scholarly journals Comparison of Effectiveness between DPP4 inhibitors combined with Versus Other Oral Hypoglycaemic Agent(s) in Diabetic patients

2019 ◽  
Vol 30 (2) ◽  
pp. 63-70
Author(s):  
Md Shameem Haidar
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Combination Group ◽  
Diabetic Patients ◽  
Glycemic Status ◽  
Good Glycemic Control ◽  
Dpp4 Inhibitor ◽  
Number Of Patients ◽  
Inhibitor Combination

Background: Diabetes is global health burden of disease that requires life-long pharmacological and non-pharmacological management to prevent complications such as cardiovascular disease, retinopathy, nephropathy, and neuropathy. Treatment of type 2 diabetes is based on an interplay of patient characteristics, severity of hyperglycemia and available therapeutic options. Metformin, sulfonylureas (SU) and DPP IV inhibitor are the most studied of the oral medications used worldwide. They play a prominent initial role in the type 2 diabetes treatment algorithm recommended by the several guideline. The growing evidence on new technologies and therapeutic interventions is rapidly expanding our knowledge and ability to manage diabetes and its complications; at the same time, however, it is challenge for physicians to select appropriate medication in appropriate dose for optimal patients care. Objectives: To compare the safety and efficacy of the dipeptidylpeptidase-4 (DPP-4) inhibitors combination with other oral hypoglycaemic agent(s) in patients with type 2 diabetes and inadequate glycemic control. Materials & method: Study was conducted among 600 patients over a period of 24 months. All the patients were adult male and female type 2 diabetic patients who received regular oral anti-diabetic drug(s) and duration of T2DM for one year or more were enrolled for study. Total 150 cases were selected. Patients with Type 1 DM, pregnant women with DM and who was receiving injectable antidiabetic medications were excluded from this study. Detail demographic data were collected from the informant and recorded in structured case report form. Clinical examination and relevant investigations were done. Main outcome variable was Glycemic status (HbA1C, FBG, 2HABF). Effectiveness of drugs was evaluated by glycaemic status of the patients. Result: Maximum number of patients (38.5%) was between 31-40 years age group with mean age 37.8±9.5 years. Present study shows that, for good glycemic control, all three results (FBS, 2H ABF and HbA1c) were within targeted level in majority patients of DPP4 Inhibitor combination group. Although FBS was best result in metformin group. About 51.9% of SUs group achieved the glycemic control targets level. In case of metformin group it was in 59.8% of patients, and in combined therapy 67.1% patients shows good glycemic target. So DPP4 Inhibitor combination is better medication than other to maintain good glycemic status in type 2 DM patient, due to maximum number of patients reached all three components of result within target range. Conclusion: Diabetes is chronic illness. Good glycemic control with choosing appropriate anti-diabetic medication is pivotal for DM management. In this study it is observed that DPP4 Inhibitor combination group of drug is better than other anti-diabetic medication to maintain good glycemic status in type 2 DM patients. Bangladesh J Medicine July 2019; 30(2) : 63-70

scholarly journals Medical care standards for diabetes in the hospital: evolution of views from glycemic control to metabolic surgery

2020 ◽  
Vol 4 (6) ◽  
pp. 340-346
Author(s):  
A.B. Fursov ◽  
◽  
R.A. Fursov ◽  
O.B. Ospanov ◽  
◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Medical Care ◽  
Metabolic Surgery ◽  
The Body ◽  
Diabetic Patients ◽  
Economic Costs ◽  
Number Of Patients ◽  
Surgical Methods

A large number of patients with type 2 diabetes (T2D) have a high incidence of complications and disease decompensation, which becomes the reason for therapy inefficacy. In recent years, endocrinologists and diabetologists are increasingly paying attention to surgical methods for treating T2D. The review attempts to study and systematize new trends in the treatment of T2D, as well as to determine the historical vector of changes in diabetologist views on the control, stabilization of the glycemic level in diabetic patients, and surgical methods.A retrospective study of scientific approaches to the treatment of diabetes confirmed the opinion of some researchers that the evolution of treatment methods commonly consisted of improving control and means of insulin delivery to the body. The analysis of scientific papers that confirm that detection of glycemic disorders among those admitted to the surgical hospital has a direct and immediate benefit both in a planned and urgent order. The growth of economic costs associated with insufficient glycemic control in diabetic patients was studied. Over the past decades, medical care standards for diabetes are analyzed in chronological order. Using the American Diabetes Association Guidelines, new trends in the treatment of T2D have been developed, and a stable vector in changing views on the efficacy of surgical bariatric and metabolic methods has been identified.KEYWORDS: medical care standards, type 2 diabetes, glycemia, evolution of diabetes mellitus treatment, economic costs, guidelines, metabolic surgery, endoscopic methods.FOR CITATION: Fursov A.B., Fursov R.A., Ospanov O.B. Medical care standards for diabetes in the hospital: evolution of views from glycemic control to metabolic surgery. Russian Medical Inquiry. 2020;4(6):340–346. DOI: 10.32364/2587-6821-2020-4-6-340-346.

Association between Macronutrient Intake Pattern, Glycemic Status and Use of Antidiabetic Drugs among Type 2 Diabetes Patients

2019 ◽  
Vol 56 (4) ◽  
pp. 412
Author(s):  
Martil Chacko ◽  
Khyrunnisa Begum
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Dual Therapy ◽  
Serum Glucose ◽  
Macronutrient Intake ◽  
Glycemic Status ◽  
Good Glycemic Control ◽  
Diabetes Patients

The study was aimed to assess the macronutrient intake pattern and its association to glycemic status and drug intake pattern of type 2 diabetes patients. Forty five subjects (25 males and 20 females) aged between 30 and 60 years, diagnosed with diabetes for less than 3 years were enrolled into the study. Based on Oral Anti-Diabetic drugs (OAD) treatment, they were grouped as those on mono-therapy (GpI, n=21) and dual therapy (GpII, n=25). Information about drugs profile, macronutrient intake (3 days diet recall reported as % equivalent of energy) and serum glucose profile were obtained at baseline and a 6th month follow up. Mean CHO, protein and fat intakes were 65.4±4.84, 12.6±1.26 and 22.0±4.7 % of total energy at baseline and remained essentially similar at 6<sup>th</sup> month. Patients who had controlled glycemic status (HbA<sub>1C </sub>≤ 7 %) consumed 63.4±2.70 % CHO which was significantly (P&lt;0.05) lower than those with not<strong>-</strong>controlled glycemic status (HbA<sub>1C </sub>&gt;7 %) during both the assessment periods. Also, mean protein intake was higher and fat intake was lower among patients with good glycemic control. Significantly a higher proportion of (P&lt;0.05) patients consuming CHO &gt; 65 % were on dual therapy. A diet with lower carbohydrates and fat but high protein exerted good glycemic control. Number of OADs and their dosages were significantly associated to CHO intakes. Since Indian diets are predominantly carbohydrate rich, it calls for a careful management of diet among Type 2 diabetes patients

scholarly journals Ischemia-Modified albumin level in type 2 diabetes mellitus—Preliminary report

2008 ◽  
Vol 24 (6) ◽  
pp. 311-317 ◽  
Author(s):  
Agnieszka Piwowar ◽  
Maria Knapik-Kordecka ◽  
Maria Warwas
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Vascular Complications ◽  
Diabetic Patients ◽  
Good Glycemic Control ◽  
Ischemia Modified Albumin ◽  
Control Subjects

Aim:The main goal of the present study was the evaluation of ischemia-modified albumin (IMA) in patients with type 2 diabetes mellitus and estimation of its connection with vascular complications, glycemic control, hypertension, dyslipidemia and obesity.Methods:In 76 diabetic patients and 25 control subjects, a plasma level of IMA by manually performed, spectrophotometric Co(II)-albumin binding assay was determined. Other parameters such as glucose, fructosamine, HbA1c, total cholesterol and its fractions (HDL, LDL), triglicerydes were estimated by routine methods.Results:Diabetic patients had significantly higher level of IMA in comparison with control subjects. There were not significant differences between groups with various states of vascular complications although the lowest concentration of IMA was observed in patients with microangiopathy. Patients with poor glycemic control had higher IMA level in comparison with these with good glycemic control. Significant correlation was observed between IMA and HbA1c. Among the risk factors, only blood pressure and LDL showed a weak relationship with IMA level.Conclusions:Our results revealed, for the first time, higher level of IMA in diabetic patients which confirms that it may be of non-cardiac origin. We can suggest that the albumin molecule in plasma of diabetic patients is modified in the chronic hypoxia conditions provoked mainly by hyperglycemia and oxidative stress in diabetes.

scholarly journals Individual Lipids and Lipid Ratios in Type-2 Diabetic Patients: Association with Glycemic Control Status

2017 ◽  
Vol 03 ◽  
pp. 42
Author(s):  
Ni Putu Tesi Maratni ◽  
Dwijo Anargha Sindhughosa ◽  
I Gusti Ayu Mardewi ◽  
Ida Bagus Amertha Putra Manuaba ◽  
Made Ratna Saraswati ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Glycosylated Hemoglobin ◽  
Poor Glycemic Control ◽  
Control Group ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Good Glycemic Control ◽  
Lipid Ratios

The amount of glycosylated hemoglobin (HbA1c) reflects the long-term glycemic control of patients with diabetes. HbA1c also predicts the risk for the development of diabetic complications such as cardiovascular disease (CVD). Patients with type-2 diabetes and the characteristic of dyslipidemia are frequently found. Also, dyslipidemia plays as an independent risk factor for CVD. This study was aimed to evaluate the relationship between glycemic control status with serum individual lipid profiles and lipid ratios in patients with type-2 diabetes. This cross-sectional study consisted of 80 patients. Depending on the HbA1c level, the patients were divided into two groups, good glycemic control group (HbA1c < 7.0%, n = 15) and poor glycemic control group (HbA1c ≥ 7.0%, n = 65). The association of HbA1c with individual lipids (TC, TG, HDL-C, LDL-C, Non- HDL-C) and lipid ratios (TC/HDL-C, TG/HDL-C, LDL-C/HDL-C, monocyte/HDL-C) were analyzed. The value of individual lipids and lipid ratios did not correlate with HbA1c level (p-value ≥ 0.05). Parameters of individual lipids and lipid ratios were not independently associated with poor glycemic control, which was analyzed by logistic regression. ROC analysis found both LDL-C and LDL-C/HDL-C were not accurate to be used as a prognostic indicator of poor glycemic control in patients with type-2 diabetes (p = 0.155, p = 0.297, respectively). The present study found that there was no association between individual lipids and lipid ratios with glycemic control status.

scholarly journals Vitamin D deficiency and cardiovascular risk in type 2 diabetes population

2021 ◽  
Vol 16 (1) ◽  
pp. 464-474
Author(s):  
Sushant Pokhrel ◽  
Nisha Giri ◽  
Rakesh Pokhrel ◽  
Bashu Dev Pardhe ◽  
Anit Lamichhane ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Vitamin D ◽  
Glycemic Control ◽  
High Density Lipoprotein ◽  
Vitamin D Deficiency ◽  
Density Lipoprotein ◽  
Poor Glycemic Control ◽  
Cvd Risk ◽  
Good Glycemic Control

Abstract This study aims to assess vitamin D deficiency-induced dyslipidemia and cardiovascular disease (CVD) risk in poor glycemic control among type 2 diabetes mellitus (T2DM) patients. This study was carried out among 455 T2DM patients involving poor glycemic control (n = 247) and good glycemic control (n = 208). Fasting plasma glucose (FPG) and HbA1c were measured to assess glycemic control. Cardiac risk ratio, atherogenic index plasma, and atherogenic coefficient were calculated to assess and compare the CVD risk in different groups. Patients with poor control had a significantly higher level of total cholesterol (TC), triglyceride (TG), and non-high-density lipoprotein lipase cholesterol (non-HDL-C), atherogenic variables, and lower level of high-density lipoprotein lipase cholesterol (HDL-C) as compared to patients with good glycemic control. We also observed significant negative correlation of vitamin D with lipid markers and atherogenic variables in poor glycemic control diabetic population. The serum vitamin D levels were inversely associated with HbA1c, FPG, TG, TC, and non-HDL-C. Furthermore, hypercholesterolemia, hypertriglyceridemia, and elevated non-HDL-C were the independent risks in hypovitaminosis D population. Vitamin D deficiency in poor glycemic control is likely to develop dyslipidemia as compared to vitamin D insufficient and sufficient groups. Thus, vitamin D supplementation and an increase in exposure to sunlight may reduce the risk of cardiovascular complications in diabetes.

Benefits of micronised Fenofibrate in type 2 diabetes mellitus subjects with good glycemic control

2001 ◽  
Vol 154 (2) ◽  
pp. 469-474 ◽  
Author(s):  
C.E. Tan ◽  
L.S. Chew ◽  
E.S. Tai ◽  
L.F. Chio ◽  
H.S. Lim ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Good Glycemic Control

scholarly journals The Effect of Health Education on Control Glycemic at Type 2 Diabetes Mellitus Patients

2020 ◽  
Vol 8 (E) ◽  
pp. 133-137
Author(s):  
Rusdiana Rusdiana ◽  
Maya Savira ◽  
Sry Suryani Widjaja ◽  
Dedi Ardinata
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Health Care ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Health Education ◽  
Diabetic Patients ◽  
The Mean ◽  
Educational Course

AIM: The aim of this study was to evaluate the effect of short-term education on glycemic control (glycated hemoglobin [HbA1c] and fasting blood sugar [FBS]) among type 2 diabetes mellitus patients attending to primary health care (PHC) in Medan Johor of North Sumatera, Indonesia. METHODS: The study was performed on type 2 diabetes mellitus patients in Johor PHC, Medan of North Sumatera, on 40 patients with type 2 diabetes mellitus. We took the samples of all the patients of type 2 diabetes mellitus who attend PHC in Medan Johor. The patients received for 3 months intervention by education. An educational course of diabetes together with exercise training and nutritional education was designed for the study population in order to increase the patients’ knowledge and attitude toward diabetes and to increase their participation in the self-monitoring of glycemic control. Samples of FBS and HbA1c were recorded for each patient at the time of the baseline survey, then health education was conducted to the diabetic patients of both sexes attending PHC. The patients received standard advice on diet management and variation about activity. We put HbA1c <6.5% as cut limit for the control of diabetes mellitus. RESULTS: All 40 type 2 diabetes patients completed the educational course. The mean of age of the samples is 62.53 years old, the mean of body mass index was 24.81 kg/m, and the mean of waist size was 92.15 cm. Before the education, the mean of FBS level was 238.83 mg/dl and the mean of Hba1c value is 8.90%. After education, the FBS was 216.88 mg/dl, the mean of HbA1c value was 8.74%. CONCLUSION: The effect of health education in Johor Public Health Care Medan city reduced glycemic control (FBS) in type 2 diabetes mellitus patients, North Sumatera, Indonesia.

scholarly journals Glycaemic Regulation with Zinc Combination in Type 2 Diabetes Mellitus

2021 ◽  
pp. 33-37
Author(s):  
Gangaram Bhadarge ◽  
Pratibha Dawande ◽  
Nandkishor Bankar ◽  
Raunak Kotecha
Keyword(s):  
Oxidative Stress ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Zn Deficiency ◽  
Diabetic Patients ◽  
Chronic Hyperglycemia ◽  
Low Levels

Introduction: Zn supplementation improved glutathione peroxidase enzyme activity and decreased malondialdehyde and nitric oxide levels in diabetic rats, revealing Zn's defensive effect against oxidative stress in type 2 diabetes. The investigators have discovered that consuming Zn increased liver function and protected pancreatic tissue from damage caused by diabetes. Since Zn also prevents chronic hyperglycemia, it helps to minimize oxidative stress caused by type 2 diabetes. Diabetes mellitus (DM) is a global health problem that affects more than 3 million people worldwide (16% of population). Chronic hyperglycemia causes oxidative stress in diabetic patients by the development of free radicals (oxidants) and lowering the antioxidant protection mechanism. Aim: Glycaemic Regulation with Zinc Combination in Type 2 Diabetes Mellitus. Materials and Methods: Faculty of Medicine and Diabetic Opd, Datta Meghe Mediсаl Соllege and Shаlinitаi Meghe Hоsрitаl аnd Reseаrсh Сenter, Nаgрur in соllаbоrаtion with Dаttа Meghe Institute оf Mediсаl Sсienсes Deemed to be University, Sаwаngi, Wаrdhа, Mаhаrаshtrа. Results: The mean Zn level was 12.213±2.342in all participants and 9.121±1.782 in the control group, whereas it was significantly low (9.121±1.782) in the diabetic group, and there was statistically significant difference in Zn levels between the controls and the diabetic group (P < 0.001).FBS, HbA1C, serum Zinc mean effects between control and patients showed statistically significant differences in type 2 diabetes mellitus (P <0.0001). Conclusion: Our findings show that people with diabetes have lower levels of Zn than healthy people. The cause and effect of the association between very low levels of Zn and the progression of diabetes, or diabetes that causes Zn deficiency, is still unknown. Low levels of Zn are associated with poor glycemic control, and poor glycemic control is a good indication of Zn deficiency, as there was a negative association between serum Zn and FBS and HBA1C. If diabetic patients have low glycemic regulation, a long history of diabetes, obesity, or are over the age of 50, we look to assess their levels in Zn so that Zn alternative treatment can begin to release oxidative stress in this high-risk group.

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