The Cumulative Dose-Dependent Effects of Metformin on the Development of Tuberculosis in Patients Newly Diagnosed with Type 2 Diabetes Mellitus

Abstract Background: Diabetes mellitus (DM) is a well-known risk factor for tuberculosis (TB). Metformin, which is an essential anti-diabetic drug, has been shown to exhibit anti-TB effects in patients with DM. Its effect on preventing the development of TB among patients who are newly diagnosed with DM remains unclear. We evaluated the protective effect of metformin on the development of TB among newly diagnosed patients with type 2 DM.Methods: This was a retrospective cohort study using the claims database. The study population included newly diagnosed type 2 DM patients between January 2003 and March 2011. A metformin user was defined if a patient had taken metformin for more than 28 days within the first 6 months after the initial cohort entry. Primary outcome was the development of TB within 2 years after the index date. Results: Metformin use was not associated with the prevention of TB development (Metformin user: 44/12,916 (0.34%) vs. Metformin non-user: 40/12,916(0.31%); HR, 1.17; 95% CI, 0.75-1.83; P = 0.482). There was, however, a reduction in the development of TB among patients taking a higher cumulative dose of metformin. Patients in the highest quartile of cumulative metformin dose had only a 10% risk of developing TB compared to metformin non-users. In contrast, patients in the second quartile had a higher risk of developing TB than patients in the first quartile. Conclusions: The highest cumulative doses of metformin were protective against the development of TB among newly diagnosed type 2 DM patients.

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The cumulative dose-dependent effects of metformin on the development of tuberculosis in patients newly diagnosed with type 2 diabetes mellitus

BMC Pulmonary Medicine ◽

10.1186/s12890-021-01667-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Eunyoung Heo ◽

Eunyoung Kim ◽

Eun Jin Jang ◽

Chang-Hoon Lee

Keyword(s):

Diabetes Mellitus ◽

Cumulative Dose ◽

Regression Models ◽

Proportional Hazard ◽

Newly Diagnosed ◽

Hazard Regression ◽

Cox Proportional Hazard ◽

Type 2 Dm ◽

Cox Proportional Hazard Regression

Abstract Background Diabetes mellitus (DM) is a well-known risk factor for tuberculosis (TB). Metformin, which is an essential anti-diabetic drug, has been shown to exhibit anti-TB effects in patients with DM. Its effect on preventing the development of TB among patients who are newly diagnosed with DM remains unclear. Methods This was a retrospective cohort study using the claims database of the Korean Health Insurance Review and Assessment Service. The study population included patients who were newly diagnosed with type 2 DM and who were treated with anti-diabetic drugs between 1 January 2003 and 31 March 2011. A patient was defined as a metformin user if he/she had taken metformin for more than 28 days within 6 months since cohort entry, and as a metformin non-user if he/she had never been treated with metformin. The development of TB within 2 years after the index date was compared by Cox proportional hazard regression models between metformin users and 1:1 propensity score (PS)-matched non-users. Results Among 76,973 patients who were newly diagnosed with type 2 DM, 13,396 were classified as metformin users, 52,736 were classified as metformin non-users, and 10,841 were excluded from the final analysis. PS-matched Cox proportional hazard regression models revealed that metformin use was not associated overall with the prevention of TB development (HR 1.17; 95% CI 0.75–1.83; P = 0.482). There was a trend, however, towards a reduction in the development of TB among patients taking a higher cumulative dose of metformin. Patients who were in the highest quartile (Q4) of cumulative metformin dose had only a 10% risk of developing TB compared to metformin non-users. In contrast, during the early phases of metformin treatment, patients in the second quartile (Q2) of cumulative metformin use had a higher risk of developing TB than patients in the first quartile (Q1). Conclusions Only the highest cumulative doses of metformin were protective against the development of TB among patients who were newly diagnosed with type 2 DM; lower cumulative doses of metformin did not appear to reduce the incidence of active TB infection.

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Dose-dependent relationship between serum metformin levels and glycemic control, insulin resistance and leptin levels in females newly diagnosed with type 2 diabetes mellitus

Journal of Diabetes Mellitus ◽

10.4236/jdm.2012.22028 ◽

2012 ◽

Vol 02 (02) ◽

pp. 179-185 ◽

Cited By ~ 2

Author(s):

Kadhim Ali Kadhim ◽

Dowser Khalil Ismael ◽

Ban Hoshi Khalaf ◽

Khalid Ibrahim Hussein ◽

Munaf Hashim Zalzala ◽

...

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Glycemic Control ◽

Newly Diagnosed ◽

Dependent Relationship ◽

Dose Dependent

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Association of aspartate and alanine transaminases with dyslipidemia in newly diagnosed and long duration of type 2 diabetes mellitus subjects.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.12.6421 ◽

2021 ◽

Vol 28 (12) ◽

pp. 1711-1717

Author(s):

Nazish Waris ◽

Samina Bano ◽

Asher Fawwad ◽

Abdul Basit

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Group Iv ◽

Newly Diagnosed ◽

Group Iii ◽

Type 2 Dm ◽

Group I ◽

Group Ii ◽

Dm Type 2

Objective: Association between alanine transaminase (ALT) and aspartate transaminase (AST) with newly diagnosed and known type 2 diabetes mellitus (DM) and to estimate association of liver enzymes with lipid profile in type 2 DM subjects. Study Design: Prospective Clinical study. Setting: Karachi University with Collaboration of Baqai Institute of Diabetology and Endocrinology. Period: November 2018 to May 2019. Material & Methods: Total 100 people were divided into four groups; Group I: 25 healthy controls with normal glucose tolerance, Group II: 25 newly diagnosed DM, Group III: 25 known DM type 2 with <5years duration and Group IV: 25 known DM type 2 between 5-10 years duration. Baseline data was collected on predesigned questionnaire. Blood samples for biochemical parameters were analyzed using standardized laboratory techniques. Results: Group I mean age (years) was 50.78±2.34, group II 50.56±1.96, group III 50.37±1.46 and group IV 56±1.36. In Group I, ALT and AST were significantly correlated to each other’s. In group II, ALT was significantly correlated with AST, triglycerides and HDL-C, while AST correlated with ALT and HDL-C. In group III, ALT was significantly correlated with AST, while AST correlated to ALT, triglycerides and HbA1c. However, in group IV, ALT was significantly correlated with AST, LDL-C and HDL-C, and, AST with ALT, total cholesterol, LDL-C and HDL-C. Conclusion: Elevated ALT and AST- the salient markers for disease of non-alcoholic fatty liver with deranged dyslipidemia were found in known type 2 DM as well as in newly diagnosed type 2 DM subjects.

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Effect of Vitamin D status on QTc interval in type 2 diabetes mellitus

Journal of Basic and Clinical Physiology and Pharmacology ◽

10.1515/jbcpp-2019-0085 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Suresh Ravichandran ◽

Shival Srivastav ◽

Prathamesh Haridas Kamble ◽

Ravindra Shukla ◽

Praveen Sharma ◽

...

Keyword(s):

Diabetes Mellitus ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Qtc Interval ◽

Vitamin D Status ◽

Newly Diagnosed ◽

Type 2 Dm ◽

Vitamin D Levels ◽

Significant Difference

AbstractObjectivesDiabetes mellitus (DM) is associated with autonomic neuropathy and metabolic abnormalities. These predispose the patients to prolongation of QTc and risk of arrhythmias and sudden cardiac death. Vitamin D may also cause QTc prolongation. We hypothesized that concomitant Vitamin D deficiency and Type 2 DM may act in synergy to prolong QTc interval.MethodsNewly diagnosed Type 2 DM patients were recruited from Department of Endocrinology. Lead II ECG was acquired for 5 min during supine rest using a digital data acquisition system. QTc interval extraction was performed using software. 25-hydroxy Vitamin D estimation was done using Chemiluminescence method. Patients were divided into two groups- Vitamin D deficient and insufficient (VDD/I) and optimal (VDO) as per standard criteria. QTc intervals were compared between the two groups.ResultsSixty-five patients participated in the study. Age was comparable between the groups (p=0.67, Unpaired t-test). There was no significant difference amongst QTc intervals between the groups (p=0.19, Mann Whitney test). Also, there was no significant correlation between Vitamin D levels and QTc intervals assessed using Spearman’s correlation coefficient.ConclusionsWhile it seems plausible, coexisting Vitamin D deficiency and Type 2 DM probably do not act in synergy to prolong QTc interval. These findings merit future research on larger cohorts to investigate the relationship between Vitamin D status and newly diagnosed Type 2 DM on QTc intervals.

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Health Effects of Abdominal Liposuction in Newly Diagnosed Type 2 Diabetes

QJM ◽

10.1093/qjmed/hcaa050.056 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

A H ELkayal ◽

A M Hefny ◽

B A Mahmoud ◽

A M A Anany

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Diabetic Patients ◽

Fatty Tissue ◽

Newly Diagnosed ◽

Type 2 Diabetic Patients ◽

Type 2 Dm ◽

The Mean ◽

Abdominal Liposuction

Abstract Background Diabetes Mellitus (DM) is a metabolic disorder characterized by the presence of chronic hyperglycaemia accompanied by greater or lesser impairment in the metabolism of carbohydrates, lipids and proteins. DM is probably one of the oldest diseases known to man. It was first reported in Egyptian manuscript about 3000 years ago. In 1936, the distinction between type 1 and type 2 DM was clearly made. Type 2 DM was first described as a component of metabolic syndrome in 1988. The origin and aetiology of DM can vary greatly but always include defects in either insulin secretion or response or in both at some point in the course of disease. Objective The aim of this study is to evaluate the effectiveness of abdominal liposuction in improving quality of life in newly diagnosed uncomplicated type 2 diabetic patients. Methodology This study will take place in plastic Surgery Department, Port Said general Hospital. As total number of cases satisfying inclusion criteria not exceed 6 cases per month during the study period (3 months) the total sample 3x6=18 cases all will be included as comprehensive sample. Results In our study, the mean FPG was 163 ± 22 mg/dl preoperatively. At three months after surgery, it was 162 ± 29 mg/dl, but at six months after surgery, it was 147 ± 28 mg/dl. The mean PPBG was 218 ± 40 mg/dl preoperatively. At three months after surgery, it was 216 ± 40 mg/dl, but at six months after surgery, it was 200 ± 34 mg/dl. The mean HbA1c percentage was 8 ± 0.8% preoperatively. At three months after surgery, it was 7.7 ± 0.8%, but at six months after surgery, it was 7.6 ± 0.8%. The mean triglyceride level was 180 ± 48 preoperatively. At three months after surgery, it was 162 ± 41, but at six months after surgery, it was 159 ± 49. The mean cholesterol was 207 ± 42 preoperatively. At three months after surgery, it was 197 ± 52, but at six months after surgery, it was 189 ± 41. The HOMA-IR was 3 ± 0.7 preoperatively. At three months after surgery, it was 2.8 ± 0.7, but at six months after surgery, it was 2.8 ± 0.7. All the laboratory investigations change over time among the studied patients were not statistically significant. Conclusion So, we can conclude that large-volume abdominal liposuction should not, by itself, be considered a clinical therapy for type 2 diabetes mellitus. Aspiration of large amounts of subcutaneous abdominal fat in diabetic patients, despite having cosmetic benefits, It does not significantly improve insulin sensitivity through altering serum levels of obesity markers. Therefore, the procedure is safe and may could successfully help diabetic subjects to reduce their potential metabolic risks. Therefore, abdominal Liposuction is effective scarless operation for subcutaneous adipose fatty tissue reduction.

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Hydroxychloroquine reduces risk of incident diabetes mellitus in lupus patients in a dose-dependent manner: a population-based cohort study

Rheumatology ◽

10.1093/rheumatology/keu451 ◽

2015 ◽

Vol 54 (7) ◽

pp. 1244-1249 ◽

Cited By ~ 56

Author(s):

Yi-Ming Chen ◽

Ching-Heng Lin ◽

Tsuo-Hung Lan ◽

Hsin-Hua Chen ◽

Shih-Ni Chang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Cohort Study ◽

Cumulative Dose ◽

Population Based ◽

Incident Diabetes ◽

High Dose ◽

Dependent Manner ◽

Newly Diagnosed ◽

Increased Risk ◽

Dose Dependent

Abstract Objective. SLE is associated with increased risk of diabetes mellitus. Treatment for SLE requires high-dose glucocorticoids that may worsen glucose homoeostasis. HCQ can reduce diabetes risk in RA. This study aimed to investigate the association of HCQ use and diabetes mellitus risk in SLE patients. Methods. This nationwide, population-based cohort study was conducted using the Taiwan National Health Insurance Research Database. In the period 2001–10, 8628 newly diagnosed SLE patients were identified after excluding those with a previous diagnosis of RA, psoriasis or diabetes mellitus. Incidence of diabetes mellitus was identified as a new diagnostic code using a diabetes mellitus-specific medication. Results. Two hundred and twenty-one newly diagnosed diabetes mellitus patients were identified among SLE patients (6795 had taken HCQ and 1833 had never taken HCQ), with an average follow-up period of 5.6 years. Compared with patients without HCQ treatment, the hazard ratio (HR) of diabetes mellitus in patients taking HCQ at a cumulative dose ≥129 g was reduced [HR 0.26 (95% CI 0.18, 0.37), P < 0.001]. Daily glucocorticoid ≥10 mg prednisolone-equivalent dose was associated with increased risk of developing diabetes mellitus [HR 2.47 (95% CI 1.44, 4.23), P = 0.001], which was minimized by concomitant HCQ use at a cumulative dose ≥129 g. Conclusion. In SLE patients, the use of HCQ is associated with reduced risk of incident diabetes mellitus in a dose-dependent manner. High-dose glucocorticoids increase the risk of diabetes, which can be decreased by concomitant HCQ use.

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