scholarly journals Current Management of Type 2 Diabetes Mellitus: What to Pay Attention to in Outpatient Settings

Doctor Ru ◽  
2021 ◽  
Vol 20 (2) ◽  
pp. 40-44
Author(s):  
N.A. Chernikova ◽  
◽  
O.A. Knyshenko ◽  
◽  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Combined Therapy ◽  
Individual Characteristics ◽  
Antihyperglycemic Agents ◽  
Number Of Patients ◽  
Antihyperglycemic Therapy ◽  
Selection Of

Objective of the Review: To discuss the problem of selecting antihyperglycemic drugs; to identify the trends in prescription of various groups of oral antihyperglycemic agents. Key Points. When type 2 diabetes mellitus (DM2) is diagnosed, a number of patients need prompt combined antihyperglycemic therapy because of a marked carbohydrate metabolism disorder. The prescription paradigm of initial therapy has shifted towards antihyperglycemic agents with established nephro- and cardioprotective effects (sodium-glucose linked transporter-2 inhibitors, glucagon-like peptide-1 receptor agonists). Drugs are recommended depending on presence or absence of a comorbid cardiovascular disease (CVD) and cardiovascular risk factors, and safety as regards hypoglycaemic events; therefore, very often selection of a therapeutic regimen can be challenging. Still, the first-line treatment for patients without CVD is metformin; however, a combined therapy is required in the majority of cases. Poor compliance, continued use of monotherapy, despite the need to boost the therapy, patient’s reluctance to take additional drugs can facilitate occurrence and progression of a lot of associated complications. In such cases, combined medications reducing the amount of tablets and improving compliance are useful. The most common combination of antihyperglycemic drugs is metformin and sulfonylureas. Still, care should be taken because of differences in pharmacokinetics and pharmacodynamics of the molecules in the latter group. High selectivity of some sulfonylureas can evidence their milder effect for glucose level reduction. Sulfonylureas are also cost-effective as compared to other antidiabetic medications. Conclusion. A wide choice of drugs allows a medical professional selecting an optimal antihyperglycemic regimen, taking into account individual characteristics of a patient. Prompt combined medications are a treatment of choice for the majority of patients with DM. Selection of antihyperglycemic drugs is affected by the cost as well. The most important thing is that the drugs are well-studied, efficient and safe. Keywords: type 2 diabetes mellitus, combined therapy, sulphonylurea, Glimepiride, metformin.

scholarly journals Pharmacoepidemiological study of treatment managment in patients with type 2 diabetes mellitus in Omsk

2016 ◽  
Vol 62 (1) ◽  
pp. 25-34
Author(s):  
Elena Viktorovna Ananicheva ◽  
Sergey Viktorovich Skalskiy ◽  
Ludmila Vladimirovna Shukil ◽  
Miroslava Valer'evna Petunina ◽  
Svetlana Aleksandrovna Paruchikova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Lipid Metabolism ◽  
Combined Therapy ◽  
Lipid Lowering ◽  
Antihyperglycemic Therapy ◽  
Efficiency And Effectiveness

Treatment management strategy for patients with type 2 diabetes mellitus (2DM) includes glycaemic control, blood pressure and lipid metabolism parameters. Pharmacoepidemiological monitoring allows evaluating the compliance of the treatment really provided for 2DM with the present guidelines.Aim.To study the actual implementation of pharmaceuticals control for patientswith type 2 diabetes, residents of the city of Omsk, in 2013—2014.Material and methods. It was a retrospective open cohort study based on the fragment data of the Regional Diabetes Register including 33 187 cases with prescription of oral antidiabetic drugs (OAD), 285 patient cases and OAD consumption and expenses data in 2014. The prescribed daily dose (PDD) was determined. It was assessed the efficiency and effectiveness of antihypertensive and lipid-lowering therapy.Results.In Omsk metformin prevails in OAD take-in that corresponds to the modern Clinical Guidelines. Prescribed daily doses of metformin (PDD) are significantly lower (by 34.71%) than the doses fixed by the WHO Centre. The second frequently prescribed drugs are sulfonylureas with gliclazide MB at the top. PDD of glimepiride and glibenclamide are considerably higher than DDD. DPP-4 medicines are quite often prescribed (up to 10.2% as a part of the combined therapy, including fixed combinations).Conclusion.The efficacy of antihyperglycemic therapy assessed upon achievement of HbA1c individual target in Omsk is 40.5%. Most patients with type 2 diabetes in the studied cohort have had the adequate antihypertensive therapy with reaching a target blood pressure in 75.8% of patients. Statin drugs are prescribed only in 39.3% of cases of dyslipidemia in type 2 diabetes, and only in 32.3% of them the targets of lipid metabolism parameters are achieved.

scholarly journals Effect of Antihyperglycemic Agents on Hemoglobin A1c Level in Type 2 Diabetes Mellitus Patients

2018 ◽  
Vol 5 (2) ◽  
pp. 57-63
Author(s):  
Tasya Kamila ◽  
Vycke Yunivita Kusumah Dewi ◽  
Miftahurachman Miftahurachman
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Hemoglobin A1c ◽  
Antihyperglycemic Agents

scholarly journals Relationship of Type 2 Diabetes Mellitus Duration with The Occurrence of Erectile Dysfunction at Puskesmas Denpasar Barat I

2021 ◽  
Vol 2 (1) ◽  
pp. 23-28
Author(s):  
Alexander Petra Sihite ◽  
I Gusti Ngurah Pramesemara ◽  
I Wayan Surudarma
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Erectile Dysfunction ◽  
Cross Sectional ◽  
Type 2 Dm ◽  
Number Of Patients ◽  
Relationship Of ◽  
The Relationship

Background: Type 2 diabetes mellitus is a metabolic disease that characterized by high blood sugar levels. This condition is often not noticed immediately and usually patient starting to realize it when complications have been occurred. A long-term complication of type 2 DM that occurred in men is erectile dysfunction (ED). ED is a condition when a person is unable to achieve or maintain an erection for sexual intercourse. One factor that influence the occurrence of ED and its severity in type 2 DM patients is the duration of the disease. Objective: The aim of this study was to determine the relationship of type 2 DM duration and the occurrence of ED. Methods: This study is an observational analytic cross-sectional study conducted at the Puskesmas (Public Health Center) Denpasar Barat I. The research data was obtained through medical record data and fill the International Index of Erectile Function (IIEF-5) questionnaire on 36 type 2 DM patients aged around 40-60 years. The statistical analysis used was Fisher's exact test. Results: The results showed that of the 36 samples, 19 (52.8%) samples had type 2 DM <24 months and 17 (47.2%) samples had type 2 DM >24 months. It was found that 5 (13.9%) samples did not experience ED while the rest experienced ED with different severity. There was a significant relationship between the type 2 DM duration and the occurrence of erectile dysfunction at Puskesmas Denpasar Barat I (p = 0.022). Conclusion: Study has found that type 2 DM patients with the longer duration (>24 months)  have a higher occurrence of ED and tended to be more severe compared to those with shorter duration (<24 months). Further studies should be performed with higher number of patients and more controlled risk factor so it will be more accurate in determining the relationship between the duration of type 2 DM and ED.

scholarly journals Electroacupuncture and Rosiglitazone Combined Therapy as a Means of Treating Insulin Resistance and Type 2 Diabetes Mellitus: A Randomized Controlled Trial

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Rong-Tsung Lin ◽  
Huei-Chin Pai ◽  
Yu-Chen Lee ◽  
Chung-Yuh Tzeng ◽  
Chin-Hsien Chang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Combined Therapy ◽  
Hypoglycemic Activity ◽  
Model Assessment ◽  
Significant Difference ◽  
Plasma Ffa

Aims.To evaluate the efficacy of rosiglitazone (TZD) and electroacupuncture (EA) combined therapy as a treatment for type 2 diabetes mellitus (T2DM) patients by randomized single-blind placebo controlled clinical trial.Methods.A total of 31 newly diagnostic T2DM patients, who fulfilled the study's eligibility criteria, were recruited. The individuals were randomly assigned into two groups, the control group (TZD,N=15) and the experimental group (TZD + EA,N=16). Changes in their plasma free fatty acid (FFA), glucose, and insulin levels, together with their homeostasis model assessment (HOMA) indices, were statistically compared before and after treatment. Hypoglycemic activity (%) was also compared between these two groups.Results.There was no significant difference in hypoglycemic activity between the TZD and TZD + EA group. The effectiveness of the combined therapy seems to derive from an improvement in insulin resistance and a significant lowering of the secreted insulin rather than the effect of TZD alone on T2DM. The combined treatment had no significant adverse effects. A lower plasma FFA concentration is likely to be the mechanism that causes this effect.Conclusion.This combined therapy seems to suppress endogenous insulin secretion by improving insulin resistance via a mechanism involving a reduction in plasma FFA. This trial is registered with ClinicalTrials.govNCT01577095.

Pharmacists’ Impact on Improving Outcomes in Patients With Type 2 Diabetes Mellitus

2012 ◽  
Vol 38 (3) ◽  
pp. 409-416 ◽  
Author(s):  
Matthew J. Pepper ◽  
Natohya Mallory ◽  
T. Nicole Coker ◽  
Amber Chaki ◽  
Karen R. Sando
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetes Management ◽  
Management Team ◽  
Outpatient Clinics ◽  
End Points ◽  
Number Of Patients

Purpose The purpose of this study was to evaluate a diabetes education program that includes a pharmacist as a member of the diabetes management team by assessing the change in hemoglobin A1c (A1C), cholesterol, and blood pressure for patients with type 2 diabetes in outpatient clinics. Methods This was a retrospective study in outpatient clinics at Shands Jacksonville Medical Center. The patients were assigned into either the pharmacist group or the nonpharmacist group, according to the presence or the absence of a pharmacist in the clinic. The primary end point was the absolute change in A1C versus baseline. Secondary end points included change in cholesterol and blood pressure and the number of patients to attain American Diabetes Association goals. End points were recorded to correlate within 3 months of the initial visit and final visit with a provider. Results Compared to the nonpharmacist group, patients in the pharmacist group had more advanced and uncontrolled diabetes at baseline. The pharmacist group showed a greater percent change in A1C and improvement between the initial and final clinic visits, after adjusting for baseline confounders. Despite the statistically significant improvement in A1C in the pharmacist group, there was no difference found between the 2 groups for the end points of cholesterol and blood pressure. Conclusion Including a pharmacist as a part of the diabetes management team may result in lower A1C in patients with more advanced and uncontrolled type 2 diabetes mellitus versus a health care team without a pharmacist.

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