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Drug, trial and diabetes

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https://www.readbyqxmd.com/read/29227582/role-of-the-sodium-hydrogen-exchanger-in-mediating-the-renal-effects-of-drugs-commonly-used-in-the-treatment-of-type-2-diabetes
#1
REVIEW
Milton Packer
Diabetes is characterized by an increased activity of the sodium-hydrogen exchanger (NHE) in the glomerulus and renal tubules, which contributes importantly to the development of nephropathy. Despite the established role played by the exchanger in experimental studies, it has not been specifically targeted by those seeking to develop novel pharmacological treatments for diabetes. This review demonstrates that many existing drugs that are commonly prescribed to patients with diabetes act on the NHE1 and NHE3 isoforms in the kidney...
December 11, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29227571/comparative-effectiveness-of-metformin-monotherapy-in-extended-release-and-immediate-release-formulations-for-the-treatment-of-type-2-diabetes-in-treatment-na%C3%A3-ve-chinese-patients-analysis-of-results-from-the-consent-trial
#2
Linong Ji, Jing Liu, Jing Yang, Yufeng Li, Li Liang, Dalong Zhu, Quanmin Li, Tianrong Ma, Haiyan Xu, Yanlan Yang, Jiaoe Zeng, Bo Feng, Shen Qu, Yiming Li, Lizhen Ma, Shanshan Lin, Jianping Wang, Wei Li, Weihong Song, Xiaoxing Li, Yong Luo, Shugang Xi, Mei Lin, Yu Liu, Zerong Liang
AIMS: Metformin treatment for type 2 diabetes (T2DM) can be limited by gastrointestinal (GI) adverse events (AEs), resulting in treatment discontinuation. We investigated whether once-daily metformin extended release (XR) is superior in terms of GI tolerability, with non-inferior efficacy, compared with thrice-daily metformin immediate release (IR) in treatment-naïve Chinese patients with T2DM. MATERIALS AND METHODS: This prospective, open-label, randomized, multicenter, phase IV interventional study enrolled Chinese T2DM patients to receive either metformin XR or metformin IR with a 2-week screening period, 16-week treatment period, and 2-week follow-up period without treatment...
December 11, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29226041/dapagliflozin-cardiovascular-safety-and-benefits-in-type-2-diabetes-mellitus
#3
REVIEW
Fatima Saleem
Sodium-glucose co-transporter 2 inhibitors (SGLT2is) such as dapagliflozin, canagliflozin, and empagliflozin, are a promising new therapy in the treatment of type 2 diabetes mellitus (T2DM). SGLT2is can effectively reduce hyperglycemia thus improving glycemic control and they offer some beneficial effects on the cardiovascular (CV) system which can benefit patients with heart failure in addition toT2DM. The United States Food and Drug Administration requires new diabetes mellitus therapies to show a CV safety profile...
October 5, 2017: Curēus
https://www.readbyqxmd.com/read/29223646/exploring-the-effects-of-dpp-4-inhibitors-on-the-kidney-from-the-bench-to-clinical-trials
#4
REVIEW
Giuseppe Coppolino, Christian Leporini, Laura Rivoli, Francesco Ursini, Eugenio Donato di Paola, Valeria Cernaro, Franco Arturi, Davide Bolignano, Emilio Russo, Giovambattista De Sarro, Michele Andreucci
Dipeptidyl-peptidase-4 (DPP-4) inhibitors are a relatively new class of non-insulin glucose-lowering agents, belonging to the incretin family, which are able to improve glycemic control with a favorable safety profile, since they are associated with a low risk of hypoglycemia, no weight gain, and good tolerability in patients with chronic renal failure. Some experimental and clinical studies suggest that these drugs may exert significant pleiotropic effects, in particular on chronic kidney disease (CKD) progression, but data from clinical trials are still controversial...
December 6, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29221659/cardiovascular-outcomes-with-glucagon-like-peptide-1-receptor-agonists-in-patients-with-type-2-diabetes-a-meta-analysis
#5
M Angelyn Bethel, Rishi A Patel, Peter Merrill, Yuliya Lokhnygina, John B Buse, Robert J Mentz, Neha J Pagidipati, Juliana C Chan, Stephanie M Gustavson, Nayyar Iqbal, Aldo P Maggioni, Peter Öhman, Neil R Poulter, Ambady Ramachandran, Bernard Zinman, Adrian F Hernandez, Rury R Holman
BACKGROUND: Glucagon-like peptide-1 (GLP-1) receptor agonists are effective glucose-lowering drugs. Findings from cardiovascular outcome trials showed cardiovascular safety of GLP-1 receptor agonists, but results for cardiovascular efficacy were varied. We aimed to examine overall cardiovascular efficacy for lixisenatide, liraglutide, semaglutide, and extended-release exenatide. METHODS: In this systematic review and meta-analysis, we analysed data from eligible trials that assessed the safety and efficacy of GLP-1 receptor agonists compared with placebo in adult patients (aged 18 years or older) with type 2 diabetes and had a primary outcome including, but not limited to, cardiovascular mortality, non-fatal myocardial infarction, and non-fatal stroke...
December 5, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29221645/primary-care-led-weight-management-for-remission-of-type-2-diabetes-direct-an-open-label-cluster-randomised-trial
#6
Michael Ej Lean, Wilma S Leslie, Alison C Barnes, Naomi Brosnahan, George Thom, Louise McCombie, Carl Peters, Sviatlana Zhyzhneuskaya, Ahmad Al-Mrabeh, Kieren G Hollingsworth, Angela M Rodrigues, Lucia Rehackova, Ashley J Adamson, Falko F Sniehotta, John C Mathers, Hazel M Ross, Yvonne McIlvenna, Renae Stefanetti, Michael Trenell, Paul Welsh, Sharon Kean, Ian Ford, Alex McConnachie, Naveed Sattar, Roy Taylor
BACKGROUND: Type 2 diabetes is a chronic disorder that requires lifelong treatment. We aimed to assess whether intensive weight management within routine primary care would achieve remission of type 2 diabetes. METHODS: We did this open-label, cluster-randomised trial (DiRECT) at 49 primary care practices in Scotland and the Tyneside region of England. Practices were randomly assigned (1:1), via a computer-generated list, to provide either a weight management programme (intervention) or best-practice care by guidelines (control), with stratification for study site (Tyneside or Scotland) and practice list size (>5700 or ≤5700)...
December 4, 2017: Lancet
https://www.readbyqxmd.com/read/29215189/dapagliflozin-as-add-on-therapy-in-asian-patients-with-type-2-diabetes-inadequately-controlled-on-insulin-%C3%A2-oral-antihyperglycemic-drugs-a-randomized-controlled-trial
#7
Wenying Yang, Jianhua Ma, Yiming Li, Yanbing Li, Zhiguang Zhou, Jae Hyeon Kim, June Zhao, Agata Ptaszynska
BACKGROUND: This 24-week, phase 3, double-blind, placebo-controlled study (NCT02096705) assessed the safety and efficacy of dapagliflozin as add-on to insulin ± oral antihyperglycemic drugs (OADs) in Asian patients with inadequately controlled type 2 diabetes. METHODS: Patients (adults; HbA1c ≥7.5-≤10.5%; body mass index ≤45 kg/m2 ; insulin dose ≥20 IU daily) were randomized to dapagliflozin 10 mg (N=139) or placebo (N=133) to assess the 24-week change in HbA1c (primary outcome), fasting plasma glucose (FPG), body weight, total daily dose of insulin (TDDI), and seated systolic blood pressure (SeSBP; exploratory outcome)...
December 7, 2017: Journal of Diabetes
https://www.readbyqxmd.com/read/29211367/coronary-artery-disease-new-insights-into-revascularization-treatment-of-diabetic-patients
#8
REVIEW
Joanna Bednarska, Dorota Bednarska-Chabowska, Joanna Adamiec-Mroczek
Diabetes mellitus is an independent cardiovascular risk factor, considered an equivalent of coronary artery disease in terms of prognosis. A history of acute coronary syndrome is a strong predictor of another coronary episode, and cardiovascular complications are the leading cause of mortality in diabetic patients. Many patients with coronary artery disease suffer from concomitant diabetes or pre-diabetes. There are 3 strategies of coronary artery disease treatment: conservative management, coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI)...
October 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/29210808/prophylactic-use-of-haloperidol-and-changes-in-glucose-levels-in-hospitalized-older-patients
#9
Kris van Keulen, Wilma Knol, Edmée J M Schrijver, Rob J van Marum, Astrid M van Strien, Prabath W B Nanayakkara
BACKGROUND: Treatment with antipsychotic drugs has been associated with glucose dysregulation in older outpatients, especially in the early stage of therapy. The underlying mechanism is, however, unclear. The aim of this study was to investigate changes in glucose levels during haloperidol use compared with the use of placebo among older hospitalized patients. METHODS: This substudy was part of a larger multicenter, randomized, double blind, placebo-controlled clinical trial among hospitalized patients aged 70 years and older who had an increased risk of in-hospital delirium...
November 27, 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/29209441/pcsk9-signaling-pathways-and-their-potential-importance-in-clinical-practice
#10
REVIEW
Michał Wiciński, Jarosław Żak, Bartosz Malinowski, Gabriela Popek, Grzegorz Grześk
In the following review, authors described the structure and biochemical pathways of PCSK9, its involvement in LDL metabolism, as well as significances of proprotein convertase subtilisin/kexin type 9 targeted treatment. PCSK9 is a proprotein convertase, which plays a crucial role in LDL receptor metabolism. Transcription and translation of PCSK9 is controlled by different nuclear factors, such as, SREBP and HNF1α. This review focuses on interactions between PCSK9 and LDL receptor, VLDLR, ApoER2, CD36, CD81, and others...
December 2017: EPMA Journal
https://www.readbyqxmd.com/read/29209216/effects-of-intensive-control-of-glycemia-on-clinical-kidney-outcomes-in-type-2-diabetes-patients-compared-with-standard-control-a-meta-analysis
#11
Francisco Herrera-Gómez, María Asensio-González, Anunciación González-López, F Javier Álvarez
Background: Association between poor control of glycemia and the onset of microvascular complications in type 2 diabetes mellitus (T2DM) patients is a hard issue. However, it seems that the impact of pharmacological treatment is important only in early stages of diabetic nephropathy. We sought to examine whether intensive glycemic control is associated with improvement of clinical Chronic Kidney Disease (CKD) outcomes compared to standard glycemic control. Methods: Meta-analysis of published and unpublished randomized controlled trials (RCT) and post-hoc analysis of RCTs comparing anti-diabetic drugs and/or insulin (intensive control) vs...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29205774/comparison-of-glucose-lowering-agents-following-dual-therapy-failure-in-type-2-diabetes-systematic-review-and-network-meta-analysis-of-randomised-controlled-trials
#12
Francesco Zaccardi, Nafeesa N Dhalwani, Jolyon Dales, Hamid Mani, Kamlesh Khunti, Melanie J Davies, David R Webb
AIMS: To assess the evidence supporting the choice of third-line agents in adults with inadequately controlled type 2 diabetes. MATERIALS AND METHODS: We searched RCTs published between Jan 2000 and July 2017 reporting data on cardiometabolic outcomes and hypoglycaemia for glucose-lowering agents added to metformin-based dual treatments. Data were stratified by background therapy and RCT duration and synthesised, when possible, with network meta-analyses. RESULTS: 43 RCTs (16590 participants) were included, with metformin combined to sulphonylurea (SU) in 20 RCTs; thiazolidinedione (TZD) in 10; basal or rapid acting insulin in 6; DPP-4i in 3; GLP-1RA in 2; and SGLT-2i in 2...
December 5, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29205691/intravenous-immunoglobulin-in-drug-and-device-refractory-patients-with-the-symptoms-of-gastroparesis-an-open-label-study
#13
M Ashat, A Lewis, H Liaquat, A Stocker, L McElmurray, V Vedanarayanan, K Soota, T Howell, A Kedar, J Obert, T L Abell
BACKGROUND: Gastroparesis is a complex clinical entity; many aspects of which remain unknown. Although most patients have idiopathic, diabetic, or postsurgical gastroparesis, many are thought to have measurable neuromuscular abnormalities. Immunotherapy has recently been utilized to treat suspected autoimmune gastrointestinal dysmotility. METHODS: Fourteen patients with symptoms of gastroparesis (Gp) who were refractory to drug/device were selected from 443 Gp patients from 2013 to 2015 who were treated at the University of Louisville motility center...
December 4, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29199767/oxcarbazepine-for-neuropathic-pain
#14
REVIEW
Muke Zhou, Ning Chen, Li He, Mi Yang, Cairong Zhu, Fengbo Wu
BACKGROUND: Several anticonvulsant drugs are used in the management of neuropathic pain. Oxcarbazepine is an anticonvulsant drug closely related to carbamazepine. Oxcarbazepine has been reported to be efficacious in the treatment of neuropathic pain, but evidence from randomised controlled trials (RCTs) is conflicting. Oxcarbazepine is reportedly better tolerated than carbamazepine. This is the first update of a review published in 2013. OBJECTIVES: To assess the benefits and harms of oxcarbazepine for different types of neuropathic pain...
December 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29199116/repaglinide-versus-insulin-for-newly-diagnosed-diabetes-in-patients-with-cystic-fibrosis-a-multicentre-open-label-randomised-trial
#15
Manfred Ballmann, Dominique Hubert, Baroukh M Assael, Doris Staab, Alexandra Hebestreit, Lutz Naehrlich, Tanja Nickolay, Nicole Prinz, Reinhard W Holl
BACKGROUND: As survival among patients with cystic fibrosis has improved in recent decades, complications have become increasingly relevant. The most frequent complication is cystic-fibrosis-related diabetes. The recommended treatment is injected insulin, but some patients are treated with oral antidiabetic drugs to ease the treatment burden. We assessed the efficacy and safety of oral antidiabetic drugs. METHODS: We did a multicentre, open-label, comparative, randomised trial in 49 centres in Austria, France, Germany, and Italy...
November 30, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29197071/peroxisome-proliferator-activated-receptor-gamma-agonists-for-preventing-recurrent-stroke-and-other-vascular-events-in-people-with-stroke-or-transient-ischaemic-attack
#16
REVIEW
Jia Liu, Lu-Ning Wang
BACKGROUND: Peroxisome proliferator-activated receptor gamma (PPAR-γ) agonists are insulin-sensitising drugs used for the treatment of insulin resistance. In addition to lowering glucose in diabetes, these drugs may also protect against hyperlipidaemia and arteriosclerosis, which are risk factors for stroke. This is an update of a review first published in January 2014 and subsequently updated in October 2015. OBJECTIVES: To assess the efficacy and safety of PPAR-γ agonists in the secondary prevention of stroke and related vascular events for people with stroke or transient ischaemic attack (TIA)...
December 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29196481/cardiovascular-mortality-and-oral-antidiabetic-drugs-protocol-for-a-systematic-review-and-network-meta-analysis
#17
Rashmi Goyat, James Douglas Thornton, Xi Tan, George A Kelley
INTRODUCTION: Cardiovascular diseases are the leading cause of morbidity and mortality among individuals with diabetes. Despite the beneficial effects of antidiabetic drugs (ADDs) in terms of lowering haemoglobin A1c, several ADDs have been shown to increase the risk of cardiovascular events. Given the high prevalence of cardiovascular disease among individuals with diabetes, it is important to weigh the benefits of ADDs against their cardiovascular safety. Therefore, the objective of the current study is to conduct a systematic review with network meta-analysis to compare the effects of different oral pharmacological classes of ADDs on cardiovascular safety...
December 1, 2017: BMJ Open
https://www.readbyqxmd.com/read/29194996/effects-of-pioglitazone%C3%A2-treatment-on-blood-leptin-levels-in-patients-with-type-2%C3%A2-diabetes
#18
Satoshi Ida, Kazuya Murata, Ryutaro Kaneko
AIMS/INTRODUCTION: The aim of the present study was to conduct a meta-analysis of randomized controlled trials (RCTs) that investigated the effects of pioglitazone on blood leptin levels in patients with type 2 diabetes. MATERIALS AND METHODS: Literature searches were performed using Medline, the Cochrane Controlled Trials Registry, and ClinicalTrials. gov, and RCTs that investigated the effects of pioglitazone on blood leptin levels in patients with type 2 diabetes were selected...
December 1, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/29193572/incretin-based-therapies-and-risk-of-pancreatic-cancer-in-patients-with-type-2-diabetes-a-meta-analysis-of-randomised-controlled-trials
#19
Haining Wang, Ye Liu, Qing Tian, Jin Yang, Ran Lu, Siyan Zhan, Jari Haukka, Tianpei Hong
AIMS: Conflicting evidence exists regarding the potential risk of pancreatic cancer with use of incretin drugs in patients with type 2 diabetes (T2DM). We performed a meta-analysis of randomised controlled trials (RCTs), including six recently published large-scale cardiovascular outcome trials (CVOTs), to evaluate the risk of pancreatic cancer with incretin-based therapies in patients with T2DM. MATERIALS AND METHODS: The PubMed, Embase, Cochrane Central Register and ClininalTrials...
November 30, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29183844/original-paper-efficacy-and-safety-analysis-of-insulin-degludec-insulin-aspart-ryzodeg%C3%A2-70-30-compared-with-biphasic-insulin-aspart-30-novomix%C3%A2-70-30-a-phase-3-multicentre-international-open-label-randomised-treat-to-target-trial-in-patients-with-type-2-diabetes
#20
Mohamed Hassanein, Akram Salim Echtay, Rachid Malek, Mahomed Omar, Shehla Sajid Shaikh, Magnus Ekelund, Kadriye Kaplan, Nor Azmi Kamaruddin
AIMS: To compare the efficacy and safety of insulin degludec/insulin aspart (IDegAsp) and biphasic insulin aspart 30 (BIAsp 30) before, during and after Ramadan in patients with type 2 diabetes mellitus (T2DM) who fasted during Ramadan. METHODS: In this multinational, randomised, treat-to-target trial, patients with T2DM who intended to fast and were on basal, pre- or self-mixed insulin ± oral antidiabetic drugs for ≥90 days were randomised (1:1) to IDegAsp twice daily (BID) or BIAsp 30 BID...
November 25, 2017: Diabetes Research and Clinical Practice
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