A prospective open labelled study of effect of vildagliptin with metformin in patients with type 2 diabetes mellitus

Background: The pathophysiology of Type 2 Diabetes Mellitus (T2DM) is characterized by deficient insulin activity arising from decreased insulin secretion secondary to beta cell failure, and/or compromised insulin action in peripheral target tissues (insulin resistance).Methods: The patients attending the medicine outpatient department of tertiary care teaching hospital were enrolled in the study. Patients, who fulfilled the selection criteria, were allocated in two treatment groups. Group A was treated with metformin (Sustained release preparation) 500mg once daily and group B was treated with vildagliptin 50mg once daily. Measurement of body weight, fasting blood glucose (FPG), postprandial blood glucose (PPG), glycated haemoglobin (HbA1c), serum urea, creatinine and urine albumin/creatinine ratio was performed at the initial visit and at the end of 12 weeks of treatment.Results: Out of 84 patients screened, 74 were enrolled for the study. Of the 74 patients, 39(52.7%) were male and 35(47.3%) were female. The patients were divided into two groups (group A and group B) consisting 37 patients in each group. Out of 74 patients, 62 completed the study. Out of 12 patients who did not complete the study, 5 patients were lost during follow-up period and 7 patients discontinued treatment due to AEs. The mean age of the patients was 51 and 49years in the groups A and B respectively. There was no statistical difference in the baseline FPG, PPG, HbA1c, serum urea, serum creatinine, urine ACR and body weight between two groups.Conclusions: The study shows that metformin and vildagliptin have similar effect on glycaemic control, but vildagliptin exerts better Reno protective effect and there were no reports of serious adverse events.

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Clinical appraisal of Lodhradi Kashaya on type 2 diabetes mellitus patients

International Journal of Clinical Trials ◽

10.18203/2349-3259.ijct20170310 ◽

2017 ◽

Vol 4 (1) ◽

pp. 58

Author(s):

Varun K. Singh ◽

K. R. C. Reddy

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Blood Glucose ◽

Dosage Form ◽

Dose Group ◽

Group A ◽

Group B

Background: Lodhradi Kashaya (LKSD) is basically ayurvedic kwath dosage form, described as Madhumehajeet (winner of diabetes mellitus) in ayurvedic classics Basavarajeeyam and the same formulation in Vaidya Chintamani and Charaka Samhita too. The aim of this study was to assess prospectively the drug’s ability in management of type 2 diabetes. Methods: Total 31 patients were taken following the guideline mention in CCRAS protocol for diabetes mellitus research. They are divided into two groups, group A and B, given LKSD 4 g & 2 g TDS respectively for three-month follow up. They are investigated against their blood glucose, HbA1C and liver profile tests. Patients were also investigated for subjective parameters viz polyurea, polyphagia, exhaustion and constipation and their response has also been noted regarding palatability acceptance and ease of administration.Results: Patients has responded positively for formulation. Decrease in FBS and PPBS were found highly significant (P ˂ 0.001) in both groups but more in higher dose (group A). Decrease in HbA1C is also found highly significant in both groups. In LFT, SGOT level were also decreased more in group B in comparison to group A, and it is significant (P = 0.017 and 0.002). SGPT level were also decreased more in group B in comparison to group A, and it is significant in group B (P= 0.085 and 0.002). Conclusions: LKSD is having astringent taste due to tannins and phenols in it. It was found significant not only in controlling blood sugar but also in management of other factors related to diabetes mellitus.

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Once daily versus twice daily Linagliptin effect on glycemic levels in type 2 diabetes mellitus- an observational study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20174567 ◽

2017 ◽

Vol 5 (10) ◽

pp. 4403

Author(s):

Riyaz Mohammed ◽

Mohammed Azfar Ali

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Observational Study ◽

Plasma Concentrations ◽

Fixed Dose ◽

Once Daily ◽

Group A ◽

Group B

Background: DPP-4 is widely distributed in endothelial cells, pancreas, uterus, liver, salivary glands, lymph node, spleen, and thymus. DPP-4 regulates glucagon-like peptide (GLP)-1, and glucose-dependent insulin tropic peptide (GIP) which leads to glucose homeostasis via enhancing insulin secretion and suppression of glucagon, which results in control of post-prandial and fasting hyperglycemia.Methods: These 40 patients who were enrolled as per the inclusion criteria of receiving metformin dosage of 2 gram per day in established type 2 diabetes mellitus patients with no comorbidities. these patients were divided randomly into two groups comprising of 20 patients each, group A received linagliptin 5 mg per day in addition to metformin 1gm twice daily whereas group B received linagliptin 5 mg per day in a fixed dose (Linagliptin + metformin) of 2.5/1000 twice daily.Results: In the present observational study, the mean age in group A was 46.7±9.4 compared to 51.65±9.9 in group B, p >0.05, mean BMI in group A was 27.8±1.1 compared to 27.28±0.93 in group B p >0.05, Mean FBS in group A was 157.9±24.1 compared to 146.2±21.8 in group B p >0.05, Mean PPBS in group A was 245.8±32.7 compared to 246.2±39.3 in group B p >0.05 and Mean HbA1c in group A was 7.67±0.58 compared to 7.6±0.5 in group B p >0.05. Group A patients were initiated on once daily linagliptin, there was a significant reduction in FBS, PPBS and HbA1c at the end of 6 months p <0.001. Similarly, Group B patients who were initiated on twice daily linagliptin also showed a significant reduction in FBS, PPBS and HbA1c at the end of 6 months p <0.001.Conclusions: The addition of linagliptin to metformin treatment was effective and well tolerated in patients with type 2 diabetes. Linagliptin add-on to metformin during the early course of treatment helps in delaying the exhaustion of pancreatic islet function. Plasma concentrations of linagliptin decline in at least a biphasic manner with a long terminal half-life (>100 hours), related to the saturable binding of linagliptin to DPP-4. The prolonged elimination phase does not contribute to the accumulation of the drug. Addition of linagliptin to metformin has shown a significant reduction in FBS, PPBS and HbA1c.

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Correlation Between Vitamin D3 and Fasting Blood Sugar in Type 2 Diabetes Mellitus Patients and Normal Individuals in a Bangladeshi Population

Journal of Advances in Internal Medicine ◽

10.3126/jaim.v9i2.32817 ◽

2020 ◽

Vol 9 (2) ◽

pp. 65-68

Author(s):

Md. Tazul Islam ◽

Miliva Mozaffor ◽

Md. Ehsanul Islam ◽

Heera Lal Roy

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Blood Glucose ◽

Vitamin D3 ◽

Fasting Blood Glucose ◽

Group A ◽

Group B ◽

25 Hydroxycholecalciferol

Background and Aims: Controversies prevail on association of vitamin D level and type 2 diabetes mellitus. The present study aims to compare serum 25-hydroxycholecalciferol (vitamin D3) level and fasting blood glucose in type 2 diabetes mellitus patients and healthy subjects and evaluate their association in both groups. Methods: This cross-sectional, observational study was done in Department of Biochemistry, Sylhet MAG Osmani Medical College, Bangladesh, between July 2015 and June 2016. The patients were selected from medicine out-patients departments (MOPD) of Sylhet MAG Osmani Medical College Hospital and Sylhet Diabetic Hospital, Bangladesh. A total of 135 study subjects were selected following convenient consecutive sampling technique. They grouped into case (Group A) i.e. 65 patients having type 2 diabetes mellitus, and control (Group B), i.e. 70 patients apparently healthy subjects (non-diabetic). Initial evaluation of the patients done by history and clinical examination was recorded in the preformed data collection sheet. Fasting blood glucose was measured by enzymatic method, while serum 25-hydroxycholecalciferol (vitamin D3) was measured by radioimmunoassay (RIA). Results: The mean age of 42.02±3.29 years in case (Group A); while 41.35±3.97 years in control (Group B). There were 33 male (50.76%) and 32 (49.23%) female in group A, while 35 (50%) male and 35 (50%) female in group B. No significant age difference was observed between the groups (p=0.284). Serum 25-hydroxycholecalciferol in cases (Group A) was 55.73±9.02 ng/ml and in controls (Group B) 53.77±10.86 ng/ ml (p=0.255). Fasting blood glucose was 161.98±62.47 mg/dl in cases (Group A) and 86.92±15.74 mg/dl in controls (Group B) (p<0.001). No correlation was found between serum 25-hydroxycholecalciferol and fasting blood glucose in any group: in type 2 diabetic patients (case group) (r=0.010, p=0.943), in healthy controls (r=0.186, p=0.122), and all study subjects together (r=0.095, p=0.268). Conclusions: Our data suggest that serum 25-hydroxycholecalciferol (vitamin D3) was within optimum level in both type 2 diabetic patients and healthy individuals. However, no correlation was found between serum 25-hydroxycholecalciferol and fasting blood glucose in any group.

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TYPE 2 DIABETES MELLITUS;

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.04.2876 ◽

2019 ◽

Vol 26 (04) ◽

Author(s):

Doctor Dilshad Muhammad ◽

Masood Javed ◽

Muzzammal Iftikhar

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Blood Glucose ◽

Fasting Blood Glucose ◽

P Value ◽

Group A ◽

Group B ◽

New Onset

Background: Diabetic complications are related to impaired glycemic control. The UK Prospective Diabetes Study (UKPDS) showed that metformin therapy in overweight and obese patients with type 2 diabetes mellitus (T2DM) could reduce HbA1c and complications. So, metformin has been suggested to be the drug of choice after life style modifications in patients with T2DM. Repaglinide, short-acting insulin secretagogues, has excellent anti-hyperglycemic effect and a lower risk of hypoglycemia. However, whether repaglinide can be used as an initial therapy in patients with newly diagnosed T2DM is still unconfirmed. Objectives: The objective of this study was: To compare efficacy of Repaglinide and Metformin in the Treatment of New Onset Type 2 Diabetes Mellitus. Study Design: Randomized Controlled Trial. Setting: District headquarter Hospital, Faisalabad. Period: 6 Months (Jan 2018 to June 2018). Methodology: Patients were randomly divided into two groups (A & B) by using computer generated random number table. Group A was given repaglinide 0.75-1.5 mg/day while group B received metformin 750-1500mg/day. The doses of metformin and repaglinide were adjusted according to blood glucose level. For HbA1C and FBS, blood samples were sent to pathology laboratory at the start of study and after 3 months. Follow up was ensured by reaching the patients through telephonic contact. Data was collected through self-conducted interviews using a standardized Performa. Results: In our study, mean+sd was calculated as 44.54+5.92 years in Group-A and 45.31+6.13 years in Group-B, 42.86%(n=15) in Group-A and 40%(n=14) in Group-B were male whereas 57.14%(n=20) in Group-A and 60%(n=21) in Group-B were females. Baseline mean HbA1c levels of the patients were calculated as 7.51+0.50 mmol/L in Group-A and 7.54+0.52 mmol/L in Group B, p value was 0.81. After treatment, these findings were reduced to 5.57+0.65 in Group-A and 6.4+0.49 in Group-B, p value was 0.0001, At baseline mean fasting blood glucose levels of the patients were calculated as 7.43+0.56 mmol/L in Group-A and 7.46+0.50 mmol/L in Group B, p value was 0.82. After treatment, these findings were reduced to 5.83+0.71 in Group-A and 6.29+0.67 in Group-B, p value was 0.007. Conclusion: We concluded that on comparison of Metformin and Repaglinide monotherapy in the Treatment of New Onset Type 2 Diabetes Mellitus in terms of mean fasting blood glucose and mean HbA1c, both drugs reduced HbA1c and fasting blood sugar but Repaglinide was found significantly better for reduction of HbA1c and fasting blood sugar when compared to Metformin.

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Pharmaceutical hit of anti type 2 Diabetes mellitus on the phenolic extract of Malaka (Phyllanthus emblica L.) flesh

Clinical Phytoscience ◽

10.1186/s40816-019-0138-7 ◽

2019 ◽

Vol 5 (1) ◽

Author(s):

Musri Musman ◽

Mauli Zakia ◽

Ratu Fazlia Inda Rahmayani ◽

Erlidawati Erlidawati ◽

Safrida Safrida

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Body Weight ◽

Blood Glucose ◽

Phyllanthus Emblica ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Phenolic Extract

Abstract Background Ethnobotany knowledge in a community has shaped local wisdom in utilizing plants to treat diseases, such as the use of Malaka (Phyllanthus emblica) flesh to treat type 2 diabetes. This study presented evidence that the phenolic extract of the Malaka flesh could reduce blood sugar levels in the diabetic induced rats. Methods The phenolic extract of the P. emblica was administrated to the glucose-induced rats of the Wistar strain Rattus norvegicus for 14 days of treatment where the Metformin was used as a positive control. The data generated were analyzed by the two-way ANOVA Software related to the blood glucose level and by SAS Software related to the histopathological studies at a significant 95% confidence. Results The phenolic extract with concentrations of 100 and 200 mg/kg body weight could reduce blood glucose levels in diabetic rats. The post hoc Dunnet test showed that the administration of the extract to the rats with a concentration of 100 mg/kg body weight demonstrated a very significant decrease in blood glucose levels and repaired damaged cells better than administering the extract at a concentration of 200 mg/kg weight body. Conclusion The evidence indicated that the phenolic extract of the Malaka flesh can be utilized as anti type 2 Diabetes mellitus without damaging other organs.

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Dipeptidyl peptidase-4 inhibitor (teneligliptin) significantly reduces liver fat content and delays progression of non-alcoholic steatohepatitis in type 2 diabetes mellitus patients

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20214516 ◽

2021 ◽

Vol 8 (12) ◽

pp. 1817

Author(s):

Vishal Kumar Gupta ◽

Richa Giri ◽

Saurabh Agrawal

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Dipeptidyl Peptidase ◽

Liver Fat ◽

Liver Fat Content ◽

Group A ◽

The Mean ◽

Group B

Background: Dipeptidyl peptidase (DPP)-4 inhibitors, anti-diabetic agents, are expected to be effective for treatment of non-alcoholic fatty liver disease (NAFLD). Several studies have shown that some DPP-4 inhibitors alleviate hepatic steatosis or steatohepatitis in type 2 diabetic mice or rats. Teneligliptin is DPP4 inhibitor whose efficacy to control blood sugar is well established but its effect on liver is not studied well. In present study we investigated effect of teneligliptin, a DPP-4 inhibitor on patients of type 2 diabetes with non-alcoholic steatohepatitis (NASH). Methods: This was a randomized, double-blind study in which 64 patients between ages of 18 to 80 years were selected for study. Participants were identified as type 2 diabetes with biopsy confirmed NASH. We excluded the patients with glucocorticoid use, hepatitis B or C, and other diseases that might affect liver function. Results: The mean HbA1c change after 48 weeks of therapy in group A was-1.06 % and in group B was-0.77% and this was statistically insignificant (p>0.06). The mean AST change after 48 weeks of therapy in group A was-45.4% and in group B was-33.3% and this was statistically significant (p<0.001). The mean ALT change after 48 weeks of therapy in group A was-41.6% and in group B was-22.7% and this was statistically significant (p<0.001). The change in liver fat content (LFC) after 48 weeks of therapy in group A was-15.4% and group B was-7.14% and this was also statistically significant (p<0.001).Conclusions: Result of our study revealed that teneligliptin significantly reduce serum transaminases in patients of NASH with type 2 DM. Teneligliptin significantly reduce LFC and delay progression of NASH independent of diabetes control in type 2 diabetes mellitus (DM) patients. These data show significant antisteatotic and anti-inflammatory effect of teneligliptin in type 2 diabetes patients.

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A Randomized Study to Compare the Effects of Once-Weekly Dulaglutide Injection and Once-Daily Glimepiride on Glucose Fluctuation of Type 2 Diabetes Mellitus Patients: A 26-Week Follow-Up

Journal of Diabetes Research ◽

10.1155/2019/6423987 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Huiqin Li ◽

Xiaohua Xu ◽

Jie Wang ◽

Xiaocen Kong ◽

Maoyuan Chen ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Blood Glucose ◽

Glycosylated Hemoglobin ◽

Oxidation Stress ◽

Once Daily ◽

Glucose Fluctuation ◽

Significant Difference

Objective. To evaluate the effects of once-weekly dulaglutide injection and once-daily glimepiride on glucose fluctuation in patients with type 2 diabetes mellitus (T2DM) using the Continuous Glucose Monitoring System (CGMS). Methods. A total of 23 patients with T2DM were randomly assigned into two groups for 26 weeks: the dulaglutide group (n=13) and the glimepiride group (n=10). 72-hour CGMS was applied to all patients: before and after the treatment. General clinical data were collected and measured, such as fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), tumor necrosis factor-α (TNF-α), 8-iso-prostaglandin F2α (8-iso-PGF2α), and interleukin-6 (IL-6). Results. HbA1c of the dulaglutide group was reduced from 8.38±0.93% to 6.68±0.73% after the treatment (P<0.05); similarly, it was reduced from 7.91±0.98% to 6.67±0.74% (P<0.05) in the glimepiride group. The levels of serum 8-iso-PGF2α, TNF-α, and IL-6 all decreased significantly in both groups after treatment, and there was no significant difference found between the two groups (P>0.05). The Mean Blood Glucose (MBG) of the two groups declined significantly after therapy (P<0.05). However, the Standard Deviation of Blood Glucose (SDBG) decreased significantly only in the dulaglutide group (from 2.57±0.74 mmol/L to 1.98±0.74 mmol/L, P<0.05). There were no significant changes of Mean Amplitude of Glycemic Excursion (MAGE) and Absolute Means of Daily Difference (MODD) after treatment in both groups. Furthermore, no statistically significant difference was found between the two groups in MBG, SDBG, MAGE, and MODD (P>0.05). The percentage time (PT) (>10 mmol/L and 3.9-10 mmol/L) of the two groups was significantly changed after the treatment (P<0.05). However, this was not seen in the PT<3.9 mmol/L after the treatment (P>0.05). Conclusion. Once-weekly dulaglutide injection has the same effectiveness as daily glimepiride on lowering blood glucose and decreasing oxidation stress and inflammation and is more effective in controlling glucose fluctuation as compared with glimepiride. This trial is registered with ClinicalTrials.gov NCT01644500.

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Increased Serum Levels of Uric Acid Are Associated with Sudomotor Dysfunction in Subjects with Type 2 Diabetes Mellitus

Experimental Diabetes Research ◽

10.1155/2011/346051 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5 ◽

Cited By ~ 11

Author(s):

N. Papanas ◽

M. Demetriou ◽

N. Katsiki ◽

K. Papatheodorou ◽

D. Papazoglou ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Uric Acid ◽

Colour Change ◽

Serum Levels ◽

Group A ◽

Group B

The aim of this paper was to assess serum uric acid (SUA) levels in patients with type 2 diabetes mellitus (T2DM) with or without sudomotor dysfunction (evaluated by the Neuropad test). We included 36 T2DM patients with sudomotor dysfunction (group A: mean age63.1±2.6years) and 40 age-, gender-, renal function- and T2DM duration-matched patients without sudomotor dysfunction (group B: mean age62.1±3.1years). SUA was significantly higher in group A (P<0.001). There was a significant correlation between SUA and Neuropad time to colour change in both groups (group A:rs=0.819,P<0.001; group B:rs=0.774,P<0.001). There was also a significant positive correlation between SUA and CRP in both groups (group A:rs=0.947,P<0.001; group B:rs=0.848,P<0.001). In conclusion, SUA levels were higher in T2DM patients with sudomotor dysfunction than those without this complication. The potential role of SUA in sudomotor dysfunction merits further study.

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Effects of Encapsulated Propolis on Blood Glycemic Control, Lipid Metabolism, and Insulin Resistance in Type 2 Diabetes Mellitus Rats

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2012/981896 ◽

2012 ◽

Vol 2012 ◽

pp. 1-8 ◽

Cited By ~ 24

Author(s):

Yajing Li ◽

Minli Chen ◽

Hongzhuan Xuan ◽

Fuliang Hu

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Body Weight ◽

Lipid Metabolism ◽

Blood Glucose ◽

Glycemic Control ◽

Density Lipoprotein

The present study investigates the encapsulated propolis on blood glycemic control, lipid metabolism, and insulin resistance in type 2 diabetes mellitus (T2DM) rats. The animal characteristics and biological assays of body weight, fasting blood glucose (FBG), fasting serum insulin (FINS), insulin act index (IAI), triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were measured and euglycemic hyperinsulinemic glucose clamp technique were used to determine these effects. Our findings show that oral administration of encapsulated propolis can significantly inhibit the increasing of FBG and TG in T2DM rats and can improve IAI and M value in euglycemic hyperinsulinemic clamp experiment. There was no significant effects on body weight, TC, HDL-C, and LDL-C in T2DM rats treated with encapsulated propolis. In conclusion, the results indicate that encapsulated propolis can control blood glucose, modulate lipid metabolism, and improve the insulin sensitivity in T2DM rats.

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Efficacy and Safety of Empagliflozin as Add-On Therapy in Patients of Type-2 Diabetes Mellitus

Journal of Gandhara Medical and Dental Science ◽

10.37762/jgmds.9-1.173 ◽

2022 ◽

Vol 9 (1) ◽

pp. 24-27

Author(s):

Nauman Wazir ◽

Shafqat Ur Rehman

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Side Effects ◽

Glycaemic Control ◽

Group A ◽

Group B ◽

Tract Infections ◽

Mycotic Infections

OBJECTIVES: To assess efficacy of two doses i.e., 10 mg and 25 mg in lowering the glycated haemoglobin (HbA1C) and fasting blood glucose (FBG) in patients of type 2 diabetes mellitus (T2DM) having suboptimal glycaemic control on maximal doses of Metformin and Sitagliptin, and to see the frequency of its side-effects. METHODOLOGY: The study design was a randomized control trial. Fifty nine adult patients of T2DM who were already on 2000 mg of Metformin and 100 mg of Sitagliptin and were having suboptimal glycaemic control (HBA1C >7% and <12%) were randomized to two groups, one group receiving 10 mg (Group A) and the other group receiving 25 mg of empagliflozin (Group B) as an additional treatment. HbA1C and FBG were taken before and 12 weeks after addition of empagliflozin in both the groups. Side effects of empagliflozin such as urinary tract infections (UTI) and genital mycotic infections were also recorded in both the groups. RESULTS: Total patients in-group A were 31 and their mean age was 51.48±4.29 years. In-group B there were 28 patients and their mean age was 52.39±5.20 years. There was a statistically significant reduction of both HbA1C and FBG in both the groups after empagliflozin treatment; (p=0.000) for both HbA1C and FBG in both the groups. Although numerically UTI and genital mycotic infections were more than pre-treatment numbers, they were not statistically significant (p>0.05). CONCLUSION: Empagliflozin can be safely added to the oral anti-diabetic regimen of patients with type 2 diabetes mellitus who have suboptimal glycaemic control and results in significant improvement in HbA1C.

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