female Rats ◽

Glucose And Lipid Metabolism ◽

Carbohydrate And Lipid Metabolism ◽

Lipid Metabolism Disorders

A sex difference of carbohydrate and lipid metabolism disorders in rats with type 2 diabetes has been studied. It was established that type 2 diabetes leads to a more pronounced deterioration in carbohydrate toleranceand insulin sensitivity in males compared to female rats, but the sex doesn’t affect basal glycemia and fructosamine levels. It was found that the increase of body weight and visceral fat in rats with type 2 diabetes is moremanifested in females than in males. It has been determined that hypertriglyceridemia is higher in diabeticmales compared to diabetic females, and the level of common lipids in the liver, both intact females and femaleswith type 2 diabetes, is lower than that of the males. The obtained results indicate a more expressive impairment of glucose and lipid metabolism in males compared to females with type 2 diabetes

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The Correlation between Secretory Phospholipase A2 Type IIA Levels and Mean Platelet Volume among Type 2 Diabetes Mellitus Patients

Childhood Stunting, Wasting, and Obesity, as the Critical Global Health Issues: Forging Cross-Sectoral Solutions ◽

10.26911/the7thicph.01.09 ◽

2020 ◽

Author(s):

Woro Ayu Sekararum ◽

◽

Nurfitri Bustamam ◽

Hikmah Muktamiroh ◽

Harli Amir Mahmudji ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Mean Platelet Volume ◽

Type Ii ◽

Diabetic Angiopathy ◽

Spearman Correlation ◽

Platelet Activity ◽

Platelet Volume

Background: Platelet activity plays a role in the occurrence of diabetic angiopathy with an increase in mean platelet volume (MPV) as a marker of platelet activity. Platelet activity is influenced by phospholipase A2 type IIA (sPLA2 type IIA), which is a lipid-mediating enzyme that connects the pathogenesis of Diabetes Mellitus (DM) with complications of diabetic angiopathy. This study aimed to examine the relationship between levels of type IIA sPLA2 and MPV among type II DM patients. Subjects and Method: This was a cross-sectional study. A total of 63 patients with type II DM was selected for this study. The inclusion criteria for the study subjects were type 2 diabetes mellitus patients who did not experience an infectious disease, acute inflammation, trauma, surgery or malignancy, anemia, taking antiplatelet drugs, having abnormal platelet counts, and smoking. The dependent variable was levels of type IIA sPLA2. The independent variable was MPV. The data were obtained from the medical records of Prof. Dr. Soerojo Mental Hospital, Magelang. The data were analyzed using Spearman correlation test. Results: The study showed the median level of sPLA2 type IIA was 3841.50 ng / dL and the average MPV value was 7.36 fl. The results of the Spearman correlation analysis showed that there was no relationship between sPLA2 type IIA and MPV (p = 0.551), but there was a tendency for an increase in type IIA sPLA2 followed by an increase in MPV value (r = 0.077). There was a difference in the average MPV value in the subject group with DM ≤ 10 years and> 10 years (p = 0.009), and it was statistically significant. Conclusion: There is a tendency for an increase in type IIA sPLA2 followed by an increase in the MPV value among type II DM patients. Keywords: type II diabetes melitus, type IIA sPLA2 enzyme, mean platelet volume Correspondence: Woro Ayu Sekararum. Faculty of Medicine, Universitas Pembangunan Nasional ‘Veteran’ Jakarta. Jl, Rumah Sakit Fatmawati, Pondok Labu, South Jakarta, Indonesia. E-mail: [email protected]. Mobile: 0811975511 DOI: https://doi.org/10.26911/the7thicph.01.09

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Predicting post one-year durability of glucose-lowering monotherapies in patients with newly-diagnosed type 2 diabetes mellitus – A MASTERMIND precision medicine approach (UKPDS 87)

Diabetes Research and Clinical Practice ◽

10.1016/j.diabres.2020.108333 ◽

2020 ◽

Vol 166 ◽

pp. 108333 ◽

Cited By ~ 1

Author(s):

Olorunsola F. Agbaje ◽

Ruth L. Coleman ◽

Andrew T. Hattersley ◽

Angus G. Jones ◽

Ewan R. Pearson ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Precision Medicine ◽

Newly Diagnosed ◽

Glucose Lowering ◽

One Year

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P1028EFFECTS OF CANAGLIFLOZIN ON MAJOR ADVERSE CARDIOVASCULAR OUTCOMES IN PATIENTS WITH DIFFERENT BASELINE LEVELS OF TYPE 2 DIABETES MELLITUS DISEASE SEVERITY: RESULTS FROM THE CANVAS PROGRAM

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1028 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Tamara Young ◽

Jing-wei Li ◽

Amy Kang ◽

Hiddo Heerspink ◽

Carinna Hockham ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Disease Severity ◽

Cardiovascular Outcomes ◽

Oral Glucose ◽

Glucose Lowering ◽

Duration Of Diabetes ◽

Event Rates

Abstract Background and Aims Patient with type 2 diabetes mellitus (T2DM) included in trials of sodium-glucose cotransporter 2 inhibitors are heterogeneous in terms of disease severity. We assessed the effects of canagliflozin compared to placebo on cardiovascular and renal outcomes in the CANVAS program according to severity of T2DM as indicated by intensity of treatment, duration of diabetes and glycaemic control. Method We compared effects on major adverse cardiovascular events ([MACE], defined as cardiovascular death, non-fatal myocardial infarction or non-fatal stroke) according to three indicators of T2DM severity at study baseline: number of oral glucose lowering treatments or insulin therapy (0-1, 2, 3+, insulin), duration of diabetes (<10, 10-16, >16 years) and HbA1c (<7.0, 7.0-7.5, 7.5-8.0, 8.0-8.5, 8.5-9, >9.0%). We also assessed effects on other pre-specified cardiovascular outcomes, and an adjudicated composite of end-stage kidney disease, renal death or sustained 40% decline in estimated glomerular filtration rate. We assessed for constancy of hazard ratios across subgroups by fitting an interaction term that tested for linear trend. Results Of 10,142 participants in the CANVAS Program, 1011 experienced a MACE during a mean follow-up of 3.6 years. Event rates for MACE were higher in those with longer duration of diabetes and higher HbA1c at baseline. The effect of canagliflozin on MACE in the overall population (HR 0.86, 95 % CI 0.75-0.97) was consistent irrespective of the number of glucose lowering treatments (p=0.509), duration of diabetes (p=0.174) and baseline HbA1c (p =0.314). Effects were also consistent across different levels of T2DM disease severity for all other outcomes studied. Conclusion Higher event rates were observed in those with longer disease duration and higher HbA1c. The proportional risk reductions achieved with canagliflozin were comparable regardless of diabetes duration, number of therapies or HbA1C at baseline.

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