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Drug, trial and diabetes

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https://www.readbyqxmd.com/read/29046921/pioglitazone-reduces-cold-induced-brown-fat-glucose-uptake-despite-induction-of-browning-in-cultured-human-adipocytes-a-randomised-controlled-trial-in-humans
#1
Rebecca K C Loh, Melissa F Formosa, Nina Eikelis, David A Bertovic, Mitchell J Anderson, Shane A Barwood, Shane Nanayakkara, Neale D Cohen, Andre La Gerche, Anne T Reutens, Kenneth S Yap, Thomas W Barber, Gavin W Lambert, Martin H Cherk, Stephen J Duffy, Bronwyn A Kingwell, Andrew L Carey
AIMS/HYPOTHESIS: Increasing brown adipose tissue (BAT) activity is a possible therapeutic strategy to increase energy expenditure and glucose and lipid clearance to ameliorate obesity and associated comorbidities. The thiazolidinedione (TZD) class of glucose-lowering drugs increase BAT browning in preclinical experimental models but whether these actions extend to humans in vivo is unknown. The aim of this study was to determine the effect of pioglitazone treatment on adipocyte browning and adaptive thermogenesis in humans...
October 18, 2017: Diabetologia
https://www.readbyqxmd.com/read/29039325/comparative-role-of-pregabalin-and-carbamazepine-regarding-efficacy-in-painful-diabetic-neuropathy
#2
Raana Mahmood, Itrat Jawed, M Irfan Khan, Iffat Mahmood, Talat Tariq, Arfa Kamil, Faiza Z Sayeed, Bushra Z Sayeed
Neuropathic pain is the most severe and resistant type of pain which has impact on quality of life and behaviour; it most commonly occurs at night causing disturbed sleep. Diabetes mellitus is a common cause of painful neuropathy. In this study, we are comparing the effectiveness of old treatment Carbamazepine with Pregabalin in painful diabetic neuropathy. The study was an open-label trial conducted in Diabetic Clinic of Medical Unit-III, Jinnah Post-graduate Medical Center, Karachi. The duration of the study was 90 days, from December 2010 to March 2011...
July 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29039237/sglt2-inhibitors-are-they-safe
#3
Sebastian Filippas-Ntekouan, Theodosios D Filippatos, Moses S Elisaf
Sodium-glucose linked transporter type 2 (SGLT2) inhibitors are a relatively new class of anti-diabetic drugs with positive cardiovascular and kidney effects. The aim of this review is to present the safety issues associated with SGLT2 inhibitors. Urogenital infections are the most frequently encountered adverse events, although tend to be mild to moderate and are easily manageable with standard treatment. Although no increased acute kidney injury risk was evident in the major trials, the mechanism of action of these drugs requires caution when they are administered in patients with extracellular volume depletion or with drugs affecting renal hemodynamics...
October 17, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/29038209/activation-and-inhibition-of-sodium-hydrogen-exchanger-is-a-mechanism-that-links-the-pathophysiology-and-treatment-of-diabetes-mellitus-with-that-of-heart-failure
#4
REVIEW
Milton Packer
The mechanisms underlying the progression of diabetes mellitus and heart failure are closely intertwined, such that worsening of one condition is frequently accompanied by worsening of the other; the degree of clinical acceleration is marked when the 2 coexist. Activation of the sodium-hydrogen exchanger in the heart and vasculature (NHE1 isoform) and the kidneys (NHE3 isoform) may serve as a common mechanism that links both disorders and may underlie their interplay. Insulin insensitivity and adipokine abnormalities (the hallmarks of type 2 diabetes mellitus) are characteristic features of heart failure; conversely, neurohormonal systems activated in heart failure (norepinephrine, angiotensin II, aldosterone, and neprilysin) impair insulin sensitivity and contribute to microvascular disease in diabetes mellitus...
October 17, 2017: Circulation
https://www.readbyqxmd.com/read/29035939/predictors-for-the-development-of-microalbuminuria-and-interaction-with-renal-function
#5
Christos Chatzikyrkou, Jan Menne, Joseph Izzo, Giancarlo Viberti, Ton Rabelink, Luis M Ruilope, Christian Rump, Peter R Mertens, Hermann Haller
AIM: It is important to know which factors predict the development of microalbuminuria in patients with diabetes mellitus type II. MATERIAL: Data from the Randomized Olmesartan and Diabetes Microalbuminuria Prevention Study were used to identify predictors for the new onset of microalbuminuria. Furthermore, the interaction of baseline albuminuria and baseline estimated glomerular filtration rate (eGFR) and the effects of treatment with olmesartan were investigated...
October 13, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/29032756/antidiabetic-drugs-as-antihypertensives-new-data-on-the-horizon
#6
Vassiliki Mamakou, Ioanna Eleftheriadou, Niki Katsiki, Konstantinos Makrilakis, Konstantinos Tsioufis, Nikoalos Tentolouris
The prevalence of type 2 diabetes mellitus (T2DM) increases worldwide, forcing for more research in the area of the optimal diabetes management. Cardiovascular disease (CVD) remains the commonest cause of death in individuals with T2DM. Besides hyperglycemia, an explanation for the increased mortality in this population is the increased prevalence of comorbidities, such as hypertension and dyslipidemia. Recent population-based studies described a prevalence of hypertension greater than 80% in patients with T2DM...
October 10, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29032638/sodium-glucose-co-transporter-2-inhibitor-tofogliflozin-shows-better-improvements-of-blood-glucose-and-insulin-secretion-in-patients-with-high-insulin-levels-at-baseline
#7
Kazuyuki Tobe, Hideki Suganami, Kohei Kaku
INTRODUCTION: Sodium glucose co-transporter 2 (SGLT2) inhibitors are a new class of drugs for the treatment of type 2 diabetes mellitus that improve control of plasma glucose and body weight, giving great hope for the clinical utility of these agents. However, it is unclear for which patients that SGLT2 inhibitors will be useful. MATERIALS AND METHODS: We analyzed data from long-term tofogliflozin monotherapy in an open-label, randomized controlled trial in Japanese patients with type 2 diabetes mellitus...
October 15, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/29032078/efficacy-and-safety-of-once-monthly-pasireotide-in-cushing-s-disease-a-12-month-clinical-trial
#8
André Lacroix, Feng Gu, Wilson Gallardo, Rosario Pivonello, Yerong Yu, Przemysław Witek, Marco Boscaro, Roberto Salvatori, Masanobu Yamada, Libuse Tauchmanova, Michael Roughton, Shoba Ravichandran, Stephan Petersenn, Beverly M K Biller, John Newell-Price
BACKGROUND: Cushing's disease is a rare debilitating endocrine disorder for which few prospective interventional studies have been done. We report results of the first phase 3 trial assessing long-acting intramuscular pasireotide in patients with Cushing's disease. METHODS: In this phase 3 clinical trial we recruited patients aged 18 years or older with persistent, recurrent, or de-novo (non-surgical candidates) Cushing's disease who had a mean urinary free cortisol (mUFC) concentration (from three 24 h samples) of 1·5-5·0 times the upper limit of normal (ULN), a normal or greater than normal morning plasma adrenocorticotropic hormone concentration, and a pituitary source of Cushing's syndrome, from 57 sites across 19 countries...
October 11, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29027993/current-pharmacotherapy-for-obesity
#9
REVIEW
Gitanjali Srivastava, Caroline M Apovian
More than one-third of adults in the USA have obesity, which causes, exacerbates or adversely impacts numerous medical comorbidities, including diabetes mellitus and cardiovascular disease. Despite intensive lifestyle modifications, the disease severity warrants further aggressive intervention, including pharmacotherapy, medical devices and bariatric surgery. Noninvasive anti-obesity drugs have thus now resurfaced as targeted adjunctive therapeutic approaches to intensive lifestyle intervention, bridging the gap between lifestyle and bariatric surgery...
October 13, 2017: Nature Reviews. Endocrinology
https://www.readbyqxmd.com/read/29025857/endocrine-side-effects-of-cancer-immunotherapy
#10
Priscilla Cukier, Fernando C Santini, Mariana Scaranti, Ana O Hoff
Immune checkpoint inhibitors have recently become a cornerstone for the treatment of different advanced cancers. These drugs, represented mainly by monoclonal antibodies anti-cytotoxic T-lymphocyte antigen 4 (CTLA-4), anti-programmed cell death protein-1 (PD-1) and anti-PD-1 ligand molecules (PD-L1 and L2), have the ability to reactivate the immune system against tumor cells, but can also trigger a myriad of autoimmune side effects, termed immune-related adverse events (irAEs). In particular, there are a number of endocrine related irAEs...
October 12, 2017: Endocrine-related Cancer
https://www.readbyqxmd.com/read/29025406/impact-of-empagliflozin-on-subclinical-left-ventricular-dysfunctions-and-on-the-mechanisms-involved-in-myocardial-disease-progression-in-type-2-diabetes-rationale-and-design-of-the-empa-heart-trial
#11
Andrea Natali, Lorenzo Nesti, Iacopo Fabiani, Enrico Calogero, Vitantonio Di Bello
BACKGROUND: Asymptomatic left ventricular (LV) dysfunction is highly prevalent in type 2 diabetes patients. Unlike the other hypoglycemic drugs, SGLT2 inhibitors have shown potential benefits for reducing cardiovascular death and risk factors, aside from lowering plasma glucose levels. With this study we aim at determining whether the treatment with empagliflozin is associated with an improvement in LV functions in diabetic patients with asymptomatic LV dysfunction against Sitagliptin, which is presumably neutral on myocardial function...
October 12, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/29025285/safety-and-efficacy-of-canagliflozin-in-elderly-patients-with-type-2-diabetes-mellitus-a-1-year-post-marketing-surveillance-in-japan
#12
Maki Goda, Tomoko Yamakura, Kazuyo Sasaki, Takumi Tajima, Makoto Ueno
Objective To evaluate the safety and efficacy of canagliflozin in elderly patients with type 2 diabetes mellitus (T2DM) in clinical settings. Methods We conducted a 1-year post-marketing surveillance (PMS) of canagliflozin in almost all the elderly patients (≥65 years old) with T2DM who began taking canagliflozin during the first 3 months after its launch in Japan. The main outcomes included the incidences of adverse drug reactions (ADRs), serious ADRs and the changes of laboratory tests as well as efficacy variables...
October 13, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29024286/modelling-cumulative-exposure-for-inference-about-drug-effects-in-observational-studies
#13
Bassam Farran, Stuart McGurnaghan, Helen C Looker, Shona Livingstone, Eva Lahnsteiner, Helen M Colhoun, Paul M McKeigue
PURPOSE: To demonstrate a modelling approach that controls for time-invariant allocation bias in estimation of associations of outcome with drug exposure. METHODS: We show that in a model that includes terms for both ever-exposure versus never-exposure and cumulative exposure, the parameter for ever-exposure represents the effect of time-invariant allocation bias, and the parameter for cumulative exposure represents the effect of the drug after adjustment for this unmeasured confounding...
October 12, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29023938/a-pharmacist-led-program-to-evaluate-and-reduce-polypharmacy-and-potentially-inappropriate-prescribing-in-older-hiv-positive-patients
#14
I R McNicholl, M Gandhi, C Bradley Hare, M Greene, E Pierluissi
OBJECTIVE: The goal of this pharmacist-led study was to utilize 2 validated instruments, Beers and Screening Tool of Older Persons' Potentially inappropriate Prescriptions (STOPP), to assess potentially inappropriate prescribing (PIP) in older patients infected with the human immunodeficiency virus (HIV) and evaluate pharmacist interventions. DESIGN: Prospective, randomized, interventional trial. SETTING: Large urban clinic providing interdisciplinary primary and HIV care for approximately 2700 HIV-positive, publically insured patients...
October 10, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29023853/antibiotics-gut-microbiome-and-obesity
#15
Karen S W Leong, José G B Derraik, Paul L Hofman, Wayne S Cutfield
Antibiotics have been hailed by many as 'miracle drugs' that have been effectively treating infectious diseases for over a century, leading to a marked reduction in morbidity and mortality. However, with the increasing use of antibiotics, we are now faced not only with the increasing threat of antibiotic resistance, but also with a rising concern about potential long-term effects of antibiotics on human health, including the development of obesity. The obesity pandemic continues to increase, a problem that affects both adults and children alike...
October 12, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/29021336/pooled-analysis-of-multiple-crossover-trials-to-optimize-individual-therapy-response-to-renin-angiotensin-aldosterone-system-intervention
#16
Sergei I Petrykiv, Gozewijn Dirk Laverman, Frederik Persson, Liffert Vogt, Peter Rossing, Martin H de Borst, Ronald T Gansevoort, Dick de Zeeuw, Hiddo J L Heerspink
BACKGROUND AND OBJECTIVES: In the treatment of CKD, individual patients show a wide variation in their response to many drugs, including renin-angiotensin-aldosterone system inhibitors (RAASi). To investigate whether therapy resistance to RAASi can be overcome by uptitrating the dose of drug, changing the mode of intervention (with drugs from similar or different classes), or lowering dietary sodium intake, we meta-analyzed individual responses to different modes of interventions. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Randomized crossover trials were analyzed to assess correlation of individual responses to RAASi and nonsteroidal anti-inflammatory drugs (NSAIDs; n=395 patients)...
October 11, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29021286/pomegranate-juice-but-not-an-extract-confers-a-lower-glycemic-response-on-a-high-glycemic-index-food-randomized-crossover-controlled-trials-in-healthy-subjects
#17
Asimina Kerimi, Hilda Nyambe-Silavwe, Julia S Gauer, Francisco A Tomás-Barberán, Gary Williamson
Background: Low-glycemic index diets have demonstrated health benefits associated with a reduced risk of developing type 2 diabetes.Objectives: We tested whether pomegranate polyphenols could lower the glycemic response of a high-glycemic index food when consumed together and the mechanism by which this might occur.Design: We compared the acute effect of a pomegranate juice and a polyphenol-rich extract from pomegranate (supplement) on the bread-derived postprandial blood glucose concentration in 2 randomized, crossover, controlled studies (double-blinded for the supplements), each on 16 healthy volunteers...
October 11, 2017: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/29020969/updates-on-cardiovascular-outcome-trials-in-diabetes
#18
REVIEW
Oliver Schnell, Lars Rydén, Eberhard Standl, Antonio Ceriello
In 2008 the Food and Drug Administration introduced a guidance for industry that requires the investigation of cardiovascular outcomes of glucose-lowering medications. Since then, an increasing number of cardiovascular outcome trials have been completed in diabetes patients with high cardiovascular risk for members of the SGLT-2 and DPP4 inhibitors and GLP-1 receptor agonist classes. The trials confirmed cardiovascular safety for all tested anti-hyperglycaemic drugs and, in addition empagliflozin, semaglutide and liraglutide could even reduce cardiovascular risk...
October 11, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/29019063/statin-prescribing-in-the-elderly-special-considerations
#19
REVIEW
M Leya, N J Stone
PURPOSE OF REVIEW: Our aim was to examine the current evidence behind prescribing statins to individuals over 65 years of age with emphasis on those older than 75. Individuals over 75 years of age may often have multiple comorbidities and take many medications. Additionally, they are often underrepresented in randomized controlled trials (RCTs) of statins in older populations. While results of RCTs demonstrate the benefit of statin therapy in both primary and secondary prevention patients, clinicians must more carefully consider adverse effects and drug-drug interactions before prescribing statin therapy as well as determining the intensity in older individuals...
October 11, 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29018489/effects-of-resveratrol-on-glucose-control-and-insulin-sensitivity-in-subjects-with-type-2-diabetes-systematic-review-and-meta-analysis
#20
REVIEW
Xiangyun Zhu, Chunhua Wu, Shanhu Qiu, Xuelu Yuan, Ling Li
Although the regular consumption of resveratrol has been known to improve glucose homeostasis and reverse insulin resistance in type 2 diabetes mellitus (T2DM), the reported results are inconsistent. Thus, we aimed to assess the effects of resveratrol on glycemic control and insulin sensitivity among patients with T2DM. We searched for relevant articles published until June 2017 on PubMed-Medline, Embase, Cochrane Library, and Web of Science. Randomized controlled trials in T2DM patients administered with resveratrol as intervention were included...
2017: Nutrition & Metabolism
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