scholarly journals Variation in CDKAL1 Gene Is Associated With Therapeutic Response to Sulphonylureas

2012 ◽  
pp. 177-183 ◽  
Author(s):  
Z. SCHRONER ◽  
M. JAVORSKÝ ◽  
J. HALUŠKOVÁ ◽  
L. KLIMČÁKOVÁ ◽  
E. BABJAKOVÁ ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Genetic Model ◽  
Statistical Significance ◽  
Melting Curve ◽  
Melting Curve Analysis ◽  
Pharmacogenetic Study ◽  
Sulphonylurea Treatment ◽  
The Difference

The aim of the present pilot pharmacogenetic study was to analyse quantitative effects of sulphonylurea treatment in addition to metformin on parameters of glycemic control with respect to CDKAL1 genotypes in patients with type 2 diabetes. Effect of 6-month sulphonylurea therapy on glycemic control according to CDKAL1 genotypes was evaluated in 101 patients with type 2 diabetes who failed to achieve glycemic control on metformin monotherapy. CDKAL1 rs7756992 polymorphism was determined by melting curve analysis of small amplicon following real-time PCR. After sulphonylurea treatment fasting plasma glucose (FPG) levels were significantly different (p=0.045) among three CDKAL1 genotype groups (AA: n=49; AG: n=36; GG: n=16). In a dominant genetic model, carriers of the G-allele (AG+GG, n=52) achieved significantly lower FPG levels in comparison with patients with the AA genotype (6.90±1.08 vs. 7.48±1.12 mmol/l, p=0.013). Consequently, adjusted ΔFPG was significantly higher in the AG+GG compared to the AA group (1.48±1.51 vs. 1.02±1.33 mmol/l, p=0.022). Similar trend was observed for HbA1c levels, but the difference between the genotype groups did not reach the level of statistical significance. Relatively small number of included patients is a limitation of the present study. In conclusion, our results suggest that the magnitude of FPG reduction after 6-month sulphonylurea treatment in patients with type 2 diabetes is related to the variation in CDKAL1.

scholarly journals Research on the correlation of serum plasminogen activator inhibitor-1 level to vascular complications in type 2 diabetes mellitus patients with overweight or obesity

2019 ◽  
Vol 6 (2) ◽  
pp. 20
Author(s):  
Jun X ◽  
Yanan Z ◽  
Zhijie C ◽  
Zhihui D ◽  
Danhua S ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Statistical Significance ◽  
Tnf Α ◽  
Significant Difference ◽  
The Difference ◽  
Pai 1 ◽  
Overweight Or Obesity

Objective: To explore the relationship between serum plasminogen activator inhibitor (PAI-1) level and Type 2 Diabetes Mellitus (T2DM) accompanied by overweight or obesity by observing not only the changes of PAI-1 level in T2DM patients with overweight or obesity, but also glucose and lipid metabolism related indicators, the changes of the inflammatory cytokines secreted by adipocytes, and then making an analysis on the correlation to PAI-1.Methods: 36 cases of healthy examinees were selected as normal control group (NC group), and the experimental group can be divided into T2DM group (54 cases), Overweight/Obesity group (35 cases) and T2DM + Overweight/Obesity group (48 cases). Glucose and lipid metabolism related indicators such as fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), glycated hemoglobin (HbA1c), fasting insulin (FINS), insulin resistance index (IR), body weight index (BMI) and inflammatory cytokines (interleukin-6 (IL-6), tumor necrosis factor (TNF-α) and PAI-1 were observed and compared between groups, and then made an analysis to explore the correlation of these factors to PAI-1.Results: (1) Compared with NC group, the levels of FBG, HbA1c, FINS and IR were increased in T2DM group, and the difference was of statistical significance. However, there was no statistically significant difference in TG, TC, LDL-C and BMI between NC group and T2DM group; the levels of FINS, IR, TG, LDL-C, TC and BMI were elevated in Overweight/Obesity group, and the difference was of statistical significance. However, there was no statistically significant difference in FBG and HbA1c; the levels of FBG, HbA1c, FINS, IR, TG, LDL-C, TC and BMI were up-regulated in T2DM + Overweight/Obesity group, and the difference was of statistical significance. Compared with T2DM group, the levels of TG, TC, LDL-C and BMI were increased in Overweight/Obesity group, and the difference was of statistical significance, however, the levels of FBG, HbA1c, FINS and IR were decreased, and the difference was statistically significant; The levels of FINS, IR, TG, TC, LDL-C and BMI were elevated in T2DM + Overweight/Obesity group, and the difference was of statistical significance, however, there was no statistically significant difference in FBG and HbA1c. Compared with Overweight/Obesity group, the levels of FBG, FINS, IR, HbA1c and LDL-C were increased in T2DM + Overweight/Obesity group, and the difference was of statistical significance. However, the difference in TG, TC and BMI was not statistically significant. (2) Compared with NC group, the levels of IL-6, TNF-α and PAI-1 were increased in T2DM group, Overweight/Obesity group and T2DM + Overweight/Obesity group, and the difference was statistically significant. Compared with T2DM group, the levels of IL-6 and TNF-α were elevated in Overweight/Obesity group, and the difference was of statistical significance, but there was no statistically significant difference in PAI-1; the levels of IL-6, TNF-α and PAI-1 were up-regulated in T2DM + Overweight/Obesity group, and the difference was statistically significant. Compared with Overweight/Obesity group, there was no statistically significant difference in IL-6 and TNF-α between T2DM + Overweight/Obesity group and Overweight/Obesity group, but the level of PAI-1 was increased in T2DM + Overweight/Obesity group, and the difference was of statistical significance. (3) Multivariate Logistic Regression Analysis showed that HbA1c, IR, TG, BMI, IL-6 and TNF-α were independently associated with the level of PAI-1 (all p < .05).Conclusions: (1) The level of PAI-1 is higher in type 2 diabetes mellitus patients with overweight or obesity than that in patients only with type 2 diabetes mellitus, and it is one of causes that result in vascular complications. (2) The increase in the level of PAI-1 is considered to be associated with IL-6 and TNF-α secreted by adipocytes.

scholarly journals Genetic variability in sodium-glucose cotransporter 2 influences glycemic control and risk for diabetic retinopathy in type 2 diabetes patients

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Jasna Klen ◽  
Katja Goričar ◽  
Vita Dolžan
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Glycemic Control ◽  
Glucose Homeostasis ◽  
Genetic Model ◽  
Microvascular Complications ◽  
Fasting Blood Glucose ◽  
Nonparametric Tests ◽  
Sodium Glucose Cotransporter

Summary Background Gluconeogenesis and renal glucose excretion in kidneys both play an important role in glucose homeostasis. Sodium-glucose cotransporter (SGLT2), coded by the SLC5A2 gene is responsible for reabsorption up to 99% of the filtered glucose in proximal tubules. SLC5A2 genetic polymorphisms were suggested to influence glucose homeostasis. We investigated if common SLC5A2 rs9934336 polymorphism influences glycemic control and risk for macro or microvascular complications in Slovenian type 2 diabetes (T2D) patients. Methods All 181 clinically well characterized T2D patients were genotyped for SLC5A2 rs9934336 G>A polymorphism. Associations with glycemic control and T2D complications were assessed with nonparametric tests and logistic regression. Results : SLC5A2 rs9934336 was significantly associated with increased fasting blood glucose levels (P<0.001) and HbA1c levels under the dominant genetic model (P=0.030). After adjustment for T2D duration, significantly higher risk for diabetic retinopathy was present in carriers of at least one polymorphic SLC5A2 rs9934336 A allele compared to non-carriers (OR=7.62; 95%CI=1.65–35.28; P=0.009). Conclusions Our pilot study suggests an important role of SLC5A2 polymorphisms in the physiologic process of glucose reabsorption in kidneys in T2D patients. This is also the first report on the association between SLC5A2 polymorphism and diabetic retinopathy.

scholarly journals The Impact of Family Support on Medication Adherence and Glycemic Control of Type 2 Diabetes Outpatients in a Nigerian Tertiary Hospital

2019 ◽  
pp. 295-300
Author(s):  
Chigozie Gloria Anene-Okeke ◽  
Maxwell Ogochukwu Adibe ◽  
Chinwe Victoria Ukwe ◽  
Cletus Nze Aguwa
Keyword(s):  
Type 2 Diabetes ◽  
Medication Adherence ◽  
Glycemic Control ◽  
Family Support ◽  
Diabetes Management ◽  
Statistical Significance ◽  
Fasting Blood Glucose ◽  
Self Care ◽  
The Impact

Background: Diabetes management rarely target family support as a means of promoting diabetes self-care behaviour among adults. The potential influence of family member on individuals with Type 2 diabetes has not been fully explored. The study aims to examine the impact of family support on medication adherence and glycemic control of their Type 2 diabetes out-patients in a tertiary hospital.Methods: The study was a prospective cross-sectional survey conducted on Type 2 diabetes out-patients attending endocrinology clinic at the University of Nigeria Teaching Hospital (UNTH) between October 2013 and April 2014. The Diabetes Family Behavioral Checklist (DFBC-13) was used to assess family support while the MMAS-8 (Morisky medication Adherence Scale) was used to assess medication adherence. Fasting blood glucose readings were obtained from patients’ case files.Data were analysed using SPSS (Statistical package for social sciences) version 16 and level of statistical significance set at p<0.05. Result:  A total number of 250 patients were assessed. The mean score for family support was 42 of 65 (range 13 to 65). Family support score (diet, glucose, exercise, diabetic self-care) associated with educational status (socio-demographic characteristics) r = 0.171** p = 0.007. Family support was inversely correlated to adherence and glycemic control (-0.161**, P = 0.011, r = -0.098, p = 0.147) respectively. Medication adherence was low as only 1.6% of the respondents adhered to their medication.Conclusion: Family support had little influence on medication adherence and glycemic control.

scholarly journals The Change in HbA1c Associated with Initial Adherence and Subsequent Change in Adherence among Diabetes Patients Newly Initiating Metformin Therapy

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Gregory A. Nichols ◽  
A. Gabriela Rosales ◽  
Teresa M. Kimes ◽  
Kaan Tunceli ◽  
Karen Kurtyka ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Observational Study ◽  
Subsequent Change ◽  
Metformin Therapy ◽  
Control Change ◽  
The Difference ◽  
Full Adherence ◽  
Diabetes Patients

Introduction. Whetherchangesin adherence are associated withchangesin HbA1c is assumed but not known.Methods. We conducted a observational study of 2,844 type 2 diabetes patients who initiated metformin as their first antihyperglycemic drug. Using HbA1c measures before, 6–12 months after, and up to 3 years after metformin initiation, we analyzed HbA1c change as a function of initial adherence and change in adherence.Results. Compared with no adherence, initial adherence of 50–79% was associated with an adjusted reduction in HbA1c of 0.45% while adherence ≥80% was associated with HbA1c reduction of 0.73%. Change from some initial adherence (1–79%) to total nonadherence was associated with 0.25% increase in HbA1c. Change from some to full adherence was associated with an HbA1c decrease of 0.15%. Those associations were accentuated among patients not in glycemic control: change from some to no adherence was associated with an HbA1c increase of 0.63% and change from some to full adherence was associated with an HbA1c decrease of 0.40%.Conclusions. Initial adherence to newly prescribed metformin therapy produces substantial HbA1c reduction. Among those with modest adherence but suboptimal glycemic control, the difference between moving to full adherence versus nonadherence results in lower HbA1c of one percentage point.

scholarly journals Inflammatory Status and Glycemic Control Level of Patients with Type 2 Diabetes and Periodontitis: A Randomized Clinical Trial

2021 ◽  
Vol 18 (6) ◽  
pp. 3018
Author(s):  
Biagio Rapone ◽  
Elisabetta Ferrara ◽  
Massimo Corsalini ◽  
Erda Qorri ◽  
Ilaria Converti ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Control Level ◽  
Intervention Group ◽  
Periodontal Therapy ◽  
Periodontal Treatment ◽  
Inflammatory Status ◽  
The Difference ◽  
To Receive

Background: Based on the holistic approach to prevention diabetic disease, the role of periodontal inflammation in type 2 diabetes mellitus (T2DM) is under intensive scrutiny. Data from clinical trials have shown benefit from a periodontal therapy in providing patients with type 2 diabetes improvement despite relatively disappointing long-terms response rates. The aim of this study was to investigate the short-term glycemic control level and systemic inflammatory status after periodontal therapy. Methods: This was a randomized trial with a 6-months follow-up. Participants aged 56.4 ± 7.9 years with diagnosed type 2 diabetes and periodontitis were enrolled. Among the 187 type 2 diabetic patients, 93 were randomly assigned to receive non-surgical periodontal treatment immediately and 94 to receive the delayed treatment. Within and between groups comparison was done during the study period, and the differences between groups were assessed. Results: The difference between HbA1c values at baseline (Mdn = 7.7) and 6 months after non-surgical periodontal treatment (Mdn = 7.2) was statistically significant, U = 3174.5, p = 0.012, r = 0.187. However, although technically a positive correlation, the relationship between the glycated hemoglobin value and periodontal variables was weak. The differences between both the groups over 6 months were not statistically considerable, failing to reach statistical significance. At 6 months the difference between groups about the C-reactive protein (CRP) levels was statistically significant, U=1839.5, p = 0, r = 0.472, with a lower concentration for the intervention group. Furthermore, the intervention group showed a statistically significant difference between baseline and 6 months evaluation (U = 2606.5, p = 0, r = 0.308). Conclusions: The periodontal intervention potentially may allow individuals with type 2 diabetes to improve glycemic control and CRP concentrations, and diabetes alters the periodontal status.

scholarly journals Impact of Covid19 Lockdown on Glycemic Control

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A345-A345
Author(s):  
Giovanna Rodriguez ◽  
Mert Bahtiyar ◽  
Johnathan Kirupakaran ◽  
Alaa Kubbar ◽  
Shikha Singh ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Glucose Control ◽  
Diabetes Management ◽  
Glucose Monitoring ◽  
Good Glycemic Control ◽  
City Community ◽  
Adherence To Medication ◽  
The Difference

Abstract Evidence shows that people with poor glycemic control are at greater risk of mortality due to Covid19. It is important to achieve and maintain good glycemic control to prevent negative outcomes during this pandemic (1). To study the effect of lockdown on glucose control we conducted an observational, retrospective cohort study involving 98 patients followed at endocrine clinic at an inner city, community hospital in Brooklyn, NY in the period February to May 2020. Of the cohort, 60% were women, mean age was 54.1 + 15.3 years, 70% was Hispanic, 24% was African American with a predominance of type 2 diabetes (86%). Mean HbA1c of prelockdown and lockdown phase was 9.77 ± 2.26% and 9.49 ± 2.17 % respectively and the difference was statistically significant (p &lt; 0.001) both in patients with Type 1 and Type 2 diabetes. Mean BMI of prelockdown and lockdown phase was 30.5 ± 6.8% and 30.1 ± 6.05% respectively and the difference was not statistically significant (p = 0.33). Despite no significant change in BMI, the factors responsible for improvement in HbA1c might be a result of refined eating patterns (increased consumption of homemade food), increased adherence to medication and time to cope with the daily challenges of diabetes management (1). Reference: Maddaloni E, Coraggio L, Pieralice S, Carlone A, Pozzilli P, Buzzetti R. Effects of COVID-19 Lockdown on Glucose Control: Continuous Glucose Monitoring Data From People With Diabetes on Intensive Insulin Therapy. Diabetes Care Aug 2020, 43 (8) e86-e87; DOI: 10.2337/dc20-0954

scholarly journals OR26-08 Efficacy and Safety of Higher Dulaglutide Doses (3.0 MG and 4.5 MG) When Added to Metformin in Patients With Type 2 Diabetes: A Phase 3, Randomized, Double-Blind, Parallel ARM Study (Award-11)

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Juan Pablo Frias ◽  
Luis Nevárez Ruiz ◽  
Ying Grace Li ◽  
Zhuoxin Yu ◽  
Zvonko Milicevic ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Adverse Events ◽  
Treatment Regimen ◽  
Safety Profile ◽  
Statistical Significance ◽  
Type I ◽  
Double Blind ◽  
Acceptable Safety Profile

Abstract Dulaglutide (DU) approved at doses of 0.75 and 1.5 mg once-weekly is an effective glucose lowering agent for treatment of type 2 diabetes (T2D). We hypothesized that higher investigational DU doses may provide further improvements in glucose control and body weight (BW) with an acceptable safety profile. The primary objective was to demonstrate superiority of once-weekly DU 3 mg and/or 4.5 mg to DU 1.5 mg for A1C change from baseline (BL) at 36 weeks (wks) in patients (pts) with inadequately controlled T2D on metformin therapy. Secondary objectives (controlled for multiplicity) included change in BW and % of pts achieving A1C &lt;7% at 36 wks. Patients were randomized (1:1:1) to once-weekly DU 1.5 mg (n=612), DU 3 mg (n=616), and DU 4.5 mg (n=614). All pts initiated once-weekly DU 0.75 mg for 4 wks, followed by step-wise dose escalation every 4 wks to the randomized dose of 1.5 mg, 3 mg, or 4.5 mg. Two estimands were defined for efficacy analyses: an efficacy estimand (data on-treatment without rescue medication) and a treatment-regimen estimand (all data regardless of adherence or initiation of rescue). At BL, patients had a mean of: age 57.1 yrs, T2D duration 7.6 yrs, and A1C 8.6%, BW 95.7 kg, and BMI 34.2 kg/m2. Using the efficacy estimand, the DU 3 mg and 4.5 mg doses were superior to the DU 1.5 mg dose for A1C change from BL (1.5 mg, 1.53%; 3 mg, 1.71% [p=0.003]; 4.5 mg, 1.87% [p&lt;0.001]), % of patients achieving HbA1c &lt;7% (1.5 mg, 57%; 3.0 mg, 65% [p=0.006]; 4.5 mg, 71% [p&lt;0.001]) and BW change from BL (1.5 mg, 3.1 kg; 3 mg, 4.0 kg [p=0.001]; 4.5 mg, 4.7 kg [p&lt;0.001]). Using the treatment-regimen estimand, DU 4.5 mg was superior to DU 1.5 mg for A1C change, while the DU 3 mg dose did not achieve statistical significance (1.5 mg, 1.54%; 3.0 mg, 1.64% [p=0.096]; 4.5 mg, 1.77% [p&lt;0.001]). Using the treatment-regimen estimand, more patients achieved A1C &lt;7% with higher DU doses (1.5 mg, 50%; 3 mg, 56%; 4.5 mg, 62%) and results for BW change were similar to the efficacy estimand (1.5 mg, 3.0 kg; 3 mg, 3.8 kg; 4.5 mg, 4.6 kg), but the approach for type I error control did not permit formal statistical comparisons of these secondary objectives using this estimand. The safety profile for the higher DU doses was consistent with that known for 1.5 mg. The most commonly reported adverse events were nausea (DU 1.5 mg, 13.4%; DU 3 mg, 15.6%; DU 4.5 mg, 16.4%), vomiting (DU 1.5 mg, 5.6%; DU 3 mg, 8.3%; DU 4.5 mg, 9.3%), and diarrhea (DU 1.5 mg, 7.0%; DU 3 mg, 11.4%; DU 4.5 mg, 10.7%). Treatment discontinuation due to adverse events through 36 wks was low and similar across dose groups (DU 1.5 mg, 4.2%; DU 3 mg, 5.5%; DU 4.5 mg, 5.0%). In pts with T2D and inadequate glycemic control on metformin, escalation from DU 1.5 mg to DU 3 mg or DU 4.5 mg once-weekly provided clinically relevant, dose-related improvements in glycemic control and BW with an acceptable safety profile.

Abstract #281 Depression in type 2 Diabetes: Relationship with Duration of Diabetes, Glycemic Control, Medications and Complications

2019 ◽  
Vol 25 ◽  
pp. 112-113
Author(s):  
Sandeep Tak ◽  
Ravi Mangalia ◽  
Rajkumar Rathore ◽  
Banshi Saboo
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Duration Of Diabetes

Abstract #298: Maintaining Glycemic Control on GLA-300 While Decreasing Hypoglycemia in an Aging Type 2 Diabetes (T2D) Population: 12-Month Results (Edition 2, Edition 3)

2016 ◽  
Vol 22 ◽  
pp. 84
Author(s):  
Medha Munshi ◽  
Jasvinder Gill ◽  
Jason Chao ◽  
Elena Nikonova ◽  
Meenakshi Patel
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control
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