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Diabetes, Obesity & Metabolism

Aris Liakos, Vaia Lambadiari, Alexandra Bargiota, Konstantinos Kitsios, Iakovos Avramidis, Kalliopi Kotsa, Spyridon Gerou, Panagiota Boura, Nikolaos Tentolouris, George Dimitriadis, Apostolos Tsapas
AIMS: To assess the effect of liraglutide on 24-h ambulatory blood pressure and heart rate in patients with hypertension (pre- and stage 1 hypertension) and inadequately controlled type 2 diabetes (hemoglobin A1c 7-10%). MATERIALS AND METHODS: Eligible patients for this investigator-initiated, parallel group, randomized, double blind trial were on stable background antihyperglycemic therapy excluding insulin, glucagon-like peptide 1 receptor agonists and dipeptidyl-peptidase 4 inhibitors...
September 22, 2018: Diabetes, Obesity & Metabolism
Stephen C Bain, Michael A Klufas, Allen Ho, David R Matthews
Worsening of diabetic retinopathy (DR) is associated with the initiation of effective treatment of glycemia in some patients with diabetes. It has been associated with risk factors such as poor blood-glucose control and hypertension, and manifests prior to the long-term benefits of optimizing glycaemic control. The majority of evidence supports an association of large and rapid reductions in blood-glucose levels with early worsening of DR. Despite a general awareness of early worsening within the diabetes community, mechanisms to explain the phenomenon remain speculative...
September 18, 2018: Diabetes, Obesity & Metabolism
Jochen Seufert, Andreas Fritsche, Stefan Pscherer, Helmut Anderten, Anja Borck, Katrin Pegelow, Peter Bramlage, Martin Pfohl
For patients with type 2 diabetes mellitus (T2DM) and inadequate glycaemic control, addition of basal-insulin is recommended, but titration and optimisation of basal insulin therapy in primary care is not well understood. Therefore, we conducted an observational trial in 2,470 T2DM patients upon initiation of insulin-glargine 100U/L (Gla-100) on top of OADs. Physicians were free to choose either a so-called "Davies", "Fritsche" or "individual" titration algorithm. We found that FBG and HbA1c levels were effectively reduced by Gla-100; 65...
September 18, 2018: Diabetes, Obesity & Metabolism
Moe Thuzar, W Phillip Law, Goce Dimeski, Michael Stowasser, Ken Ky Ho
AIM: To investigate whether mineralocorticoid (MC) antagonism enhances brown adipose tissue (BAT) function in humans. MATERIALS & METHODS: In a randomized double-blind cross-over design, 10 healthy adults (2 men, 8 women) underwent two weeks of spironolactone (100mg/day) and placebo treatments with an intervening 2-week wash-out. BAT function was assessed in response to cooling and to a mixed meal. Metabolic activity was measured by fluoro-deoxyglucose (FDG) uptake (maximal standardized uptake value, SUVmax ) using PET-CT, thermogenic activity by measuring skin temperatures overlying supraclavicular (SCL) BAT depots using infrared thermography, and postprandial metabolism by measuring energy production rate (EPR) and lipid synthesis using indirect calorimetry...
September 17, 2018: Diabetes, Obesity & Metabolism
Desiree Abdurrachim, Xing Qi Teo, Chern Chiuh Woo, Wei Xin Chan, Janise Lalic, Carolyn S P Lam, Philip Teck Hock Lee
AIMS: Sodium glucose cotransporter-2 inhibitors (SGLT2i) have been shown to reduce the risk of cardiovascular events in clinical trials; yet the underlying mechanisms for cardio-protection remain poorly understood. Increased myocardial ketone body utilization has been hypothesized to contribute to improved cardiac metabolic efficiency with SGLT2i, but this has not been conclusively demonstrated. We investigated the effects of the SGLT2i empagliflozin on myocardial ketone body utilization in diabetic, obese spontaneously hypertensive heart failure (SHHF) rats, after six months of treatment...
September 17, 2018: Diabetes, Obesity & Metabolism
Gregory A Nichols, Sephy Philip, Kristi Reynolds, Craig B Granowitz, Sergio Fazio
AIMS: To determine whether high triglycerides (TG) in the presence of statin-controlled LDL-C influence cardiovascular disease (CVD) risk among patients with diabetes in real-world clinical practice. MATERIALS AND METHODS: We identified adults with diabetes from the Southern California and Northwest regions of Kaiser Permanente. We included patients on statin therapy with LDL-C from 40-100 mg/dL who were not on other lipid-lowering therapies and had a prior diagnosis of atherosclerotic CVD or at least one other CVD risk factor...
September 17, 2018: Diabetes, Obesity & Metabolism
Othmar Moser, Max L Eckstein, Alexander Mueller, Philipp Birnbaumer, Felix Aberer, Gerd Koehler, Caren Sourij, Harald Kojzar, Peter Holler, Helmut Simi, Peter Pferschy, Pavel Dietz, Richard M Bracken, Peter Hofmann, Harald Sourij
AIMS: Though basal insulin dose reductions are recommended when people with type 1 diabetes (T1D) are exercising regularly, no research has explored ultra-long-acting basal insulin dose reductions around exercise. We compared the time spent in specified glycaemic ranges in participants with T1D during five consecutive days of moderate-intensity exercise, on either 100% or 75% of their usual insulin degludec (IDeg) dose. MATERIAL AND METHODS: Nine participants with T1D (4 females, mean age 32...
September 17, 2018: Diabetes, Obesity & Metabolism
Chintan V Dave, Sebastian Schneeweiss, Elisabetta Patorno
It is unclear the extent to which Sodium-glucose co-transporter 2 (SGLT2) inhibitors increase the risk of genital infections in routine clinical care against other antidiabetic medications, or whether the increased risk is consistent across gender or age subgroups, within individual SGLT2 agents, or it is more pronounced at a particular time after treatment initiation. We conducted a retrospective cohort study in two US commercial claims databases (2013-2017). In the primary analysis, a 1:1 propensity-score matched cohorts of female and male with type-2 diabetes mellitus initiating a SGLT2 inhibitor vs DPP-4 inhibitors was created...
September 12, 2018: Diabetes, Obesity & Metabolism
Avivit Cahn, Cheli Melzer-Cohen, Rena Pollack, Gabriel Chodick, Varda Shalev
AIMS: Concern has been raised regarding possible risk of acute kidney injury (AKI) with use of sodium-glucose-co-transporter-2-inhibitors (SGLT2-i). We aimed to assess this risk, as well as changes in estimated glomerular-filtration-rate (eGFR), hospitalizations and mortality in a real-world setting. MATERIALS AND METHODS: Included in this historical cohort study were patients with type-2-diabetes in a large health organization in Israel who initiated therapy with SGLT2-i or dipeptidyl-peptidase-4-inhibitors (DPP-4i) during 1/4/2015-30/6/2017...
September 12, 2018: Diabetes, Obesity & Metabolism
Kåre I Birkeland, Valdemar Grill, Cecilie Wium, Matthew J McQueen, Patricio Lopez-Jaramillo, Shun Fu Lee, Hertzel C Gerstein
We compared cardiovascular and other outcomes in patients with dysglycaemia with or without anti-GAD antibodies participating in the ORIGIN (Outcome Reduction with Initial Glargine Intervention) trial. Of the 12 537 participants, 8162 had anti-GAD measured at baseline and 267 were anti-GAD positive. The effects of insulin glargine versus standard care and of n-3 fatty acids supplements versus placebo were compared by testing the interaction of the treatment effects and anti-GAD status. The effect of glargine on development of new diabetes was assessed in participants without previous diabetes at baseline...
September 10, 2018: Diabetes, Obesity & Metabolism
Swantje Brede, Sebastian Fehr, Chiara Dalla-Man, Claudio Cobelli, Hendrik Lehnert, Manfred Hallschmid, Johanna Klement
The hypothalamic neuropeptide oxytocin not only modulates psychosocial function but also contributes to metabolic regulation. We have recently demonstrated that intranasal oxytocin acutely improves beta-cell responsivity and glucose tolerance in normal-weight men. In the present experiments, we therefore investigated the acute glucoregulatory impact of oxytocin in obese men with impaired insulin sensitivity. Fifteen obese healthy men with an average BMI of 35 kg/m2 and an average body fat content of 33% received a single intranasal dose (24 IU) of oxytocin before undergoing an oral glucose tolerance test...
September 10, 2018: Diabetes, Obesity & Metabolism
Rebecca K C Loh, Melissa F Formosa, Andre La Gerche, Anne T Reutens, Bronwyn A Kingwell, Andrew L Carey
AIMS: β3-adrenoceptor activation represents a potential target for increased energy expenditure through brown adipose tissue (BAT) thermogenesis. The purpose of this study was to quantify acute energy expenditure, supraclavicular skin temperature and cardiovascular responses to 4 doses of the β3-adrenoceptor agonist, mirabegron. MATERIALS AND METHODS: Seventeen individuals (11 male, 6 female) participated in this ascending dose study, receiving single 50, 100, 150 and 200 mg of mirabegron on 4 separate days with 3-14 days wash-out between each dose...
September 10, 2018: Diabetes, Obesity & Metabolism
A Pingitore, N Gonzalez-Abuin, I Ruz-Maldonado, G C Huang, G Frost, S J Persaud
AIMS: The aims of this study were to evaluate the role of free fatty acid receptor 2 (FFAR2/GPR43) in mediating the effects of the short chain fatty acids (ScFAs) sodium acetate (SA) and sodium propionate (SP) on islet function in vitro, and to identify the intracellular signalling pathways utilised in ScFA-induced potentiation of glucose-induced insulin secretion. MATERIAL AND METHODS: Islets of Langerhans were isolated from WT and FFAR2-/- mice and from non-diabetic human donors...
September 10, 2018: Diabetes, Obesity & Metabolism
Shihchen Kuo, Chun-Ting Yang, Jin-Shang Wu, Huang-Tz Ou
AIMS: In real-world clinical practice, insulin is commonly initiated later in the antidiabetic treatment course, but information is lacking on diabetes complications associated with initiating insulin as the fourth-line antidiabetic therapy versus enhancing oral antidiabetic drug (OAD) therapy in type 2 diabetes mellitus (T2DM) patients with triple OAD therapy failure. MATERIALS AND METHODS: We conducted a nationwide population-based, retrospective cohort study involving 1,022 (without prevalent diabetes-related complications [PDRCs]) and 2,077 (with/without PDRCs) propensity score-matched pairs of fourth-line insulin therapy users and enhanced OAD therapy users identified in 2004-2010...
September 5, 2018: Diabetes, Obesity & Metabolism
Rafael Simó, Cristina Hernández
We have read with attention the paper by Hebsgaard et al. (1) in which it is concluded that retinal GLP-1R expression is limited to a very small population of ganglion cells in "controls" and appear to be undetectable in advanced stages of PDR. Although in this study well-characterized and specific antibodies were used, there are some aspects that need to be commented. This article is protected by copyright. All rights reserved.
September 5, 2018: Diabetes, Obesity & Metabolism
Ruma G Singh, Ngoc N Nguyen, Steve V DeSouza, Sayali A Pendharkar, Maxim S Petrov
Current knowledge on biomarkers of intra-pancreatic fat deposition (IFD) is limited. We aimed to analyse comprehensively body composition and insulin traits as biomarkers of IFD in healthy normoglycaemic individuals as well as individuals with new-onset prediabetes and diabetes after acute pancreatitis (NODAP). A total of 29 healthy and 34 NODAP individuals took part in this cross-sectional study. The studied biomarkers belonged to the following domains: body composition (anthropometry and magnetic resonance imaging (MRI)-derived variables), indices of insulin secretion, indices of insulin sensitivity, incretins and related peptides, as well as pancreatitis-related factors...
September 5, 2018: Diabetes, Obesity & Metabolism
Fukumi Yoshikawa, Naoki Kumashiro, Fumika Shigiyama, Hiroshi Uchino, Yasuyo Ando, Hiroshi Yoshino, Masahiko Miyagi, Kayoko Ikehara, Takahisa Hirose
AIMS: This study was designed to explore the effects of intermittent use of empagliflozin, a sodium glucose cotransporter 2 inhibitor, on dietary self-management and glycemic control in patients with inadequately controlled type 2 diabetes. MATERIALS AND METHODS: This is a prospective, randomized, open-label, blinded-endpoint, parallel-group, comparative clinical trial of 50 type 2 diabetes patients treated with no more than 3 oral anti-diabetic drugs (HbA1c ≥7...
September 5, 2018: Diabetes, Obesity & Metabolism
Dan Siskind, Margaret Hahn, Christoph U Correll, Anders Fink-Jensen, Anthony W Russell, Nikolaj Bak, Brian V Broberg, Julie Larsen, Pelle L Ishøy, Tina Vilsbøll, Filip K Knop, Steve Kisely, Bjørn H Ebdrup
OBJECTIVE: Patients with schizophrenia have higher cardio-metabolic risk, partially from antipsychotic-induced weight-gain. Glucagon-like-peptide-1 receptor-agonists (GLP-1RAs) may reduce antipsychotic-associated weight-gain, however, safety and efficacy in schizophrenia has not been systematically reviewed. MATERIALS AND METHODS: We systematically searched PubMed/EMBASE/PsycINFO/Cochrane, using the search terms "(antipsychotic and GLP-1RA)". Individual participant data from studies randomizing patients to GLP-1RA or control were meta-analysed...
September 5, 2018: Diabetes, Obesity & Metabolism
Masanori Shimizu, Kunihiro Suzuki, Kanako Kato, Teruo Jojima, Toshie Iijima, Toshimitsu Murohisa, Makoto Iijima, Hidehiro Takekawa, Isao Usui, Hideyuki Hiraishi, Yoshimasa Aso
OBJECTIVE: To investigate the effects of dapagliflozin on liver steatosis and fibrosis evaluated in patients with type 2 diabetes and non-alcoholic fatty liver disease (NAFLD). RESEARCH DESIGN AND METHODS: In a randomized, active-controlled, open-label trial, 57 patients with type 2 diabetes and NAFLD were randomized to a dapagliflozin (5 mg/day) group (n=33) or to the control group (n=24) and were treated for 24 weeks. Hepatic steatosis and fibrosis were assessed by using a transient elastography (FibroScan) to measure the controlled attenuation parameter (CAP) and liver stiffness measurement (LSM), respectively...
September 3, 2018: Diabetes, Obesity & Metabolism
Miao Yu, R Ravi Shankar, Ruya Zhang, Ye Zhang, Jianxin Lin, Edward A O'Neill, Guojuan Chen, Shu Liu, Yingmei Tu, Samuel S Engel
To improve understanding of the safety and efficacy of adding sitagliptin to treatment of patients with type 2 diabetes taking pre-mixed insulin, data from patients using pre-mixed insulin ± metformin (screening HbA1c ≥7.5% and ≤11%) in either of two clinical trials in which sitagliptin 100 mg once daily or placebo was added to various formulations of insulin treatment were analyzed. In both trials, insulin doses were to remain stable throughout the 24-week trial period. At Week 24, the between-group difference (sitagliptin - placebo) in the LS mean (95% CI) change from baseline in HbA1c in patients using pre-mixed insulin was -0...
September 3, 2018: Diabetes, Obesity & Metabolism
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