scholarly journals What Is Valued Most by Patients With Type 2 Diabetes Mellitus When Selecting Second-Line Antihyperglycemic Medications in China

2021 ◽  
Vol 12 ◽  
Author(s):  
Shimeng Liu ◽  
Jing Liu ◽  
Yijiang Yu ◽  
Lei Si ◽  
Chengxiang Tang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Side Effects ◽  
Treatment Efficacy ◽  
Cardiovascular Health ◽  
Preference Heterogeneity ◽  
Second Line ◽  
Dosing Frequency

Objective: To estimate patient preferences for second-line antihyperglycemic medications in China.Methods: A face to face survey with the best-worst scaling (BWS) choices was administered in patients with diagnosed type 2 diabetes mellitus (T2DM). Study participants were asked to indicate which attribute they valued most and which attribute they valued least in 11 choice sets, each of which consisted of five alternatives out of 11 antihyperglycemic medication-specific attributes (treatment efficacy, weight change, hypoglycemic events, gastrointestinal side effects, cardiovascular health, urinary tract infection and genital infection side effects, edema, mode of administration, bone fracture, dosing frequency and out-of-pocket cost). A counting approach, a conditional logit model, and K-means clustering were used to estimate the relative importance of items and preference heterogeneity.Results: A total of 362 participants were included with a mean age of 63.6 (standard deviation: 11.8) years. There were 56.4% of participants were women, and 56.3% being diagnosed with diabetes for at least 5 years. Efficacy, cardiovascular health and hypoglycemic events were valued most, while dosing frequency, mode of administration and bone fracture were valued least. The K-means clustering further showed preference heterogeneity in out-of-pocket cost across the participants.Conclusion: Our study suggests that treatment efficacy, cardiovascular health and hypoglycemic events are valued most by Chinese patients with T2DM when selecting second-line antihyperglycemic medications. The study improves the understanding of patients’ preferences for second-line antihyperglycemic medications in China.

Abstract 234: Treatment Satisfaction Levels among Adults with Concomitant Conditions of Type 2 Diabetes Mellitus and Hypertension

2012 ◽  
Vol 5 (suppl_1) ◽  
Author(s):  
Kathleen M Fox ◽  
Susan Grandy ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Heart Disease ◽  
Side Effects ◽  
Diabetes Medication ◽  
Medication Therapy ◽  
The Us ◽  
Medication Side

Objective: This investigation evaluated the satisfaction with therapy for adults with the concomitant conditions of type 2 diabetes mellitus (T2DM) and hypertension (HTN). Methods: Respondents to the US S tudy to H elp I mprove E arly evaluation and management of risk factors L eading to D iabetes (SHIELD) 2009 survey reported their disease conditions, current medications, and satisfaction with therapy. Respondents reporting T2DM with concomitant HTN were identified. Current medications were catalogued, as respondents referred to their prescription bottles to record the name of each medication. Therapy satisfaction was captured with 3 separate questions as satisfaction/dissatisfaction with: 1) ability of the medication to prevent or treat your condition, 2) side effects of the medication, and 3) the medication overall; and scored using a 0 (completely dissatisfied) to 5 (completely satisfied) scale for heart disease treatment and diabetes treatment, separately. Scores of 0-2 were categorized as dissatisfied, score of 3 was neutral and scores 4-5 were satisfied. Results: A total of 911 adults with T2DM and HTN reported their satisfaction with therapy. For those who were dissatisfied with their diabetes medication (n = 63), 52.6% were also dissatisfied with their heart disease medication's ability to treat their HTN, 64.5% were dissatisfied with the side effects of their heart medications, and 61.9% were dissatisfied with their heart medication overall. For those who were dissatisfied with their heart disease medication (n = 59), 74.5% were also dissatisfied with their diabetes medication's ability to treat their diabetes, 56.6% were dissatisfied with the side effects of their diabetes medication, and 66.1% were dissatisfied with their diabetes medication overall. Conclusions: Although most respondents with T2DM and HTN were satisfied with their treatment, dissatisfaction with treatment for one condition was associated with therapy dissatisfaction in the other condition. Approximately 53%-65% of respondents who were dissatisfied with their diabetes medication were also dissatisfied with their HTN medication overall and in the ability to treat the condition and medication side effects.

scholarly journals Oxidative stress in patients with type 2 diabetes mellitus treated with metformin

2017 ◽  
Vol 27 (2) ◽  
pp. 25857
Author(s):  
Samuel Selbach Dries ◽  
Bárbara Da Silveira Soares ◽  
Ana Luiza Ziulkoski ◽  
Simone Gasparin Verza ◽  
Rafael Linden ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Superoxide Dismutase ◽  
Type 2 Diabetes Mellitus ◽  
Blood Glucose ◽  
Side Effects ◽  
Diabetic Complications

*** Oxidative stress in patients with type 2 diabetes mellitus treated with metformin ***AIMS: To evaluate oxidative stress parameters in patients with type 2 diabetes mellitus treated with metformin, relating these values to its side effects, plasma levels, glycemic control, diabetic complications, lipid profile, and the influence of pharmacotherapeutic follow-up.METHODS: Patients with type 2 diabetes mellitus, on metformin and in pharmacotherapeutic follow-up for four months, were evaluated. The pharmacotherapeutic follow-up consisted in providing information and answering patients’ questions about medication and disease. In addition, administration times, dosages, and presence or absence of side effects related to the use of metformin were verified. Glycemic and lipid profile, oxidative stress (superoxide dismutase and malondialdehyde) and plasma metformin were evaluated. Pearson’s correlation and Spearman’s correlation were performed to evaluate the relationship between the variables at the beginning of the study. The independent t-test and Mann-Whitney U test were used to assess the difference between the groups with and without diabetic complications. The range of values between the beginning and  end of the study was evaluated using Student’s t-test or Wilcoxon U test. The significance level was set at 5%.RESULTS: The initial sample consisted of 49 patients aged 59±9 years with a body mass index of 29.8±5.1 kg/m2, who have had diabetes for a median time of 36 months (interquartile range of 1-240) and have been on metformin for a median time of 36 months (interquartile range of 1-180). Twenty-five patients left the study between the second and fourth meetings. Malondialdehyde levels differed between before and after pharmacotherapeutic follow-up, being positively correlated with blood glucose, glycohemoglobin, and triglyceride level, and negatively correlated with metformin and superoxide dismutase. Blood glucose, glycohemoglobin, and malondialdehyde levels increased, whereas metformin levels decreased in the group with diabetic complications, and there was a correlation between malondialdehyde and the number of diabetic complications per patient.CONCLUSIONS: In this sample of patients with type 2 diabetes mellitus treated with metformin, oxidative stress was more pronounced in those with poor glycemic control and diabetic complications.

scholarly journals Investigation on the Enzymatic Profile of Mulberry Alkaloids by Enzymatic Study and Molecular Docking

Molecules ◽  
2019 ◽  
Vol 24 (9) ◽  
pp. 1776 ◽  
Author(s):  
Zhihua Liu ◽  
Ying Yang ◽  
Wujun Dong ◽  
Quan Liu ◽  
Renyun Wang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Molecular Docking ◽  
Side Effects ◽  
Inhibitory Effect ◽  
Active Ingredients ◽  
Wide Range ◽  
Consensus Score

α-glucosidase inhibitors (AGIs) have been an important category of oral antidiabetic drugs being widely exploited for the effective management of type 2 diabetes mellitus. However, the marketed AGIs not only inhibited the disaccharidases, but also exhibited an excessive inhibitory effect on α-amylase, resulting in undesirable gastrointestinal side effects. Compared to these agents, Ramulus Mori alkaloids (SZ-A), was a group of effective alkaloids from natural Morus alba L., and showed excellent hypoglycemic effect and fewer side effects in the Phase II/III clinical trials. Thus, this paper aims to investigate the selective inhibitory effect and mechanism of SZ-A and its major active ingredients (1-DNJ, FA and DAB) on different α-glucosidases (α-amylase and disaccharidases) by using a combination of kinetic analysis and molecular docking approaches. From the results, SZ-A displayed a strong inhibitory effect on maltase and sucrase with an IC50 of 0.06 μg/mL and 0.03 μg/mL, respectively, which was similar to the positive control of acarbose with an IC50 of 0.07 μg/mL and 0.68 μg/mL. With regard to α-amylase, SZ-A exhibited no inhibitory activity at 100 μg/mL, while acarbose showed an obvious inhibitory effect with an IC50 of 1.74 μg/mL. The above analysis demonstrated that SZ-A could selectively inhibit disaccharidase to reduce hyperglycemia with a reversible competitive inhibition, which was primarily attributed to the three major active ingredients of SZ-A, especially 1-DNJ molecule. In the light of these findings, molecular docking study was utilized to analyze their inhibition mechanisms at molecular level. It pointed out that acarbose with a four-ring structure could perform desirable interactions with various α-glucosidases, while the three active ingredients of SZ-A, belonging to monocyclic compounds, had a high affinity to the active site of disaccharidases through forming a wide range of hydrogen bonds, whose affinity and consensus score with α-amylase was significantly lower than that of acarbose. Our study illustrates the selective inhibition mechanism of SZ-A on α-glucosidase for the first time, which is of great importance for the treatment of type 2 diabetes mellitus.

scholarly journals The association of ideal cardiovascular health with incident type 2 diabetes mellitus: the Multi-Ethnic Study of Atherosclerosis

Diabetologia ◽  
2016 ◽  
Vol 59 (9) ◽  
pp. 1893-1903 ◽  
Author(s):  
Joshua J. Joseph ◽  
Justin B. Echouffo-Tcheugui ◽  
Mercedes R. Carnethon ◽  
Alain G. Bertoni ◽  
Christina M. Shay ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cardiovascular Health ◽  
Ethnic Study ◽  
Ideal Cardiovascular Health ◽  
Incident Type ◽  
Incident Type 2 Diabetes

scholarly journals Protocol for an observational cohort study investigating personalised medicine for intensification of treatment in people with type 2 diabetes mellitus: the PERMIT study

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e046912
Author(s):  
Patrick Bidulka ◽  
Stephen O’Neill ◽  
Anirban Basu ◽  
Samantha Wilkinson ◽  
Richard J Silverwood ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Relative Effectiveness ◽  
Second Line ◽  
Short Term ◽  
Risk Profiles ◽  
The Uk

IntroductionFor people with type 2 diabetes mellitus (T2DM) who require an antidiabetic drug as an add-on to metformin, there is controversy about whether newer drug classes such as dipeptidyl peptidase-4 inhibitors (DPP4i) or sodium-glucose co-transporter-2 inhibitors (SGLT2i) reduce the risk of long-term complications compared with sulfonylureas (SU). There is widespread variation across National Health Service Clinical Commissioning Groups (CCGs) in drug choice for second-line treatment in part because National Institute for Health and Care Excellence guidelines do not specify a single preferred drug class, either overall or within specific patient subgroups. This study will evaluate the relative effectiveness of the three most common second-line treatments in the UK (SU, DPP4i and SGLT2i as add-ons to metformin) and help target treatments according to individual risk profiles.Methods and analysisThe study includes people with T2DM prescribed one of the second-line treatments-of-interest between 2014 and 2020 within the UK Clinical Practice Research Datalink linked with Hospital Episode Statistics and Office of National Statistics. We will use an instrumental variable (IV) method to estimate short-term and long-term relative effectiveness of second-line treatments according to individuals’ risk profiles. This method minimises bias from unmeasured confounders by exploiting the natural variation in second-line prescribing across CCGs as an IV for the choice of prescribed treatment. The primary outcome to assess short-term effectiveness will be change in haemoglobin A1c (%) 12 months after treatment initiation. Outcome measures to assess longer-term effectiveness (maximum ~6 years) will include microvascular and macrovascular complications, all-cause mortality and hospital admissions during follow-up.Ethics and disseminationThis study was approved by the Independent Scientific Advisory Committee (20-064) and the London School of Hygiene & Tropical Medicine Research Ethics Committee (21395). Results, codelists and other analysis code will be made available to patients, clinicians, policy-makers and researchers.

scholarly journals A Review of Exenatide in the Treatment of Type 2 Diabetes Mellitus

2010 ◽  
Vol 2 ◽  
pp. CMT.S3489
Author(s):  
Aashish G. Samat ◽  
Amit Bhargava ◽  
Vasantha Reddy
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Side Effects ◽  
Glycemic Control ◽  
Day Treatment ◽  
The United States ◽  
Total Direct Medical Cost ◽  
Legacy Effect

Diabetes Mellitus (DM) is a chronic disease, with a rapidly increasing worldwide incidence and prevalence. Diabetes accounts for 8% of the US population, according to the United States Centers for Disease Control and Prevention. In terms of individuals, this number comes to a staggering 24 million. 1 In 2007, the total direct medical cost of treating diabetes and its associated complications was $116 billion. More than half of this is spent in treating its complications, both micro and macrovasular. Indirect costs in terms of disability, loss of work or premature mortality amounted to an additional $58 billion. 2 Several trials have shown the benefits of improved glycemic control on microvasular complications 3 – 7 and a propensity to reduce macrovasular disease. Furthermore tight glycemic control early in the disease, so called the legacy effect, has shown to reduce mortality. 5 However, these and several other trials have shown the progressive and unrelenting nature of the disease. Reduced efficacies of existing medications over prolonged periods, and continued beta cell dysfunction have lead to unmet glycemic targets. In addition, current antidiabetic medications have significant side effects most of which include hypoglycemia and weight gain. All the above points are rasion d'être that new additional therapies are needed. Recently, new classes of agents targeting the incretin system have become available. These can be divided into two broad categories; glucagon like peptide-1 (GLP-1) agonists/analogs (exenatide, liraglutide), and dipeptidyl peptidase-4 (DPP-4) inhibitors (sitagliptin, vildagliptin, and Saxagliptin (undergoing phase 3 trials)). Exenatide, a 39-amino acid peptide produced in the salivary gland of the Gila monster lizard, is a GLP-1 agonist. It is the first of its class approved for use as adjunctive therapy, in patients with Type 2 diabetes mellitus (T2DM). Current data suggests that exenatide, in combination with metformin, glyburide, or a glitazone, results in significant reductions in fasting and postprandial plasma glucose and hemoglobin A1c (HbA1c). Apart form gastrointestinal side effects, exenatide is relatively well tolerated and does not cause hypoglycemia when used alone. Additionally, the drug serves to promote moderate weight loss. The authors aim to provide a comprehensive overview of exenatide, detail its mechanism of action, and discuss its role in the present day treatment of patients with T2DM.

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