Association Between Prior Antidiabetic Therapy and Outcome in Hospitalized COVID-19 Diabetic Subjects

2021 ◽  
Author(s):  
Arjun Baidya ◽  
DR RISHAD AHMED
Keyword(s):  
Antidiabetic Therapy

scholarly journals Dual-Target Compounds against Type 2 Diabetes Mellitus: Proof of Concept for Sodium Dependent Glucose Transporter (SGLT) and Glycogen Phosphorylase (GP) Inhibitors

2021 ◽  
Vol 14 (4) ◽  
pp. 364
Author(s):  
Ádám Sipos ◽  
Eszter Szennyes ◽  
Nikolett Éva Hajnal ◽  
Sándor Kun ◽  
Katalin E. Szabó ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Glycogen Phosphorylase ◽  
Glucose Transporter ◽  
Current Trend ◽  
Cell System ◽  
Synthetic Methods ◽  
Dual Inhibitor ◽  
Antidiabetic Therapy ◽  
Sodium Dependent ◽  
Dual Target

A current trend in the quest for new therapies for complex, multifactorial diseases, such as diabetes mellitus (DM), is to find dual or even multi-target inhibitors. In DM, the sodium dependent glucose cotransporter 2 (SGLT2) in the kidneys and the glycogen phosphorylase (GP) in the liver are validated targets. Several (β-D-glucopyranosylaryl)methyl (het)arene type compounds, called gliflozins, are marketed drugs that target SGLT2. For GP, low nanomolar glucose analogue inhibitors exist. The purpose of this study was to identify dual acting compounds which inhibit both SGLTs and GP. To this end, we have extended the structure-activity relationships of SGLT2 and GP inhibitors to scarcely known (C-β-D-glucopyranosylhetaryl)methyl arene type compounds and studied several (C-β-D-glucopyranosylhetaryl)arene type GP inhibitors against SGLT. New compounds, such as 5-arylmethyl-3-(β-D-glucopyranosyl)-1,2,4-oxadiazoles, 5-arylmethyl-2-(β-D-glucopyranosyl)-1,3,4-oxadiazoles, 4-arylmethyl-2-(β-D-glucopyranosyl)pyrimidines and 4(5)-benzyl-2-(β-D-glucopyranosyl)imidazole were prepared by adapting our previous synthetic methods. None of the studied compounds exhibited cytotoxicity and all of them were assayed for their SGLT1 and 2 inhibitory potentials in a SGLT-overexpressing TSA201 cell system. GP inhibition was also determined by known methods. Several newly synthesized (C-β-D-glucopyranosylhetaryl)methyl arene derivatives had low micromolar SGLT2 inhibitory activity; however, none of these compounds inhibited GP. On the other hand, several (C-β-D-glucopyranosylhetaryl)arene type GP inhibitor compounds with low micromolar efficacy against SGLT2 were identified. The best dual inhibitor, 2-(β-D-glucopyranosyl)-4(5)-(2-naphthyl)-imidazole, had a Ki of 31 nM for GP and IC50 of 3.5 μM for SGLT2. This first example of an SGLT-GP dual inhibitor can prospectively be developed into even more efficient dual-target compounds with potential applications in future antidiabetic therapy.

scholarly journals Metabolomic profiling to reveal the therapeutic potency of Posidonia oceanica nanoparticles in diabetic rats

RSC Advances ◽  
2021 ◽  
Vol 11 (14) ◽  
pp. 8398-8410
Author(s):  
Naglaa M. Ammar ◽  
Heba A. Hassan ◽  
Mona A. Mohammed ◽  
Ahmed Serag ◽  
Sameh Hosam Abd El-Alim ◽  
...  
Keyword(s):  
Posidonia Oceanica ◽  
Diabetic Rats ◽  
Gelatin Nanoparticles ◽  
Antidiabetic Therapy ◽  
Butanol Extract ◽  
Metabolomic Profiling

The potential of P. oceanica butanol extract encapsulated in gelatin nanoparticles as a promising and effective antidiabetic therapy has been investigated via metabolomics.

scholarly journals CANCER OF THE ORGANS OF THE REPRODUCTIVE SYSTEM IN WOMEN WITH TYPE 2 DIABETES. EFFECTS OF ANTIDIABETIC THERAPY

2020 ◽  
Vol 73 (5) ◽  
pp. 967-971
Author(s):  
Tamara S. Vatseba
Keyword(s):  
Type 2 Diabetes ◽  
Combination Therapy ◽  
Postmenopausal Women ◽  
Reproductive System ◽  
Uterine Cancer ◽  
Antidiabetic Therapy ◽  
Increased Risk ◽  
Risk Of Cancer ◽  
The Impact

The aim: to investigate the prevalence of cancer of the reproductive system in women with type 2 diabetes, and to examine the impact of antidiabetic therapy on cancer risk of this localization. Materials and methods: The study included a retrospective analysis of medical records of women with T2D with first diagnosed cancer during 2012-2016. The bases for the study were specialized medical institutions in Ivano-Frankivsk region. The obtained results were processed using statistical programs “Microsoft Excel” and “Statistika-12”. Results: Breast, uterine, and ovarian cancer were detected in 202 postmenopausal women, 63.92% from the total number of cancer cases in women. An increased risk of breast [OR = 1.24; 95% CI (1.04 – 1.50) P = 0.019] and uterine cancer [OR = 1.32; 95% CI (1.02 – 1.69) P = 0.040] has been identified. Most often, before the detection of cancer, women received combination therapy with sulfonylurea and metformin (83 patients (57.64%)) with BMI 32.64 ± 3.69 kg/m2. The difference between risk of cancer on metformin monotherapy and on sulfonylurea monotherapy [OR = 2.17; 95% CI (0.88 – 5.36) P = 0.141] or on combination therapy [OR = 1.68; 95% CI (0.76 – 3.74) P = 0.276] was not found. Conclusions: Postmenopausal women have an increased risk of breast and uterine cancer and are recommended to be screened for these diseases

scholarly journals Design and Evaluation of Chitosan films for Transdermal delivery of Glimepiride

2018 ◽  
pp. 13-25
Author(s):  
Syed Ata Ur Rahman ◽  
Neeraj Sharma
Keyword(s):  
Delivery System ◽  
Transdermal Delivery ◽  
Inclusion Complexation ◽  
Penetration Enhancers ◽  
In Vivo Studies ◽  
Skin Barrier Function ◽  
Antidiabetic Therapy ◽  
Transdermal Delivery System ◽  
Chitosan Films

Glimepiride is a third generation oral antidiabetic sulphonylurea drug frequently prescribed to patients of type 2 diabetes. However, its oral therapy is encountered with bioavailability problems due to its poor solubility leading to irreproducible clinical response, in addition to adverse effects like dizziness and gastric disturbances. As a potential for convenient, safe and effective antidiabetic therapy, the rationale of this study was to develop a transdermal delivery system for glimepiride. Chitosan polymer was utilized in developing transdermal films for glimepiride. Chitosan has film forming ability, bioadhesive and absorption enhancing properties. Aiming at optimizing the drug delivery and circumventing the skin barrier function, inclusion complexation of glimepiride with beta-cyclodextrin (β-CyD) as well as the use of several conventional penetration enhancers were monitored for augmenting the drug flux. The physical and mechanical properties of the prepared films were investigated using tensile testing, IR spectroscopy and X-ray diffractometry. Release studies revealed adequate release rates from chitosan films. Permeation studies through full thickness rat abdominal skin were conducted. High flux values were obtained from films comprising a combination of the drug with limonene and ethanol as well as from films containing glimepiride-β-CyD complex. In vivo studies on diabetic rats for selected formulae revealed a marked therapeutic efficacy sustained for about 48 hours. The above-mentioned results shed light on feasibility of utilizing chitosan as an effective, safe transdermal delivery system for glimepiride characterized by increased patient compliance and better control of the disease.

scholarly journals Second line therapy in type 2 diabetes: legacy effect activation

2017 ◽  
Vol 20 (5) ◽  
pp. 356-362
Author(s):  
Ekaterina A. Shestakova
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Patients ◽  
Second Line ◽  
Type 2 Diabetic Patients ◽  
Antidiabetic Therapy ◽  
First Line Therapy ◽  
Legacy Effect ◽  
Line Therapy ◽  
Multiple Drugs

Type 2 diabetes causes hundred thousand deaths worldwide every year. Though new antidiabetic drugs appear annually and new classes of drugs are invented approximately every ten years still a lot of type 2 diabetic patients remain to be out of the target glycemic levels. According to most of the guidelines for type 2 diabetes,treatment metformin is the first line therapy for this disease. The choice of second-line antidiabetic drug usually depends on doctors preference. That is why defining the correct drug for exact patient is still an urgent question. This review provides data on antidiabetic drugspotential for preventing the progression of micro- and macrovascular complications.The question of the potential of early antidiabetic therapy intensification to activate legacy effect is debated. Early and lasting compensation of diabetes with the use of multiple drugs can become a basis for primary prevention of cardiovascular disease in such patients.

scholarly journals Diabetes Mellitus and Autoimmune Hepatitis: Demographical and Clinical Description of a Relatively Rare Phenotype

2018 ◽  
Vol 50 (07) ◽  
pp. 568-574
Author(s):  
Gideon de Sousa ◽  
Nicole Prinz ◽  
Marianne Becker ◽  
Renate Dürr ◽  
Uta Faller ◽  
...  
Keyword(s):  
Autoimmune Hepatitis ◽  
Liver Enzymes ◽  
Lower Percentage ◽  
Oral Antidiabetic Drugs ◽  
Autoimmune Thyroid ◽  
Antidiabetic Therapy ◽  
Patients With Diabetes ◽  
Rare Phenotype ◽  
Clinical Description ◽  
Diabetes Patients

AbstractWe studied demographic, metabolic, and clinical characteristics of patients with diabetes and autoimmune hepatitis (AIH) from the German/Austrian DPV registry. A total of 139 patients with diabetes and AIH were analyzed and compared to 437 728 patients with diabetes without AIH. The prevalence of AIH in patients with T1DM (44.8/100 000) seems higher than in the general population, the prevalence of AIH in patients with T2DM (23.6/100 000) does not seem to be increased. Patients with T2DM and AIH had a shorter duration of diabetes (p=0.007) and a higher proportion of females (p<0.001) compared to T2DM without AIH. Patients with diabetes (T1DM or T2DM) and AIH required higher insulin doses (p<0.001 and p=0.03, respectively) and showed increased liver enzymes (aspartate transaminase, alanine transaminase, gamma-glutamyltransferase) compared to diabetes patients without (all p<0.001). We detected a lower percentage of patients treated with oral antidiabetic drugs (p=0.01) and a higher percentage of patients treated by insulin in patients with T2DM and AIH (p<0.001) compared to patients with T2DM alone. We observed a higher incidence of autoimmune thyroid disease (AIT) in patients with diabetes (T1DM or T2DM) and AIH (p<0.001) compared to diabetes patients without AIH. AIH seems more frequent in patients with T1DM. Patients with diabetes and AIH require intensification of antidiabetic therapy and seem to have a higher prevalence of AIT.

Patterns of drug therapy, glycemic control, and predictors of escalation – non-escalation of treatment among diabetes outpatients at a tertiary care center

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Shubham Atal ◽  
Rajnish Joshi ◽  
Saurav Misra ◽  
Zeenat Fatima ◽  
Swati Sharma ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Medication Adherence ◽  
Glycemic Control ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Clinical Predictors ◽  
Antidiabetic Therapy ◽  
Adherence To Medication

Abstract Objectives The study was conducted to assess patterns of prescribed drug therapy and clinical predictors of need for therapy escalation in outpatients with diabetes mellitus (DM). Methods This was a prospective cohort study, conducted at an apex tertiary care teaching hospital in central India for a period of 18 months. The demographic, clinical, and treatment details on the baseline and follow up visits were collected from the patients’ prescription charts. Glycemic control, adherence, pill burdens along with pattern of antidiabetic therapy escalation, and deescalations were analyzed. Results A total of 1,711 prescriptions of 925 patients of diabetes with a mean age of 53.81 ± 10.42 years and duration of disease of 9.15 ± 6.3 years were analyzed. Approximately half of the patients (n=450) came for ≥1 follow up visits. Hypertension (59.35%) was the most common comorbidity followed by dyslipidemia and hypothyroidism. The mean total daily drugs and pills per prescription were 4.03 ± 1.71 and 4.17 ± 1.38, respectively. Metformin (30.42%) followed by sulphonylureas (SUs) (21.39%) constituted majority of the AHA’s and dual and triple drug therapy regimens were most commonly prescribed. There were improvements in HbA1c, fasting/postprandial/random blood sugar (FBS/PPBS/RBS) as well as adherence to medication, diet, and exercise in the follow up visits. Among patients with follow ups, therapy escalations were found in 31.11% patients, among whom dose was increased in 12.44% and drug was added in 17.28%. Apart from Hb1Ac, FBS, and PPBS levels (p<0.001), characteristics such as age, BMI, duration of diagnosed diabetes, presence of hypertension and dyslipidemia, and daily pill burdens were found to be significantly higher in the therapy escalation group (p<0.05). Inadequate medication adherence increased the relative risk (RR) of therapy escalation by almost two times. Conclusions Disease and therapy patterns are reflective of diabetes care as expected at a tertiary care center. Higher BMI, age, pill burden, duration of diabetes, presence of comorbidities, and poor medication adherence may be the predictors of therapy escalation independent of glycemic control and such patients should be more closely monitored.

TRIPLE ORAL ANTIDIABETIC THERAPY IN TYPE 2 DIABETES MELLITUS

1998 ◽  
Vol 4 (3) ◽  
pp. 146-147 ◽  
Author(s):  
Fernando Ovalle, MD ◽  
David S. H. Bell, MB, FACE, FACP
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Antidiabetic Therapy ◽  
Oral Antidiabetic

scholarly journals Antidiabetic Therapy in the Treatment of Nonalcoholic Steatohepatitis

2020 ◽  
Vol 21 (6) ◽  
pp. 1907 ◽  
Author(s):  
Yoshio Sumida ◽  
Masashi Yoneda ◽  
Katsutoshi Tokushige ◽  
Miwa Kawanaka ◽  
Hideki Fujii ◽  
...  
Keyword(s):  
Liver Disease ◽  
Nonalcoholic Steatohepatitis ◽  
Body Weight Gain ◽  
Severe Form ◽  
Sglt2 Inhibitors ◽  
Glucagon Receptor ◽  
Nonalcoholic Fatty Liver ◽  
Antidiabetic Therapy ◽  
Sodium Glucose Cotransporter ◽  
Glucagon Like Peptide 1

Liver-related diseases are the third-leading causes (9.3%) of mortality in type 2 diabetes (T2D) in Japan. T2D is closely associated with nonalcoholic fatty liver disease (NAFLD), which is the most prevalent chronic liver disease worldwide. Nonalcoholic steatohepatitis (NASH), a severe form of NAFLD, can lead to hepatocellular carcinoma (HCC) and hepatic failure. No pharmacotherapies are established for NASH patients with T2D. Though vitamin E is established as a first-line agent for NASH without T2D, its efficacy for NASH with T2D recently failed to be proven. The effects of pioglitazone on NASH histology with T2D have extensively been established, but several concerns exist, such as body weight gain, fluid retention, cancer incidence, and bone fracture. Glucagon-like peptide 1 (GLP-1) receptor agonists and sodium-glucose cotransporter 2 (SGLT2) inhibitors are expected to ameliorate NASH and NAFLD (LEAN study, LEAD trial, and E-LIFT study). Among a variety of SGLT2 inhibitors, dapagliflozin has already entered the phase 3 trial (DEAN study). A key clinical need is to determine the kinds of antidiabetic drugs that are the most appropriate for the treatment of NASH to prevent the progression of hepatic fibrosis, resulting in HCC or liver-related mortality without increasing the risk of cardiovascular or renal events. Combination therapies, such as glucagon receptor agonist/GLP-1 or gastrointestinal peptide/GLP-1, are under development. This review focused on antidiabetic agents and future perspectives on the view of the treatment of NAFLD with T2D.

scholarly journals The Influence of In Vitro Gastrointestinal Digestion on the Chemical Composition and Antioxidant and Enzyme Inhibitory Capacities of Carob Liqueurs Obtained with Different Elaboration Techniques

Antioxidants ◽  
2019 ◽  
Vol 8 (11) ◽  
pp. 563 ◽  
Author(s):  
Raquel Rodríguez-Solana ◽  
Natacha Coelho ◽  
Antonio Santos-Rufo ◽  
Sandra Gonçalves ◽  
Efrén Pérez-Santín ◽  
...  
Keyword(s):  
Chemical Composition ◽  
Alcoholic Beverage ◽  
Total Phenolic ◽  
Gastrointestinal Digestion ◽  
Antidiabetic Therapy ◽  
Wide Range ◽  
Production Techniques ◽  
Inhibitory Potential ◽  
The Stability

Carob liqueur is a traditional Mediterranean alcoholic beverage obtained via a wide range of production techniques contributing to the different organoleptic attributes of the final product. The aim of this research was to evaluate the stability of the chemical composition and biological capacities (antioxidant and enzyme inhibition) under in vitro simulated gastrointestinal digestion of liqueurs prepared by flavouring the fig spirit with carob pulp by maceration, distillation, percolation, or aqueous and hydro-alcoholic infusions. For this purpose, the phenolic and furanic compositions, the total phenolic (TPC) and flavonoid (TFC) contents, antioxidant capacity (AC), and enzyme inhibitory potential against acethylcholinesterase, tyrosinase, α-glucosidase and α-amylase enzymes were evaluated. The content of gallic acid decreased after gastrointestinal digestion, while TPC, TFC, and AC significantly increased after each digestion phase. Overall, no significantly different enzyme inhibitions (p < 0.05) were observed among digested liqueurs, with moderate inhibition against acethylcholinesterase and tyrosinase (enzymes related with neurodegenerative diseases), and potent and low inhibitory capacities for α-glucosidase and α-amylase, respectively (ideal conditions employed in antidiabetic therapy). The study indicates that hydro-alcoholic infusion and maceration were the most appropriate methods to obtain liqueurs with higher values of the aforementioned parameters and safe levels of toxic furanics.

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