scholarly journals The Cross-talk Relationship between Metformin and Gut Microbiota

2020 ◽  
Author(s):  
Hyder O. Mirghani
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Gut Microbiota ◽  
Plasma Glucose ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Current Review

Background: Metformin is the first-line oral therapy for type 2 diabetes mellitus. However, its mode of action is poorly defined. There is an increasing awareness regarding the cross talk of gut microbiota and metformin. The current review aimed to assess the bidirectional relationship between metformin and gut microbiota. Methods: Electronic search was conducted in Pub Med and the first 100 articles in Google Scholar published until November 2019. However, only randomized controlled trials on humans published in the English language were included.  The terms “gut microbiota,” “gut flora "and “ metformin” were as keywords to perform the search. Although 124 articles were retrieved, only six met the inclusion criteria of the study. Results: Of the six full texts of randomized controlled trials included in the study, two-thirds were published in Europe, one in the USA, and one in China. Six hundred-thirty five patients were included and the duration of the studies ranged from seven days to six months. The studies concluded that microbiota modulates some metformin actions on plasma glucose; while metformin enhances the abundance of microbiota that positively affect insulin resistance and plasma glucose. Conclusion: The current review showed that microbiota dysbiosis may mediate metformin antidiabetic effects. Whereas metformin shifted the gut microbiota toward the beneficial species ameliorating insulin resistance. The present study might provide insights into a novel therapeutic approach to treat type 2 diabetes mellitus. Key words: gut microbiota, metformin, type 2 diabetes

scholarly journals Efficacy and Safety of Curcumin Supplement on Improvement of Insulin Resistance in People with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 2021 ◽  
pp. 1-19
Author(s):  
Tianqing Zhang ◽  
Qi He ◽  
Yao Liu ◽  
Zhenrong Chen ◽  
Hengjing Hu
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Middle East ◽  
Randomized Controlled Trials ◽  
Health Concern ◽  
Controlled Trials ◽  
Randomized Controlled

Background. Diabetes is a major public health concern. In addition, there is some evidence to support curcumin as part of a diabetes treatment program. Methods. Data from randomized controlled trials were obtained to assess the effects of curcumin versus placebo or western medicine in patients with type 2 diabetes mellitus (T2DM). The study’s registration number is CRD42018089528. The primary outcomes included homeostasis model assessment-insulin resistance (HOMA-IR), glycosylated hemoglobin (HbAlc), total cholesterol (TC), and triglyceride (TG). Results. Four trials involving 453 patients were included. The HOMA-IR of curcumin group is lower in Asia (WMD: −2.41, 95% CI: −4.44 to −0.39, P = 0.02 ) and the Middle East subgroups (WMD: −0.60, 95% CI: −0.74 to −0.46, P < 0.00001 ). The HbAlc in the curcumin group is lower than that in the control group (WMD: −0.69; 95% CI: −0.91, −0.48; P < 0.0001 ). The TC and TG levels of the curcumin group are lower in the Asia subgroup (TC: WMD: −23.45, 95% CI: −40.04 to −6.84, P = 0.006 ; TG: WMD: −54.14, 95% CI: −95.71 to −12.57, P = 0.01 ), while in the Middle East the difference was of not statistically significant (TC: WMD: 22.91, 95% CI: −16.94 to 62.75, P = 0.26 ; TG: WMD: −4.56, 95% CI: −19.28 to 10.16, P = 0.54 ). Conclusion. Based on the current evidence, curcumin may assist in improving the insulin resistance, glycemic control, and decreased TG and TC in patients with T2DM.

scholarly journals Herbal Formula Gegen-Qinlian Decoction for Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Lin Ren ◽  
Yanxia Cheng ◽  
Feng Qin
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Side Effects ◽  
Plasma Glucose ◽  
Controlled Trials ◽  
Herbal Formula ◽  
Glucose Levels ◽  
Randomized Controlled

Background. Herbal formula Gegen-Qinlian Decoction (GQD) has been widely used in China for the treatment of type 2 diabetes mellitus (T2DM), but its efficacy and safety are unclear. Method. The studies were identified from the PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure database, Wanfang database, and VIP database using the keywords “Gegenqinlian” or “Gegen-Qinlian” or “Gegen-Qin-Lian” or “Ge Gen Qin Lian.” Relevant studies were selected according to predefined inclusion and exclusion criteria. Study selection, data extraction, and validation were carried out by, at least, two reviewers with disagreements being settled by discussion. Results. After literature search, a total of 26 randomized controlled trials were included with a total of 2553 patients. There was evidence that compared with metformin, the combination of GQD and metformin significantly reduced the fasting plasma glucose levels (MD −1.79, 95% CI (−2.31, −1.27), p < 0.00001 ); 2-hour postprandial plasma glucose levels (MD −1.72, 95% CI (−2.12, −1.31), p < 0.00001 ); and glycosylated hemoglobin levels (MD −1.26, 95% CI (−1.80, −0.72), p < 0.00001 ), and no serious side effects were identified. Conclusion. These data suggest that GQD may be an effective herbal formula in treating T2DM without serious side effects. The addition of GQD also enhances the hypoglycemic effects of metformin. However, the evidence remains weak due to methodological flaws, which may amplify the therapeutic benefit of GQD.

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

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.

Efficacy and safety of empagliflozin in type 2 diabetes mellitus: a meta-analysis of randomized controlled trials

2016 ◽  
Vol 129 (3) ◽  
pp. 382-392 ◽  
Author(s):  
R. Devi ◽  
Ghanshyam Mali ◽  
Indrani Chakraborty ◽  
Mazhuvancherry Kesavan Unnikrishnan ◽  
Suhaj Abdulsalim
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Randomized Controlled

A Review: Comparison of Efficacy of Liraglutide Versus Sitagliptin add-on-to Metformin in Type 2 Diabetes Mellitus patients

2021 ◽  
pp. 2291-2295
Author(s):  
A. Kavyasree ◽  
P. Geetha ◽  
P. Shanmugasundaram
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Randomized Controlled Trials ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Duration Of Treatment ◽  
Randomized Controlled ◽  
Gastrointestinal Problems

Background: The aim of this review is to compare the efficacy of liraglutide versus sitagliptin add-on-to metformin in patients with Type 2 Diabetes Mellitus and inadequate glycemic control for rational use of drugs. Methods: We searched for randomized controlled trials (RCT) in MEDLINE, Web of science, PubMed, Cochrane library, CNKI, and Wanfang database and extracted data from all randomized controlled trials (RCTs) up to July 11, 2019 of liraglutide versus sitagliptin given in combination with metformin. RCTs were selected only if they were RCTs comparing DPP-4 inhibitor (sitagliptin) monotherapy to metformin monotherapy with the GLP-1 Receptor Agonists (liraglutide), duration of treatment was ≥26 weeks and reported data on hemoglobin A1c (HbA1c) change, fasting plasma glucose (FPG) change, Odds ratio (OR), mean difference (MD), 95% confidence interval are used to analyze the outcomes. Results: A total of 2,257 patients from 6 RCTs were included in the study. When compared with sitagliptin (100mg) in combination with metformin group, the group of patients treated with liraglutide1.2mg and 1.8mg and metformin, produced greater reduction in HbA1c, FBG. (95% CI). The group of patients with 1.8mg liraglutide had significant weight loss. The incidence of nausea, hypoglycemic episodes, gastrointestinal problems was higher than the sitagliptin with metformin groups. Conclusions: The results of this study indicated that the liraglutide – metformin combination therapy could significantly lower the HbA1c level and increased reduction of body weight. ADRs such as gastrointestinal problems, hypoglycemic episodes were common in liraglutide treatment group.

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