Influence of TCF7L2 gene polymorphisms on the effectiveness of various variants of antihyperglycaemic therapy in patients with type 2 diabetes

Single nucleotide polymorphisms of the TCF7L2 gene demonstrate the strongest association with the risk of developing type 2 diabetes, linking its effects to changes in insulin secretion. The mechanism of action of hypoglycaemic drugs used in treatment of type 2 diabetes is, to a certain extent, related to their influence on the function of β-cells, which implies that variants of the TCF7L2 gene will affect the therapeutic effect of certain anti-hyperglycaemic drugs, including the variability in the effects of incretin-based therapy, and sulphonylurea derivatives. Along with the direct influence of the TCF7L2 gene on the function of β-cells, there is evidence of the effects of TCF7L2 gene polymorphism on the susceptibility to external risk factors associated with the development of type 2 diabetes, including the alimentary factors. Pharmacogenetic studies in diabetology have at present the greatest potential in terms of selection of the optimal comprehensive anti-hyperglycaemic therapy based on preliminary genetic testing, which might improve the outcomes of treatment and the prognosis for the course of type 2 diabetes, reducing the number of life-threatening complications. Key words: GPP-1 agonists, TCF7L2 gene, metformin, nutrition, type 2 diabetes, sulphonylureas

Therapy of diabetes mellitus and the risk of malignization

The safety of therapy of diabetes mellitus with hyperglycemic agents is a challenging problem in modern diabetology extensively discussed in the last years, with the special emphasis being laid on the associated risk of formation and development of various neoplasms. The main forms of cancer known to occur in association with type 2 diabetes mellitus are related to obesity and insulin resistance. It suggests the important role of various factors, besides hyperinsulinism and hyperglycemia, in cancer pathogenesis. The present review is designed to analyse the influence of insulin analogs, sulphonylurea derivatives, metformin, and thiazolidindiones on the risk of malignization in the patients with diabetes mellitus.

The advantages of the treatment of the patients with type 2 diabetes mellitus with gliclazide MR

Type 2 diabetes mellitus (DM2) is a chronic condition characterized by progressive hyperglycemia resulting from beta-cell dysfunction and impaired insulin secretion. The maintenance of the target blood glucose level not only promotes preservation of the beta-cell pool but also reduces the risk of the development and progression of vascular complications of diabetes. This paper is designed to report the results of comparative investigations of the application of sulphonylurea derivatives for the treatment of the patients with type 2 diabetes mellitus.

Treatment of DM2 to-day. Should we change priorities? Conclusions based on recent clinical studies

This work is devoted to the analysis of results of recent clinical studies. It is argued that the absence of close association between normalized glycemiaand reduced incidence of cardiovascular disorders may be due to both relatively short duration of observations and possible effect of co-factors (e.g. hypoglycemia/drug interaction, etc.). Some results suggest the necessity of multifactor approach to the treatment of DM2 especially for the reductionof cardiovascular mortality or prevention of vascular catastrophes. Sulphonylurea derivatives are regarded as putative risk factors of hypoglycemiaor vascular disorders. A number of publications are reviewed in which glibenclamide was shown to be safe in terms of risk of myocardial infarction.