Recommendations for Practical Use of Metformin, a Central Pharmacological Therapy in Type 2 Diabetes

2021 ◽  
pp. cd210043
Author(s):  
Inês H. Vieira ◽  
Luísa M. Barros ◽  
Carla F. Baptista ◽  
Dírcea M. Rodrigues ◽  
Isabel M. Paiva
2020 ◽  
Vol 66 (9) ◽  
pp. 1283-1288
Author(s):  
Eduardo Bello Martins ◽  
Eduardo Gomes Lima ◽  
Fábio Grunspun Pitta ◽  
Leticia Neves Solon Carvalho ◽  
Thiago Dias de Queiroz ◽  
...  

SUMMARY The pharmacological therapy for type 2 diabetes mellitus has presented important advances in recent years, which has impacted the treatment of patients with established cardiovascular disease or with high cardiovascular risk. In this scenario, two drug classes have emerged and demonstrated clear clinical benefits: SGLT-2 inhibitors and GLP-1 agonists. The present review discusses the pharmacology, adverse effects, and clinical trials that have demonstrated the benefits of these medications in reducing cardiovascular risk.


PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0256478
Author(s):  
Teresa Spadea ◽  
Roberta Onorati ◽  
Francesca Baratta ◽  
Irene Pignata ◽  
Marco Parente ◽  
...  

Introduction Type 2 diabetes is an important public health issue, yet adherence to drugs and regular clinical follow-up is still suboptimal. This study aims to evaluate a community pharmacy programme for monitoring and enhancing adherence to prescribed pharmacological therapies and recommended examinations among patients with confirmed diabetes. Methods The intervention was conducted in different Italian areas between April 2017 and January 2018. All adult patients who entered a pharmacy with a personal prescription for any antidiabetic drug and agreed to participate, were interviewed. Those found to be non-adherent received counselling from the pharmacists. All patients were invited for a follow-up interview after 3 months. Results Overall, 930 patients were enrolled and completed the baseline interview. We found low rates of non-adherence, ranging from 8% to 13% for prescribed pharmacological therapies, and 11–29% for the recommended clinical examinations. Non-adherence to oral therapies was higher among younger and recently diagnosed patients; that to clinical examinations was higher in men, those with an intermediate duration of diabetes and less educated patients. Large geographical differences persisted after the adjustment for individual factors. Only 306 patients (32.9%) returned for the follow-up interview, most of whom were already adherent at baseline. Conclusions Poor adherence to drugs or clinical examinations is not easy to identify in the usual operating setting of community pharmacies. Furthermore, the majority of patients did not return for follow-up, making it impossible to evaluate the efficacy of the pharmacists’ counselling. It might be more effective to plan interventions addressed to specific subgroups of patients or areas.


2015 ◽  
Vol 93 (5) ◽  
pp. 479-486 ◽  
Author(s):  
Wenguang Chang ◽  
Li Chen ◽  
Grant M. Hatch

The incidence of type 2 diabetes is increasing rapidly worldwide, and the development of novel anti-diabetic drugs is emerging. However, most anti-diabetic drugs cannot be used in patients with hepatic dysfunction, renal disease, and heart disease, which makes pharmacological therapy of type 2 diabetes complicated. Despite continued introduction of novel agents, the search for an ideal drug that is useful as both a hypoglycemic agent and to reduce diabetes-related complications remains elusive. Berberine is an isoquinoline alkaloid extract that has shown promise as a hypoglycemic agent in the management of diabetes in animal and human studies. Mechanistic studies have revealed beneficial effects of berberine on diabetes-related complications. Although there have been few clinical reports of the anti-diabetic effects of berberine, little documentation of adverse effects in humans positions it as a potential candidate drug to treat type 2 diabetes. In the present review, the anti-diabetic mechanism of berberine, its effect on diabetes-related complications, and its recent use in human clinical studies is highlighted. In addition, we summarize the different treatments for type 2 diabetes in adults and children.


2004 ◽  
Vol 17 (1) ◽  
pp. 5-9
Author(s):  
Joan M. Rider

Diabetes mellitus is a heterogeneous group of metabolic disorders characterized by persistent hyperglycemia resulting from defects in insulin secretion, insulin activity, or both. Long-term complications of diabetes can include retinopathy, nephropathy, peripheral, and/or autonomic neuropathy. Type 1 diabetes is readily diagnosed since patients usually demonstrate the classic symptoms of diabetes accompanied by markedly elevated blood glucose levels. Thosewith type 2 diabetes are often not diagnosed until complications appear. In addition, there has been a considerable rise in the diagnosis of type 2 diabetes in adolescents and children in the last ten years. The three major treatment components of diabetes include diet (medical nutrition therapy-MNT), exercise, and pharmacological therapy. Each component interacts with the others to the extent that no modification of one can be made without knowledge of the other two. This article focuses on the pathophysiology, etiologic classification, diagnosis, and treatment options for diabetes mellitus (DM).


el–Hayah ◽  
2014 ◽  
Vol 5 (1) ◽  
pp. 9
Author(s):  
Nurlaili Susanti

<em>Diabetes is a group of metabolic diseases characterized by hyperglycemia. Type 2 Diabetes is most commonly type which accounts for 90-95% of those, resulting from defects in insulin secretion and insulin action. Management of type 2 diabetes should combine pharmacological therapy with both diet modification and increasing physical activity. Nutraceutical was known to have important role. A kind of Araceae family, Porang (Amorphophallus muelleri Blume), has a main content of glucomannan. Glucomannan is a water-soluble polysaccharide, high fibers and low calories. Various studies suggest the benefit effects of glucomannan in type 2 diabetes mellitus to improve blood glucose level and lipid profiles. Its mechanism is postulated to be associated with the intrinsic physical effects of soluble fiber in the gastrointestinal tract and fermentation by microflora in the large intestine that trigger production of several gut hormones. Short Chain Fatty Acids, product of fiber fermentation, can improve insulin sensitivity through competition with free fatty acids and increasing expression of GLUT 4 in insulin sensitive tissues. Therefore, glucomannan from Porang has a great potential to be a nutraceutical for the management of type 2 diabetes mellitus.</em>


2021 ◽  
Vol 14 (8) ◽  
pp. 806
Author(s):  
Jana Blahova ◽  
Monika Martiniakova ◽  
Martina Babikova ◽  
Veronika Kovacova ◽  
Vladimira Mondockova ◽  
...  

Type 2 diabetes mellitus (T2DM) is the most widespread form of diabetes, characterized by chronic hyperglycaemia, insulin resistance, and inefficient insulin secretion and action. Primary care in T2DM is pharmacological, using drugs of several groups that include insulin sensitisers (e.g., biguanides, thiazolidinediones), insulin secretagogues (e.g., sulphonylureas, meglinides), alpha-glucosidase inhibitors, and the newest incretin-based therapies and sodium–glucose co-transporter 2 inhibitors. However, their long-term application can cause many harmful side effects, emphasising the importance of the using natural therapeutic products. Natural health substances including non-flavonoid polyphenols (e.g., resveratrol, curcumin, tannins, and lignans), flavonoids (e.g., anthocyanins, epigallocatechin gallate, quercetin, naringin, rutin, and kaempferol), plant fruits, vegetables and other products (e.g., garlic, green tea, blackcurrant, rowanberry, bilberry, strawberry, cornelian cherry, olive oil, sesame oil, and carrot) may be a safer alternative to primary pharmacological therapy. They are recommended as food supplements to prevent and/or ameliorate T2DM-related complications. In the advanced stage of T2DM, the combination therapy of synthetic agents and natural compounds with synergistic interactions makes the treatment more efficient. In this review, both pharmaceutical drugs and selected natural products, as well as combination therapies, are characterized. Mechanisms of their action and possible negative side effects are also provided.


2019 ◽  
Vol 10 (5) ◽  
pp. 291-303 ◽  
Author(s):  
Leonardo Pozo ◽  
Fatimah Bello ◽  
Andres Suarez ◽  
Francisco E Ochoa-Martinez ◽  
Yamely Mendez ◽  
...  

2010 ◽  
Vol 9 (2) ◽  
pp. 86 ◽  
Author(s):  
Karen Meyvis ◽  
Christophe De Block ◽  
Luc F Van Gaal ◽  
◽  
◽  
...  

With the rapid increase in obesity there has been a pronounced increase in obesity-related metabolic disorders including type 2 diabetes, cardiovascular disease, dyslipidaemia and hypertension. Bariatric surgery is a highly effective treatment for achieving long-term weight loss and is increasingly recognised to have benefits in diabetes treatment and cause improvement in other metabolic factors. Recent small randomised trials reported better glycaemic control after surgical intervention compared to pharmacological therapy. Physiological studies suggest a surgery-specific, weight-independent effect on glucose homeostasis. Long-term efficacy is to be proven. Consensus on definition of diabetes and diabetes remission must be achieved. Larger multicentre, randomised trials need to be done to clarify the place of metabolic surgery in diabetes treatment algorithms.


2020 ◽  
Vol 2020 ◽  
pp. 1-14
Author(s):  
Hirut Bekele ◽  
Adisu Asefa ◽  
Bekalu Getachew ◽  
Abebe Muche Belete

Background. Diabetes mellitus is a major chronic illness in Africa that requires lifelong lifestyle interventions and pharmacological therapy. Lifestyle change is the most important aspect of diabetes care and includes diabetes self-management education and support, medical nutrition therapy, physical activity, smoking cessation counseling, and psychosocial care. Purpose. The purpose of this project was to review published articles that investigate lifestyle and dietary pattern interventions for diabetes prevention and management in Africa. Barriers to lifestyle interventions and strategies to overcome the barriers are also reviewed in this study. Methods. The article search was conducted in an electronic database search of PubMed, Google Scholar, and Cochrane Library. Studies were included if they were published between 2011 and 2019, if they were conducted in an African country, and were written in the English language. Results. Articles reviewed included several that examined the basic lifestyle and dietary pattern changes for all patients diagnosed with type 2 diabetes, on self-care behavior of type 2 diabetes patients, on the cost of diabetes in Africa, and on barriers for adherence to lifestyle and dietary changes in Africa, with strategies to address those barriers. Conclusion. Lifestyle interventions including regular physical exercise, weight management, and adherence to health care professionals’ recommendations on a healthy diet are the cornerstone in the prevention and management of diabetes in Africa. The main barriers to adherence were both systemic (population changes, poor access, western cultural influences, and low-quality healthcare) and personal (poverty and cost, educational status, and perceptions about the disease) in nature. The strategies for the barriers include health education programs, advocacy, and capacity building.


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