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the combination of insulin and GLP-1 analog

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https://www.readbyqxmd.com/read/27776453/individualized-patient-centered-use-of-lixisenatide-for-the-treatment-of-type-2-diabetes-mellitus
#1
Markolf Hanefeld, Denis Raccah, Louis Monnier
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease associated with hyperglycemia, which can lead to serious vascular complications. Current treatment guidelines place particular emphasis on personalization of therapy. Within this guidance, the use of various second-line therapies, including glucagon-like peptide-1 receptor agonists (GLP-1 RAs), is recommended under certain circumstances. Areas covered: Factors influencing glucose homeostasis, including gastric emptying and the associated cardiovascular (CV) risk when homeostasis is not maintained, are reviewed...
November 3, 2016: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/27049466/synergy-between-g%C3%AE-z-deficiency-and-glp-1-analog-treatment-in-preserving-functional-%C3%AE-cell-mass-in-experimental-diabetes
#2
Allison L Brill, Jaclyn A Wisinski, Mark T Cadena, Mary F Thompson, Rachel J Fenske, Harpreet K Brar, Michael D Schaid, Renee L Pasker, Michelle E Kimple
A defining characteristic of type 1 diabetes mellitus (T1DM) pathophysiology is pancreatic β-cell death and dysfunction, resulting in insufficient insulin secretion to properly control blood glucose levels. Treatments that promote β-cell replication and survival, thus reversing the loss of β-cell mass, while also preserving β-cell function, could lead to a real cure for T1DM. The α-subunit of the heterotrimeric Gz protein, Gαz, is a tonic negative regulator of adenylate cyclase and downstream cAMP production...
May 2016: Molecular Endocrinology
https://www.readbyqxmd.com/read/26794660/inhibition-of-the-map3-kinase-tpl2-protects-rodent-and-human-%C3%AE-cells-from-apoptosis-and-dysfunction-induced-by-cytokines-and-enhances-anti-inflammatory-actions-of-exendin-4
#3
E M Varin, A Wojtusciszyn, C Broca, D Muller, M A Ravier, F Ceppo, E Renard, J-F Tanti, S Dalle
Proinflammatory cytokines exert cytotoxic effects on β-cells, and are involved in the pathogenesis of type I and type II diabetes and in the drastic loss of β-cells following islet transplantation. Cytokines induce apoptosis and alter the function of differentiated β-cells. Although the MAP3 kinase tumor progression locus 2 (Tpl2) is known to integrate signals from inflammatory stimuli in macrophages, fibroblasts and adipocytes, its role in β-cells is unknown. We demonstrate that Tpl2 is expressed in INS-1E β-cells, mouse and human islets, is activated and upregulated by cytokines and mediates ERK1/2, JNK and p38 activation...
2016: Cell Death & Disease
https://www.readbyqxmd.com/read/26309403/exenatide-once-weekly-injection-for-the-treatment-of-type-2-diabetes-in-chinese-patients-current-perspectives
#4
REVIEW
Wuquan Deng, Sheng Qiu, Gangyi Yang, Bing Chen
Glucagon-like peptide-1 (GLP-1) analogs, such as exenatide, have played an important role as antidiabetic medications in the treatment of type 2 diabetes (T2DM). Like most other hypoglycemic agents, exenatide has a number of actions, including lowering blood glucose, promoting weight loss, improving insulin resistance, and protecting islet β-cells. Although GLP-1 analogs, combined with other antidiabetic medications, have excellent performance in T2DM, some side effects and imperfections limit its use in clinical practice...
2015: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/26169871/effects-of-wheat-bran-extract-rich-in-arabinoxylan-oligosaccharides-and-resistant-starch-on-overnight-glucose-tolerance-and-markers-of-gut-fermentation-in-healthy-young-adults
#5
Elin V Johansson Boll, Linda M N K Ekström, Christophe M Courtin, Jan A Delcour, Anne C Nilsson, Inger M E Björck, Elin M Östman
PURPOSE: Specific combinations of dietary fiber (DF) have been observed to result in improved glucose tolerance at a subsequent standardized breakfast. Arabinoxylan oligosaccharides (AXOS) are considered as DF with prebiotic potential, but so far no studies have investigated their metabolic effects in humans. This randomized cross-over study evaluated the overnight impact of breads containing AXOS-rich wheat bran extract and resistant starch (RS, Hi-Maize), separately or combined, on glucose tolerance, related metabolic parameters and markers of gut fermentation in healthy subjects...
June 2016: European Journal of Nutrition
https://www.readbyqxmd.com/read/25568561/effects-of-teraphy-with-basal-insulin-analogues-combined-with-glp-1-analogues-and-metformin-in-the-treatment-of-obese-patients-with-poorly-regulated-postprandial-glycemia
#6
Belma Ascic Buturovic, Lejla Burnazovic Ristic, Alma Mujanovic Narancic
INTRODUCTION: Patient-oriented therapy represents a modern approach in the treatment of patients with diabetes, an approach which is supported in the most recent guidelines by the ADA and the European Association for the Study of Diabetes (EASD). The progressive nature of diabetes demands the introduction of insulin therapy much earlier in order to prevent the development of late complications of the disease. MATERIAL AND METHODS: The study included 30 patients who had been treated with long-acting insulin analogue and metformin in doses of 3 x 850 mg at least 6 months prior to study entry and in which a good glycaemic control had not been achieved, or with HbA1c > 7%...
October 2014: Medical Archives
https://www.readbyqxmd.com/read/25419451/basal-insulin-combined-incretin-mimetic-therapy-with-glucagon-like-protein-1-receptor-agonists-as-an-upcoming-option-in-the-treatment-of-type-2-diabetes-a-practical-guide-to-decision-making
#7
REVIEW
Gerhard H Scholz, Holger Fleischmann
The combination of basal insulin and glucagon-like protein 1 receptor agonists (GLP-1 RAs) is a new intriguing therapeutic option for patients with type 2 diabetes. In our daily practice we abbreviate this therapeutic concept with the term BIT (basal insulin combined incretin mimetic therapy) in a certain analogy to BOT (basal insulin supported oral therapy). In most cases BIT is indeed an extension of BOT, if fasting, prandial or postprandial blood glucose values have not reached the target range. In our paper we discuss special features of combinations of short- or prandial-acting and long- or continuous-acting GLP-1 RAs like exenatide, lixisenatide and liraglutide with basal insulin in relation to different glycemic targets...
October 2014: Therapeutic Advances in Endocrinology and Metabolism
https://www.readbyqxmd.com/read/25361428/cannabinoid-receptor-1-antagonist-treatment-induces-glucagon-release-and-shows-an-additive-therapeutic-effect-with-glp-1-agonist-in-diet-induced-obese-mice
#8
Kartikkumar Navinchandra Patel, Amit Arvind Joharapurkar, Vishal Patel, Samadhan Govind Kshirsagar, Rajesh Bahekar, Brijesh Kumar Srivastava, Mukul R Jain
Cannabinoid 1 (CB1) receptor antagonists reduce body weight and improve insulin sensitivity. Preclinical data indicates that an acute dose of CB1 antagonist rimonabant causes an increase in blood glucose. A stable analog of glucagon-like peptide 1 (GLP-1), exendin-4 improves glucose-stimulated insulin secretion in pancreas, and reduces appetite through activation of GLP-1 receptors in the central nervous system and liver. We hypothesized that the insulin secretagogue effect of GLP-1 agonist exendin-4 may synergize with the insulin-sensitizing action of rimonabant...
December 2014: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/25315008/role-of-epac2a-rap1-signaling-in-interplay-between-incretin-and-sulfonylurea-in-insulin-secretion
#9
Harumi Takahashi, Tadao Shibasaki, Jae-Hyung Park, Shihomi Hidaka, Toshimasa Takahashi, Aika Ono, Dae-Kyu Song, Susumu Seino
Incretin-related drugs and sulfonylureas are currently used worldwide for the treatment of type 2 diabetes. We recently found that Epac2A, a cAMP binding protein having guanine nucleotide exchange activity toward Rap, is a target of both incretin and sulfonylurea. This suggests the possibility of interplay between incretin and sulfonylurea through Epac2A/Rap1 signaling in insulin secretion. In this study, we examined the combinatorial effects of incretin and various sulfonylureas on insulin secretion and activation of Epac2A/Rap1 signaling...
April 2015: Diabetes
https://www.readbyqxmd.com/read/25004768/-combined-treatment-of-insulin-and-glp-1-analogs-what-do-we-expect
#10
REVIEW
Bénédicte de Kalbermatten, Jaafar Jaafar, François R Jornayvaz, Jacques Philippe
Type 2 diabetes mellitus is a progressive and heterogeneous disease. The decrease in insulin secretion by pancreatic beta cells and the increase of glucagon secretion by pancreatic beta cells, are the two major pathophysiologic characteristics. The majority of type 2 diabetics will therefore require insulin in the evolution of their disease, with weight gain and hypoglycaemia as side effects. GLP-1 analogs are effective therapeutic alternatives due to their actions on glucagon and insulin secretion, on satiety and gastric emptying...
June 4, 2014: Revue Médicale Suisse
https://www.readbyqxmd.com/read/24918799/a-short-acting-glp-1-analog-or-prandial-insulin-to-supplement-basal-insulin-moving-toward-personalized-management-of-type-2-diabetes-mellitus
#11
REVIEW
Irl B Hirsch, Doron Schneider, Aaron King, William H Polonsky, Timothy S Reid, Jay Shubrook, Carol A Verderese, Jeffrey Wallace, Matthew C Riddle
New models of health care delivery that emphasize patient-centered care affirm the need for alternatives to add-on prandial insulin therapy when optimized basal insulin fails to maintain glycemic control in patients with type 2 diabetes mellitus. Regimens that are easy to teach, convenient, and flexible generally improve the outlook for long-term success. Our review reconsiders traditional barriers to insulin intensification in primary care and provides an illustration of how the benefits and drawbacks of > 1 choice of action--specifically, adding rapid-acting insulin or a short-acting glucagon-like peptide-1 analog--can be weighed by the patient and provider together to determine the best next treatment step that balances efficacy, safety, and adherence to therapy...
May 2014: Postgraduate Medicine
https://www.readbyqxmd.com/read/24769505/treating-patients-with-diabetes-of-long-duration-glp-1-receptor-agonists-and-insulin-in-combination
#12
REVIEW
Etie S Moghissi
Patients with long-standing type 2 diabetes mellitus (T2DM) can be clinically challenging for physicians to treat because these patients often lack sufficient β-cell function to respond to some oral glucose-lowering agents, may have profound comorbidities, and may have renal impairment that limits the use of traditional agents. These complications, in addition to older age, also increase the risk of hypoglycemia, which can be a major barrier to treatment success. Individualizing treatment targets to balance the benefits of glycemic control with risks of hypoglycemia is the first step to successfully treating these patients...
May 2014: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/24738001/basal-supported-oral-therapy-with-sitagliptin-counteracts-rebound-hyperglycemia-caused-by-glp-1-tachyphylaxis
#13
Shu Meguro, Toshihide Kawai, Tomohiro Matsuhashi, Motoaki Sano, Keiichi Fukuda, Hiroshi Itoh, Yoshihiko Suzuki
Introduction. Treatment with a glucagon-like peptide 1 (GLP-1) analog fails in some patients due to rebound hyperglycemia caused by tachyphylaxis (GLP-1 tachyphylaxis). We investigated the efficacy of basal-supported oral therapy (BOT) with insulin glargine and sitagliptin for counteracting GLP-1 tachyphylaxis. Materials and Methods. The subjects were 12 men and 3 women aged 59.9 ± 10.0 years who had been treated with GLP-1 analogs. All of them had developed rebound hyperglycemia caused by GLP-1 tachyphylaxis...
2014: International Journal of Endocrinology
https://www.readbyqxmd.com/read/24403842/pathogenesis-and-management-of-postprandial-hyperglycemia-role-of-incretin-based-therapies
#14
REVIEW
John Gerich
Postprandial plasma glucose concentrations are an important contributor to glycemic control. There is evidence suggesting that postprandial hyperglycemia may be an independent risk factor for cardiovascular disease. Glucagon-like peptide-1 (GLP-1) receptor agonists and dipeptidyl peptidase-4 (DPP-4) inhibitors are antidiabetic agents that predominantly reduce postprandial plasma glucose levels. DPP-4 inhibitors are associated with fewer gastrointestinal side effects than GLP-1 receptor agonists and are administered orally, unlike GLP-1 analogs, which are administered as subcutaneous injections...
December 4, 2013: International Journal of General Medicine
https://www.readbyqxmd.com/read/24340348/increased-priority-for-regimens-involving-incretin-based-and-insulin-therapy
#15
REVIEW
Helena W Rodbard
The ADA/EASD and AACE guidelines emphasize the importance of individualizing treatment to best meet each patient's situation. Metformin remains the preferred choice as initial therapy for most patients. The 2009 AACE algorithm elevated the role of incretin-based therapies (GLP-1R agonists and DPP-4 inhibitors) relative to previous algorithms and this has been endorsed by subsequent algorithms and guidelines. The incretin-based therapies and insulin therapy should be considered with very high priority. Either incretin-based therapy or insulin therapy can be used as monotherapy or in combination with other agents...
December 2013: Journal of Family Practice
https://www.readbyqxmd.com/read/23827952/effect-of-the-combination-of-metformin-and-fenofibrate-on-glucose-homeostasis-in-diabetic-goto-kakizaki-rats
#16
Tae Jung Oh, Ji Yon Shin, Gyeong Hoon Kang, Kyong Soo Park, Young Min Cho
Metformin has been reported to increase the expression of the glucagon-like peptide-1 (GLP-1) receptor in pancreatic beta cells in a peroxisome proliferator-activated receptor (PPAR)-α-dependent manner. We investigated whether a PPARα agonist, fenofibrate, exhibits an additive or synergistic effect on glucose metabolism, independent of its lipid-lowering effect, when added to metformin. Non-obese diabetic Goto-Kakizaki (GK) rats were divided into four groups and treated for 28 days with metformin, fenofibrate, metformin plus fenofibrate or vehicle...
2013: Experimental & Molecular Medicine
https://www.readbyqxmd.com/read/23511332/acute-effects-of-continuous-infusions-of-glucagon-like-peptide-glp-1-glp-2-and-the-combination-glp-1-glp-2-on-intestinal-absorption-in-short-bowel-syndrome-sbs-patients-a-placebo-controlled-study
#17
K B Madsen, C Askov-Hansen, R M Naimi, C F Brandt, B Hartmann, J J Holst, P B Mortensen, P B Jeppesen
BACKGROUND AND AIMS: The ileocolonic brake is impaired in short bowel syndrome (SBS) patients with distal bowel resections. An attenuated meal-stimulated hormone secretion may cause gastric hypersecretion, rapid gastric and intestinal transit and a poor adaptation. Attempting to restore this ileocolonic brake, this study evaluated the acute effects of continuous intravenous administration of glucagon-like peptide (GLP) 1 and 2, alone or in combination, on gastrointestinal function in SBS patients...
June 10, 2013: Regulatory Peptides
https://www.readbyqxmd.com/read/23436382/dual-factor-delivery-of-cxcl12-and-exendin-4-for-improved-survival-and-function-of-encapsulated-beta-cells-under-hypoxic-conditions
#18
Stephanie Duncanson, Athanassios Sambanis
A bioartifical pancreas (BAP) remains a promising approach for treating insulin-dependent diabetes. Several obstacles to the clinical implementation of a BAP remain, including hypoxia following implantation. Within native pancreatic islets, CXCL12 and glucagon-like peptide-1 (GLP-1) act in a paracrine fashion to promote the survival, function, and proliferation of β-cells. This work sought to investigate if the presentation of CXCL12 and delivery of a GLP-1 receptor analog, Exendin-4 (Ex-4), alone and in combination, conferred pro-survival and insulinotropic effects on an encapsulated β-cell line, βTC-tet, cultured under hypoxic conditions of 7...
August 2013: Biotechnology and Bioengineering
https://www.readbyqxmd.com/read/23258124/-combination-therapy-with-glucagon-like-peptide-1-analogs-and-insulin-indications-and-contraindications-in-coronary-artery-disease-patients
#19
REVIEW
Giorgio Sesti
Type 2 diabetes mellitus is a progressive disease characterized by an impairment of insulin action, and failure of pancreatic β-cells to compensate for the enhanced insulin demand. Owing to the progressive nature of the disease, many individuals require insulin replacement therapy to maintain glycemic control. Intensification of treatment in these circumstances usually results in weight gain and increased risk of hypoglycemia, two undesirable events that are associated with a worse cardiovascular risk profile and decreased adherence to treatment...
December 2012: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/23136915/resistant-starch-and-pullulan-reduce-postprandial-glucose-insulin-and-glp-1-but-have-no-effect-on-satiety-in-healthy-humans
#20
RANDOMIZED CONTROLLED TRIAL
Abby S Klosterbuer, William Thomas, Joanne L Slavin
The aim of this study was to determine the effects of three novel fibers on satiety and serum parameters. In a randomized, double-blind, crossover design, fasted subjects (n=20) consumed a low-fiber control breakfast or one of four breakfasts containing 25 g of fiber from soluble corn fiber (SCF) or resistant starch (RS), alone or in combination with pullulan (SCF+P and RS+P). Visual analog scales assessed appetite, and blood samples were collected to measure glucose, insulin, ghrelin, and glucagon-like peptide-1 (GLP-1)...
December 5, 2012: Journal of Agricultural and Food Chemistry
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