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Management of hyperglycemia type 2 diabetes

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https://www.readbyqxmd.com/read/28741382/sodium-glucose-co-transporter-2-inhibitor-luseogliflozin-in-the-management-of-type-2-diabetes-a-drug-safety-evaluation
#1
Daisuke Yabe, Yoshiyuki Hamamoto, Yusuke Seino, Hitoshi Kuwata, Takeshi Kurose, Yutaka Seino
Sodium glucose co-transporter-2 (SGLT2) inhibitors have been developed recently as a new class of anti-diabetic drug, and are becoming widely used in the management of type 2 diabetes (T2D). As these agents have a considerably different glucose-lowering mechanism from those of other anti-diabetic drugs, safe use of this drug class needs to be discussed based on data available from preapproval clinical trials as well as real-world studies. The SGLT2 inhibitor luseogliflozin was developed by Taisho Pharmaceutical Co...
July 25, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28733378/is-it-time-to-change-the-type-2-diabetes-treatment-paradigm-no-metformin-should-remain-the-foundation-therapy-for-type-2-diabetes
#2
Silvio E Inzucchi
Most treatment guidelines, including those from the American Diabetes Association/European Association for the Study of Diabetes and the International Diabetes Federation, suggest metformin be used as the first-line therapy after diet and exercise. This recommendation is based on the considerable body of evidence that has accumulated over the last 30 years, but it is also supported on clinical grounds based on metformin's affordability and tolerability. As such, metformin is the most commonly used oral antihyperglycemic agent in the U...
August 2017: Diabetes Care
https://www.readbyqxmd.com/read/28733377/is-it-time-to-change-the-type-2-diabetes-treatment-paradigm-yes-glp-1-ras-should-replace-metformin-in-the-type-2-diabetes-algorithm
#3
Muhammad Abdul-Ghani, Ralph A DeFronzo
Most treatment guidelines, including those from the American Diabetes Association/European Association for the Study of Diabetes and the International Diabetes Federation, suggest metformin be used as the first-line therapy after diet and exercise. This recommendation is based on the considerable body of evidence that has accumulated over the last 30 years, but it is also supported on clinical grounds based on metformin's affordability and tolerability. As such, metformin is the most commonly used oral antihyperglycemic agent in the U...
August 2017: Diabetes Care
https://www.readbyqxmd.com/read/28721687/practical-approach-to-initiating-sglt2-inhibitors-in-type-2-diabetes
#4
REVIEW
Fernando Gomez-Peralta, Cristina Abreu, Albert Lecube, Diego Bellido, Alfonso Soto, Cristóbal Morales, Miguel Brito-Sanfiel, Guillermo Umpierrez
Sodium-glucose co-transporter 2 (SGLT2) inhibitors are an attractive novel therapeutic option for the treatment of type 2 diabetes. They block the reabsorption of filtered glucose in kidneys, mainly in proximal renal tubules, resulting in increased urinary glucose excretion and correction of the diabetes-related hyperglycemia. Beyond improving glucose control, SGLT2 inhibitors offer potential benefits by reducing body weight and blood pressure. On the basis of the efficacy demonstrated in clinical trials, SGLT2 inhibitors are recommended as second- or third-line agents for the management of patients with type 2 diabetes...
July 18, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28716404/partial-jejunal-diversion-using-an-incisionless-magnetic-anastomosis-system-1-year-interim-results-in-subjects-with-obesity-and-diabetes
#5
Evžen Machytka, Marek Bužga, Pavel Zonca, David B Lautz, Marvin Ryou, Donald C Simonson, Christopher C Thompson
BACKGROUND AND AIMS: The majority of patients with type 2 diabetes mellitus (T2DM) have obesity. Studies show that bariatric surgery is superior to medical treatment for remission of T2DM. Nevertheless, very few patients undergo surgery, and a less-invasive endoscopic alternative is desirable. METHODS: This was a single-arm first-in-human pilot study, designed to evaluate the technical feasibility, safety, and clinical performance of the incisionless magnetic anastomosis system (IMAS) in creation of a partial jejunal diversion (PJD)...
July 14, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28704113/role-of-resveratrol-in-the-management-of-insulin-resistance-and-related-conditions-mechanism-of-action
#6
Ebrahim Abbasi Oshaghi, Mohammad Taghi Goodarzi, Victoria Higgins, Khosrow Adeli
Resveratrol (RES), a well-known antioxidant, is present in numerous plant species and, as a result, is easily obtained through dietary intake of plant-based foods and beverages. Several studies suggest that RES has anti-carcinogenic, anti-microbial, and anti-viral effects. It may also have beneficial metabolic properties that result in mitigation of insulin resistance (IR) and related metabolic abnormalities, including dyslipidemia, hyperglycemia, and hyperinsulinemia through regulation of gene expression or the activity of rate-limiting enzymes...
July 13, 2017: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/28693595/biochemical-characterization-and-1-h-nmr-based-metabolomics-revealed-melicope-lunu-ankenda-leaf-extract-a-potent-anti-diabetic-agent-in-rats
#7
Mizher Hezam Al-Zuaidy, Muhammad Waseem Mumtaz, Azizah Abdul Hamid, Amin Ismail, Suhaila Mohamed, Ahmad Faizal Abdul Razis
BACKGROUND: Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterized by continuous hyperglycemia associated with insulin resistance and /or reduced insulin secretion. There is an emerging trend regarding the use of medicinal plants for the treatment of diabetes mellitus. Melicope lunu-ankenda (ML) is one of the Melicope species belonging to the family Rutaceae. In traditional medicines, its leaves and flowers are known to exhibit prodigious health benefits. The present study aimed at investigating anti-diabetic effect of Melicope lunu-ankenda (ML) leaves extract...
July 10, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28673577/cognitive-impairment-in-diabetes-and-poor-glucose-utilization-in-the-intracellular-neural-milieu
#8
Carlos M Contreras, Ana G Gutiérrez-García
The main characteristic of diabetes is hyperglycemia. Depending on whether diabetes is type-1 or type-2, it is characterized by deficiencies in insulin secretion, insulin receptor sensitivity, hexokinase activity, and glucose transport. Current drug treatments are able to lower circulating glucose but do not address the problem of glucose utilization in the intracellular milieu, the consequence of which is tissue damage. In the long-term, such changes can produce structural damage in many cortical and subcortical brain areas that are related to cognitive function...
July 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28667580/assessing-the-therapeutic-utility-of-professional-continuous-glucose-monitoring-in-type-2-diabetes-across-various-therapies-a-retrospective-evaluation
#9
Jothydev Kesavadev, Robert Vigersky, John Shin, Pradeep Babu Sadasivan Pillai, Arun Shankar, Geethu Sanal, Gopika Krishnan, Sunitha Jothydev
BACKGROUND: There have been few large studies that have analyzed the effect of professional (masked) continuous glucose monitoring (P-CGM) on glycemic control in patients with type 2 diabetes (T2DM) who were on a broad spectrum of baseline therapies. METHODS: We performed a retrospective, blinded evaluation of glycemic control in 296 T2DM adults for 6 months following a 6- to 7-day study of their glycemic profile using masked P-CGM. At baseline, 91% of the patients were on some form of insulin treatment with oral hypoglycemic agents (OHA), while 7% were on one or more OHAs without insulin, and the remaining 2% were on GLP-1RAs...
June 30, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28662968/adherence-to-guidelines-for-inpatient-pharmacologic-management-of-type-2-diabetes-and-glycemic-outcomes
#10
Resheed Alkhiari, Hussain Alzayer, Jafar Aljazeeri, Thuva Vanniyasingam, Zubin Punthakee
OBJECTIVES: Diabetes is often poorly managed in hospitals. This study assessed the level of adherence to current Canadian practice guidelines for inpatient pharmacologic management of type 2 diabetes and whether it affected the frequency of hyperglycemia or hypoglycemia. METHODS: Retrospectively, we assessed the first 3 days of routine inpatient capillary blood glucose measurement (CBGM) records for hyperglycemia (>8 mmol/L fasting, >10 mmol/L nonfasting) and hypoglycemia (<4 mmol/L) in adults with drug-treated type 2 diabetes admitted to internal medicine without metabolic decompensation or nil per os (NPO) status at 2 hospitals during October through December 2014...
June 26, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28641786/association-of-apolipoprotein-ciii-apoc-iii-endothelium-dependent-vasodilation-and-peripheral-neuropathy-in-a-multi-ethnic-population-with-type-2-diabetes
#11
Sharon Li Ting Pek, Chee Fang Sum, Lee Ying Yeoh, Simon Biing Ming Lee, Wern Ee Tang, Su Chi Lim, Subramaniam Tavintharan
BACKGROUND: Diabetic peripheral neuropathy (DPN) is a common complication of Type 2 diabetes (T2D). Apart from hyperglycemia, its pathogenesis is poorly understood. Apolipoprotein-CIII (apoC-III) associated with triglyceride metabolism, is a risk factor for cardiovascular disease. Its role in DPN is not well-established. We studied the associations of apoC-III, endothelial function and DPN. METHODS: In patients with T2D, anthropometric data, fasting blood, and urine were collected for biochemistry and urine albumin/creatinine measurements (uACR)...
July 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/28618991/effects-of-polyphenolic-derivatives-on-heme-oxygenase-system-in-metabolic-dysfunctions
#12
Valeria Pittala, Luca Vanella, Loredana Salerno, Giuseppe Romeo, Agostino Marrazzo, Claudia Di Giacomo, Valeria Sorrenti
BACKGROUND: The aim of this review is to summarize the effects of various naturally occurring polyphenols in the management of metabolic dysfunctions. This cluster of metabolic abnormalities comprises insulin resistance, increased levels of free fatty acids, hypercholesterolemia, obesity, hyperglycemia and hypertension, diabetes mellitus (DM) type 1 (T1DM) and type 2 (T2DM) along with DM-induced complications. Most of them are included in the well-known metabolic syndrome (MS). These metabolic dysfunctions in turn are tightly associated to a high risk of development of cardiovascular diseases...
June 16, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28606343/pharmacologic-management-of-type-2-diabetes-mellitus-available-therapies
#13
James Thrasher
Choices for the treatment of type 2 diabetes mellitus (T2DM) have multiplied as our understanding of the underlying pathophysiologic defects has evolved. Treatment should target multiple defects in T2DM and follow a patient-centered approach that considers factors beyond glycemic control, including cardiovascular risk reduction. The American Association of Clinical Endocrinologists/American College of Endocrinology and the American Diabetes Association recommend an initial approach consisting of lifestyle changes and monotherapy, preferably with metformin...
July 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28606340/cardiovascular-protection-in-the-treatment-of-type-2-diabetes-a%C3%A2-review-of-clinical-trial-results-across-drug-classes
#14
Francesco Paneni, Thomas F Lüscher
Patients with type 2 diabetes (T2DM) have a significantly higher risk of developing cardiovascular disease (CVD)-namely myocardial infarction, heart failure, and stroke. Despite clear advances in the prevention and treatment of CVD, the impact of T2DM on CVD outcome remains high and continues to escalate. Available evidence indicates that the risk of macrovascular complications increases with the severity of hyperglycemia, thus suggesting that the relation between metabolic disturbances and vascular damage is approximately linear...
July 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28600118/so-many-antihyperglycemics-how-to-choose-a-practical-approach
#15
Alice Y Y Cheng
Guidelines from around the world have stressed the importance of glycemic control in the management of patients with type 2 diabetes (T2DM) to reduce the risk of developing complications. To achieve this goal, both lifestyle and pharmacologic therapies are available. There are 9 classes of antihyperglycemic therapies available in Canada and each class provides a different mechanism of action to address the pathophysiology of T2DM. Metformin remains the first choice for pharmacologic therapy. Thereafter, individualization is essential...
June 6, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28571661/-evaluation-and-perioperative-management-of-patients-with-diabetes-mellitus-a-challenge-for-the-anesthesiologist
#16
REVIEW
João Paulo Jordão Pontes, Florentino Fernandes Mendes, Mateus Meira Vasconcelos, Nubia Rodrigues Batista
Diabetes mellitus (DM) is characterized by alteration in carbohydrate metabolism, leading to hyperglycemia and increased perioperative morbidity and mortality. It evolves with diverse and progressive physiological changes, and the anesthetic management requires attention regarding this disease interference in multiple organ systems and their respective complications. Patient's history, physical examination, and complementary exams are important in the preoperative management, particularly glycosylated hemoglobin (HbA1c), which has a strong predictive value for complications associated with diabetes...
May 30, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28567297/pasireotide-in-an-insulin-requiring-diabetic-acromegalic-patient-without-worsening-of-hyperglycemia
#17
Murray B Gordon, Kellie L Spiller
Long-acting pasireotide is an effective treatment option for acromegaly, but it is associated with hyperglycemia, which could impact its use in patients with diabetes. We present a case of a 53-year-old man with acromegaly and type 2 diabetes mellitus (glycated hemoglobin (HbA1c): 7.5%), who refused surgery to remove a pituitary macroadenoma and enrolled in a Phase 3 clinical trial comparing long-acting pasireotide and long-acting octreotide in acromegalic patients. The patient initially received octreotide, but insulin-like growth factor 1 (IGF-1) levels remained elevated after 12 months (383...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28552652/blood-pressure-management-in-patients-with-diabetes-insights-from-the-diabetes-mellitus-status-in-canada-survey
#18
Jasmine Grenier, Shaun G Goodman, Lawrence A Leiter, Anatoly Langer, Hwee Teoh, Deepak L Bhatt, Alice Y Y Cheng, Mary K Tan, Thomas Ransom, Kim A Connelly, Andrew T Yan
OBJECTIVES: Optimal treatment of blood pressure (BP) and other cardiovascular risk factors, including hyperglycemia, is integral to diabetes management. There are limited data from the primary care setting concerning the contemporary and comprehensive management of type 2 diabetes and other cardiovascular risk factors in relation to guideline-recommended BP target achievement. METHODS: The Diabetes Mellitus Status in Canada (DM-SCAN) survey included 5172 ambulatory patients with type 2 diabetes...
May 25, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28545542/recognition-and-treatment-of-sleep-disordered-breathing-an-important-component-of-chronic-disease-management
#19
REVIEW
Peter C Farrell, Glenn Richards
Sleep-disordered breathing (SDB) is a highly prevalent condition, and is associated with many debilitating chronic diseases. The role of untreated obstructive sleep apnea (OSA) in arterial hypertension has been recognized in international guidelines. Treatment with continuous positive airway pressure (CPAP) is associated with clinically-relevant reductions in blood pressure. In heart failure (HF), SDB is associated with worse prognosis and increased mortality. Major HF guidelines recommend that patients should be treated for sleep apnea to improve their HF status...
May 25, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28527166/consensus-on-initiation-and-intensification-of-premix-insulin-in-type-2-diabetes-management
#20
Viswanathan Mohan, Sanjay Kalra, Jothydev Kesavadev, Awadhesh Kumar Singh, Ajay Kumar, Ambika Gopalakrishnan Unnikrishnan, Rajeev Chawla, Jagat Jyoti Mukherjee, Rakesh Kumar Sahay, J S Kumar, Anil Bhoraskar, Arthur J Asirvatham, Jayanta Kumar Panda, Abdul Hamid Zargar, Ashok Kumar Das
INTRODUCTION: Premix insulin is the most commonly used insulin preparation in India. The first Indian premix guidelines were developed in 2009 and thereafter were updated in 2013. There is a need to revisit the Indian premix insulin guidelines, in view of emerging evidence and introduction of newer co-formulations. OBJECTIVE: The present consensus has been developed to evaluate available premix formulations, examine existing evidence related to premix formulations, and evolve consensus statement of recommendations on the topic...
April 2017: Journal of the Association of Physicians of India
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