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HbA1c AND triple therapy

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https://www.readbyqxmd.com/read/28948541/cost-of-glycemic-target-achievement-with-sodium-glucose-co-transporter-2-inhibitors-in-patients-with-type-2-diabetes-in-the-uk
#1
Marc Evans, Sayeed Achha, Cheryl Neslusan
INTRODUCTION: Diabetes-related costs make up a large portion of healthcare expenditures in the UK. Many of these costs are related to treatment of diabetes-related complications. Reducing HbA1c to <7.0% (53 mmol/mol) reduces the incidence of complications and comorbidities. Metformin plus sulfonylurea is the most common dual oral combination therapy in the UK. The costs of achieving HbA1c <7.0% in patients inadequately controlled on metformin plus sulfonylurea were analyzed for the sodium glucose co-transporter 2 (SGLT2) inhibitors canagliflozin, dapagliflozin, and empagliflozin from the perspective of the UK National Health System...
September 25, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28792171/glycemic-pentad
#2
Glycemic Pentad Forum
BACKGROUND: Conventionally, diabetes management involved targeting the triad of FPG, PPG, and HbA1c. However, several studies have suggested the quintessential need for a paradigm shift to incorporate glycemic variability and quality of life in the holistic diabetes control regimen. AIM: To generate a consensus and ratify the position of Glycemic Variability (GV) and Quality of Life (QOL), along with the traditional triad, in diabetes management in India. To evaluate whether the triple fixed dose combination of metformin, glimepiride, and voglibose can accomplish the goals of glycemic pentad...
July 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28690682/autologous-bone-marrow-derived-mononuclear-cells-transplantation-in-type-2-diabetes-mellitus-effect-on-%C3%AE-cell-function-and-insulin-sensitivity
#3
Shobhit Bhansali, Pinaki Dutta, Mukesh Kumar Yadav, Ashish Jain, Sunder Mudaliar, Meredith Hawkins, Anura V Kurpad, Deepak Pahwa, Ashok Kumar Yadav, Ratti Ram Sharma, Vivekanand Jha, Neelam Marwaha, Shipra Bhansali, Anil Bhansali
BACKGROUND: Insulin resistance and insulin deficiency are the cardinal defects in the pathogenesis of type 2 diabetes mellitus (T2DM). Despite the plethora of anti-diabetic medications, drugs specifically targeting the β-cells are still desired. Stem cell therapy has emerged as a novel therapeutics strategy to target β-cells; however, their mechanism of action has not been well defined. This study aims to examine the efficacy and safety of autologous bone marrow-derived mononuclear cells (ABM-MNCs) transplantation in T2DM, and explores the mechanistic insights into stem cells action through metabolic studies...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/28352212/canagliflozin-in-the-treatment-of-type-2-diabetes-an-evidence-based-review-of-its-place-in-therapy
#4
REVIEW
Thomas Karagiannis, Eleni Bekiari, Apostolos Tsapas
INTRODUCTION: Deciding on an optimal medication choice for type 2 diabetes is often challenging, due to the increasing number of treatment options. Canagliflozin is a novel glucose-lowering agent belonging to sodium-glucose co-transporter 2 (SGLT2) inhibitors. AIM: The aim of this study was to examine and summarize the evidence based on the efficacy, safety, and cost-effectiveness of canagliflozin for type 2 diabetes. EVIDENCE REVIEW: Compared to placebo, canagliflozin 100 and 300 mg lower glycated hemoglobin (HbA1c) by ~0...
2017: Core Evidence
https://www.readbyqxmd.com/read/28275958/comparative-effectiveness-of-adding-alogliptin-to-metformin-plus-sulfonylurea-with-other-dpp-4-inhibitors-in-type-2-diabetes-a-systematic-review-and-network-meta-analysis
#5
REVIEW
Stephen Kay, Amanda Strickson, Jorge Puelles, Ross Selby, Eugene Benson, Keith Tolley
INTRODUCTION: Alogliptin is an oral antihyperglycemic agent that is a selective inhibitor of the enzyme dipeptidyl peptidase-4 (DPP-4), approved for the treatment of type 2 diabetes mellitus (T2DM). There currently exists no comparative data to support the use of alogliptin in combination with metformin (met) and sulfonylurea (SU). A decision-focused network meta-analysis (NMA) was performed to compare the relative efficacy and safety of alogliptin 25 mg once daily to other DPP-4 inhibitors as part of a triple therapy regimen for patients inadequately controlled on metformin and SU dual therapy...
April 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28271251/efficacy-and-safety-of-metformin-and-sitagliptin-based-triple-antihyperglycemic-therapy-strategy-a-multicenter-randomized-controlled-non-inferiority-clinical-trial
#6
RANDOMIZED CONTROLLED TRIAL
Wen Xu, Yiming Mu, Jiajun Zhao, Dalong Zhu, Qiuhe Ji, Zhiguang Zhou, Bin Yao, Anhua Mao, Samuel S Engel, Bin Zhao, Yan Bi, Longyi Zeng, Xingwu Ran, Juming Lu, Linong Ji, Wenying Yang, Weiping Jia, Jianping Weng
Despite the current guideline's recommendation of a timely stepwise intensification therapy, the "clinical inertia", termed as the delayed treatment intensification, commonly exists in the real world, which may be partly due to the relatively little substantial evidence and no clear consensus regarding the efficacy and safety of triple oral agents in patients inadequately controlled with dual therapy. In this clinical trial performed in 237 centers in China, 5,535 type 2 diabetic patients inadequately controlled by previous therapies were treated with a stable metformin/sitagliptin dual therapy for 20 weeks...
March 2017: Science China. Life Sciences
https://www.readbyqxmd.com/read/28006991/efficacy-of-autologous-bone-marrow-derived-mesenchymal-stem-cell-and-mononuclear-cell-transplantation-in-type-2-diabetes-mellitus-a-randomized-placebo-controlled-comparative-study
#7
RANDOMIZED CONTROLLED TRIAL
Shobhit Bhansali, Pinaki Dutta, Vinod Kumar, Mukesh Kumar Yadav, Ashish Jain, Sunder Mudaliar, Shipra Bhansali, Ratti Ram Sharma, Vivekanand Jha, Neelam Marwaha, Niranjan Khandelwal, Anand Srinivasan, Naresh Sachdeva, Meredith Hawkins, Anil Bhansali
Drugs targeting β-cells have provided new options in the management of T2DM; however, their role in β-cell regeneration remains elusive. The recent emergence of cell-based therapies such as autologous bone marrow-derived mesenchymal stem cells (ABM-MSCs) and mononuclear cells (ABM-MNCs) seems to offer a pragmatic approach to augment β-cell function/mass. This study aims to examine the efficacy and safety of ABM-MSC and ABM-MNC transplantation in T2DM and explores alterations in glucose-insulin homeostasis by metabolic studies...
April 1, 2017: Stem Cells and Development
https://www.readbyqxmd.com/read/27854055/fixed-dose-combination-of-canagliflozin-and-metformin-for-the-treatment-of-type-2-diabetes-an-overview
#8
REVIEW
Jaime A Davidson, Lance Sloan
Metformin is recommended as a first-line therapy for patients with type 2 diabetes mellitus (T2DM). However, many patients do not achieve glycemic goals with metformin monotherapy and require subsequent combination therapy with other antihyperglycemic agents (AHAs). For newly diagnosed patients with high blood glucose, initial combination therapy may be required to achieve glycemic control. The American Association for Clinical Endocrinologists algorithm for the treatment of T2DM recommends metformin plus a sodium glucose co-transporter 2 (SGLT2) inhibitor as the first oral combination in patients who present with HbA1c ≥7...
January 2017: Advances in Therapy
https://www.readbyqxmd.com/read/27796904/strategies-for-diabetes-management-using-newer-oral-combination-therapies-early-in-the-disease
#9
REVIEW
Joel Zonszein, Per-Henrik Groop
INTRODUCTION: The duration of uncontrolled type 2 diabetes mellitus (T2DM) can adversely impact small and large vessels, eventually leading to microvascular and macrovascular complications. Failure of therapeutic lifestyle changes, monotherapy, and clinical inertia contribute to persistent hyperglycemia and disease progression. The aim was to review the complex pathophysiology of type 2 diabetes and how different oral agents can be used effectively as first-line therapy in combination with metformin, as well as in patients not achieving glycemic goals with metformin therapy...
December 2016: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/27762514/a-prospective-analysis-of-the-efficacy-and-safety-of-sodium-glucose-cotransporter-2-inhibitors-real-world-evidence-from-clinical-practice-in-india
#10
Bhavana Sosale, Aravind R Sosale, Prassanna M Kumar, Shashank R Joshi
BACKGROUND AND AIM: The number of patients with type 2 diabetes (T2DM) is increasing. Most patients with T2DM are uncontrolled and fail to achieve their target Hba1c. In recent years, newer agents such as SGLT2 inhibitors (SGLT2i) have been approved for clinical use. Though data from clinical trials and sub set analysis of Indian patients in global studies are promising, real world evidence from standard clinical practice in India is lacking. The aim of this study was to analyze the metabolic parameters in patients with T2DM on SGLT2i in real world clinical practice...
September 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27761471/exercise-therapy-for-management-of-type-2-diabetes-mellitus-superior-efficacy-of-activity-monitors-over-pedometers
#11
RANDOMIZED CONTROLLED TRIAL
Masaaki Miyauchi, Masao Toyoda, Noriko Kaneyama, Han Miyatake, Eitaro Tanaka, Moritsugu Kimura, Tomoya Umezono, Masafumi Fukagawa
We compared the efficacy of activity monitor (which displays exercise intensity and number of steps) versus that of pedometer in exercise therapy for patients with type 2 diabetes. The study subjects were divided into the activity monitor group (n = 92) and pedometer group (n = 95). The primary goal was improvement in hemoglobin A1c (HbA1c). The exercise target was set at 8,000 steps/day and 20 minutes of moderate-intensity exercise (≥3.5 metabolic equivalents). The activity monitor is equipped with a triple-axis accelerometer sensor capable of measuring medium-intensity walking duration, number of steps, walking distance, calorie consumption, and total calorie consumption...
2016: Journal of Diabetes Research
https://www.readbyqxmd.com/read/27585582/glycated-hemoglobin-body-weight-and-blood-pressure-in-type-2-diabetes-patients-initiating-dapagliflozin-treatment-in-primary-care-a-retrospective-study
#12
John Wilding, Clifford Bailey, Una Rigney, Betina Blak, Wendy Beekman, Cathy Emmas
INTRODUCTION: The present study aimed to describe characteristics of patients with type 2 diabetes (T2D) in UK primary care initiated on dapagliflozin, post-dapagliflozin changes in glycated hemoglobin (HbA1c), body weight and blood pressure, and reasons for adding dapagliflozin to insulin. METHODS: Retrospective study of patients with T2D in the Clinical Practice Research Datalink with first prescription for dapagliflozin. Patients were included in the study if they: (1) had a first prescription for dapagliflozin between November 2012 and September 2014; (2) had a Read code for T2D; (3) were registered with a practice for at least 6 months before starting dapagliflozin; and (4) remained registered for at least 3 months after initiation...
December 2016: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/27434443/comparison-of-clinical-outcomes-and-adverse-events-associated-with-glucose-lowering-drugs-in-patients-with-type-2-diabetes-a-meta-analysis
#13
Suetonia C Palmer, Dimitris Mavridis, Antonio Nicolucci, David W Johnson, Marcello Tonelli, Jonathan C Craig, Jasjot Maggo, Vanessa Gray, Giorgia De Berardis, Marinella Ruospo, Patrizia Natale, Valeria Saglimbene, Sunil V Badve, Yeoungjee Cho, Annie-Claire Nadeau-Fredette, Michael Burke, Labib Faruque, Anita Lloyd, Nasreen Ahmad, Yuanchen Liu, Sophanny Tiv, Natasha Wiebe, Giovanni F M Strippoli
IMPORTANCE: Numerous glucose-lowering drugs are used to treat type 2 diabetes. OBJECTIVE: To estimate the relative efficacy and safety associated with glucose-lowering drugs including insulin. DATA SOURCES: Cochrane Library Central Register of Controlled Trials, MEDLINE, and EMBASE databases through March 21, 2016. STUDY SELECTION: Randomized clinical trials of 24 weeks' or longer duration. DATA EXTRACTION AND SYNTHESIS: Random-effects network meta-analysis...
July 19, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27327605/within-sulfonylurea-class-evaluation-of-time-to-intensification-with-insulin-zodiac-43
#14
Dennis Schrijnders, Laura C Hartog, Nanne Kleefstra, Klaas H Groenier, Gijs W D Landman, Henk J G Bilo
BACKGROUND: Previous studies have shown that many within-class differences exist between sulfonylureas (SUs), however, whether differences exist regarding the time it takes between initiating an SU and the need to intensify treatment with insulin is unclear. The aim of this study was investigate the relationships between the three frequently used sulphonylureas, prescribed as dual therapy next to metformin, and the time needed to treatment intensification with either insulin or oral triple therapy in patients with type 2 diabetes mellitus...
2016: PloS One
https://www.readbyqxmd.com/read/27321330/triple-therapy-combinations-for-the-treatment-of-type-2-diabetes-a-network-meta-analysis
#15
Crystal Man Ying Lee, Mark Woodward, Stephen Colagiuri
AIM: To estimate and compare the results from all randomised trials of triple combinations of anti-diabetes therapies that reported the reduction of glycated haemoglobin (HbA1c) and associated effects on body weight and hypoglycaemia. METHODS: PubMed and the Cochrane Library were searched for trials with at least one study arm on triple therapy and which reported the differences in mean change in HbA1c between two study arms. These were included in a network meta-analysis...
June 2016: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/27215243/the-effects-of-dual-and-triple-combinations-of-trandolapril-telmisartan-and-verapamil-on-overt-proteinuria-in-the-patients-with-diabetic-nephropathy
#16
Bülent Albayrak, Erdem Cankaya, Ramazan Cetinkaya, Serkan Cerrah, Yusuf Bilen
Diabetic nephropathy (DN) is one of the most important causes of the end-stage renal failure and its prevalence is found to be increasing. The presence of hypertension and progressive proteinuria is among the important findings. In this study, the effects of double and triple combinations of trandolapril, telmisartan, and verapamil on proteinuria were investigated in diabetic patients with nephropathy. Seventy-eight patients (mean age: 56.11 ± 11.26 years; 47 females and 31 males) with overt proteinuria and DN were included in this study...
May 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/26844723/phase-iii-study-on-efficacy-and-safety-of-triple-combination-exenatide-metformin-biphasic-insulin-aspart-therapy-for-type-2-diabetes-mellitus
#17
Ke Su, Chunmei Lv, Zongwen Ji, Yishu Wang, Haifeng Wang, Ying Bai, Yaping Liu
Exenatide, metformin (MET), and biphasic insulin aspart 30 (BIA30) have been widely used in the treatment of patients with type 2 diabetes mellitus (T2DM); however, each of these medications has significant adverse effects, which limit their utilization. This study aimed to evaluate the efficacy and safety of triple combination (exenatide/metformin/biphasic insulin aspart) therapy for T2DM. Two hundred patients with poorly controlled T2DM were randomly divided into the low-dose (0.5 μg exenatide, 0.05 U·kg·d BIA30, and 0...
February 3, 2016: American Journal of Therapeutics
https://www.readbyqxmd.com/read/26700585/network-meta-analysis-of-treatments-for-type-2-diabetes-mellitus-following-failure-with-metformin-plus-sulfonylurea
#18
REVIEW
G Lozano-Ortega, S Goring, H A Bennett, K Bergenheim, C Sternhufvud, J Mukherjee
UNLABELLED: Aims The efficacy and safety of sodium-glucose linked transporters (SGLT2s) plus metformin and a sulfonylurea (MET + SU) for the treatment of type 2 diabetes mellitus (T2DM) in patients who fail to achieve glycemic control with MET + SU, relative to other triple therapies licensed in the EU, were estimated. Methods A systematic literature review and network meta-analysis (NMA) of randomized controlled trials (RCTs) involving anti-diabetes treatments added to MET + SU were conducted...
May 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/26664803/triple-therapy-in-type-2-diabetes-a-systematic-review-and-network-meta-analysis
#19
Martin J Downes, Emilie K Bettington, Jenny E Gunton, Erika Turkstra
Aims. The purpose was to evaluate the evidence for triple therapy regimen using medicines available in Australia for type 2 diabetes. Methods. A systematic literature review was performed to update the relevant evidence from 2002 to 2014 on triple therapy for type 2 diabetes. A multiple-treatments network meta-analysis was undertaken to summarise the comparative efficacy and harms of different triple therapies. Results. Twenty seven trials were identified, most were six months of duration. The following combinations were included in the network meta-analysis: metformin (MET) + sulfonylureas (SU) (used as reference combination); MET + SU+ dipeptidyl peptidase 4 inhibitors (DPP-4-i); MET + SU+ thiazolidinediones (TZD); MET + SU+ glucagon-like peptide-1 receptor agonists (GLP-1-RA); MET + SU+ insulins; MET + TZD + DPP-4-i; and MET + SU+ sodium/glucose cotransporter 2 inhibitors (SGLT2-i)...
2015: PeerJ
https://www.readbyqxmd.com/read/26616595/clinical-characteristics-and-metabolic-predictors-of-rapid-responders-to-dipeptidyl-peptidase-4-inhibitor-as-an-add-on-therapy-to-sulfonylurea-and-metformin
#20
Ye An Kim, Won Sang Yoo, Eun Shil Hong, Eu Jeong Ku, Kyeong Seon Park, Soo Lim, Young Min Cho, Kyong Soo Park, Hak Chul Jang, Sung Hee Choi
BACKGROUND: Dipeptidyl peptidase-4 (DPP-4) inhibitor add-on therapy is a new option for patients with inadequately controlled type 2 diabetes who are taking combined metformin and sulfonylurea (SU). We evaluated the efficacy and safety of this triple therapy and the characteristics of rapid responders and hypoglycemia-prone patients. METHODS: We included 807 patients with type 2 diabetes who were prescribed a newly added DPP-4 inhibitor to ongoing metformin and SU in 2009 to 2011...
December 2015: Diabetes & Metabolism Journal
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