Present and Prospective Pharmacotherapy for the Management of Patients with Type 2 Diabetes

Diabetes Mellitus is a chronic condition prevalent worldwide. Type 2 diabetes is the most common form of diabetes, comprising 90% to 95% of all cases. Over the last few decades, the importance of glycemic control and its impact on prevention of diabetes-related complications has been documented in multiple clinical trials. As most patients with type 2 diabetes will require pharmacologic intervention to achieve and maintain appropriate glycemic control, new medications targeting different aspects of the pathophysiology of type 2 diabetes have been a significant focus of research and development. During the last decade, multiple new medications for diabetes management have become available: these medications have novel mechanisms of action, differences in effectiveness, and varying side effect profiles which will be reviewed in this article. Some of these newer medications, such as the GLP-1 analogues and DPP-4 inhibitors, have become widely accepted as therapeutic options for the management of type 2 diabetes. Additional classes of glucose-lowering medications are expected to become available in the near future. This manuscript will summarize available data regarding these newer and prospective medications for the management of type 2 diabetes.

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Safety and Mode of Action of Diabetes Medications in comparison with 5-Aminolevulinic Acid (5-ALA)

Journal of Diabetes Research ◽

10.1155/2019/4267357 ◽

2019 ◽

Vol 2019 ◽

pp. 1-10 ◽

Cited By ~ 4

Author(s):

Peter R. Rehani ◽

Hanaa Iftikhar ◽

Motowo Nakajima ◽

Tohru Tanaka ◽

Zaid Jabbar ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Amino Acid ◽

Diabetes Management ◽

Aminolevulinic Acid ◽

Mechanisms Of Action ◽

Mitochondrial Functions ◽

Porphyrin Synthesis

5-Aminolevulinic acid (5-ALA) is a delta amino acid naturally present in every living cell of the human body. 5-ALA is produced in the mitochondria as the first product of the porphyrin synthesis pathway and composes heme; exogenously supplemented 5-ALA helps in upregulating mitochondrial functions. Mitochondrial dysfunction has been associated with the pathophysiology of diabetes mellitus. Thus, in this review, we evaluate the mechanisms of action and adverse effects of common medications used to treat type 2 diabetes mellitus as well as 5-ALA including its mechanism and possible use in diabetes management.

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Clinical characteristics and determinants of glycaemic control among type 2 diabetes mellitus (T2DM) patients in Fiji

10.21203/rs.3.rs-47923/v2 ◽

2021 ◽

Author(s):

Pablo Romakin ◽

Donald Wilson ◽

Sabiha Khan ◽

Masoud Mohaammadnezhad

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Glycemic Control ◽

Glycaemic Control ◽

Blood Sugar ◽

Diabetes Management ◽

Control Level ◽

Poor Glycaemic Control

Abstract Background: Glycemic control is the centre in diabetes management. In patients with type 2 diabetes mellitus (T2DM), glycemic control is associated with clinical determinants. The aim of this study was to determine the proportion of poor glycemic control level and its clinical determinants among T2DM patients.Methods: This retrospective cross-sectional study was conducted on the medical records of T2DM patients attending diabetes clinics at the three selected health centres in Suva, Fiji. Patients who met the following criteria were included in the study: adult T2DM >18 years old registered during 2011 to 2016; on treatment for >1year; had >4 clinic visits and; had a recent HbA1c result in 2017. Logistic regression analysis was performed. A p value of <0.05 was considered as significant.Results: There were 200 female (59.2%) and 138 male (40.8%) T2DM patients included in this study with a mean age of 56.5 years (SD = + 9.9). Majority have poorly controlled random blood sugar (RBS), 67.1% and fasting blood sugar (FBS), 63.0%. Two-thirds (65.4%) had co-morbidities. The proportion of poor glycaemic control (HbA1c <7%) was 77.2% with mean HbA1c of 8.6% (+ 2.04). RBS, FBS, cholesterol, estimated glomerular filtration rate (eGFR) and diastolic blood pressure (DBP) were significant (p<0.05) determinants of poor glycaemic control.Conclusions: This study identified clinical determinants of T2DM patients that are highly associated with glycemic control. Health care workers managing T2DM patients should address these clinical determinants in order to achieve glycemic control.

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Clinical Features, Biochemical Profile, and Response to Standard Treatment in Lean, Normal-Weight, and Overweight/Obese Indian Type 2 Diabetes Patients

The Review of Diabetic Studies ◽

10.1900/rds.2021.17.68 ◽

2021 ◽

Vol 17 (2) ◽

pp. 68-74

Author(s):

Ahmad Faraz ◽

Hamid Ashraf ◽

Jamal Ahmad

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Glycemic Control ◽

Diabetes Management ◽

Normal Weight ◽

Cross Sectional ◽

Northern India

BACKGROUND: Much evidence is available on the relationship between type 2 diabetes mellitus (T2D) and obesity, but less on T2D in lean individuals. AIM: This study was conducted in 12,069 T2D patients from northern India to find out which clinical and biochemical features are related to lean, normal weight, and overweight/obese T2D patients. METHODS: The study was conducted at two endocrine clinics in northern India as a retrospective cross-sectional study. The records of all patients who attended these clinics from January 2018 to December 2019 were screened. After screening 13,400 patients, 12,069 were labelled as type 2 diabetes mellitus according to the criteria of the American Diabetes Association, 2020, and were included in the study. The patients were subdivided into the three groups by their body mass index (BMI): lean (BMI < 18), normal weight (BMI = 18-22.9), overweight/obese (BMI ≥ 23). The study evaluated how the three subgroups responded to standard diabetes management, including antidiabetic medication and lifestyle interventions. RESULTS: Of a total of 12,069 patients 327 (2.7%) were lean, 1,841 (15.2%) of normal weight, and 9,906 (82.1%) overweight/obese. Lean patients were younger, but had more severe episodes of hyperglycemia. All three subgroups experienced significant improvements in glycemic control during follow-up; HbA1c values were significantly lowered in the overweight/obese group during follow-up compared with baseline. CONCLUSIONS: While overweight/obese patients could benefit from the improvements in glycemic control achieved by lowering HbA1c, lean and normal-weight patients had more severe and difficult-to-control hyperglycemia.

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