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Gliptins AND HbA1c

Emil Martinka, Vladimír Uličiansky, Marián Mokáň, Ivan Tkáč, Peter Galajda, Silvia Dókušová, Zbynek Schroner
Type 2 diabetes mellitus is a heterogeneous medical condition involving multiple pathophysiological mechanisms. Its successful treatment requires an individualized approach and frequently combined therapy with utilizing its effect on multiple levels. Current possibilities enable the employment of such procedures to an incomparably greater extent than before. The effects of different classes of oral antidiabetic drugs on the reduction of glycemia and HbA1c is mutually comparable. However differences are observed in the proportions of patients who met the required criteria, regarding the increase in weight, incidence of hypoglycemia as well as the effect on cardiovascular, renal or oncologic morbidity and mortality, and severity of specific adverse effects, potential risks and contraindications...
2018: Vnitr̆ní Lékar̆ství
Angelo Avogaro, Gian Paolo Fadini
Patients with Type 2 diabetes have an excess risk for cardiovascular disease. One of the several approaches, included in the guidelines for the management of Type 2 diabetes, is based on dipeptidyl peptidase 4 (DPP-4; also termed CD26) inhibitors, also called gliptins. Gliptins inhibit the degradation of glucagon-like peptide-1 (GLP-1): this effect is associated with increased circulating insulin-to-glucagon ratio, and a consequent reduction of HbA1c. In addition to incretin hormones, there are several proteins that may be affected by DPP-4 and its inhibition: among these some are relevant for the cardiovascular system homeostasis such as SDF-1α and its receptor CXCR4, brain natriuretic peptides, neuropeptide Y and peptide YY...
April 17, 2018: British Journal of Clinical Pharmacology
Štěpán Svačina, Petra Ovesná, Matyáš Kuhn, Martina Nováčková
INTRODUCTION: Type 2 diabetes is an enormous medical problem caused by increasing prevalence of the disease and increasing prevalence of severe chronic complications of diabetes. New ADA/EASD guidelines and also Czech diabetes society guidelines enable effective individual approach to the patient. Goal of the therapy is optimal compensation of diabetes and prevention of acute and chronic complications of diabetes and decrease of mortality. Diabetes therapy is started by education in diet a regime combined with metformin...
December 0: Vnitr̆ní Lékar̆ství
Lana Kosi-Trebotic, Anita Thomas, Jürgen Harreiter, Marek Chmelik, Siegfried Trattnig, Alexandra Kautzky-Willer
BACKGROUND: Increased hepatic fat and cardiac fat are common in patients with type 2 diabetes mellitus (T2DM) and are associated with a greater risk of liver fibrosis and cardiovascular (CV) events. Sex-specific differences of dipeptidyl peptidase-four (DPP-4) inhibitor effects on hepatic (HCL) and myocardial fat content (MYCL) have not yet been evaluated. METHOD: Forty-one T2DM patients (20 male, 21 female) received a gliptin add-on therapy if HbA1c goals were not reached under metformin monotherapy...
August 16, 2017: European Journal of Clinical Investigation
Ida Unhammer Njerve, Sissel Åkra, Thomas W Weiss, Svein Solheim, Reidun Øvstebø, Hans Christian D Aass, Rune Byrkjeland, Harald Arnesen, Ingebjørg Seljeflot
BACKGROUND: Promising results regarding potential anti-inflammatory and antiatherosclerotic effects of gliptins have been reported. Our aim was to investigate whether saxagliptin treatment modifies expression of inflammatory markers, primarily in peripheral blood mononuclear cells (PBMCs) and in circulating leukocytes in patients with stable coronary artery disease (CAD) and T2DM. METHODS: Patients ( n = 12) were randomized to saxagliptin 5 mg daily or placebo for 3 months...
2017: Mediators of Inflammation
Arwa Younis, Dana Eskenazi, Ronen Goldkorn, Jonathan Leor, Nili Naftali-Shani, Enrique Z Fisman, Alexander Tenenbaum, Ilan Goldenberg, Robert Klempfner
BACKGROUND: Patients with type 2 diabetes present with an accelerated atherosclerotic process. Animal evidence indicates that dipeptidyl peptidase-4 inhibitors (gliptins) have anti-inflammatory and anti-atherosclerotic effects, yet clinical data are scarcely available. DESIGN AND METHODS: A prospective, randomized, open-label study was performed in 60 patients with coronary artery disease (CAD) and type 2 diabetes, who participated in a cardiac rehabilitation program...
May 22, 2017: Cardiovascular Diabetology
Aurélien Mary, Agnes Hartemann, Sophie Liabeuf, Carole Elodie Aubert, Salim Kemel, Joe Elie Salem, Philippe Cluzel, Aurélie Lenglet, Ziad A Massy, Jean-Daniel Lalau, Romuald Mentaverri, Olivier Bourron, Saïd Kamel
BACKGROUND: Vascular calcification (VC) is common in type 2 diabetes, and is associated with cardiovascular complications. Recent preclinical data suggest that metformin inhibits VC both in vitro and in animal models. However, metformin's effects in patients with diabetic VC have not previously been characterized. The present study investigated the association between metformin use and lower-limb arterial calcification in patients with type 2 diabetes and high cardiovascular risk. METHODS: The DIACART cross-sectional cohort study included 198 patients with type 2 diabetes but without severe chronic kidney disease...
February 15, 2017: Cardiovascular Diabetology
Ivan Tkáč, Ivana Gotthardová
Incretin effect enhancers are drugs used in the treatment of Type 2 diabetes and include GLP-1 receptor agonists and dipeptidyl peptidase-4 inhibitors (gliptins). Variants in several genes were shown to be involved in the physiology of incretin secretion. Only two gene variants have evidence also from pharmacogenetic studies. TCF7L2 rs7903146 C>T and CTRB1/2 rs7202877 T>G minor allele carriers were both associated with a smaller reduction in HbA1c after gliptin treatment when compared with major allele carriers...
May 2016: Pharmacogenomics
M Javorský, I Gotthardová, L Klimčáková, M Kvapil, J Židzik, Z Schroner, P Doubravová, I Gala, I Dravecká, I Tkáč
Gliptins act by increasing endogenous incretin levels. Glucagon-like peptide-1 receptor (GLP1R) and glucose-dependent insulinotropic peptide receptor (GIPR) are their indirect drug targets. Variants of GLP1R and GIPR have previously been associated with the incretin effect. The aim of the present pilot study was to examine associations of the GLP1R and GIPR gene variants with the glycaemic response to gliptins. A total of 140 consecutive patients with type 2 diabetes were followed-up 6 months after initiation of gliptin treatment...
September 2016: Diabetes, Obesity & Metabolism
Takashi Nakamura, Yoshitaka Iwanaga, Yuki Miyaji, Ryuji Nohara, Takao Ishimura, Shunichi Miyazaki
BACKGROUND: Gliptins should have beneficial effects beyond glycemic control, potentially on the pathophysiology of cardiovascular (CV) diseases, with some basic studies demonstrating this possibility. However, we are yet to answer whether there are any direct CV effects in the clinical setting. We aimed to examine the beneficial effects of sitagliptin in Japanese patients with diabetes and high CV risk for 12 months. METHODS: This was a prospective, multicenter, observational study of 205 patients with type 2 diabetes...
March 31, 2016: Cardiovascular Diabetology
Pin Wang, Rong Huang, Sen Lu, Wenqing Xia, Haixia Sun, Jie Sun, Rongrong Cai, Shaohua Wang
OBJECTIVE: Whether lowering glycosylated haemoglobin (HbA1c) level below 7.0% improves macro-vascular outcomes in diabetes remains unclear. Here, we aimed to assess the effect of relatively tight glucose control resulting in a follow-up HbA1c level of less or more than 7.0% on cardiovascular outcomes in diabetic patients. RESEARCH DESIGN AND METHODS: We systematically searched Medline, Web of science and Cochrane Library for prospective randomized controlled trials published between Jan 1, 1996 and July 1, 2015 that recorded cardiovascular outcome trials of glucose-lowering drugs or strategies in patients with type 2 diabetes mellitus...
September 22, 2015: Cardiovascular Diabetology
Se Hee Min, Soo Heon Kwak, Young Min Cho, Kyong Soo Park, Hye Seung Jung
BACKGROUND: Even though several oral anti-diabetic drugs (OAD) with various modes of action are replacing sulfonylurea (SU), some patients seem to be dependent on SU for adequate glycemic control. Therefore, we evaluated the clinical characteristics of such patients. METHODS: We selected the patients with type 2 diabetes who met following criteria from 2009 to 2014 at Seoul National University Hospital: glycated hemoglobin (HbA1c) was maintained below 7.5% for at least 6 months under small dose of SU (glimepiride ≤2 mg/day or equivalent dose); after discontinuation of SU, HbA1c increased ≥1...
December 2015: Endocrinology and Metabolism
(no author information available yet)
Metformin alone is the glucose-lowering drug of first choice for patients with type 2 diabetes. None of the other glucose-lowering drugs available in 2014 have any proven efficacy in preventing diabetes complications. How important are adverse effects in the choice of glucose-lowering alternatives to metformin for patients with type 2 diabetes? What about their effects on HbA1c levels? To answer these questions, we conducted a review of the literature using the standard Prescrire methodology. Sulphonylureas have been in use for many years...
May 2015: Prescrire International
Zdeněk Rušavý, Michal Žourek
Type 2 diabetes has become a pandemic disease over the past 50 years. Its incidence increases the most rapidly in the senior population, i.e. among people older than 65. In a number of countries 1/4 of the people with diabetes are now older than 65 years. Geriatrics now examines numerous differences regarding the senior patients, which often lead to somewhat different therapeutic procedures as compared to the treatment of other adult patients. This paper aims to show some different aspects of the treatment of an elderly patient with diabetes...
April 2015: Vnitr̆ní Lékar̆ství
Deep Dutta, Sanjay Kalra
Sodium glucose transporter 2 (SGLT2) inhibitors including dapagliflozin, canagliflozin and empagliflozin act by a novel insulin-independent mechanism by blocking glucose reabsorption in the proximal convoluted tubules resulting in markedly increased glycosuria, a mechanism not limited by the degree of insulin resistance or beta-cell dysfunction, and which results in weight loss due to loss of 300 to 400kcal/day. Currently dapagliflozin, canagliflozin and empagliflozin are the three primary drugs, which represent this group...
October 2014: JPMA. the Journal of the Pakistan Medical Association
Regin Elsa George, Siby Joseph
Diabetes resulting from both genetic and lifestyle factors causes high insulin deficiency or its resistance. As hyperglycemia and decreased insulin secretion and/or its sensitivity appear to be the primary defects associated with diabetes, available treatments focus on reducing those defects. A novel approach of treatment is to target the incretin mimetic hormones, which are secreted by intestinal cells in response to food intake, provoking glucose-dependent insulin secretion from the pancreas. Efficacy and safety studies of dipetidyl peptidase inhibitors (DPP-IV), sitagliptin, vildagliptin and linagliptin provide similar improvements in HbA1c levels when compared with metformin, sulfonylureas or glitazones without contributing to weight gain and hypoglycemia...
November 2014: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
K V S Hari Kumar, A K Gupta
AIMS: Dipeptidyl peptidase-4 inhibitors (DPP 4i) are oral hypoglycemic agents and are supposed to be beneficial in the early stages of diabetes. In this study, we evaluated the role of DPP4i in long standing type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: This retrospective data analysis was conducted from the patient records. All the patients (T2DM>5 years; Age>50 years; Gliptin use >12 months) were divided into 2 groups based on the duration of T2DM: Group A (<10 years) and Group B (>10 years)...
October 2015: Diabetes & Metabolic Syndrome
Dongsheng Cheng, Yang Fei, Yumei Liu, Junhui Li, Yuqiang Chen, Xiaoxia Wang, Niansong Wang
OBJECTIVE: To perform a systematic review and meta-analysis regarding the efficacy and safety of dipeptidyl peptidase-4 (DDP-4) inhibitors ("gliptins") for the treatment of type 2 diabetes mellitus (T2DM) patients with moderate to severe renal impairment. METHODS: All available randomized-controlled trials (RCTs) that assessed the efficacy and safety of DDP-4 inhibitors compared with placebo, no treatment, or active drugs were identified using PubMed, EMBASE, Cochrane CENTRAL, conference abstracts, clinical trials...
2014: PloS One
Chun-Jun Li, Xiao-Juan Liu, Lian Bai, Qian Yu, Qiu-Mei Zhang, Pei Yu, De-Min Yu
BACKGROUND: The oral DPP-4 inhibitors are new incretin-based therapies for treatment of type 2 diabetes. To assess the efficacy and safety of three DPP-4 inhibitors (Saxagliptin, Sitagliptin and Vildagliptin) as add-on therapy to dual combination of traditional oral hypoglycemic agents in Chinese type 2 diabetes patients. METHODS: In this 24-week, randomized, open-label, parallel clinical trial, we enrolled inadequately controlled (glycosylated haemoglobin A1c [HbA1c] ≥7...
2014: Diabetology & Metabolic Syndrome
Ananth Samith Shetty, Arun Nandith, Chamukuttan Snehalath, Ambady Ramachandran
OBJECTIVES: This retrospective analysis was done in type 2 diabetes patients to study whether treatment with either sitagliptin or other Dipeptidyl peptidase-4 (DPP-4) inhibitors increased the risk of pancreatitis. Comparison with patients treated with other Oral Antidiabetic Drugs (OADs) was done. METHODS: Asian Indian type 2 diabetic subjects (duration > or = 5 years) treated with sitagliptin or other DPP-4 inhibitors (n = 957) were selected from the clinic records...
August 2013: Journal of the Association of Physicians of India
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