scholarly journals TYPE 2 DIABETES MELLITUS’S DECOMPENSATED FORM: ON THE PROBLEM OF EFFECTIVE PHARMACOTHERAPY IN REAL CLINICAL PRACTICE

2021 ◽  
Vol 9 (5) ◽  
pp. 377-386
Author(s):  
A. V. Safronenko ◽  
E. V. Gantsgorn ◽  
E. A. Sanina ◽  
M. A. Khachumova ◽  
S. O. Panenko ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Hba1c Level ◽  
Venous Blood ◽  
Cardiovascular Risks ◽  
Treatment Optimization ◽  
Clinical Recommendations ◽  
Significant Pathology ◽  
History Of ◽  
Hypoglycemic Therapy

The aim of this retrospective study was to analyze the pharmacotherapy regimens of the decompensated form of type 2 diabetes mellitus (DM2) and to evaluate its effectiveness, its compliance with clinical recommendations.Materials and methods: A retrospective analysis of 54 medical cards of patients with decompensated DM2 was conducted. The 1st group (n=24; 44%) included the patients who had a decrease in glycated hemoglobin (HbA1c) by 50% or more in 3 months after hypoglycemic therapy; and the 2nd group (n=30; 56%) – the patients whose HbA1c level decreased by less than 50%.Results. A HbA1c level was 10.4% in the 1st group and 13.2% in the 2nd group (р<0.001). However, the target levels of venous blood plasma glucose and HbA1c were not achieved in any of the patient groups. The total number of the drugs prescribed to the patients ranged from 4 (in 25% (n=6) and 10% (n=3) cases in the 1st and the 2nd groups, respectively) to 8 (in 12.5% (n=3) and 20% (n=6) cases in the 1st and the 2nd, groups, respectively). However, in a number of cases some violations of clinical recommendations were recorded: the prescription to the obese patients of insulin drugs, the administration of sulfonylureas derivatives to patients with a history of cardiovascular diseases of the atherosclerotic origin, but modern hypoglycemic drugs with proven benefits in reducing cardiovascular risks were rarely prescribed.Conclusion. The tactics of pharmacotherapy in the patients with a decompensated form of DM2 does not fully comply with the approved clinical guidelines, which requires the effectiveness of treatment optimization of this medically and socially significant pathology.

scholarly journals Supply of vitamins for patients with type 2 diabetes and obesity in the autumn

2019 ◽  
Vol 18 (1) ◽  
pp. 95-101
Author(s):  
N. A. Beketova ◽  
O. V. Kosheleva ◽  
O. A. Vrzhesinskaya ◽  
V. M. Kodentsova ◽  
H. H. Sharafetdinov ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Serum Concentration ◽  
Venous Blood ◽  
Beta Carotene ◽  
Vitamin Deficiencies ◽  
Vitamin Status ◽  
25 Oh Vitamin D ◽  
High Level ◽  
Hypoglycemic Therapy

Aim. To assess the availability of patients with type 2 diabetes mellitus (DM-2) and obesity with vitamins C, A, E, D, B2, B6, niacin and betacarotene.Material and methods. We assess vitamin status of 40 patients with DM-2 (14 men and 26 women) aged 42-80 years was 60,2±1,3 (Me=60,5) with concomitant obesity and a body mass index from 31,2 to 57,4 kg 42,1±1,1 (Me=42,0), receiving oral hypoglycemic therapy. The disease duration ranged from six months to 32 years — 7,4±1,0 (Me=6,0), the level of glycohemoglobin — from 5,20% to 7,70% — 6,27±0,11 (Me=6,05). The provision of C, A, E, D, B2 vitamins and beta-carotene was assessed by their serum concentration, B6 and niacin vitamins — by excretion of their metabolites with urine.Results. Against the background of a good supply of patients with A, E, C and PP vitamins, a reduced serum concentration of 25-OH vitamin D was detected in the majority (83%) of the patients, beta carotene — in 55%, insufficient provision with vitamins B6 and B2 — 15-18%. A reduced serum concentration of 1-2 vitamins was detected in 65% of the patients. A combined deficiency of 3-4 vitamins had 25% of patients.Conclusion. The presence of vitamin deficiencies in patients with DM-2, which are a risk factor for its occurrence and the development of complications, indicates the need to optimize vitamin status. The negative association between the level of basal glycemia in venous blood and glucosuria and the concentration of γ-tocopherol may indicate certain benefits of using dietary oils with a high level of vitamer.

scholarly journals Barriers for efficacious hypoglycemic therapy in clinical practice (results of the Dialogue study)

2010 ◽  
Vol 13 (4) ◽  
pp. 54-56
Author(s):  
Irina Evgen'evna Sapozhnikova ◽  
Elena Nikolaevna Anufrieva ◽  
Ekaterina Iosifovna Tarlovskaya ◽  
Alexander Anatol'evich Sobolev
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Clinical Practice ◽  
Hba1c Level ◽  
Insulin Administration ◽  
Daily Dose ◽  
Hypoglycemic Therapy ◽  
Poor Efficacy

Aim. To analyse factors hampering the achievement of compensation of carbohydrate metabolism in patients with type 2 diabetes mellitus treated for3 months with diabeton MB at a daily dose of 90-120 mg under real practical conditions. Materials and methods. This open study included 70 patients with type 2 diabetes mellitus given gliclazide MB-based hypoglycemic therapy(90-120 mg/day); their HbA1c level was measured before and 3 months after the onset of therapy. Results. The treatment resulted in a significant decrease of the HbA1c level especially pronounced in patients capable of following the rational therapeuticstrategy. At the closing visit, each patient was prescribed a pathogenetically sound regime of combined hypoglycemic therapy. Conclusion. Poor efficacy of hypoglycemic treatment in real clinical practice is attributable to frequent prescription of monotherapy, untimely onsetof insulin administration, its correction and intensification to meet changing requirements

Clinical Experience with Insulin Detemir: Results from the Bangladesh Cohort of Global A1chieve Study

2013 ◽  
Vol 3 (1) ◽  
pp. 11-18 ◽  
Author(s):  
Zafar Ahmed Latif ◽  
Md. Faruque Pathan ◽  
Md. Nazrul Islam Siddiqui ◽  
MA Mannan ◽  
SM Ashrafuzzaman ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Weight ◽  
Glycaemic Control ◽  
Insulin Therapy ◽  
Hba1c Level ◽  
Insulin Detemir ◽  
Entire Cohort ◽  
Baseline Visit ◽  
Effective Option

Objective: To present results from the Bangladesh cohort of the A1chieve study receiving insulin detemir (Levemir) ± oral anti diabetic drugs. Methods: Out of 1093 patients recruited from 49 sites in Bangladesh, 370 were initiated on insulin detemir (Levemir).Study visits were defined as baseline, interim (around 12 weeks from baseline) and final (around 24 weeks from baseline) visit. Results: Glycaemic control was poor in all the groups at baseline. In the entire cohort at 24 weeks, significant reductions from baseline were observed in mean HbA1c (from 10.0 % to 7.2%, p<0.001), FPG (from 10.5 to 6.7 mmol/L, p<0.001) and PPPG (from 15.3 to 8.9 mmol/L, p<0.001) levels. Overall 45.5% of the participants achieved target HbA1c level of < 7% after 24 weeks. The rate of all hypoglycaemic events in the entire cohort reduced from 1.34 (baseline) to 0.12 events/person year after 24 weeks of insulin detemir therapy (p<0.0001). There was no clinically relevant change in body weight in insulin naïve or prior insulin users groups after 24 weeks of insulin detemir therapy. Conclusions: The current study suggests that insulin detemir may be considered as a safe and effective option for initiating insulin therapy for type 2 diabetes in Bangladesh. Birdem Med J 2013; 3(1): 11-18 DOI: http://dx.doi.org/10.3329/birdem.v3i1.17121

1386-P: Long-Term Weight Change after Pregnancy and Type 2 Diabetes Risk in Women with a History of Gestational Diabetes

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1386-P
Author(s):  
SYLVIA E. BADON ◽  
FEI XU ◽  
CHARLES QUESENBERRY ◽  
ASSIAMIRA FERRARA ◽  
MONIQUE M. HEDDERSON
Keyword(s):  
Type 2 Diabetes ◽  
Gestational Diabetes ◽  
Weight Change ◽  
Diabetes Risk ◽  
History Of

1715-P: Impaired Postprandial Adipose Tissue Microvascular Blood Flow in Healthy People with a Family History of Type 2 Diabetes

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1715-P
Author(s):  
KATHERINE ROBERTS-THOMSON ◽  
RYAN D. RUSSELL ◽  
DONGHUA HU ◽  
TIMOTHY M. GREENAWAY ◽  
ANDREW C. BETIK ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Blood Flow ◽  
Adipose Tissue ◽  
Family History ◽  
Healthy People ◽  
Microvascular Blood Flow ◽  
History Of

Glucagon-like peptide-1 agonist therapy in patients with diabetes mellitus and obesity

2020 ◽  
Vol 98 (3) ◽  
pp. 210-217
Author(s):  
A. Yu. Babenko ◽  
Yu. A. Kononova ◽  
M. V. Martjanova ◽  
A. V. Simanenkova ◽  
M. A. Kokina ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Hba1c Level ◽  
High Efficiency ◽  
Receptor Agonists ◽  
Predictors Of Response ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1 ◽  
Lipids Metabolism

Due to the high efficiency of glucagon-like peptide-1 (GLP-1) receptor agonists therapy in only a part of patients, the search for predictors of response to the treatment is a relevant problem. Purpose. The purpose is to compare the efficacy of liraglutide and exenatide therapy in obese patients with type 2 diabetes mellitus (T2DM) and to evaluate the predictors of response to glycated hemoglobin (HbA1c), weight and lipids reduction. Material and methods. The study included 47 patients with type 2 diabetes and obesity who received GLP-1 receptor agonists therapy. 26 patients were treated with liraglutide, 21 patients were treated with exenatide. We measured the parameters of carbohydrate and lipid metabolism, the levels of hormones involved in glucose and lipids metabolism and in appetite regulation. Blood pressure was measured. These parameters were evaluated at baseline and after 24 weeks of treatment. Results. Patients receiving exenatide therapy showed a tendency towards more frequent HbA1c level reduction by 1% or more (60% versus 30.4%, p = 0.07). The effects of liraglutide and exenatide on weight and waist circumference were comparable. When assessing the predictors of response to the therapy, a more pronounced decrease in HbA1c level (by 1% or more) was in the patients with a higher initial HbA1c level (8.7 (8.2; 9.7) versus 8.2 (6.9; 8.7)%, p = 0.04), as well as with a higher initial GLP-1 level (0.12 (0.05; 0.17) versus 0.040 (0.01; 0.09) ng/ml.) A more significant decrease in the triglycerides (TG) level was detected in patients with a higher level of glucose-dependent insulinotropic peptide (GIP) before therapy (409 (316.0; 431.4) pg/ml in patients who reduced TG level by 30% or more and 331.5 (324.9; 367.1) pg/ml in patients with a lower decrease in TG level). Among the studied parameters, no predictors of body mass reduction were revealed. Conclusion. Measurement of HbA1c, GLP-1, GIP level may be useful to predict the efficacy of GLP-1 receptor agonists therapy.

Microcirculation disorders in patients with vibration disease and comorbidity

2020 ◽  
pp. 672-672
Author(s):  
A. N. Kuks ◽  
N. V. Slivnitsyna
Keyword(s):  
Type 2 Diabetes ◽  
Laser Doppler Flowmetry ◽  
Laser Doppler ◽  
Combined Effects ◽  
Doppler Flowmetry ◽  
Vibration Disease ◽  
History Of

The results of laser Doppler flowmetry in patients with vibration disease associated with the combined effects of local and general vibration with a history of type 2 diabetes are presented.

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