Comparison of Dapaglifozin and Liraglutide in patients with poorly controlled type 2 Diabetes Mellitus: a 24-week, Open, Double-centered, Head to Head Trial

2020 ◽  
Vol 20 ◽  
Author(s):  
Jianjia Jiang ◽  
Lu Lin ◽  
Pin Chen
Keyword(s):  
Body Weight ◽  
Triple Therapy ◽  
Treatment Satisfaction ◽  
Hba1c Level ◽  
Statistical Significance ◽  
Blood Lipid ◽  
The Body ◽  
C Peptide

Objective: To evaluate the efficacy and treatment satisfaction of dapagliflozin and liraglutide in T2DM patients with glucose poorly controlled after triple therapy. Methods: In addition to the original therapeutic regimen, dapagliflozin (n=83) and liraglutide (n=89) once a day were added, respectively. Height, body weight, waist circumference, and blood pressure were recorded. FBG, 2hPBG, HbA1c, fasting C-peptide, HOMA-IR, blood lipid, eGFR, BUA and DTSQ were detected before the treatment and after 24 weeks of treatment. Results: At the end of 24 weeks of treatment, a follow-up visit was completed for 79 patients in the dapagliflozin group and 77 patients in the liraglutide group. The body weight of the patients in the dapagliflozin group and the liraglutide group decreased significantly (P< 0.05). The HbA1c level in the dapagliflozin group decreased from 8.96 ± 1.23% to 7.03 ±0.74% (P< 0.01), more than that in the liraglutide group, namely, from 8.99 ± 1.34% to 7.24 ±0.77% (P< 0.01). After 12 weeks of treatment, eGFR in the dapagliflozin group first decreased and then increased after 12 weeks of treatment. The percentages of patients achieving combined endpoints in the two groups were of no statistical significance (P=0.204). And there were mild adverse events in both groups. Conclusion: The add-on treatment of dapagliflozin and liraglutide had promising clinical outcomes in patients with T2DM and poorly controlled glucose after triple therapy, which include the improvement in blood glucose, insulin resistance, SBP, and renal function. However, the overall treatment satisfaction was higher in the dapagliflozin group.

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

Effectiveness of Dulaglutide in the Real World and in Special Populations of Type 2 Diabetic Patients

2020 ◽  
Vol 105 (7) ◽  
pp. e2617-e2625 ◽  
Author(s):  
Mario Luca Morieri ◽  
Vera Frison ◽  
Mauro Rigato ◽  
Michele D’Ambrosio ◽  
Federica Tadiotto ◽  
...  
Keyword(s):  
Body Weight ◽  
Real World ◽  
Disease Duration ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Body Weight Reduction ◽  
Background Population ◽  
Glucagon Like Peptide 1

Abstract Context In randomized controlled trials (RCTs) on type 2 diabetes (T2D) patients, the glucagon-like peptide-1 (GLP-1) receptor agonist (GLP-RA) dulaglutide reduced HbA1c and body weight, but generalizability of such findings to real-world T2D patients is challenging. Objective We evaluated effectiveness of dulaglutide in routine clinical practice, especially in subgroups of patient that are underrepresented in RCTs. Design Retrospective multicenter study. Setting Diabetes outpatient clinics. Patients and intervention All consecutive patients who initiated dulaglutide between 2015 and 2018. Main outcome measures Changes in HbA1c and body weight were assessed up to 30 months after baseline. Effectiveness was analyzed in patient subgroups according to: prior use of GLP-1RA, persistence on treatment and dose, age, sex, disease duration, renal function, obesity, cardiovascular disease, or concomitant use of insulin or sulphonylurea. Results From a background population of 83,116 patients, 2084 initiated dulaglutide (15.3% switching from another GLP-1RA), 1307 of whom had at least 1 follow-up visit. Overall, dulaglutide reduced HbA1c by 1.0% and body weight by 2.9 kg at the end of observation. These effects were more pronounced in GLP-1RA-naïve patients and in those with shorter disease duration. Improvement in HbA1c was highly significant and consistent across all subgroups, including those aged ≥ 75 years, nonobese, or with chronic kidney disease. Body weight declined in all subgroups and significantly more with the 1.5-mg versus 0.75-mg dose. Conclusions In real-world T2D patients, effectiveness of dulaglutide on HbA1c and body weight reduction was highly consistent and significant even in subgroups of patients poorly represented in RCTs.

scholarly journals Clinical and in Vivo Response Following Surgery or Surgery Plus Adjuvant Chemotherapy or Immunotherapy for Colorectal Carcinoma in a Rat Model

1983 ◽  
Vol 76 (10) ◽  
pp. 833-840 ◽  
Author(s):  
A K House ◽  
M A L Maley
Keyword(s):  
Body Weight ◽  
Adjuvant Chemotherapy ◽  
Surgical Excision ◽  
The Body ◽  
Recurrent Tumour ◽  
Mesenteric Node ◽  
And Control ◽  
Tumour Weight

Two cohorts of rats, 240 with colon cancer and 150 controls, were assessed clinically and immunologically for their response to tumour and its management which was either by surgical excision alone or by surgical excision combined with either adjuvant chemotherapy or immunotherapy. The histology and invasion characteristics were observed for similarity with those of human lesions. Metastases were found in liver, lymph nodes, the peritoneum or lungs in 27% of animals during follow up. Significantly fewer adjuvant-treated rats had metastases than those receiving surgery alone ( P < 0.05), and less total tumour weight was found in the adjuvant-treated rats at four ( P < 0.03) and six ( P < 0.001) weeks postoperatively. Animals in the adjuvant immunotherapy group survived longer than in either other group ( P < 0.001). The crude parameters of host response to tumour, body, spleen and mesenteric lymph node weight were recorded and the latter two indexed to body weight. The body weight of tumour and control rats increased significantly with time ( P < 0.04). The spleen and mesenteric node indices were significantly ( P < 0.04) greater in tumour than control rats and were varied by recurrent tumour growth and by the adjuvant treatment administered postoperatively.

scholarly journals Body Weight Effects on Extra-Osseous Subtalar Arthroereisis

2019 ◽  
Vol 8 (9) ◽  
pp. 1273 ◽  
Author(s):  
Chiun-Hua Hsieh ◽  
Chia-Che Lee ◽  
Tzu-Hao Tseng ◽  
Kuan-Wen Wu ◽  
Jia-Feng Chang ◽  
...  
Keyword(s):  
Body Weight ◽  
Lateral View ◽  
The Body ◽  
Posterior View ◽  
Flexible Flatfoot ◽  
Subtalar Arthroereisis ◽  
Overweight Group ◽  
Anterior Posterior

Implant extrusion in subtalar arthroereisis is a common complication for pediatric flexible flatfoot. However, there were a limited number of articles addressing the body weight effects on implant extrusion after the procedure. We conducted a 24-month follow-up assessment after subtalar arthroereisis. Surgical patients who underwent the Vulpius procedure were retrospectively collected from May 2010 to January 2017, including 59 cases of both feet having implants in situ and 43 cases of both feet having implant extrusion. The average age of 102 patients was 9 years old. The mean body mass index (BMI) of the implant in situ group was 19.5, whilst the extrusion group was 21.2 (p = 0.035). The inter-observer correlation was excellent. There were 11 cases (39.3%) of bilateral extrusion in the overweight group (BMI ≥ 24) and 13 cases (23.2%) in the low body weight group (BMI ≤ 18.5) (p < 0.0004). Postoperative radiographic angles were corrected in both the implant in situ group and the extrusion group. Nonetheless, the implant in situ group revealed better postoperative outcomes of Meary’s angle and the talonavicular angle from an anterior-posterior view, and the talar inclination angle from a lateral view. We conclude that a higher BMI is related to implant extrusion and worse results after subtalar arthroereisis. Further prospective study to investigate whether preoperative weight loss results in improved surgical outcomes is warranted in the future.

The Combination of Aerobic and Resistance Exercise Induces Weight Loss via the PGC-1α/Irisin/UCP-1 Pathway

2019 ◽  
Vol 9 (10) ◽  
pp. 1388-1394
Author(s):  
Hong Deng ◽  
Wei Zhang ◽  
Dingguo Ruan ◽  
Dezhi Chen ◽  
Xiaoyang Xu ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Resistance Exercise ◽  
Aerobic Exercise ◽  
Human Subjects ◽  
Blood Lipid ◽  
The Body ◽  
Lipid Levels ◽  
Reduced Body ◽  
Blood Lipid Levels

Obesity is a modern disease and the cause is quite complicated. This study explores the effects of aerobic and resistance exercise on weight loss and their relationship with the PGC-1α/Irisin/UCP-1 signaling pathway. First, we selected 52 obese students for aerobic and resistance exercise. Second, we established an obesity rat model, and then subjected them to 12 weeks of aerobic and resistance exercise. The body weights and blood lipid contents of all the subjects were measured, and mRNA and protein expressions were determined via real-time PCR and western blot. In obese students, aerobic exercise and the combination of aerobic and resistance exercise significantly reduced body weight and blood lipid levels. In obese model rats, aerobic and resistance exercise significantly reduced the body weight, blood lipid levels, and increased the PGC-1, Irisin, and UCP-1 levels. Furthermore, the combined effects of aerobic and resistance exercise were similar to those of prolonged aerobic exercise in both human subjects and model rats. The mechanism of weight loss via aerobic and resistance exercise may be related to the PGC-1α/Irisin/UCP-1 pathway, and the combination of aerobic and resistance exercise may be a more suitable weight loss option for obese patients.

C-peptide immunoreactivity index is associated with improvement of HbA1c: 2-Year follow-up of sitagliptin use in patients with type 2 diabetes

2015 ◽  
Vol 108 (3) ◽  
pp. 441-447 ◽  
Author(s):  
Takeshi Nishimura ◽  
Shu Meguro ◽  
Risa Sekioka ◽  
Karin Tanaka ◽  
Yoshifumi Saisho ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
C Peptide

scholarly journals The Effect of Baduanjin on Promoting the Physical Fitness and Health of Adults

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Ran Li ◽  
Li Jin ◽  
Ping Hong ◽  
Zi-Hong He ◽  
Chuan-Ye Huang ◽  
...  
Keyword(s):  
Physical Fitness ◽  
Statistical Significance ◽  
Intervention Group ◽  
Blood Lipid ◽  
The Body ◽  
Control Group ◽  
Triceps Brachii ◽  
Fitness And Health ◽  
Subcutaneous Adipose ◽  
Lower Corner

The purpose of study was to assess the efficacy of a 16-week Baduanjin qigong training intervention in promoting physical fitness and health for adults. An experimental design was adopted, and subjects were assigned randomly into an experimental group (n=55) and a control group (n=55). In the intervention group comprised of adults, there were no significant variations in blood glucose, blood lipid, blood pressure, heart rate variability, and vital capacity indices. The body weight and body mass index (BMI) dropped in the intervention group. Compared with the control group, the skinfold thicknesses decreased at lower corner of scapula, triceps brachii, and abdomen, with a statistical significance (P<0.001;P=0.005;P=0.003). By comparing the physical fitness indices, it was found that the increase of the results of sit-and-reach test in the intervention group had statistical significance (P=0.001). In conclusion, it was found by our trial that Baduanjin exercise could significantly improve the physical flexibility and subcutaneous adipose accumulation in the healthy adults.

scholarly journals C-peptide and the risk for incident complications and mortality in type 2 diabetic patients: a retrospective cohort study after a 14-year follow-up

2012 ◽  
Vol 167 (2) ◽  
pp. 173-180 ◽  
Author(s):  
S Bo ◽  
L Gentile ◽  
A Castiglione ◽  
V Prandi ◽  
S Canil ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Retrospective Cohort ◽  
Microvascular Complications ◽  
Chronic Complications ◽  
C Peptide ◽  
All Cause Mortality

ObjectiveC-peptide, a cleavage product of insulin, exerts biological effects in patients with type 1 diabetes mellitus, but its role in type 2 diabetes mellitus is controversial. Our aim was to examine the associations between fasting C-peptide levels and all-cause mortality, specific-cause mortality and the incidence of chronic complications in patients with type 2 diabetes.DesignRetrospective cohort study with a median follow-up of 14 years.MethodsA representative cohort of 2113 patients with type 2 diabetes mellitus and a subgroup of 931 individuals from this cohort without chronic complications at baseline from a diabetic clinic were studied.ResultsPatients with higher C-peptide levels had higher baseline BMI and triglyceride and lower HDL-cholesterol values. During the follow-up, 46.1% of the patients died. In a Cox proportional hazard model, after multiple adjustments, no significant association was found between the C-peptide tertiles and all-cause mortality or mortality due to cancer, diabetes or cardiovascular diseases. In the subgroup of 931 patients without chronic complications at baseline, the incidence of microvascular complications decreased from the first to the third C-peptide level tertile, while the incidence of cardiovascular disease did not differ. The risks for incident retinopathy (hazard ratio (HR)=0.33; 95% confidence interval (CI) 0.23–0.47), nephropathy (HR=0.27; 95% CI 0.18–0.38) and neuropathy (HR=0.39; 95% CI 0.25–0.61) were negatively associated with the highest C-peptide tertile, after adjusting for multiple confounders.ConclusionsHigher baseline C-peptide levels were associated with a reduced risk of incident microvascular complications but imparted no survival benefit to patients with type 2 diabetes mellitus.

scholarly journals Comparison of Exenatide and Metformin Monotherapy in Overweight/Obese Patients with Newly Diagnosed Type 2 Diabetes

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Jia Liu ◽  
Yanjin Hu ◽  
Yuan Xu ◽  
Yumei Jia ◽  
Li Miao ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Hba1c Level ◽  
Initial Therapy ◽  
The Body ◽  
Metformin Hydrochloride ◽  
Obese Patients ◽  
Newly Diagnosed ◽  
Metformin Monotherapy ◽  
Metformin Group

Aims. The present study assessed the therapeutic effect of exenatide and metformin as the initial therapy on overweight/obese patients with newly diagnosed type 2 diabetes (T2D). Methods. The prospective, nonrandomized, interventional study enrolled a total of 230 overweight or obese patients with newly diagnosed T2D who were administrated exenatide or metformin hydrochloride for 12 weeks. Results. 224/230 patients, including 106 in the exenatide group and 118 in the metformin group, completed the 12-week treatment. Both exenatide and metformin significantly decreased the HbA1c levels in overweight/obese patients with newly diagnosed T2D (all P<0.05). The reduction in HbA1c and the proportion of patients with HbA1c < 7.0% (53 mmol/mol) were higher in the exenatide group than in the metformin group (all P<0.05). The exenatide treatment caused a greater decline in the body weight and BMI as compared to the metformin treatment (all P<0.01). The exenatide treatment (β = 0.41, P<0.01) and baseline HbA1c level (β = −0.84, P<0.01) were independent influencing factors for the decrease in HbA1c level. Conclusions. For an initial therapy in overweight/obese patients with newly diagnosed T2D, exenatide causes a better glycemic control than metformin. This trial is registered with NCT03297879.

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