scholarly journals Effect of add-on proton pump inhibitors on parameters of glycemic control in type-2 diabetic patients

2017 ◽  
Vol 6 (6) ◽  
pp. 1233 ◽  
Author(s):  
Amruta P. Patil ◽  
Prashant A. Shirure
Keyword(s):  
Glycemic Control ◽  
Glucose Tolerance ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Gastric Ulcers ◽  
Controlled Study ◽  
Diabetic Patients ◽  
Β Cell ◽  
Number Of Patients

Proton pump inhibitors (PPIs) block the parietal cell H+/K+ ATPase, are superior at suppressing acid secretion & promoting peptic ulcer healing, wildly used clinically for the therapy of gastro-esophageal reflex disease, gastritis due to excess stomach acid, and gastric ulcers. After blocking the production of gastric acid, the proton-pump inhibitors indirectly elevate serum gastrin levels via a negative feedback effect. Evidences are reported that gastrin promotes β cell neogenesis in pancreatic ductal complex, modest pancreatic β cell replication and improvement of glucose tolerance in animal models. Some recent clinical studies have shown improved glucose tolerance in type-2 diabetes mellitus (T2DM). Although PPIs may be possible candidates for a new approach in the therapy of diabetes, a prospective, long-term, randomized, double-blind, placebo-controlled study is needed to establish the effect of PPIs on glycemic control in a large number of patients with T2DM.

scholarly journals Comparison of Effectiveness between DPP4 inhibitors combined with Versus Other Oral Hypoglycaemic Agent(s) in Diabetic patients

2019 ◽  
Vol 30 (2) ◽  
pp. 63-70
Author(s):  
Md Shameem Haidar
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Combination Group ◽  
Diabetic Patients ◽  
Glycemic Status ◽  
Good Glycemic Control ◽  
Dpp4 Inhibitor ◽  
Number Of Patients ◽  
Inhibitor Combination

Background: Diabetes is global health burden of disease that requires life-long pharmacological and non-pharmacological management to prevent complications such as cardiovascular disease, retinopathy, nephropathy, and neuropathy. Treatment of type 2 diabetes is based on an interplay of patient characteristics, severity of hyperglycemia and available therapeutic options. Metformin, sulfonylureas (SU) and DPP IV inhibitor are the most studied of the oral medications used worldwide. They play a prominent initial role in the type 2 diabetes treatment algorithm recommended by the several guideline. The growing evidence on new technologies and therapeutic interventions is rapidly expanding our knowledge and ability to manage diabetes and its complications; at the same time, however, it is challenge for physicians to select appropriate medication in appropriate dose for optimal patients care. Objectives: To compare the safety and efficacy of the dipeptidylpeptidase-4 (DPP-4) inhibitors combination with other oral hypoglycaemic agent(s) in patients with type 2 diabetes and inadequate glycemic control. Materials & method: Study was conducted among 600 patients over a period of 24 months. All the patients were adult male and female type 2 diabetic patients who received regular oral anti-diabetic drug(s) and duration of T2DM for one year or more were enrolled for study. Total 150 cases were selected. Patients with Type 1 DM, pregnant women with DM and who was receiving injectable antidiabetic medications were excluded from this study. Detail demographic data were collected from the informant and recorded in structured case report form. Clinical examination and relevant investigations were done. Main outcome variable was Glycemic status (HbA1C, FBG, 2HABF). Effectiveness of drugs was evaluated by glycaemic status of the patients. Result: Maximum number of patients (38.5%) was between 31-40 years age group with mean age 37.8±9.5 years. Present study shows that, for good glycemic control, all three results (FBS, 2H ABF and HbA1c) were within targeted level in majority patients of DPP4 Inhibitor combination group. Although FBS was best result in metformin group. About 51.9% of SUs group achieved the glycemic control targets level. In case of metformin group it was in 59.8% of patients, and in combined therapy 67.1% patients shows good glycemic target. So DPP4 Inhibitor combination is better medication than other to maintain good glycemic status in type 2 DM patient, due to maximum number of patients reached all three components of result within target range. Conclusion: Diabetes is chronic illness. Good glycemic control with choosing appropriate anti-diabetic medication is pivotal for DM management. In this study it is observed that DPP4 Inhibitor combination group of drug is better than other anti-diabetic medication to maintain good glycemic status in type 2 DM patients. Bangladesh J Medicine July 2019; 30(2) : 63-70

Acarbose improves glycemic control in insulin-treated Asian type 2 diabetic patients: Results from a multinational, placebo-controlled study

2003 ◽  
Vol 60 (2) ◽  
pp. 111-118 ◽  
Author(s):  
Chii-Min Hwu ◽  
Low-Tone Ho ◽  
Martin M.T. Fuh ◽  
Shing Chung Siu ◽  
Dwi Sutanegara ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Controlled Study ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic

scholarly journals Medical care standards for diabetes in the hospital: evolution of views from glycemic control to metabolic surgery

2020 ◽  
Vol 4 (6) ◽  
pp. 340-346
Author(s):  
A.B. Fursov ◽  
◽  
R.A. Fursov ◽  
O.B. Ospanov ◽  
◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Medical Care ◽  
Metabolic Surgery ◽  
The Body ◽  
Diabetic Patients ◽  
Economic Costs ◽  
Number Of Patients ◽  
Surgical Methods

A large number of patients with type 2 diabetes (T2D) have a high incidence of complications and disease decompensation, which becomes the reason for therapy inefficacy. In recent years, endocrinologists and diabetologists are increasingly paying attention to surgical methods for treating T2D. The review attempts to study and systematize new trends in the treatment of T2D, as well as to determine the historical vector of changes in diabetologist views on the control, stabilization of the glycemic level in diabetic patients, and surgical methods.A retrospective study of scientific approaches to the treatment of diabetes confirmed the opinion of some researchers that the evolution of treatment methods commonly consisted of improving control and means of insulin delivery to the body. The analysis of scientific papers that confirm that detection of glycemic disorders among those admitted to the surgical hospital has a direct and immediate benefit both in a planned and urgent order. The growth of economic costs associated with insufficient glycemic control in diabetic patients was studied. Over the past decades, medical care standards for diabetes are analyzed in chronological order. Using the American Diabetes Association Guidelines, new trends in the treatment of T2D have been developed, and a stable vector in changing views on the efficacy of surgical bariatric and metabolic methods has been identified.KEYWORDS: medical care standards, type 2 diabetes, glycemia, evolution of diabetes mellitus treatment, economic costs, guidelines, metabolic surgery, endoscopic methods.FOR CITATION: Fursov A.B., Fursov R.A., Ospanov O.B. Medical care standards for diabetes in the hospital: evolution of views from glycemic control to metabolic surgery. Russian Medical Inquiry. 2020;4(6):340–346. DOI: 10.32364/2587-6821-2020-4-6-340-346.

Thiazolidinediones improve β-cell function in type 2 diabetic patients

2007 ◽  
Vol 292 (3) ◽  
pp. E871-E883 ◽  
Author(s):  
Amalia Gastaldelli ◽  
Ele Ferrannini ◽  
Yoshinori Miyazaki ◽  
Masafumi Matsuda ◽  
Andrea Mari ◽  
...  
Keyword(s):  
Insulin Secretion ◽  
Glycemic Control ◽  
Plasma Glucose ◽  
Cell Function ◽  
Glucose Disposal ◽  
Diabetic Patients ◽  
Β Cell ◽  
Β Cell Function ◽  
To Receive

Thiazolidinediones (TZDs) improve glycemic control and insulin sensitivity in patients with type 2 diabetes mellitus (T2DM). There is growing evidence from in vivo and in vitro studies that TZDs improve pancreatic β-cell function. The aim of this study was to determine whether TZD-induced improvement in glycemic control is associated with improved β-cell function. We studied 11 normal glucose-tolerant and 53 T2DM subjects [age 53 ± 2 yr; BMI 29.4 ± 0.8 kg/m2; fasting plasma glucose (FPG) 10.3 ± 0.4 mM; Hb A1c 8.2 ± 0.3%]. Diabetic patients were randomized to receive placebo or TZD for 4 mo. Subjects received 1) 2-h OGTT with determination of plasma glucose, insulin, and C-peptide concentrations and 2) two-step euglycemic insulin (40 and 160 mUm−2min−1) clamp with [3-3H]glucose. T2DM patients were then randomized to receive 4 mo of treatment with pioglitazone (45 mg/day), rosiglitazone (8 mg/day), or placebo. Pioglitazone and rosiglitazone similarly improved FPG, mean plasma glucose during OGTT, Hb A1c, and insulin-mediated total body glucose disposal (Rd) and decreased mean plasma FFA during OGTT (all P < 0.01, ANOVA). The insulin secretion/insulin resistance (disposition) index [ΔISR(AUC)/Δglucose(AUC) ÷ IR] was significantly improved in all TZD-treated groups: +1.8 ± 0.7 (PIO + drug-naïve diabetics), +0.7 ± 0.3 (PIO + sulfonylurea-treated diabetics), and 0.7 ± 0.2 (ROSI + sulfonylurea-withdrawn diabetics) vs. −0.2 ± 0.3 in the two placebo groups ( P < 0.01, all TZDs vs. placebo, ANOVA). Improved insulin secretion correlated positively with increased body weight, fat mass, and Rd and inversely with decreased plasma glucose and FFA during the OGTT. In T2DM patients, TZD treatment leads to improved β-cell function, which correlates strongly with improved glycemic control.

scholarly journals The Effect of Proton Pump Inhibitors on Glycemic Control in Patients with Type 2 Diabetes

2019 ◽  
Vol 17 (4) ◽  
pp. 192-196 ◽  
Author(s):  
Kelly Villegas ◽  
Joy L. Meier ◽  
Maureen Long ◽  
Julio Lopez ◽  
Arthur Swislocki
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Proton Pump Inhibitors ◽  
Proton Pump

scholarly journals Baseline characteristics in the Aliskiren Trial in Type 2 Diabetes Using Cardio-Renal Endpoints (ALTITUDE)

2012 ◽  
Vol 13 (3) ◽  
pp. 387-393 ◽  
Author(s):  
Hans-Henrik Parving ◽  
Barry M Brenner ◽  
John JV McMurray ◽  
Dick de Zeeuw ◽  
Steven M Haffner ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
High Risk ◽  
Enzyme Inhibitor ◽  
Microvascular Complications ◽  
Geometric Mean ◽  
Controlled Study ◽  
Diabetic Patients ◽  
Number Of Patients ◽  
Baseline Characteristics

Introduction: Patients with type 2 diabetes are at enhanced risk for macro- and microvascular complications. Albuminuria and/or reduced kidney function further enhances the vascular risk. We initiated the Aliskiren Trial in Type 2 Diabetes Using Cardio-Renal Endpoints (ALTITUDE). Aliskiren, a novel direct renin inhibitor, which lowers plasma renin activity, may thereby provide greater cardio-renal protection compared with angiotensin converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) alone. Materials and methods: ALTITUDE is a randomized, double-blind, placebo-controlled study in high risk type 2 diabetic patients receiving aliskiren 300 mg once daily or placebo added to recommended cardio-renal protective treatment including ACEi or ARB, but not both. The number of patients randomized was 8606. Results: Baseline characteristics (median, IQR) are: age 65 (58, 72) years, male 68%, BMI 29.1 (25.7, 32.2) kg/m2, cardiovascular disease 47.9%, blood pressure 134.7 (126, 150)/74.3 (67, 81) mmHg, HbA1c 7.5 (6.6, 8.6)%, LDL-cholesterol 2.4 (1.9, 3.0) mmol/L, haemoglobin 130 (119, 143) g/L, serum creatinine 115 (91, 137) µmol/L, eGFR 51.7 (42, 65) ml/min per 1.73 m2, geometric mean UACR 198.9 (52, 2886) mg/g and frequency of micro/macroalbuminuria 25.7% and 58.2%. ALTITUDE is an event-driven trial to continue until 1628 patients experience a primary cardiovascular-renal event. Conclusions: ALTITUDE will determine the potential cardio-renal benefit and safety of aliskiren in combination with ACEi or ARB in high risk patients with type 2 diabetes.

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