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https://www.readbyqxmd.com/read/28520449/-novelties-in-the-treatment-of-heart-failure
#1
Filip Souček, Jan Novak
Heart failure (HF) is a complex clinical syndrome which is manifested by characteristic symptoms and objective signs of cardiac insufficiency. The incidence of HF, particularly its chronic form, is estimated 0.4-2 % in the central and western Europe, with an increase in higher age groups, affecting 10-20 % of the population aged over 80. With respect to its growing incidence and prevalence, novel modalities of pharmacological and non-pharmacological treatment are being developed in order to improve quality of life and survival of the affected patients...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28387494/-optimizing-basal-insulin-therapy-in-type-2-diabetes
#2
A J Scheen, N Paquot
Because of the natural history of type 2 diabetes and the increasing life expectancy, more and more patients are treated with insulin after failure of oral therapy. International guidelines give the preference to basal insulin, most often while maintaining metformin. If this treatment does not allow to reach the glycaemic objectives, optimizing therapy is mandatory. This clinical case offers the opportunity of discussing both advantages and disadvantages of three therapeutic options : the shift from basal insulin to a basal-plus or a basal-bolus insulin regimen, the addition of another oral glucose-lowering agent, either a dipeptidyl peptidase-4 inhibitor (gliptin) or an inhibitor of cotransporters sodium-glucose type 2 cotransporters (gliflozin), or the combination of basal insulin and a glucagon-like peptide-1 receptor agonist...
March 2017: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28387100/-about-the-choice-between-a-dpp-4-inhibitor-and-a-sglt-2-inhibitor-tor-treating-type-2-diabetes
#3
REVIEW
A J Scheen, N Paquot
Two new classes of oral antidiabetic agents play an increasing role in the management of type 2 diabetes, dipeptidyl peptidase-4 (DPP-4) inhibitors (gliptins) and sodiumglucose cotransporters type 2 (SGLT2) inhibitors (gliflozins). After failure of a monotherapy with metformin (first pharmacological choice in type 2 diabetes), both may offer an alternative to the add-on of a sulphonylurea, especially in patients at risk of hypoglycaemia. However, the choice between a DPP-4 inhibitor and a SGLT2 inhibitor is not easy and should be oriented based upon the individual patient characteristics...
December 2016: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28138853/sodium-glucose-co-transporter-2-sglt2-inhibitors-comparing-trial-and-real-world-use-study-protocol
#4
Andrew McGovern, Michael Feher, Neil Munro, Simon de Lusignan
BACKGROUND: Sodium-glucose co-transporter-2 (SGLT2) inhibitors (gliflozins) are the newest class of medication available to treat type 2 diabetes (T2DM). Recent findings from the first complete cardiovascular safety trial in SGLT2 inhibitors, the Empagliflozin, Cardiovascular Outcomes, and Mortality in type 2 diabetes (EMPA-REG OUTCOMES) trial, demonstrated reduced cardiovascular outcomes in people with high cardiovascular risk. How to apply these findings to clinical practice remains unclear, with questions remaining on who will reap this cardiovascular benefit...
April 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28132538/-the-safety-of-anti-diabetic-drugs-in-heart-failure
#5
Attila Frigy, Márta Germán-Salló, Lehel Máthé, Mónika Szabó
The association of diabetes and heart failure is very common, furthermore, the pathophysiology and clinical course of the two entities have many crossing-points. Today, the spectrum of available anti-diabetic drugs is extremely wide, ranging from the classical (insulin, biguanides, sulphonylureas) to the most recent agents (gliptins, gliflozins). The cardiovascular effects of these drugs are multiple, their knowledge is important in the everyday practice, as the use of safe drugs regarding of heart failure is preferred...
February 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28039605/pharmacokinetic-characteristics-and-clinical-efficacy-of-an-sglt2-inhibitor-plus-dpp-4-inhibitor-combination-therapy-in-type-2-diabetes
#6
REVIEW
André J Scheen
Type 2 diabetes (T2D) generally requires a combination of several pharmacological approaches to control hyperglycaemia. Combining a sodium-glucose cotransporter type 2 inhibitor (SGLT2I, also known as gliflozin) and a dipeptidyl peptidase-4 inhibitor (DPP-4I, also known as gliptin) appears to be an attractive strategy because of complementary modes of action. This narrative review analyzes the pharmacokinetics and clinical efficacy of different combined therapies with an SGLT2I (canagliflozin, dapagliflozin, empagliflozin, ertugliflozin, ipragliflozin, luseogliflozin, tofogliflozin) and DPP-4I (linagliptin, saxagliptin, sitagliptin, teneligliptin)...
December 30, 2016: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28036112/protocol-of-glucose-control-safety-and-efficacy-in-type-2-diabetes-a-network-meta-analysis-glucose-dinet-protocol-rational-and-design
#7
REVIEW
Guillaume Grenet, Audrey Lajoinie, Shams Ribault, Gia Bao Nguyen, Thomas Linet, Augustin Metge, Catherine Cornu, Michel Cucherat, Philippe Moulin, François Gueyffier
The aim of this study was to propose a ranking of the currently available antidiabetic drugs, regarding vascular clinical outcomes, in patients with type 2 diabetes, through a network meta-analysis approach. Randomized clinical trials, regardless of the blinding design, testing contemporary antidiabetic drugs, and considering clinically relevant outcomes in patients with type 2 diabetes mellitus will be included. The primary outcomes of this analysis will be overall mortality, cardiovascular mortality, and major cardiovascular events...
December 30, 2016: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/27753989/sy-10-3-sglt2-inhibitors-as-potential-antihypertensive-and-renoprotective-agents
#8
Peter Mertens
Remarkable progress has been achieved in the field of diabetes with the development of incretin analogues, dipeptidyl peptidase IV inhibitors and novel insulin analogues; nevertheless, there is an unmet need for additional therapeutic options. The new generation of drugs, denoted gliflozines, that specifically interfere with sodium-glucose cotransporters (SGLT)-2 and exhibit a favourable impact on glucose metabolism in patients with type 2 diabetes are emerging as hopeful avenues. The resultant negative energy balance caused by glucosuria results in long-term weight losses, significantly reduced HbA1c levels approximating 0...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27642900/sy-10-3-sglt2-inhibitors-as-potential-antihypertensive-and-renoprotective-agents
#9
Peter Mertens
Remarkable progress has been achieved in the field of diabetes with the development of incretin analogues, dipeptidyl peptidase IV inhibitors and novel insulin analogues; nevertheless, there is an unmet need for additional therapeutic options. The new generation of drugs, denoted gliflozines, that specifically interfere with sodium-glucose cotransporters (SGLT)-2 and exhibit a favourable impact on glucose metabolism in patients with type 2 diabetes are emerging as hopeful avenues. The resultant negative energy balance caused by glucosuria results in long-term weight losses, significantly reduced HbA1c levels approximating 0...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27627081/-the-effect-of-antidiabetic-treatment-on-the-bone-of-patients-with-type-2%C3%A2-diabetes
#10
David Karásek
UNLABELLED: Despite a normal or higher bone mass, type 2 diabetes is associated with a higher risk of osteoporotic fractures. Besides a higher falls frequency the lower quality of diabetics bone plays the crucial role in this case. One of the factors affecting their fracture risk is a choice of antidiabetic treatment. So far, professional societies have warned before the thiazolidinediones use only, but gliflozines can be harmful for bone too. Metformin, sulfonylureas, GLP-1 agonists and DPP-4 inhibitors belong to the drugs without a negative effect on the fracture risk...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27508606/-op-1d-08-synergetic-prevention-of-sudden-death-by-acei-statin-and-gliflozin-in-type-2-diabetes-a-simulation-study
#11
H Le, I Marchant, J P Boissel, P Nony, B Kassai, C Cornu, F Gueyffier
OBJECTIVE: Sudden cardiac death (SCD) is at the first rank of cardiovascular death causes in patients with type 2 diabetes (T2D). ACEIs and statins, but not antidiabetic agents were known to be effective in preventing this accident in these patients, until the EMPAREG OUTCOME trial. This study reported a significant protective effect on SCD by empagliflozin, a hypoglycemic drug inhibiting sodium-glucose cotransporter.We aimed here to estimate the public health impact of this tri-therapy in preventing SCD in a French type 2 diabetic virtual realistic population (VRP)...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27489899/-diabetes-mellitus-and-chronic-kidney-disease-possibilities-of-prediction-early-diagnosis-and-nephroprotection-in-the-21st-century
#12
REVIEW
M V Shestakova
The. review gives data on the prognostic value of genetic markers when analyzing the risk of chronic kidney disease in diabetes mellitus, those on new possibilities of early diagnosis of diabetic nephropathy using urinary biomarkers (nephrinuria, podocinuria) and proteomic urinalysis at the stage of normoalbuminuria. The interpretation of the index mrcroalbuminuria in type 2 diabetesis critically analyzed. The nephroprotective properties of novel classes of glucose-lowering drugs, such as incretins and gliflozins, are considered...
2016: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/27486640/empagliflozin-jardiance-type-2-diabetes-no-rush-to-use-this-drug
#13
REVIEW
(no author information available yet)
* In early 2016, metformin monotherapy remains the treatment of choice for most patients with type 2 diabetes. There are several alternatives for patients in whom metformin is poorly tolerated or ineffective. However, dapagliflozin and canagiflozin have an unfavourable harm-benefit balance and should not be used to enhance the action of metformin. Empagliflozin is the third glifozin to be authorised in the European Union for the treatment of type 2 diabetes. A randomised, double-blind, placebo-controlled trial of empaglifloznin, in combination with other glucose-lowering drugs, involved 7020 patients with type 2 diabetes, an average glycated haemoglobin (HbA1c) concentration of about 8%, and a history of at least one cardiovascular event...
June 2016: Prescrire International
https://www.readbyqxmd.com/read/27435042/dpp-4-inhibitor-plus-sglt-2-inhibitor-as-combination-therapy-for-type-2-diabetes-from-rationale-to-clinical-aspects
#14
REVIEW
André J Scheen
Type 2 diabetes (T2D) is a complex disease with multiple defects, which generally require a combination of several pharmacological approaches to control hyperglycemia. Combining a dipeptidyl peptidase-4 inhibitor (DPP-4i) and a sodium-glucose cotransporter type 2 inhibitor (SGT2i) appears to be an attractive approach. Area covered: An extensive literature search was performed to analyze the pharmacokinetics, pharmacodynamics and clinical experience of different gliptin-gliflozin combinations. Expert opinion: There is a strong rationale for combining a DPP-4i and a SGLT2i in patients with T2D because the two drugs exert different and complementary glucose-lowering effects...
December 2016: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/27389050/pharmacological-aspects-of-the-safety-of-gliflozins
#15
REVIEW
Jean-Luc Faillie
Sodium-glucose transporter 2 (SGLT2) inhibitors, also known as gliflozins, are a new class of orally active drugs used in the management of type 2 diabetes. By inhibiting the SGLT responsible for the reabsorption of glucose from the kidney, their use aims primarily to induce glycosuria and, as a consequence, lower glycemic levels. However, their specific mechanism of action involves other pharmacodynamic consequences including potentially harmful adverse reactions. This manuscript reviews the physiological and pharmacological background behind inhibition of SGLTs, and discusses the pharmacological aspects of the safety of gliflozins...
April 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/27373139/novel-antidiabetic-drugs-and-cardiovascular-risk-primum-non-nocere
#16
R C Bonadonna, C Borghi, A Consoli, M Volpe
AIMS: Diabetes treatments aim at preventing undesirable metabolic effects of hyperglycemia and at preventing/reducing tissue damage, including cardiovascular (CV) events. For approval, novel diabetes drugs undergo early systematic investigation to assess CV safety. This review provides an updated analysis of the results of recent studies examining novel diabetes medications and CV outcomes. DATA SYNTHESIS: The new regulatory guidelines enforce adjudication of all CV events when testing novel diabetes drugs...
September 2016: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
https://www.readbyqxmd.com/read/27329017/precision-medicine-the-future-in-diabetes-care
#17
REVIEW
André J Scheen
Personalized medicine aims at better targeting therapeutic intervention to the individual to maximize benefit and minimize harm. Type 2 diabetes (T2D) is a heterogeneous disease from a genetic, pathophysiological and clinical point of view. Thus, the response to any antidiabetic medication may considerably vary between individuals. Numerous glucose-lowering agents, with different mechanisms of action, have been developed, a diversified armamentarium that offers the possibility of a patient-centred therapeutic approach...
July 2016: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/27180673/-management-of-type-2-diabetes-mellitus-therapy-in-a-mature-age
#18
Jiří Hradec, Eva Račická
Type 2 diabetes mellitus represents a serious medical, social and economic problem, since it has become a pandemic in recent years, affecting up to 1/3 of the Czech population in old age. It is the clinically most significant metabolic disease in older age. A pharmacotherapeutic approach needs to be adjusted to the presence of multiple comorbidities in the elderly and to the patients ability to cooperate with treatment, and owing to the feared hypoglycemia which may contribute to increased morbidity, it detracts from the quality of life and limits the possibilities of treatment in many cases...
March 2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27152399/gliflozins-ketoacidosis
#19
(no author information available yet)
Metabolic acidosis with elevated levels of ketones in patients with type 2 diabetes.
March 2016: Prescrire International
https://www.readbyqxmd.com/read/27111121/pharmacogenetics-implications-for-modern-type-2-diabetes-therapy
#20
Harald Staiger, Elke Schaeffeler, Matthias Schwab, Hans-Ulrich Häring
Many clinical treatment studies have reported remarkable interindividual variability in the response to pharmaceutical drugs, and uncovered the existence of inadequate treatment response, non-response, and even adverse drug reactions. Pharmacogenetics addresses the impact of genetic variants on treatment outcome including side-effects. In recent years, it has also entered the field of clinical diabetes research. In modern type 2 diabetes therapy, metformin is established as first-line drug. The latest pharmaceutical developments, including incretin mimetics, dipeptidyl peptidase 4 inhibitors (gliptins), and sodium/glucose cotransporter 2 inhibitors (gliflozins), are currently experiencing a marked increase in clinical use, while the prescriptions of α-glucosidase inhibitors, sulfonylureas, meglitinides (glinides), and thiazolidinediones (glitazones) are declining, predominantly because of reported side-effects...
October 2015: Review of Diabetic Studies: RDS
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