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https://www.readbyqxmd.com/read/28526416/treatment-strategy-for-type-2-diabetes-with-obesity-focus-on-glucagon-like-peptide-1-receptor-agonists
#1
REVIEW
Qiuhe Ji
PURPOSE: The progressive nature of type 2 diabetes mellitus (T2DM) calls for step-wise intensification of therapy for maintaining normal glycemic levels and lowering cardiovascular (CV) risk. Because obesity is a prominent risk factor and comorbidity of T2DM, it further elevates the CV risk in T2DM. Therefore, it is vital to manage weight, obesity, and glycemic parameters for effective T2DM management. Few oral antidiabetic drugs (sulfonylureas and thiazolidinediones) and insulin are not suitable for obese patients with T2DM because these drugs cause weight gain...
May 16, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28526182/pharmacologic-management-of-type-2-diabetes-mellitus-available-therapies
#2
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...
May 12, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28523483/modeling-the-long-term-cost-effectiveness-of-ideglira-in-patients-with-type-2-diabetes-who-are-failing-to-meet-glycemic-targets-on-basal-insulin-alone-in-the-netherlands
#3
Barnaby Hunt, Divina Glah, Maarten van der Vliet
INTRODUCTION: Insulin degludec/liraglutide (IDegLira) is the first basal insulin and glucagon-like peptide-1 receptor agonist (GLP-1 RA) in a single pen injection device, and a once-daily treatment option for patients with type 2 diabetes mellitus (T2DM) who are uncontrolled on basal insulin and require treatment intensification. The objective of this analysis was to evaluate the long-term cost-effectiveness of IDegLira versus basal-bolus therapy (insulin glargine U100 + 3× daily insulin aspart) for patients with T2DM uncontrolled on basal insulin [HbA1c >53 mmol/mol (>7%)] in the Netherlands...
May 18, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28520705/disparities-in-diabetes-deaths-among-children-and-adolescents-united-states-2000-2014
#4
Sharon Saydah, Giuseppina Imperatore, Yiling Cheng, Linda S Geiss, Ann Albright
Diabetes is a common chronic disease of childhood affecting approximately 200,000 children and adolescents in the United States (1). Children and adolescents with diabetes are at increased risk for death from acute complications of diabetes, including hypoglycemia and diabetic ketoacidosis (2,3); in 2012, CDC reported that during 1968-2009, diabetes mortality among U.S. persons aged ≤19 years declined by 61% (4). CDC observed disparities by race during 1979-2004, with black children and adolescents dying from diabetes at twice the rate of white children and adolescents (5)...
May 19, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28514729/meglitinides-increase-the-risk-of-hypoglycemia-in-diabetic-patients-with-advanced-chronic-kidney-disease-a-nationwide-population-based-study
#5
Pei-Chen Wu, Vin-Cent Wu, Cheng-Jui Lin, Chi-Feng Pan, Chih-Yang Chen, Tao-Min Huang, Che-Hsiung Wu, Likwang Chen, Chih-Jen Wu, The Nrpb Kidney Consortium
The safety of short-acting meglitinides in diabetic patients with advanced chronic kidney disease (CKD) has not been widely reported.Diabetic patients with advanced CKD who had a serum creatinine level of > 6 mg/dL a hematocrit level of ≦ 28% and received erythropoiesis-stimulating agent treatment between 2000 and 2010, were included in this nationwide study in Taiwan.The outcomes of interest were defined as hypoglycemia and long-term mortality. The risks of hypoglycemia and death were analyzed using Cox proportional hazards models, with end-stage renal disease and anti-diabetic drugs as time-dependent variables...
April 27, 2017: Oncotarget
https://www.readbyqxmd.com/read/28511644/relationship-between-glycemic-levels-and-treatment-outcome-among-critically-ill-children-admitted-into-emergency-room-in-enugu
#6
Nwachinemere Davidson Uleanya, Elias Chikee Aniwada, Ikenna Chidiebele Nwokoye, Ikenna Kingsley Ndu, Christopher Bismarck Eke
BACKGROUND: Critically ill children are those in need of immediate attention on arrival to an emergency room. The importance of glycemic level measurement as well as maintaining the patency of the airway, effective breathing and circulation cannot be overemphasied. It has been highlighted that the peak hyperglycemia and hypoglycemia predict poor prognosis, longer lengths of hospital stay and higher mortality. The study aims to assess the relationship between glycemic level and treatment outcomes as well as length of hospital stay...
May 16, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28504012/inpatient-glycemic-management-in-internal-medicine-an-observational-multicenter-study-in-nanjing-china
#7
Shujie Hao, Ning Zhang, Anne Folta Fish, Xiaodan Yuan, Lin Liu, Fan Li, Zhaohui Fang, Qingqing Lou
Aims To evaluate the prevalence of hyperglycemia among inpatients in internal medicine, and specifically, to assess the glycemic management of inpatients in non-endocrinology departments in three large urban hospitals in China. Methods A multicenter observational study was conducted using electronic health records, and a survey of 1939 patients who were admitted to internal medicine units and followed until discharge. Those with previously diagnosed diabetes, newly diagnosed diabetes, or impaired fasting glucose were included...
May 13, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28502028/hypoglycemia-following-bariatric-surgery-our-31-year-experience
#8
Alex D Michaels, J Hunter Mehaffey, W Brenton French, Bruce D Schirmer, Jennifer L Kirby, Peter T Hallowell
PURPOSE: The purposes of this study are to identify the cumulative incidence of post-bariatric surgery hypoglycemia (PBSH), describe its symptomatology, and characterize treatment patterns at a large academic institution. MATERIALS AND METHODS: All patients who underwent bariatric surgery at a single institution from 1985 to 2015 were identified using a clinical database, administrative billing data identified patients who were treated for hypoglycemia, and chart reviews were performed to make a diagnosis of PBSH based on Whipple's triad...
May 13, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28498352/encapsulation-of-16-hydroxycleroda-3-13-dine-16-15-olide-in-mesoporous-silica-nanoparticles-as-a-natural-dipeptidyl-peptidase-4-inhibitor-potentiated-hypoglycemia-in-diabetic-mice
#9
Po-Kai Huang, Shi-Xiang Lin, May-Jywan Tsai, Max K Leong, Shian-Ren Lin, Ranjith Kumar Kankala, Chia-Hung Lee, Ching-Feng Weng
Natural supplements comprise good efficacy with less adverse effects as against diabetic therapy, but their advancement as anti-diabetic agents is unsatisfactory with regard to the delivery system. Dipeptidyl peptidase-4 (DPP4)/CD26) can degrade glucagon-like pepetide-1 (GLP-1) which renders a decrease of blood glucose levels. 16-hydroxycleroda-3,13-dine-16,15-olide (HCD) extracted from Polyalthia longifolia, exhibits numerous medicinal potentials including hypoglycemic potential. On consideration of HCD application, the bioavailability is affected by low solubility...
May 12, 2017: Nanomaterials
https://www.readbyqxmd.com/read/28497277/brazilin-ameliorates-diabetic-nephropathy-and-inflammation-in-db-db-mice
#10
Zhan-Yuan Li, Yu Zheng, Yan Chen, Min Pan, Shu-Bei Zheng, Wen Huang, Zhi-Hong Zhou, Han-Yang Ye
Hyperglycemia and inflammation play important roles in the pathogenesis of diabetic nephropathy (DN). Brazilin might be an effective pharmacological agent against hyperglycemia and inflammation. In our present study, we explored whether brazilin mitigated pathological progression, inflammation, and extracellular matrix (ECM) accumulation in a mouse model of diabetic nephropathy. Brazilin reduced aggravated biochemical indices of DN (proteinuria and the serum glucose level) and renal hypertrophy. Brazilin also improved renal morphology and inhibited macrophage infiltration, as manifested by different pathological staining methods...
May 11, 2017: Inflammation
https://www.readbyqxmd.com/read/28496176/efficacy-and-safety-of-thiazolidinediones-in-diabetes-patients-with-renal-impairment-a-systematic-review-and-meta-analysis
#11
Wen Wang, Xu Zhou, Joey S W Kwong, Ling Li, Youping Li, Xin Sun
We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of TZDs in treatment of diabetes mellitus patients with renal impairment. We searched PubMed, EMBASE and Cochrane Central Register of Controlled Trials. Randomized controlled trials (RCTs), cohort studies, and case-control studies that investigated the effects of TZDs in patients with diabetes and renal impairment were eligible. Outcomes included glycosylated hemoglobin, fasting plasma glucose, serum lipids, and patient-important outcomes (i...
May 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28487437/hypoglycemic-effect-of-combined-ghrelin-and-glucagon-receptor-blockade
#12
Bharath K Mani, Aki Uchida, Young Lee, Sherri Osborne-Lawrence, Maureen J Charron, Roger H Unger, Eric D Berglund, Jeffrey M Zigman
Glucagon receptor (GcgR) blockade has been proposed as an alternative to insulin monotherapy for treating Type 1 diabetes mellitus since deletion or inhibition of GcgRs corrects hyperglycemia in diabetic models. The factors regulating glycemia in a setting devoid of insulin and glucagon function remain unclear, but may include the hormone ghrelin. Not only is ghrelin release controlled by glucose, but also ghrelin has many actions that can raise or reduce falls in blood glucose. Here, we tested the hypothesis that ghrelin rises to minimize hypoglycemia in the absence of glucagon function...
May 9, 2017: Diabetes
https://www.readbyqxmd.com/read/28486736/comparison-of-the-effects-of-mitiglinide-and-glibenclamide-administered-in-combination-with-the-dipeptidyl-peptidase-iv-inhibitor-sitagliptin-in-rats-with-streptozotocin-nicotinamide-induced-type-2-diabetes
#13
Kenji Akahane, Kazuma Ojima, Ayaka Yokoyama, Toshihiro Inoue, Sumiyoshi Kiguchi, Satoshi Tatemichi, Hiroo Takeda, Mamoru Kobayashi
We compared the individual effects of mitiglinide and glibenclamide administered in combination with the dipeptidyl peptidase-IV (DPP-IV) inhibitor sitagliptin on plasma DPP-IV activity and blood glucose levels in rats with streptozotocin-nicotinamide-induced type 2 diabetes (STZ-NA rats). We examined the inhibitory activity of mitiglinide and glibenclamide as well as their combination with sitagliptin on plasma DPP-IV activity in STZ-NA rats. The oral glucose tolerance test (OGTT) was used to compare effects of mitiglinide, glibenclamide, and their combination with sitagliptin on blood glucose levels in STZ-NA rats...
May 9, 2017: Drug Research
https://www.readbyqxmd.com/read/28483786/faster-aspart-versus-insulin-aspart-as-part-of-a-basal-bolus-regimen-in-inadequately-controlled-type-2-diabetes-the-onset-2-trial
#14
Keith Bowering, Christopher Case, John Harvey, Michael Reeves, Michael Sampson, Robert Strzinek, Ditte-Marie Bretler, Rikke Beck Bang, Bruce W Bode
OBJECTIVE: This multicenter, double-blind, treat-to-target, phase 3 trial evaluated the efficacy and safety of fast-acting insulin aspart (faster aspart) versus insulin aspart (IAsp) in adults with type 2 diabetes receiving basal insulin and oral antidiabetic agents. RESEARCH DESIGN AND METHODS: The primary end point was HbA1c change from baseline after 26 weeks' treatment. After an 8-week run-in to optimize basal insulin, subjects were randomized (1:1) to mealtime faster aspart (n = 345) or IAsp (n = 344), titrated using a simple daily patient-driven algorithm, plus insulin glargine U100 and metformin...
May 8, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28467934/ppar%C3%AE-promotes-running-endurance-by-preserving-glucose
#15
Weiwei Fan, Wanda Waizenegger, Chun Shi Lin, Vincenzo Sorrentino, Ming-Xiao He, Christopher E Wall, Hao Li, Christopher Liddle, Ruth T Yu, Annette R Atkins, Johan Auwerx, Michael Downes, Ronald M Evans
Management of energy stores is critical during endurance exercise; a shift in substrate utilization from glucose toward fat is a hallmark of trained muscle. Here we show that this key metabolic adaptation is both dependent on muscle PPARδ and stimulated by PPARδ ligand. Furthermore, we find that muscle PPARδ expression positively correlates with endurance performance in BXD mouse reference populations. In addition to stimulating fatty acid metabolism in sedentary mice, PPARδ activation potently suppresses glucose catabolism and does so without affecting either muscle fiber type or mitochondrial content...
May 2, 2017: Cell Metabolism
https://www.readbyqxmd.com/read/28467694/durable-control-of-autoimmune-diabetes-in-mice-achieved-by-intraperitoneal-transplantation-of-neo-islets-three-dimensional-aggregates-of-allogeneic-islet-and-mesenchymal-stem-cells
#16
Christof Westenfelder, Anna Gooch, Zhuma Hu, Jon Ahlstrom, Ping Zhang
Novel interventions that reestablish endogenous insulin secretion and thereby halt progressive end-organ damage and prolong survival of patients with autoimmune Type 1 diabetes mellitus (T1DM) are urgently needed. While this is currently accomplished with allogeneic pancreas or islet transplants, their utility is significantly limited by both the scarcity of organ donors and life-long need for often-toxic antirejection drugs. Coadministering islets with bone marrow-derived mesenchymal stem cells (MSCs) that exert robust immune-modulating, anti-inflammatory, anti-apoptotic, and angiogenic actions, improves intrahepatic islet survival and function...
May 3, 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28467113/efficacy-and-safety-of-insulin-glargine-300-u-ml-versus-insulin-glargine-100-u-ml-in-high-risk-and-low-risk-patients-with-type-2-diabetes-stratified-using-common-clinical-performance-measures
#17
Ildiko Lingvay, Jason Chao, Mehul R Dalal, Luigi F Meneghini
BACKGROUND: To determine whether previously reported reductions in hypoglycemia associated with insulin glargine 300 U/mL (Gla-300) compared with insulin glargine 100 U/mL (Gla-100) are impacted by patient risk category in type 2 diabetes (T2D), clinical performance measures based on the Healthcare Effectiveness Data and Information Set (HEDIS) were applied to patient-level data from the EDITION 2 and EDITION 3 clinical trials that compared Gla-300 and Gla-100. METHODS: In this post hoc analysis, patients were stratified as low risk (LR) if patients were <65 years old with no comorbidities derived from HEDIS (HbA1c target <7...
May 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28463898/glucose-kinetics-an-update-and-novel-insights-into-its-regulation-by-glucagon-and-glp-1
#18
Amalia Gastaldelli, Melania Gaggini, Ralph DeFronzo
PURPOSE OF REVIEW: Glucagon and GLP-1 share the same origin (i.e., proglucagon); primarily GLP-1 is generated from intestinal L-cells and glucagon from pancreatic α-cell, but intestinal glucagon and pancreatic GLP-1 secretion is likely. Glucose kinetics are tightly regulated by pancreatic hormones insulin and glucagon, but other hormones, including glucagon-like peptide-1 (GLP-1), also play an important role. The purpose of this review is to describe the recent findings on the mechanisms by which these two hormones regulate glucose kinetics...
April 29, 2017: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/28462560/seizures-due-to-insulinoma-a-rare-but-treatable-cause
#19
Shubha Bhalla, Vps Punia, M Narang, Pushpa Kumari, Saurabh Gupta
Hypoglycemia can cause multiple neuroglycopenic symptoms; seizures being one of them. Misdiagnosis and delay in treatment are common and prolonged hypoglycemia can lead to permanent neurological deficit or fatal coma. Hypoglycemia caused by an insulinoma is a readily treatable condition that should be considered in the differential diagnosis of intractable seizures. The following case report highlights the need for careful reassessment of all seizures that are atypical and refractory to medication.
March 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28459036/consensus-statement-on-dose-modifications-of-antidiabetic-agents-in-patients-with-hepatic-impairment
#20
REVIEW
Kalyan Kumar Gangopadhyay, Parminder Singh
Liver disease is an important cause of mortality in type 2 diabetes mellitus (T2DM). It is estimated that diabetes is the most common cause of liver disease in the United States. Virtually, entire spectrum of liver disease is seen in T2DM including abnormal liver enzymes, nonalcoholic fatty liver disease, cirrhosis, hepatocellular carcinoma, and acute liver failure. The treatment of diabetes mellitus (DM) in cirrhotic patients has particular challenges as follows: (1) about half the patients have malnutrition; (2) patients already have advanced liver disease when clinical DM is diagnosed; (3) most of the oral antidiabetic agents (ADAs) are metabolized in the liver; (4) patients often have episodes of hypoglycemia...
March 2017: Indian Journal of Endocrinology and Metabolism
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