scholarly journals Comparative Study on Adding Pioglitazone or Sitagliptin to Patients with Type 2 Diabetes Mellitus Insufficiently Controlled With Metformin

2017 ◽  
Vol 5 (7) ◽  
pp. 955-962 ◽  
Author(s):  
Maryam Jameshorani ◽  
Saba Sayari ◽  
Narjes Kiahashemi ◽  
Nima Motamed

BACKGROUND: Diabetes mellitus is a progressive disorder that often requires combination therapy.AIM: This study aimed to compare and study of add-on sitagliptin versus pioglitazone in patients with type 2 diabetes inadequately controlled with metformin.METHODS: This 12-week, randomised, open-label and single centre study compared sitagliptin (100 mg daily, n = 80) and pioglitazone (30 mg daily, n = 80) in type 2 diabetic patients whose disease was not adequately controlled with metformin.RESULTS: The mean change in HbA1c from baseline was -1.001 ± 0.83 with sitagliptin and -0.75 ± 1.20 with pioglitazone, and there were no significant difference between groups (P = 0.132). The mean change in fasting blood sugar (FBS) was -18.48 ± 33.32 mg/dl with sitagliptin and -20.53 ± 53.97 mg/dl with pioglitazone, and there were no significant difference between groups (P = 0.773). Sitagliptin caused 1.08 ± 2.39 kg decrease in weight, whereas pioglitazone caused 0.27 ± 2.42 kg increase in weight, with a between-group difference of 0.81 kg (P < 0.001). On the other hand, in sitagliptin group, there was greater improvement in lipid profile than pioglitazone group.CONCLUSION: Sitagliptin and Pioglitazone demonstrated similar improvements in glycemic control in type 2 diabetes mellitus patients whose diabetes had been inadequately controlled with metformin. Nevertheless, sitagliptin was more effective than pioglitazone regarding lipid and body weight change.

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Jia Feng ◽  
Shujin Wang ◽  
Hong Zuo ◽  
Xufeng Liu ◽  
Guohong Li ◽  
...  

Objective: To investigate the peroxisome proliferator-activated receptor-? (peroxisome) in patients with type 2 diabetes mellitus. Proliferators-activated receptors-?, PPARs-? (?) gene polymorphisms about serum lipofuscin and leptin. Methods: One hundred and twenty patients with type 2 diabetes admitted to our hospital from June 2015 to June 2018 were selected. The patients were divided into an obese group and a non-obese group of 60 patients each according to their waist circumference. A polymerase chain reaction-length polymorphism protocol was implemented in all patients to explore the PPAR-? gene polymorphism, and blood glucose, lipid, adiponectin and leptin levels were measured in both groups. Results: PPAR-? gene polymorphisms in type 2 diabetic patients were dominated by wild-type homozygous; The levels of total cholesterol, triglyceride and LDL cholesterol in the obese group were significantly higher than those in the non-obese group, while the levels of HDL cholesterol were lower than those in the non-obese group. There is significant difference in comparison between groups (P<0.05) Those carrying the A allele had a significant lipid disorder profile and decreased adiponectin levels. Conclusions: PPAR-? gene polymorphisms in type 2 diabetes are not significantly associated with adiponectin and leptin, and only in the obese group, the patients with the Allele A showed significant dyslipidemia and a declining trend of adiponectin levels.


Author(s):  
Iin Presetiawati ◽  
Retnosari Andrajati ◽  
Rani Sauriasari

Objective: This study aimed to evaluate the effectiveness of counseling and the use of a medication booklet on the level of treatment compliancethrough reduced levels of glycated hemoglobin (HbA1C) and Morisky Medication Adherence Scale (MMAS-8) scores in patients with type 2 diabetesmellitus.Methods: This pre-experimental prospectively study was conducted at Dr. Adjidarmo General Hospital, KabupatenLebak, Banten Province, Indonesia.The study sample consisted of 30 type 2 diabetic patients who met the inclusion and exclusion criteria and who underwent a counseling interventionsession and received a medication booklet. Compliance was measured against the MMAS-8 scores and HbA1C levels before the intervention and after10 weeks of administration of counseling and receipt of the booklet).Results: The MMAS-8 scores before and after the intervention were 2.63±1.50 and 0.7±1.18, respectively. The HbA1C levels before and after theintervention were 11.31±2.95 and 8.12±2.79, respectively. The measurement results for MMAS-8 and HbA1C were analyzed using the Wilcoxon test.Conclusions: The analysis showed a significant difference (p<0.001) between the HbA1Cvalues and MMAS-8 scores before and after the intervention.Therefore, this study’s finding indicate that the provision of counseling and an informational booklet can improve type 2 diabetes mellitus patientcompliance with treatment.


2018 ◽  
Vol 7 (1) ◽  
pp. 193-198
Author(s):  
Metin Guclu ◽  
Sinem Kiyici ◽  
Zulfiye Gul ◽  
Sinan Cavun

Aim In the present study, we investigated the long-term effects of exenatide treatment on serum fasting ghrelin levels in patients with type 2 diabetes mellitus. Methods Type 2 diabetic patients, who were using metformin with and without the other antihyperglycemic drugs on a stable dose for at least 3 months, were enrolled in the study. BMI>35 kg/m2 and HbA1c>7.0% were the additional inclusion criteria. Oral antihyperglycemic drugs, other than metformin, were stopped, and metformin treatment was continued at 2000 mg per day. Exenatide treatment was initiated at 5 µg per dose subcutaneously (sc) twice daily, and after one month, the dose of exenatide was increased to 10 µg twice daily. Changes in anthropometric variables, glycemic control, lipid parameters and total ghrelin levels were evaluated at baseline and following 12 weeks of treatment. Results Thirty-eight patients (male/female = 7/31) entered the study. The mean age of patients was 50.5 ± 8.8 years with a mean diabetes duration of 8.5 ± 4.9 years. The mean BMI was 41.6 ± 6.3 kg/m2 and the mean HbA1c of patients was 8.9 ± 1.4%. The mean change in the weight of patients was −5.6 kg and the percentage change in weight was −5.2 ± 3.7% following 12 weeks of treatment. BMI, fasting plasma glucose and HbA1c levels of patients were decreased significantly (P < 0.001 and P < 0.001; respectively), while there was no change in lipid parameters. Serum fasting ghrelin levels were significantly suppressed following 12 weeks of exenatide treatment compared with baseline values (328.4 ± 166.8 vs 245.3 ± 164.8 pg/mL) (P = 0.024). Conclusion These results suggest that the effects of exenatide on weight loss may be related with the suppression of serum fasting ghrelin levels, which is an orexigenic peptide.


2021 ◽  
Vol 8 (37) ◽  
pp. 3334-3338
Author(s):  
Satish Kumar

BACKGROUND Type 2 diabetes mellitus is common in the Indian population and awareness regarding the disease and its complications is low among the patients with diabetes. There is lack of studies regarding awareness of complications of diabetes among type 2 diabetic patients. The purpose of this study was to assess the awareness of diabetic complications among type 2 diabetic patients. METHODS This is an institutional based observational study. The sample comprised of 150 adult patients with type 2 diabetes mellitus who underwent treatment in the Department of Medicine, Medical College Kottayam and the patient’s age ranged from 18 - 77 years. RESULTS Majority of patients were in the age group 38 to 57 and the sample comprised of 56 % males and 44 % female patients. Out of 150 patients involved in the study, 120 patients (80 %) were aware of the complications of diabetes mellitus. Among the male patients, 70 (83.33 %) and among females, 50 (75.75 %) were aware of the complications in diabetes. In the study sample, 92 (61.33 %) were aware of the foot problems, 120 patients (80 %) were aware of renal complications, 91 patients were aware regarding eye problems of diabetes, 38 (25.33 %) regarding development of hypertension, 62 (41.33 %) regarding heart attack, 42 (28 %) patients were aware regarding development of stroke and 78 patients (52 %) had awareness regarding occurrence of recurrent infections. CONCLUSIONS Awareness regarding diabetes and its complications is fairly good among the diabetic patients in Kerala. Awareness regarding all complications of diabetes was higher among males than females. Providing awareness to type 2 diabetic patients by various educational programs may be of further help to prevent complications and to decrease the mortality and morbidity in type 2 diabetes patients. KEYWORDS Awareness, Diabetes


2016 ◽  
Vol 9 (5) ◽  
pp. 234
Author(s):  
Zahra Heidari ◽  
Zahra Sepehri ◽  
Aleme Doostdar

<p>In addition to known risk factors, the role of different micronutrients such as selenium in diabetes incidence has been proposed. Some previous studies have shown an association of selenium deficiency and type 2 diabetes mellitus, while other studies have not confirmed such a relationship. The aim of this study was to evaluate serum level of selenium in patients with Type 2 diabetes compared with the control group. This cross-sectional study was carried out on patients with type 2 diabetes in Zahedan, southeastern Iran. One hundred newly diagnosed type 2 diabetic patients were evaluated for serum selenium level. One hundred subjects from the general population who had normal fasting blood sugar levels were selected as the control group. The control group subjects were matched in pairs with each of patients on the basis of sex, age (± one year), and body mass index (±1). Serum level of selenium was determined by spectrometry method. Results were compared using t-test. The mean serum level of selenium in patients was 94.47±18.07 µg/L whereas in control group was 142.79±23.67 µg/L. The mean serum level of selenium was significantly different between the two groups (P&lt;0.001). Serum levels of selenium in diabetic patients with significant difference statistically were lower than the control group. In order to evaluate serum level of selenium in patients with diabetes, studies with larger sample size are required. Likewise, prospective studies along with selenium supplementation and investigating its effect on incidence of diabetes are accordingly needed.</p>


2013 ◽  
Vol 20 (02) ◽  
pp. 237-243
Author(s):  
GHULAM HUSSAIN BALOCH ◽  
ABDUL QADIR DALL ◽  
ATIF SITWAT HAYAT ◽  
Syed Zulfiquar Ali Shah ◽  
Bikha Ram Devrajani

Objective: To determine the frequency and pattern of dental carries in patients with type 2 diabetes mellitus. Design: Crosssectional descriptive study. Patients and methods: Patients with history of type 2 diabetes mellitus for ≥ 02 years duration with ≥ 35 years ofage and of either gender with dental pain visit at medical and dental outpatient department (OPD) of Liaquat University Hospital Hyderabad.The detail history was taken and the blood samples were taken for haemoglobin A1c (HbA1c) to assess the glycemic status. The existenceof dental carries and its pattern was diagnosed through dental examination by consultant dentist had clinical experience ≥05 years. The datawas collected on pre-designed proforma, entered and analyzed in SPSS version 11.00. Results: A total of 137 type 2 diabetic patients wereselected for this study, out of these 82 were males and 55 females. The dental carries was found in 98 (71.5%) patients. Out of these ninetyeight, 53 (54.08%) were males and 45 (45.92%) were female. Upper molar teeth involvement was present in 46 patients and lower molarteeth were involved in 52 patients. Dentine carries was seen in 35 patients, enamel carries in 19, white spot carries in 20 patients, pulpitis in16 patients, and pulp capping in 8 patients. Involvement of individual teeth was also assessed, the upper molar involvement was present in32 patients, premolar involvement was present in 11, incisor involvement in 03 patients. The lower molars were involved in 28 patients,lower pre molar in 21 and lower incisors in 03 patients. Dental carries was present in 43 (43.9%) patients in patients whose duration ofdiabetes was between 5-10 years, whereas those patients having duration >10 years had 31.6% frequency of dental carries, whileregarding duration of <5 years only 24 (24.5%) patients had dental carries. Conclusions: The diabetic patients are more prone to acquiredental caries.


2020 ◽  
Vol 8 (E) ◽  
pp. 133-137
Author(s):  
Rusdiana Rusdiana ◽  
Maya Savira ◽  
Sry Suryani Widjaja ◽  
Dedi Ardinata

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.


2012 ◽  
Vol 56 (5) ◽  
pp. 285-290 ◽  
Author(s):  
Serdal Korkmaz ◽  
Abdulkerim Yilmaz ◽  
Gürsel Yildiz ◽  
Fatih Kiliçli ◽  
Serhat Içağasioğlu

OBJECTIVE: The rate of reduction of nocturnal blood pressure (NBP) is lesser than normal in patients with type 2 diabetes mellitus (type 2 DM). Hyperhomocysteinemia (HHC) disrupts vascular structure and function, no matter the underlying causes. The risk of development of vascular disease is greater in diabetic patients with hyperhomocysteinemia than in patients with normal homocystein levels. The aim of the study was to investigate whether there are differences of homocystein levels in dipper and non-dippers patients with type 2 DM. SUBJECTS AND METHODS: We compared 50 patients (33 females, 17 males) with type 2 DM and 35 healthy individuals (18 females, 17 males ) in a control group. Ambulatory blood pressure monitoring (ABPM) was performed and homocysteine levels were measured in all patients. RESULTS: We found that the percentage of non-dipper pattern was 72% in patients with type 2 DM and 57% in control group. In diabetic and control individuals, homocystein levels were higher in non-dipper (respectively 13.4 ± 8.1 µmol/L and 11.8 ± 5 µmol/L) than in dipper subjects (respectively, 11.8 ± 5.8 µmol/L and 10.1 ± 4.2 µmol/L), but there was no significant difference between the two groups (respectively, p = 0.545, p = 0.294). CONCLUSION: In both groups, homocystein levels were higher in non-dipper than in dipper participants, but there was no significant difference between the groups. High homocystein levels and the non-dipper pattern increases cardiovascular risk. Therefore, the relationship between nocturnal blood pressure changes and homocystein levels should be investigated in a larger study.


2015 ◽  
Vol 6 (6) ◽  
pp. 16-19 ◽  
Author(s):  
Devendra Pratap Singh Rajput ◽  
Javed Yusuf Shah ◽  
Priti Singh ◽  
Shyransh Jain

Back ground: In type 2 diabetes mellitus lipid abnormalities are almost the rule. Dyslipidemia has been noted to play an integral role in the pathogenesis and progression of micro and macrovascular complications in diabetes mellitus patients. The complications exemplified by renal, cerebrovascular and cardiovascular disease cause the most morbidity and mortality in this group of patients.Aims and Objectives: This study is aimed at understanding the pattern of dyslipidemia among type 2 diabetic patients. Materials and Methods: During two month study period, total 100 patients with diabetes mellitus were evaluated for dyslipidemia. Plasma glucose was estimated by GOD –POD method and Lipid profile by photometry method. Lipid profile was evaluated by investigating the subjects for total cholesterol, serum triglyceride, high density lipoprotein, low density lipoprotein and very low density lipoprotein. In statistical analysis data were analyzed by using various statistical methods like percentage, proportions and tables by using epi info software.Results: Out of 100 patients 72(72%) were males and 28(28%) were females. The mean  fasting blood sugar of total patients with type 2 diabetes mellitus was 158.35mg/dl. in male diabetics, fasting blood sugar level with diabetes mellitus was 157.56mg/dl and in female diabetics it was 159.14mg/dl. The pattern of dyslipidemia in our study showed significantly higher levels of serum cholesterol, serum triglyceride, LDL-C in both male and female diabetics and lower levels of HDL-C in female diabetics. There was no significant difference in lipid profile pattern in male and female diabetic patients except lower levels of HDL-C in female diabetic patients. Conclusion: This study showed that dyslipidemia is highly prevalent among type 2 diabetic patients. DOI: http://dx.doi.org/10.3126/ajms.v6i6.12452Asian Journal of Medical Sciences Vol.6(6) 2015 16-19                                     


2014 ◽  
Vol 6 (3) ◽  
pp. 33-37
Author(s):  
Pranav Kumar Raghuwanshi ◽  
Devendra Pratap Singh Rajput ◽  
Bhupendra Kumar Ratre ◽  
Roopesh Jain ◽  
Narmada Patel ◽  
...  

Background: Diabetes mellitus is a very common endocrinal disorders and incidence of thyroid dysfunction also rising in India and world over. Thyroid hormones directly control insulin secretion and insulin clearance. Diabetes also may affect the thyroid function to variable extent first at the level of hypothalamic control of TSH release and second at peripheral tissue by converting T4 to T3. Aims and Objectives: The present study was carried out aiming to evaluate thyroid dysfunction among type 2 diabetes mellitus patients. Material and Methods: Study included total 80 subjects. Thyroid dysfunction was evaluated by investigating the subjects for Total tri-iodo-thyronine (T3), Total thyroxine (T4) and thyroid stimulating hormone (TSH). Plasma glucose was estimated by- GOD-POD method and Thyroid profile was estimated by- CLIA (chemiluminescence immunoassay) system. Statistical analysis was performed using software statistical package for social sciences (SPSS) version 20, unpaired T test, Pearson’s correlation. Results: In type 2 diabetic patients the prevalence of hypothyroidism and subclinical hypothyroidism was found to be 4(10.00%) and 6(15.00%) respectively, while the prevalence of subclinical hyperthyroidism and hyperthyroidism was found to be 0(0.0%) and 1(2.5%) respectively. In non diabetic healthy subjects the prevalence of hypothyroidism and subclinical hypothyroidism was found to be 1(2.5%) and 3(7.5%) respectively while the prevalence of subclinical hyperthyroidism and hyperthyroidism was found to be 0(0.0%) and 0(0.0%) respectively. Conclusion: The prevalence of thyroid dysfunction was found to be higher in type 2 diabetes mellitus subjects as compared to non-diabetic subjects. DOI: http://dx.doi.org/10.3126/ajms.v6i3.10814Asian Journal of Medical Sciences Vol.6(3) 2015 33-37  


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