scholarly journals Circulating microRNAs Signature for Predicting Response to GLP1-RA Therapy in Type 2 Diabetic Patients: A Pilot Study

2021 ◽  
Vol 22 (17) ◽  
pp. 9454
Author(s):  
Caterina Formichi ◽  
Daniela Fignani ◽  
Laura Nigi ◽  
Giuseppina Emanuela Grieco ◽  
Noemi Brusco ◽  
...  
Keyword(s):  
Significant Proportion ◽  
Diabetic Patients ◽  
Health Issues ◽  
Type 2 Diabetic Patients ◽  
Early Treatment Response ◽  
High Expression Group ◽  
Novel Biomarkers ◽  
Glucagon Like Peptide 1 ◽  
Glycemic Target

Type 2 diabetes (T2D) represents one of the major health issues of this century. Despite the availability of an increasing number of anti-hyperglycemic drugs, a significant proportion of patients are inadequately controlled, thus highlighting the need for novel biomarkers to guide treatment selection. MicroRNAs (miRNAs) are small non-coding RNAs, proposed as useful diagnostic/prognostic markers. The aim of our study was to identify a miRNA signature occurring in responders to glucagon-like peptide 1 receptor agonists (GLP1-RA) therapy. We investigated the expression profile of eight T2D-associated circulating miRNAs in 26 prospectively evaluated diabetic patients in whom GLP1-RA was added to metformin. As expected, GLP1-RA treatment induced significant reductions of HbA1c and body weight, both after 6 and 12 months of therapy. Of note, baseline expression levels of the selected miRNAs revealed two distinct patient clusters: “high expressing” and “low expressing”. Interestingly, a significantly higher percentage of patients in the high expression group reached the glycemic target after 12 months of treatment. Our findings suggest that the evaluation of miRNA expression could be used to predict the likelihood of an early treatment response to GLP1-RA and to select patients in whom to start such treatment, paving the way to a personalized medicine approach.

Effectiveness of Dulaglutide in the Real World and in Special Populations of Type 2 Diabetic Patients

2020 ◽  
Vol 105 (7) ◽  
pp. e2617-e2625 ◽  
Author(s):  
Mario Luca Morieri ◽  
Vera Frison ◽  
Mauro Rigato ◽  
Michele D’Ambrosio ◽  
Federica Tadiotto ◽  
...  
Keyword(s):  
Body Weight ◽  
Real World ◽  
Disease Duration ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Body Weight Reduction ◽  
Background Population ◽  
Glucagon Like Peptide 1

Abstract Context In randomized controlled trials (RCTs) on type 2 diabetes (T2D) patients, the glucagon-like peptide-1 (GLP-1) receptor agonist (GLP-RA) dulaglutide reduced HbA1c and body weight, but generalizability of such findings to real-world T2D patients is challenging. Objective We evaluated effectiveness of dulaglutide in routine clinical practice, especially in subgroups of patient that are underrepresented in RCTs. Design Retrospective multicenter study. Setting Diabetes outpatient clinics. Patients and intervention All consecutive patients who initiated dulaglutide between 2015 and 2018. Main outcome measures Changes in HbA1c and body weight were assessed up to 30 months after baseline. Effectiveness was analyzed in patient subgroups according to: prior use of GLP-1RA, persistence on treatment and dose, age, sex, disease duration, renal function, obesity, cardiovascular disease, or concomitant use of insulin or sulphonylurea. Results From a background population of 83,116 patients, 2084 initiated dulaglutide (15.3% switching from another GLP-1RA), 1307 of whom had at least 1 follow-up visit. Overall, dulaglutide reduced HbA1c by 1.0% and body weight by 2.9 kg at the end of observation. These effects were more pronounced in GLP-1RA-naïve patients and in those with shorter disease duration. Improvement in HbA1c was highly significant and consistent across all subgroups, including those aged ≥ 75 years, nonobese, or with chronic kidney disease. Body weight declined in all subgroups and significantly more with the 1.5-mg versus 0.75-mg dose. Conclusions In real-world T2D patients, effectiveness of dulaglutide on HbA1c and body weight reduction was highly consistent and significant even in subgroups of patients poorly represented in RCTs.

scholarly journals Determinants of the Impaired Secretion of Glucagon-Like Peptide-1 in Type 2 Diabetic Patients

2001 ◽  
Vol 86 (8) ◽  
pp. 3717-3723 ◽  
Author(s):  
Mai-Britt Toft-Nielsen ◽  
Mette B. Damholt ◽  
Sten Madsbad ◽  
Linda M. Hilsted ◽  
Thomas E. Hughes ◽  
...  
Keyword(s):  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1 ◽  
Type 2 Diabetic

scholarly journals Glucagon-like peptide-1 receptor agonists in type 2 diabetes: a meta-analysis of randomized clinical trials

2009 ◽  
Vol 160 (6) ◽  
pp. 909-917 ◽  
Author(s):  
Matteo Monami ◽  
Niccolò Marchionni ◽  
Edoardo Mannucci
Keyword(s):  
Type 2 Diabetes ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Relevant Information ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Receptor Agonists ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

ObjectiveThe role of glucagon-like peptide-1 (GLP-1) receptor agonists in the treatment of type 2 diabetes is debated; many recent trials, which were not included in previous meta-analyses, could add relevant information.Design and methodsAll available randomized controlled trials (RCTs), either published or unpublished, performed in type 2 diabetic patients with GLP-1 receptor agonists (exenatide and liraglutide), with a duration>12 weeks were meta-analysed for HbA1c, body mass index, hypoglycaemia and other adverse events.Results and conclusionsA total of 21 RCTs (six of which unpublished), enrolling 5429 and 3053 patients (with GLP-1 receptor agonists and active comparator or placebo respectively), was retrieved and included in the analysis. GLP-1 receptor agonists determine a significant improvement of HbA1c in comparison with placebo (−1.0 (−1.1, −0.8),P<0.001), with a low risk of hypoglycaemia. There is no evidence of increased cardiovascular risk with the use of GLP-1 receptor agonists. GLP-1 receptor agonists, which induce weight loss, are associated with gastrointestinal side effects. GLP-1 receptor agonists are effective in reducing HbA1c and postprandial glucose. In patients failing to sulphonylureas and/or metformin, GLP-1 receptor agonists are similarly effective as insulin. Available data suggest that the efficacy and tolerability of the novel agent, liraglutide, which is adequate for once-a-day administration, are comparable with those of exenatide bis in die.

scholarly journals Type 2 Diabetes Mellitus in urban and rural districts in the area of Wolisso Hospital, Ethiopia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Madia ◽  
M Soprana ◽  
A Mele ◽  
C Kadhim ◽  
N Binello ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Rural Districts ◽  
Glycemic Target ◽  
Insulin Storage ◽  
Prevalence Of Diabetes Mellitus ◽  
Type 2 Diabetic

Abstract The prevalence of Diabetes Mellitus has been rapidly growing in developing countries, both in urban and rural contexts. Ethiopia has the largest diabetes population in sub-Saharan Africa (2.6 million adult people). At Wolisso Hospital, a collaboration is underway between Doctors with Africa CUAMM and the local Association of Diabetic Patients, with the aim of guaranteeing the correct monitoring and treatment of the disease. Between December 2018 and May 2019, 244 diabetic patients were visited in a dedicated outpatient room in Wolisso Hospital; in 55 selected patients (type 2 Diabetes Mellitus, ≥ 2 visits in the 6 months, on insulin therapy), a further set of variables was measured, including: modality of insulin storage, monthly glycemic measurements, compliance with prescribed therapy, glycemic control, knowledge of glycemic target. Based on their urban or rural provenience, patients were split in two groups (27 urban, 28 rural). The χ2-test was used to determine significance. P ≤ 0.05 was considered statistically significant. A statistically significant difference was reported for the following variables: availability of a fridge for insulin storage (51.9% urban vs 21.4% rural, p = 0.039), compliance with prescribed therapy (63.0% urban vs 35.7% rural, p = 0.043), prevalence of hypertension (55.6% urban vs 28.6% rural, p = 0.043), alcohol consumption (32.1% rural vs 11.1% urban, p = 0.018). 13/27 urban patients and 21/28 rural patients reported that they stored insulin in the sand. No substantial variation between the groups is observed for BMI, glycemic control, number of monthly glycemic measurements and knowledge of glycemic target. The differences highlighted between type 2 diabetic patients from urban and rural districts of the area of Wolisso suggest that these populations probably have different features and risk factors; this consideration may be useful in the organization of specific public health interventions aimed at addressing the issue in the different settings. Key messages The prevalence of Diabetes Mellitus has been rapidly growing in developing countries, both in urban and rural contexts. The differences highlighted between type 2 diabetic patients from urban and rural districts of the area of Wolisso suggest that these populations probably have different features and risk factors.

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