Role of standard test meal in initiation of insulin therapy in type 2 diabetes

Introduction Secondary monotherapy failure in diabetes mellitus type 2 occurs early in the course of disease. Choosing the optimal combination therapy depends on the primary pathogenic mechanism. Evaluation of the residual beta cell function is of primary importance in deciding whether insulin should be included in the combination therapy. Objective To investigate the influence of standard meal test and homeostasis model assessment (HOMA-B) index, as markers of residual insulin secretion, on the efficacy of two different therapeutic strategies in secondary sulphonylurea (SU) failure. Methods In the group of thirty subjects with diabetes type 2, metabolic syndrome and secondary SU failure, metformin (MET) was added for the following six months. In the group of 30 subjects with diabetes type 2, secondary SU failure, with no metabolic syndrome, insulin (INS) was added for the same period. During the six-month follow-up period, fasting, postprandial, mean daily blood glucose and glycosylated haemoglobin (HbA1C) were evaluated. Fasting and meal stimulated C-peptide (CP) and insulin levels were measured at the beginning; absolute and relative increase of CP (delta CP, delta CP%), and HOMA-B were calculated. Correlation between CP secretion and HOMA-B at the beginning and glycaemic control after six months of therapy were evaluated by using Pearson correlation coefficient. Results Glycaemic control after six months was significantly improved in both therapeutic combinations (p<0.01). However, target values were not met in either group. Stimulated CP levels correlated best with all the parameters of glycaemic control in the group SU+MET (r -0.479 to -0.791; p<0.01), and in the group SU+INS (r 0.382 to 0.635; p<0.01). HOMA-B correlated only with HbA1C in the SU+MET group (r=-0.382; p<0.05). Conclusion Clinical diagnosis of metabolic syndrome and evaluation of residual insulin secretion are necessary in choosing the best combination therapy in secondary SU failure in subjects with type 2 diabetes. Stimulated standard meal CP level is a clinically useful marker of residual insulin secretion.

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СУЧАСНІ ПІДХОДИ ДО ФАРМАКОЛОГІЧНОЇ КОРЕКЦІЇ МЕТАБОЛІЧНИХ ЗРУШЕНЬ ПРИ ЦУКРОВОМУ ДІАБЕТІ ТИПУ 2

Scientific Issue Ternopil Volodymyr Hnatiuk National Pedagogical University. Series: Biology ◽

10.25128/2078-2357.19.3.10 ◽

2019 ◽

Vol 77 (3) ◽

pp. 71-80

Author(s):

Kh. I. Kurylo ◽

A. S. Volska ◽

I. M. Klishch ◽

B. V. Zablotskyi

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Type 2 Diabetes ◽

Metabolic Syndrome ◽

Type 2 Diabetes Mellitus ◽

Diabetes Type 2 ◽

Diabetes Type ◽

Metabolic Changes ◽

Hypoglycemic Action

Diabetes mellitus is caused by one of the largest medical and social problems in Ukraine, because it causes a high risk of invasive disease. According to the WHO data, the number of patients is rising and people of varying age groups become ill, which causes an increase in the incidence of 3 to 4 pauses and the overall life expectancy of 20-30%. Pathogenesis of diabetes mellitus and enclosure, require the extraction of drugs for prophylaxis and treatment with late pharmacological effects. One of these is a herbal remedy. Analysis and systematization of the literature on metabolitotropic effects and substantiation of the use of new goat's-rue, blueberry and taurine phytocompositions for the correction of metabolic changes in diabetes type 2 were carried out. The methods of information search, analysis of literature on the medicinal plants with hypoglycemic action were used. The literary resources on pharmacological correction of metabolic changes in diabetes type 2 deal with natural herbs and amino acids that possess hypoglycemic action and can be used with therapeutic and prophylactic measure in patients with type 2 diabetes. In type 2 diabetes mellitus significant anticytolytic, detoxifying and antioxidant properties of phytocompositions were confirmed. It is known that in hyperglycemia and insulin resistance that occur at type 2 diabetes mellitus end products of glycosylation and glucose autooxidation are formed, which is accompanied by the activation of lipid peroxidation and the formation of a large number of free radicals. It is known that one of the basic mechanisms for the development of insulin resistance, diabetes mellitus and specific diabetic angiopathies is oxidative stress. One of the major pathogenetic factors in the development and course of type 2 diabetes mellitus is metabolic syndrome. It has been established that correction using both investigated phytocompositions and reference phytopreparation with different efficiency prevented the development of metabolic changes in metabolic syndrome. Biologically active components of medicinal plants, may show hypoglycemic effect which will influence the activity of the enzymes, glucose transcription and the function of the peptide to the incyline, the processes which play an important role in the pathogenesis of diabetes.

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Diabetes

Oxford Handbook of Nutrition and Dietetics ◽

10.1093/med/9780198800132.003.0022 ◽

2020 ◽

pp. 493-518

Keyword(s):

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Glycaemic Control ◽

Diabetes Type 2 ◽

Diabetes Type ◽

Children And Young People ◽

Structured Education ◽

P Type

type 1 diabetes, type 2 diabetes, Hypoglycaemia, Structured education, Weight management and monitoring glycaemic control, pregnancy, children, and young people, elderly

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Sitagliptin add-on to low dosage sulphonylureas: efficacy and safety of combination therapy on glycaemic control and insulin secretion capacity in type 2 diabetes

International Journal of Clinical Practice ◽

10.1111/j.1742-1241.2012.02903.x ◽

2012 ◽

Vol 66 (5) ◽

pp. 465-476 ◽

Cited By ~ 32

Author(s):

S-I. Harashima ◽

M. Ogura ◽

D. Tanaka ◽

T. Fukushima ◽

Y. Wang ◽

...

Keyword(s):

Type 2 Diabetes ◽

Insulin Secretion ◽

Glycaemic Control ◽

Combination Therapy ◽

Efficacy And Safety ◽

Low Dosage

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755-P: A Plant-Based Meal Stimulates Incretin and Insulin Secretion More than an Energy- and Macronutrient-Matched Standard Meal in Type 2 Diabetes: A Randomized Crossover Study

Diabetes ◽

10.2337/db19-755-p ◽

2019 ◽

Vol 68 (Supplement 1) ◽

pp. 755-P

Author(s):

HANA KAHLEOVA ◽

ANDREA TURA ◽

MARTA KLEMENTOVA ◽

LENKA BELINOVA ◽

MARTIN HALUZIK ◽

...

Keyword(s):

Type 2 Diabetes ◽

Insulin Secretion ◽

Crossover Study ◽

Standard Meal ◽

Randomized Crossover Study

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Eksplorasi Kesadaran Diri, Persepsi Dan Sikap Pada Individu Yang Memiliki Riwayat Keluarga Diabetes Melitus Tipe 2

NURSING UPDATE : Jurnal Ilmiah Ilmu Keperawatan P-ISSN : 2085-5931 e-ISSN : 2623-2871 ◽

10.36089/nu.v1i1.107 ◽

2019 ◽

Vol 1 (1) ◽

pp. 52-62

Author(s):

Mulia Mayangsari

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Family History ◽

Diabetes Type 2 ◽

Diabetes Type ◽

Self Awareness ◽

Perceptions And Attitudes ◽

History Of ◽

Diabetes Melitus

Individuals who have a family history oftype 2 diabetes mellitus (DM) have a highrisk for type 2 diabetes. Type 2 diabetescan be prevented by improving modifiablerisk factors, supported by self-awareness,perceptions and attitudes of individualswho have a high family history of DM. Thisstudy used a qualitative phenomenologicaldesign. A Purposive Sampling techiniquewas applied to determine individuals whohad parents with type 2 diabetes. Nineindividuals participated in this study. AQualitative content analysis with Collaiziapproach used as a data analysis method.The main themes depicted individuals selfawareness,perceptions, & attitudes were:denials that diabetes caused by heredityfactors; misperception about diabetes;“traditional modalities” as a preventionmeasurement toward type 2 diabetes; andDM is perceived as a “threatening disease”.Further study is needed to examine indepth the themes that have been identifiedon the number of participants are morenumerous and varied.

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Risk Factors Associated With Hyperuricemia in Patients with Diabetes Type 2: About 190 Cases

10.36502/2020/droa.6163 ◽

2020 ◽

Vol 2 (1) ◽

pp. 12-16

Author(s):

Fennoun H ◽

Haraj NE ◽

El Aziz S ◽

Bensbaa S ◽

Chadli A

Keyword(s):

Type 2 Diabetes ◽

Heart Disease ◽

Glycemic Control ◽

Ischemic Heart Disease ◽

Diabetes Type 2 ◽

Diabetes Type ◽

Ischemic Heart ◽

Factors Associated ◽

Patients With Diabetes

Introduction: Hyperuricemia is common Type 2 diabetes at very high cardiovascular risk. Objective: Evaluate the relationship between hyperuricemia and diabetes type 2, and determine its predictive factors in this population. Patients and Methods: Retrospective study cross including 190 patients with diabetes type 2 hospitalized Service of Endocrinology of CHU Ibn Rushd Casablanca from January 2015 to December 2017. Hyperuricemia was defined as a serum uric acid concentration> 70 mg/L (men) and> 60 mg/L (women). The variables studied were the anthropometric measurements), cardiovascular factors (tobacco, hypertension, dyslipidemia), and degenerative complications (retinopathy, neuropathy, kidney failure, ischemic heart disease). The analyzes were performed by SPSS software. Results: Hyperuricemia was found in 26.5% of patients with a female predominance (76%), an average age of 55.9 years, and an average age of 12.4ans diabetes. The glycemic control was found in 84.6% of cases with mean glycated hemoglobin 8.6%. Factors associated al hyperuricemia were the blood pressure in 86% (p <0.05), dyslipidemia in 76.3% of cases (p <0.001) with hypertriglyceridemia in 48.3% of cases (p <0.02), and a hypoHDLémie 28% (p <0.001). The age, obesity, smoking, and glycemic control were associated significantly n al hyperuricemia. The research of degenerative complications of hyperuricemia has objectified renal impairment (GFR between 15 and 60ml / min) chez47% (p <0.001), it was kind of moderate in 35.8% (p <0.01) and severe in 5.1% (p <0.02), ischemic heart disease was found in 34% of cases (p <0.01). Conclusion: In our study, hyperuricemia in type 2 diabetes is common in female patients, especially with hypertension, dyslipidemia, and renal failure. Other factors such as age, obesity, smoking is not associated with hyperuricemia in type 2 diabetics.

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Vildagliptin plus metformin combination therapy provides superior glycaemic control to individual monotherapy in treatment-naive patients with type 2 diabetes mellitus

Diabetes Obesity and Metabolism ◽

10.1111/j.1463-1326.2009.01040.x ◽

2009 ◽

Vol 11 (5) ◽

pp. 506-515 ◽

Cited By ~ 125

Author(s):

E. Bosi ◽

F Dotta ◽

Y Jia ◽

M Goodman

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Glycaemic Control ◽

Combination Therapy ◽

Treatment Naïve

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Roux-en-Y gastric bypass increases glycaemic variability and time in hypoglycaemia in patients with obesity and pre-diabetes/type 2 diabetes mellitus: a prospective cohort study

10.2337/figshare.13260275.v1 ◽

2020 ◽

Author(s):

Ibiyemi Ilesanmi ◽

George Tharakan ◽

Kleopatra Alexiadou ◽

Preeshila Behary ◽

Haya Alessimii ◽

...

Keyword(s):

Type 2 Diabetes ◽

Gastric Bypass ◽

Diabetes Type 2 ◽

Diabetes Type ◽

Glucose Measurement ◽

Glycaemic Variability ◽

Study Objective ◽

Post Surgery ◽

Glucagon Like Peptide 1

Objective: Roux-en-Y gastric bypass (RYGB) is an established treatment for type 2 diabetes. The study objective was to establish RYGB’s effects on glycaemic variability (GV) and hypoglycaemia. Research Design and Methods: Prospective observational study of 10 participants with pre-diabetes/Type 2 diabetes undergoing RYGB, studied before surgery (Pre), 1 month (1m), 1 year (1y) and 2 years (2y) post-surgery with continuous glucose measurement (CGM). A mixed meal test (MMT) was performed at Pre, 1m and 1y. [ClinicalTrials.gov NCT01945840] Results: After RYGB, mean CGM glucose fell (at 1m, 1y and 2y), and GV increased (at 1y and 2y). Fifty percent (5/10) of participants exhibited a percentage time in range <3.0 mmol/L [54 mg/dl] (%TIR<3.0) greater than the consensus target of 1% at 1y or 2y. Peak glucagon-like peptide-1 (GLP-1) and glucagon area-under-curve (AUC) during MMT were respectively positively and negatively associated with contemporaneous %TIR<3.0. Conclusions: Patients undergoing RYGB are at risk of developing post-bariatric hypoglycaemia due to a combination of reduced mean glucose, increased GV and increased GLP-1 response.

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Transcription factor 7-like 2 (TCF7L2): a culprit gene in Type 2 Diabetes Mellitus

Diabetes Mellitus ◽

10.14341/dm12313 ◽

2021 ◽

Vol 24 (4) ◽

pp. 371-376

Author(s):

A. Jan ◽

H. Jan ◽

Z. Ullah

Keyword(s):

Type 2 Diabetes ◽

Transcription Factor ◽

Insulin Secretion ◽

Blood Glucose ◽

Pancreatic Beta Cell ◽

Genetic Research ◽

Wnt Signaling Pathway ◽

Diabetes Type 2 ◽

Ethnic Population

The genetics of Type 2 diabetes a complex metabolic disorder, characterized by decreased insulin secretion and insulin resistance resulting in impaired blood glucose homeostasis remains enigma for geneticists. In 2006 an important step while finding genetic causes of diabetes type 2 was identification of transcription factor 7-like 2 (TCF7L2) gene an important marker in predisposition of type 2 diabetes in almost all ethnic population. Recent genetic research identifies numerous novel type 2 diabetes susceptible genes among these genes TCF7L2 is considered as gang head and emerged as the most promising types 2 diabetes causing gene. Risk variants in TCF7L2 effects pancreatic beta cell development and insulin secretion by influencing Wnt Signaling pathway. Genetic variants in TCF7L2 confer risk for type 2 diabetes by altering expression of transcription factor (which has key role in blood glucose regulation) in pancreas. The purpose of this paper is to evaluate type 2 diabetes susceptible gene the TCF7L2 and to present a comprehensive review of studies carried out worldwide in different ethnic population on association of TCF7L2 polymorphism with type 2 diabetes.

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