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Diabetes, Obesity & Metabolism

Marjolein Y A M Kroonen, Jasper Stevens, Dick de Zeeuw, Hiddo J L Heerspink
AIM: The PLANET trials showed that atorvastatin 80 mg but not rosuvastatin at either 10 or 40 mg reduced urinary protein to creatinine ratio (UPCR) at similar effects on LDL-cholesterol. However, individual changes in both UPCR and LDL-cholesterol during treatment with these statins varied widely between patients. This inter-individual variability could not be explained by patients' physical or biochemical characteristics. We assessed whether the plasma concentrations of both statins were associated with LDL-cholesterol and UPCR response...
August 15, 2019: Diabetes, Obesity & Metabolism
Robert J Chilton
Sodium-glucose cotransporter-2 inhibitors (SGLT-2is) have been shown to mitigate the risks of cardiovascular (CV) and renal complications in patients with type 2 diabetes (T2D) and CV risk factors or CV disease (CVD). In CV outcomes trials (CVOTs) of patients with T2D and established CVD or multiple CV risk factors, empagliflozin and canagliflozin were associated with significant reductions in the risks of major adverse CV events (MACE), hospitalization for heart failure (HF), and kidney disease progression...
August 13, 2019: Diabetes, Obesity & Metabolism
Claire C J Dekkers, C David Sjöström, Peter J Greasley, Valerie Cain, David W Boulton, Hiddo J L Heerspink
AIMS: Sodium glucose co-transporter 2 (SGLT2) inhibitors reduce the rate of hospitalization for heart failure in cardiovascular outcome trials likely as a result of natriuretic and osmotic diuresis leading to volume contraction. The aims of the present study were to compare the effects of the SGLT2 inhibitor dapagliflozin on estimated and measured plasma volume and to characterize the effects of dapagliflozin on estimated plasma volume in a broad population of patients with type 2 diabetes...
August 13, 2019: Diabetes, Obesity & Metabolism
Kohei Kaku, Eiichi Araki, Yukio Tanizawa, Bue Ross Agner, Tomoyuki Nishida, Mattis Ranthe, Nobuya Inagaki
AIMS: To investigate the efficacy and safety of insulin degludec/liraglutide (IDegLira) compared with its individual components in Japanese subjects with type 2 diabetes (T2D) uncontrolled on an oral antidiabetic drug (OAD). MATERIALS AND METHODS: This 52-week, open-label, multicentre, treat-to-target trial randomised subjects (n=819) 1:1:1 to IDegLira, liraglutide 1.8 mg or degludec, as add-on to pre-trial OAD. Maximum IDegLira dose was 50 dose steps (50 U degludec/1...
August 13, 2019: Diabetes, Obesity & Metabolism
Raffaella Gentilella, Giorgio Sesti, Luis Vazquez, Hélène Sapin, Victoria Reed, Irene Romera, Paolo Pozzilli
BACKGROUND AND AIMS: Dulaglutide, a once weekly GLP-1 receptor agonist, has been studied in the Phase 3 AWARD clinical trial programme in adult patients with type 2 diabetes. To assess the relationship between baseline BMI and glycaemic control in dulaglutide-treated patients, post-hoc analyses were conducted on HbA1c and baseline BMI data from eight AWARD studies, with a total of 5770 patients. MATERIALS AND METHODS: Change from baseline in HbA1c data from patients treated with 1...
August 7, 2019: Diabetes, Obesity & Metabolism
E Miller, A Doshi, R Grøn, E Jodar, P Őrsy, M F Ranthe, D Sugimoto, N Tentolouris, A Viljoen, L K Billings
AIMS: Basal-bolus therapy is associated with greater treatment burden and lower adherence compared with more simplified regimens. This post hoc analysis studied the difference between insulin degludec/liraglutide (IDegLira) and basal-bolus therapy on number of injections, dose adjustments and patient outcomes, in DUAL VII. MATERIALS AND METHODS: DUAL VII was a 26-week, open-label trial, where patients with uncontrolled type 2 diabetes on metformin and insulin glargine 100 units/mL (20-50U) were randomised 1:1 to IDegLira (N=252) or basal-bolus (insulin glargine U100 + insulin aspart ≤4 times/day; N=254)...
August 6, 2019: Diabetes, Obesity & Metabolism
Anna Norhammar, Johan Bodegard, Thomas Nyström, Marcus Thuresson, Klas Rikner, David Nathanson, Jan W Eriksson
AIMS: To investigate how cardiovascular (CV) risk benefits of dapagliflozin translate into healthcare costs compared with other non-sodium-glucose cotransporter-2 inhibitor glucose lowering drugs (oGLDs) in a real-world population with type 2 diabetes (T2D) that is similar to the population of the DECLARE-TIMI 58 trial. METHODS: Patients initiating dapagliflozin or oGLDs between 2013 and 2016 in Swedish nationwide healthcare registries were included if they fulfilled the inclusion and exclusion criteria of DECLARE-TIMI 58 (DECLARE-like population)...
August 5, 2019: Diabetes, Obesity & Metabolism
Soo Lim, Tae Jung Oh, Jesse Dawson, Naveed Sattar
People with diabetes mellitus are at higher risk of ischemic stroke and worse outcomes thereafter. However, whether it is better to prescribe intensive glucose-lowering treatment compared with conventional treatment in people with diabetes to prevent recurrent stroke is debated. It is also crucial to consider whether specific antidiabetic agents are more efficacious and safer than others for prevention of stroke. In this review, we provide an overview of the efficacy of intensive and conventional glucose-lowering treatment in the management after stroke...
August 5, 2019: Diabetes, Obesity & Metabolism
Dario Giugliano, Maria Ida Maiorino, Giuseppe Bellastella, Miriam Longo, Paolo Chiodini, Katherine Esposito
A meta-analysis is presented of cardiovascular outcome trials (CVOTs) comparing glucagon-like peptide-1 receptor agonists (GLP-1RA) versus placebo on cardiorenal outcomes in patients with type 2 diabetes (T2D). We did an electronic search without language restrictions up to June 15, 2019, for eligible trials. We did a meta-analysis of available trial data using a random-effects model to calculate overall hazard ratios (HRs) and 95% CI (confidence intervals). We included data from 7 CVOTs and 56 004 patients (68·9% with established cardiovascular disease)...
August 2, 2019: Diabetes, Obesity & Metabolism
Noppadol Kietsiriroje, Sam Pearson, Matthew Campbell, Robert A S Ariëns, Ramzi A Ajjan
The term double diabetes (DD) has been used to refer to individuals with type 1 diabetes who are overweight, have a family history of type 2 diabetes and/or clinical features of insulin resistance. Several pieces of evidence indicate that individuals who display features of DD are at higher risk of developing future diabetes complications, independent of average glucose control, measured as glycated haemoglobin (HbA1c). Given the increased prevalence of individuals with features of DD, pragmatic criteria are urgently required to identify and stratify this group, which will help with subsequent implementation of more effective personalised interventions...
August 2, 2019: Diabetes, Obesity & Metabolism
Jea Young Min, Amber J Hackstadt, Marie R Griffin, Robert A Greevy, Jonathan Chipman, Carlos G Grijalva, Adriana M Hung, Christianne L Roumie
AIMS: To evaluate whether weight change or hypoglycemia mediated the association between insulin use and death. MATERIALS AND METHODS: In a retrospective cohort of Veterans who filled a new prescription for metformin and added insulin or sulfonylurea (2001-2012), we assessed change in body mass index (BMI) and hypoglycemia during the first 12 months of treatment intensification. Cox proportional hazards models compared the risk of death between treatment groups...
August 2, 2019: Diabetes, Obesity & Metabolism
Ilaria Dicembrini, Edoardo Mannucci, Matteo Monami, Laura Pala
AIMS: Aim of the present meta-analysis is to assess the effect of CSII, CGM, and the combination of the two, on glycemic control in type 2 diabetes. MATERIALS AND METHODS: The present analysis includes randomized clinical trials comparing CSII with traditional injections in type 2 diabetes, as well as those comparing CGM or FGM with self-monitoring of blood glucose (SMBG), with a duration of at least 12 weeks, identified in Medline or The principal endpoint was HbA1c at the end of the trial...
August 1, 2019: Diabetes, Obesity & Metabolism
Yi Huan, Xuan Pan, Jun Peng, Chunming Jia, Sujuan Sun, Guoliang Bai, Xing Wang, Tian Zhou, Rongcui Li, Shuainan Liu, Caina Li, Quan Liu, Zhanzhu Liu, Zhufang Shen
AIMS: Peroxisome proliferator-activated receptor γ (PPARγ) plays a key role in the regulation of glucose and lipids homeostasis. Here we report a novel tetrahydroisoquinoline derivative YR4-42 as a selective PPARγ modulator (SPPARM) and have explored its anti-diabetic effects in vitro and in vivo. MATERIALS AND METHODS: Using two classical full PPARγ agonists rosiglitazone and pioglitazone as controls, the PPARγ binding affinity and transactivation action of YR4-42 were evaluated by biochemical and cell-based reporter gene assays, as well as the capacity of YR4-42 to recruit co-activators of PPARγ...
July 31, 2019: Diabetes, Obesity & Metabolism
Clifford J Bailey, Stefano Del Prato, Cheryl Wei, Daniel Reyner, Gabriela Saraiva
Dapagliflozin is associated with greater reductions in HbA1c and weight than saxagliptin in type 2 diabetes (T2DM) management. The present post-hoc analyses compared the durability of these effects over short- and long-term follow-up in patients with T2DM inadequately controlled by metformin (≥1,500-mg/day) and receiving either dapagliflozin (10-mg/day) or saxagliptin (5-mg/day). Failure of glycemic-control was assessed using the slope of the ΔHbA1c -over-time regression line (coefficient of failure [CoF])...
July 31, 2019: Diabetes, Obesity & Metabolism
Emma G Wilmot, Pratik Choudhary, Lalantha Leelarathna, Mike Baxter
Type 1 diabetes mellitus (T1DM) remains one of the most challenging long-term conditions to manage. Despite robust evidence to demonstrate that near normoglycaemia minimizes (but does not completely eliminate) the risk of complications, its achievement has proved almost impossible to attain in a real-world setting. HbA1c to date has been used as the gold standard marker of glucose control and has been shown to reflect directly the risk of diabetes complications. However, it has been recognized that HbA1c is a crude marker of glucose control...
July 31, 2019: Diabetes, Obesity & Metabolism
Francesco Giorgino, Maria Yu, Axel Haupt, Zvonko Milicevic, Luis-Emilio García-Pérez
The long-acting glucagon-like peptide-1 receptor agonist dulaglutide acts by stimulating insulin secretion and reducing glucagon levels in a glucose-dependent manner both in the fasting and postprandial states, resulting in reductions of both fasting glucose (FG) and postprandial glucose (PPG). In contrast, the main mechanism of action of basal insulin is to reduce elevated FG by inhibiting hepatic glucose production. The aim of this post-hoc analysis of the phase 3 AWARD-2 trial was to investigate whether specific baseline glycaemic patterns respond differentially to dulaglutide compared to insulin glargine (glargine)...
July 31, 2019: Diabetes, Obesity & Metabolism
Mario Luca Morieri, Mauro Rigato, Vera Frison, Natalino Simioni, Michele D'Ambrosio, Federica Tadiotto, Agostino Paccagnella, Annunziata Lapolla, Angelo Avogaro, Gian Paolo Fadini
BACKGROUND AND AIMS: The combination of basal insulin (BI) and GLP-1 receptor agonists (GLP-1RAs) is a rational and effective therapy for patients with uncontrolled type 2 diabetes (T2D). We compared the effectiveness of fixed and flexible BI/GLP-1RA combinations using routinely accumulated clinical data. METHODS: This was a retrospective, multicentre, real-world study concerning T2D patients initiating a fixed or flexible BI/GLP-1RA combination (NCT03959865). The primary endpoint was change in HbA1c...
July 31, 2019: Diabetes, Obesity & Metabolism
Changting Xiao, Priska Stahel, Cecilia Morgantini, Avital Nahmias, Satya Dash, Gary F Lewis
AIMS: Triglycerides (TG) are retained in the small intestine following ingestion of a fat-rich meal for later release as chylomicrons in response to certain stimuli including the gut hormone glucagon-like peptide-2 (GLP-2). GLP-2 is known to increase mesenteric blood flow by a nitric oxide (NO)-dependent mechanism and administration of a NO synthase inhibitor in animals attenuated GLP-2-stimulated chylomicron secretion. The present study tests the hypothesis that GLP-2 mobilizes intestinal TG stores and stimulates chylomicron secretion by a NO-dependent mechanism in humans...
July 31, 2019: Diabetes, Obesity & Metabolism
José M Santos-Lozano, Mirela Rada, José Lapetra, Ángeles Guinda, María C Jiménez-Rodríguez, José A Cayuela, Antonio Ángel-Lugo, Ángel Vilches-Arenas, Ana M Gómez-Martín, Manuel Ortega-Calvo, José M Castellano
AIMS/HYPOTHESIS: Oleanolic acid (OA), a natural component of olive (Olea europaea L.), has demonstrated antidiabetic action in vitro and in experimental animals. However, a similar action has not been proved in humans. The PREDIABOLE (PREvention of DIABetes with OLEanolic acid) Study is a randomised and controlled trial, performed in primary care, designed to assess whether the regular intake of an OA-enriched olive oil is effective in the prevention of diabetes. METHODS: Prediabetic individuals (IFG + IGT) of both sex (176 patients, 30-80 years old) were randomised to receive 55 mL/day of OA-enriched olive oil (equivalent-dose 30 mg OA/day) (intervention group; IG) or the same oil not enriched (control group; CG)...
July 31, 2019: Diabetes, Obesity & Metabolism
Jessica Turton, Grant D Brinkworth, Rowena Field, Helen Parker, Kieron Rooney
AIM: To identify core diet and delivery components of low-carbohydrate (LC) diets that have demonstrated efficacy for type 2 diabetes (T2D) management. MATERIALS AND METHODS: MEDLINE, Pre-MEDLINE, EMBASE, CINAHL, and the Cochrane Library of Controlled Trials databases were systematically searched from inception until 18 August 2018. Primary intervention studies of LC diets (≤130 g/day or 26% total energy intake (TEI)) were included. Content analysis was performed on the LC diet protocols classified as safe and effective for T2D management...
July 26, 2019: Diabetes, Obesity & Metabolism
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