Antidiabetic Treatment Research Articles

Diabetic Cardiomyopathy-From Basics through Diagnosis to Treatment.

Diabetic cardiomyopathy (DCM) is the development of myocardial dysfunction in patients with diabetes despite the absence of comorbidities such as hypertension, atherosclerosis or valvular defect. The cardiovascular complications of poorly controlled diabetes are very well illustrated by the U.K. Prospective Diabetes Study (UKPDS), which showed a clear association between increasing levels of glycated hemoglobin and the development of heart failure (HF). The incidence of HF in patients with diabetes is projected to increase significantly, which is why its proper diagnosis and treatment is so important. Providing appropriate therapy focusing on antidiabetic and hypolipemic treatment with the consideration of pharmacotherapy for heart failure reduces the risk of CMD and reduces the incidence of cardiovascular complications. Health-promoting changes made by patients such as a low-carbohydrate diet, regular exercise and weight reduction also appear to be important in achieving appropriate outcomes. New hope for the development of therapies for DCM is offered by novel methods using stem cells and miRNA, which, however, require more thorough research to confirm their efficacy.

Review on the Therapeutic Role of Asclepias tuberosa Seeds in Diabetes Management

Diabetes mellitus (DM) presents a significant global health challenge characterized by elevated blood glucose levels, leading to debilitating complications. Despite various therapeutic approaches, effective glucose regulation remains elusive, often accompanied by adverse effects from current medications. Medicinal plants, including Asclepias tuberosa, have shown promise in managing blood glucose levels with fewer side effects. This review highlights the potential of Asclepias tuberosa as herbal antidiabetic agents based on recent literature, suggesting avenues for further research and therapeutic development in DM management. Considering the urgent need for safer and more effective antidiabetic treatments, exploring the therapeutic potential of Asclepias tuberosa presents a promising avenue for addressing this growing public health concern. Future studies should focus on elucidating the mechanisms of action, conducting clinical trials to validate the efficacy and safety of Centaurea-based interventions in DM management, and exploring synergistic effects with existing therapies.
 Furthermore, within the context of utilizing plant materials for the treatment of Diabetes mellitus, particular attention is directed towards the utilization of Asclepias tuberosa seeds. Asclepias tuberosa, commonly known as butterfly weed or pleurisy root, is a medicinal plant native to North America. Traditionally, various parts of this plant, including the roots, leaves, and seeds, have been used in folk medicine for their purported therapeutic effects
 Keywords: Diabetes mellitus, Asclepias tuberosa, antidiabetic agents, herbal remedies, blood glucose regulation.

Immediate Impact of Switching from Dipeptidyl Peptidase4 (DPP4) Inhibitors to Low-Dose (0.3mg) Liraglutide on Glucose Profiles: A Retrospective Observational Study.

As treatment agents for diabetes, liraglutide is a long-acting glucagon-like peptide1 receptor agonist, and dipeptidyl peptidase4 (DPP4) inhibitors are widely used because of their safety and tolerability. Regular treatment with liraglutide has been reported to significantly reduce blood glucose levels, but the impact of low-dose (0.3mg) liraglutide on blood glucose levels immediately after treatment switching from a DPP4 inhibitor remains unknown. We conducted a single-arm, retrospective, observational study in 55 inpatients with type2 diabetes (T2D) to investigate the changes (Δ) in their blood glucose levels at six time points (6-point) from the day before (day-1) to the day after (day1) by switching the antidiabetic treatment from a DPP4 inhibitor to liraglutide 0.3mg (low-dose liraglutide) once daily. We also attempted to identify factors associated with the blood glucose-lowering effects of liraglutide. The median values of the changes in fasting, preprandial, and postprandial blood glucose levels and the fluctuations in the blood glucose levels expressed as the standard deviation of the 6-point blood glucose levels were significantly lower on day1 than on day-1 (P < 0.05, P < 0.0001, P < 0.0001, P < 0.01, respectively); there were no cases of severe hypoglycemia. The Δblood glucose levels were not associated with the baseline serum hemoglobin A1c values or with any markers of the insulin secreting capacity. There were no associations between the previously used blood glucose-lowering drug and the Δblood glucose levels. Switching from a DPP4 inhibitor to low-dose (0.3mg) liraglutide once daily significantly reduced the blood glucose levels and excursions of the blood glucose levels even from the very day after the treatment switch, with no serious adverse events.

α-Glucosidase Inhibitory Activity of Tea and Kombucha from Rhizophora mucronata Leaves

A decoction of Rhizophora mucronata Lam. mangrove bark is used as an antidiabetic treatment in Asia. Kombucha tea is a fermented beverage, which is also claimed to be antidiabetic. In this work, the potency of R. mucronata leaves as α-glucosidase inhibitor was studied to assess whether it could be a suitable alternative to the use of R. mucronata bark. α-glucosidase inhibitory activities were determined for three extracts prepared from R. mucronata leaves, being the unfermented tea of R. mucronata leaves, the fermented kombucha tea and an 80% methanolic extract of the residual R. mucronata leaves. Flavonoid glycosides were identified in tea powder, kombucha tea and in the crude methanolic extract. Both the unfermented tea and the kombucha tea after 7 days of fermentation inhibited α-glucosidase with IC50 values of 0.12 ± 0.02 mg/mL and 0.09 ± 0.04 mg/mL, respectively. The methanolic extract showed a stronger α-glucosidase inhibitory activity compared to the kombucha tea and tea powder with an IC50 value of 0.0435 ± 0.0007 mg/mL. Acarbose, used as a positive control, inhibited α-glucosidase with an IC50 value of 2.4 ± 0.2 mg/mL. It was found that the three types of preparations of R. mucronata all were potent α-glucosidase inhibitors.

Exploring the therapeutic mechanism of potential phytocompounds from Kalanchoe pinnata in the treatment of diabetes mellitus by integrating network pharmacology, molecular docking and simulation approach

Since ancient times, bioactive phytocompounds from different parts of medicinal plants have been used to heal various disease ailments and they are now regarded as a valuable source of disease prevention globally.Kalanchoe pinnatais a member of the Crassulaceae family; it has a long history of usage in traditional ayurvedic treatment. Analysis of bioactive compounds for their potential anti-type-2 diabetes mellitus (T2DM) mechanism along within-vitroandin-silicoapproaches was studied in the present research. The alpha-amylase and alpha-glucosidase inhibitory activity of methanolic extract of Kalanchoe pinnata (α-amylase: IC50 29.50 ± 0.04 μg/ml; α-glucosidase IC50 32.04 ± 0.35 μg/ml) exhibit a high degree of similarity to the standard drug acarbose (IC50 35.82 ± 0.14 μg/ml). Different biological databases were used to list phytocompounds from the plant, and ADME analysis using swissADME was carried out to screen compounds that obeyed the Lipinski rule of 5 and were employed further. STRING and KEGG pathway analysis was performed for gene enrichment analysis followed by network pharmacology to identify key target proteins involved in DM. AMY2A, NOX4, RPS6KA3, ADRA2A, CHRM5, and IL2 were identified as core targets for luteolin, kaempferol, alpha amyrin, stigmasterol compounds by modulating neuroactive ligand interaction, P13-AKT, MAPK, and PPAR signaling pathways. Molecular docking was performed to study the binding affinity among bioactive compounds ofK. pinnataagainst aldose reductase, alpha-amylase, alpha-glucosidase, and dipeptidyl peptidase IV. Alpha-amylase-friedelin [FRI] and alpha-amylase-acarbose [STD] complexes were subjected to molecular simulation for a 200 ns duration that depicted the stability of the compounds and proteins. In the current study, employing dual approach in-silico and in-vitroenzyme assays has yielded a comprehensive and strong understanding of its potential therapeutic properties, making a significant step towards the development of novel anti-diabetic treatment.

Role of β-cell autophagy in β-cell physiology and the development of diabetes.

Elucidating the molecular mechanism of autophagy was a landmark in understanding not only the physiology of cells and tissues, but also the pathogenesis of diverse diseases, including diabetes and metabolic disorders. Autophagy of pancreatic β-cells plays a pivotal role in the maintenance of the mass, structure and function of β-cells, whose dysregulation can lead to abnormal metabolic profiles or diabetes. Modulators of autophagy are being developed to improve metabolic profile and β-cell function through the removal of harmful materials and rejuvenation of organelles, such as mitochondria and endoplasmic reticulum. Among the known antidiabetic drugs, glucagon-like peptide-1 receptor agonists enhance the autophagic activity of β-cells, which might contribute to the profound effects of glucagon-like peptide-1 receptor agonists on systemic metabolism. In this review, the results from studies on the role of autophagy in β-cells and their implication in the development of diabetes are discussed. In addition to non-selective (macro)autophagy, the role and mechanisms of selective autophagy and other minor forms of autophagy that might occur in β-cells are discussed. As β-cell failure is the ultimate cause of diabetes and unresponsiveness to conventional therapy, modulation of β-cell autophagy might represent a future antidiabetic treatment approach, particularly in patients who are not well managed with current antidiabetic therapy.

Exposure of Pregnancy to Pregestational Diabetes, Gestational Diabetes, and Antidiabetic Medications With Especial Focus on Major Congenital and Cardiac Malformations in Offspring.

The global prevalence of type 2 diabetes mellitus (T2DM) is increasing. T2DM is more common in patients with psychiatric disorders and those who take certain psychotropic drugs. T2DM occurs in 2%-7% of women of reproductive age. The prevalence of pregestational diabetes is 0.5%-2.4%, and that of gestational diabetes is 7%-28%, depending on geographical region. About 20%-50% of pregnancies, across the world, are unplanned; this figure is higher, at about 65%, in women with psychiatric disorders. As a result, many women of reproductive age who have diabetes, including women who do not know that they have diabetes, may unintentionally become pregnant, thus unknowingly exposing their pregnancy to diabetes and its treatment. Exposure of pregnancy to pregestational and gestational diabetes is associated with risks to the mother as well as risks to the child. Risks to the mother include obesity, hypertension, and preeclampsia. Risks to the child include spontaneous abortion, fetal death, macrosomia, major congenital malformations (MCMs), preterm delivery, neonatal hypoglycemia, neonatal hyperbilirubinemia, and neonatal respiratory distress syndrome. A recent large retrospective cohort study with data from 6 countries in Europe, Asia, and North America found that, in about 51,000 women with pregestational T2DM, neither MCMs nor cardiac malformations were more prevalent in offspring of children periconceptionally exposed to second-line antidiabetic treatments relative to exposure to insulin. These findings are reassuring but have limitations that are discussed. A reasonable conclusion from a reading of the reviewed literature is that pregestational and gestational diabetes are best treated during pregnancy, that insulin is a first-line treatment, that metformin is an increasingly accepted alternative, and that safety data on second-line antidiabetic treatments are, so far, reassuring.

Anti-diabetic and anti-inflammatory bioactive hits from Coriaria intermedia Matsum. stem and Dracontomelon dao (Blanco) Merr. & Rolfe bark through bioassay-guided fractionation and liquid chromatography-tandem mass spectrometry.

Women have been found to be at a higher risk of morbidity and mortality from type 2 diabetes mellitus (T2DM) and asthma. α-Glucosidase inhibitors have been used to treat T2DM, and arachidonic acid 15-lipoxygenase (ALOX15) inhibitors have been suggested to be used as treatments for asthma and T2DM. Compounds that inhibit both enzymes may be studied as potential treatments for people with both T2DM and asthma. This study aimed to determine potential anti-diabetic and anti-inflammatory bioactive hits from Coriaria intermedia Matsum. stem and Dracontomelon dao (Blanco) Merr. & Rolfe bark. A bioassay-guided fractionation framework was used to generate bioactive fractions from C. intermedia stem and D. dao bark. Subsequently, dereplication through ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) and database searching was performed to putatively identify the components of one bioactive fraction from each plant. Seven compounds were putatively identified from the C. intermedia stem active fraction, and six of these compounds were putatively identified from this plant for the first time. Nine compounds were putatively identified from the D. dao bark active fraction, and seven of these compounds were putatively identified from this plant for the first time. One putative compound from the C. intermedia stem active fraction (corilagin) has been previously reported to have inhibitory activity against both α-glucosidase and 15-lipoxygenase-1. It is suggested that further studies on the potential of corilagin as an anti-diabetic and anti-inflammatory treatment should be pursued based on its several beneficial pharmacological activities and its low reported toxicity.

Willingness to Pay (WTP) for Newer Treatment Options for Diabetes: A Study Among Patients at a Tertiary Care Centre.

Introduction Type 2 diabetes mellitus (T2DM) poses a substantial burden globally and particularly in India, affecting health, finances, and overall quality of life. The management of this condition relies on lifestyle modifications and advanced pharmacological interventions, with emerging drugs showing promise in areas such as administration, side effects, efficacy, and cardiovascular benefits. However, their market penetration is hindered by high costs. Understanding the target population's expectations and willingness to pay (WTP) for these drugs is crucial. WTP, a key concept in behavioral science, reflects the maximum price consumers are willing to pay for a product, aiding in healthcare cost-effectiveness evaluations. Despite its relevance, only one WTP study has been conducted in the Indian context for diabetes. This study explores WTP for two novel drugs: oral semaglutide and icodec (weekly insulin). Material and methods This observational study, conducted in a diabetes specialty clinic and telemedicine facility in All India Institute of Medical Sciences, Bhopal, India, involved adults (18-80 years) diagnosed with T2DM. Data collection adhered to ethical guidelines, and participants provided written informed consent. Face-to-face interviews were employed to gather socio-economic, demographic, and medical details. Participants estimated their WTP for oral semaglutide and weekly insulin, considering reference ranges for existing antidiabetic treatments. Statistical analyses, including t-tests and analysis of variance, explored sociodemographic and clinical factors influencing WTP. Results Of 105 approached patients, 87 (74.3%) participated. The majority were males (55.2%) with an average age of 57.2 years. The average WTP for oral semaglutide was INR 9.35±5.66 per pill, significantly lower than its market price (INR 315). For weekly insulin (icodec), the WTP was INR 157.25±112.60 per dose. Subgroup analyses revealed no significant correlations based on sociodemographic or clinical parameters. Conclusion This study demonstrated the feasibility of WTP assessments in an Indian outpatient setting, revealing a substantial cost disparity between patients' WTP for oral semaglutide and its market price. The findings underscore the importance of considering WTP in introducing new diabetes medications in India, offering valuable insights for healthcare decision-makers and developers.

Prevalence of potentially inappropriate medications among newly treated patients with type 2 diabetes in UK primary care.

The aim of this study was to estimate the prevalence of potentially inappropriate prescriptions (PIPs) in patients starting their first noninsulin antidiabetic treatment (NIAD) using two explicit process measures of the appropriateness of prescribing in UK primary care, stratified by age and polypharmacy status. A descriptive cohort study between 2016 and 2019 was conducted to assess PIPs in patients aged ≥45 years at the start of their first NIAD, stratified by age and polypharmacy status. The American Geriatrics Society Beers criteria 2015 was used for older (≥65 years) patients and the Prescribing Optimally in Middle-age People's Treatments criteria was used for middle-aged (45-64 years) patients. Prevalence of overall PIPs and individual PIPs criteria was reported using the IQVIA Medical Research Data incorporating THIN, a Cegedim Database of anonymized electronic health records in the UK. Among 28 604 patients initiating NIADs, 18 494 (64.7%) received polypharmacy. In older and middle-aged patients with polypharmacy, 39.6% and 22.7%, respectively, received ≥1 PIP. At the individual PIP level, long-term proton pump inhibitors (PPI) use was the most frequent PIP among older adults, and strong opioid without laxatives was the most frequent PIP in middle-aged patients with polypharmacy (11.1% and 4.1%, respectively). This study revealed that patients starting NIAD treatment receiving polypharmacy have the potential for pharmacotherapy optimization.

Potential Antidiabetic Properties of Syzygium Cumini (L.) Skeels Leaf Extract-Mediated Silver Nanoparticles

This study explores the use of Syzygium cumini (L.) Skeels plant aqueous leaf extract as a reducing agent, which enables the green synthesis and comprehensive characterization of silver nanoparticles (AgNPs). The results indicated that the synthesized AgNPs were spherical in shape with an average size of 27.5 nm and a silver content of approximately 43.18%. The AgNPs exhibited promising antidiabetic and wound-healing properties. The antidiabetic activity, measured through glucose uptake and α-amylase inhibition assays, showed values of 80.08% and 83.91%, respectively. Additionally, the cytotoxicity assessment revealed that the AgNPs exhibited good biocompatibility even at higher doses, indicating their lower toxicity profile. Furthermore, the AgNPs demonstrated wound-closure percentages of 27.59% and 92.48% at 12 h and 24 h respectively, post-treatment, indicating that they were as effective as that of the standard ascorbic acid. These findings suggest that Syzygium cumini-mediated AgNPs have significant potential for applications in antidiabetic and wound-healing treatments.

Metformin use is associated with reduced mortality risk in diabetic patients with Parkinson's disease

IntroductionParkinson’s disease (PD) and type-2 diabetes (T2D) arguably share pathophysiologic mechanisms, resulting in a more severe phenotype and progression and diabetes is currently considered a risk factor of PD. Besides, research suggests antidiabetic therapies as potential disease-modifying strategies. The main aim was to assess the impact of a metformin-inclusive antidiabetic treatment on patient all-cause mortality. MethodsA nested case-control prospective study including newly diagnosed PD patients reporting the onset of T2D within ±2 years from the onset of PD (n=159) and matched (1:5; gender, year of PD onset and age at PD onset) non-diabetic cases (n=795) followed until death or censoring. Patients on a metformin-inclusive treatment regimen were compared to those receiving other oral anti-diabetics (OADs). ResultsAmong patients with T2D, 123 were treated with a drug regimen containing metformin (alone [65.0%] or in combination with other drugs [35.0%]) and 36 were prescribed other OADs. During a median PD duration of 96 months [IQR, 60-144], 171 patients died. Diabetes was not associated with reduced survival: fully-adjusted HR=1.19 [95%CI, 0.81-1.76] (P=0.37). After stratifying for T2D treatment, a metformin-inclusive regimen was not associated with increased risk of death (HR=1.06 [95%CI, 0.61-1.84]; P=0.83), while patients receiving other OADs had reduced survival (HR=1.83 [95%CI, 1.01-3.32]; P=0.034). ConclusionsMetformin use was not associated with increased risk of death in diabetic patients with PD reporting concomitant onset of the two diseases. Metformin appears to be a promising disease-modifying therapy given also the preclinical background, low cost and satisfactory safety and tolerability. Further studies are warranted to investigate its impact on disease progression.

Cosmetopoeia of African Plants in Hair Treatment and Care: Topical Nutrition and the Antidiabetic Connection?

To make the distinction against pharmaceuticals, natural product medicines are more accurately denoted as nutritional therapies. In the context of topical therapies targeting dermatological conditions, nutritional therapy may explain the mechanism of ethnocosmetic plants used in hair treatment and care. Inspired by emerging theories of a connection between dysregulated glucose metabolism and hair loss, the current review of the literature focused on African plants used to target hair conditions in general, such as alopecia or scalp dermis infections, with a cross-examination of the potential of the species to alleviate issues with glucose metabolism. We distinguish between topical nutrition and sterilization (i.e., dandruff and lice). Sixty-eight plants were identified as an African treatment for alopecia, dandruff, lice, and tinea. Fifty-eight of the species have potential as antidiabetic treatments when taken orally. The family Lamiaceae was the most represented (six spp.), followed by Fabaceae and Asteraceae (five spp. each). Most species are herbs, and the most used plant part is the leaf. Thirty of the sixty species have research associated with hair growth and general hair care, with studies focused on 5α-reductase inhibition, biomarkers such as vascular endothelial growth factor, and the rate of telogen to anagen phase transition. While studies tend to conceptualize the mechanisms of these medicinal species similarly to pharmaceuticals, the current review argues that a nutritional interpretation is more appropriate, where a general improvement to local glucose metabolism may play a role.

Sodium-glucose linked transporter 2 inhibitors in liver cirrhosis: Beyond their antidiabetic use.

Type 2 diabetes mellitus (T2DM) and liver cirrhosis are clinical entities that frequently coexist, but glucose-lowering medication options are limited in cirrhotic patients. Sodium-glucose linked transporter 2 (SGLT2) inhibitors are a class of glucose-lowering medication that act independently of insulin, by causing glycosuria in the proximal convoluted tubule. In this review, we aimed to briefly present the main data and to provide insight into the pathophysiology and potential usefulness of SGLT2 inhibitors in cirrhotic patients with or without T2DM. SGLT2 inhibitors have been proven useful as antidiabetic treatment in patients with metabolic liver disease, with most robust data from patients with metabolic dysfunction-associated steatotic liver disease (MASLD), where they also showed improvement in liver function parameters. Moreover, it has been suggested that SGLT2 inhibitors may have effects beyond their antidiabetic action. Accordingly, they have exhibited cardioprotective effects, expanding their indication in patients with heart failure without T2DM. Since decompensated liver cirrhosis and congestive heart failure share common pathophysiological features, namely renin-angiotensin-aldosterone axis and sympathetic nervous system activation as well as vasopressin secretion, SGLT2 inhibitors could also be beneficial in patients with decompensated cirrhosis, even in the absence of T2DM.

Prediabetes remission after bariatric surgery: a 4-years follow-up study

BackgroundBariatric surgery leads to weight loss and to cardiometabolic risk improvement. Although prediabetes remission after bariatric surgery is biologically plausible, data on this topic is scarce. We aimed to assess prediabetes remission rate and clinical predictors of remission in a 4 year follow up period.MethodsObservational longitudinal study including patients with obesity and prediabetes who had undergone bariatric surgery in our centre. Prediabetes was defined as having a baseline glycated haemoglobin (A1c) between 5.7% and 6.4% and absence of anti-diabetic drug treatment. We used logistic regression models to evaluate the association between the predictors and prediabetes remission rate.ResultsA total of 669 patients were included, 84% being female. The population had a mean age of 45.4 ± 10.1 years-old, body mass index of 43.8 ± 5.7 kg/m2, and median A1c of 5.9 [5.8, 6.1]%. After bariatric surgery, prediabetes remission rate was 82%, 73%, 66%, and 58%, respectively in the 1st, 2nd, 3rd, and 4th years of follow-up. Gastric sleeve (GS) surgery was associated with higher prediabetes remission rate than Roux-en-Y gastric bypass surgery in the 3rd year of follow-up. Men had a higher remission rate than women, in the 1st and 3nd years of follow-up in the unadjusted analysis. Younger patients presented a higher remission rate comparing to older patients in the 3rd year of follow-up.ConclusionWe showed a high prediabetes remission rate after bariatric surgery. The remission rate decreases over the follow-up period, although most of the patients maintain the normoglycemia. Prediabetes remission seems to be more significant in patients who had undergone GS, in male and in younger patients.

Theory of the Leaky Intestine: Gender Differences in Intestinal Parasitic Infections, Cytoskeletal Wall Dysfunctions, and Hypertension

BACKGROUND: Intestinal parasitic infections (IPIs) impact approximately 3.5 billion individuals globally. Protozoan IPIs may influence the intestinal microbiome. This research investigates IPI effects on intestinal wall thickness and their potential links to gender-specific hypertension. It also explores the impact of alterations in intestinal wall permeability on sodium and blood glucose levels. METHODS: The study enrolled 108 subjects, including 83 consecutive patients with confirmed symptomatic IPIs (48 males, 35 females) and 25 healthy controls (9 males, 16 females). B-mode ultrasound grayscale images of the duodenum and colon were taken with and without water contrast. RESULTS: Patients with parasites exhibited a higher BMI (mean = 28.98 ± 7.43) compared to controls (mean = 24.68 ± 7.2), F (1, 96) = 5.78, _p _&lt; 0.05. IPI patients showed a tendency towards increased duodenal wall thickness (DUOTHICK = 0.88 ± 0.73 cm) versus controls (0.6 ± 0.1 cm), _p = _0.056. Additionally, IPI patients had significantly greater thickness in the ascending colon (ASCTHICK = 1.1 ± 0.3 cm) and descending colon (DSCTHICK = 1.2 ± 0.4 cm) compared to controls (ASCTHICK = 0.6 ± 0.2 cm, DSCTHICK = 0.6 ± 0.1 cm), _p _&lt; 0.05. Men over 50 years exhibited greater DSCTHICK (1.25 ± 0.434 cm) than postmenopausal women (0.986 ± 0.389 cm), _p _&lt; 0.05. DSCTHICK significantly predicted diastolic blood pressure (β = −0.295, _p _&lt; 0.05) and blood sodium level (β = −0.300, _p _&lt; 0.05). DUOTHICK in diabetic IPI patients exceeded that in nondiabetic patients. Effective antiparasitic and antidiabetic treatments induced changes in the echoanatomy of the intestinal wall, suggesting the sealing of ‘the leak’. CONCLUSIONS: IPIs disrupted the intestinal cytoskeleton, leading to “leaky gut syndrome” development.

Effectiveness and Safety of Initiation and Titration of Insulin Glargine 300 U/mL in Insulin-Naive Patients with Type 2 Diabetes Mellitus Uncontrolled on Oral Antidiabetic Drug Treatment in Turkey: The EASE Study

Effectiveness and Safety of Initiation and Titration of Insulin Glargine 300 U/mL in Insulin-Naive Patients with Type 2 Diabetes Mellitus Uncontrolled on Oral Antidiabetic Drug Treatment in Turkey: The EASE Study

The nonadherence to prescriptions among type 2 diabetes patients, and its determining factors

&lt;b&gt;Aim&lt;/b&gt;: The aim is to clarify the prevalence of nonadherence to antidiabetic therapies among type 2 diabetes mellitus (T2DM) patients and identify its causes.&lt;br /&gt; &lt;b&gt;Methods&lt;/b&gt;: A three-part questionnaire (general background, Knowledge-Attitude-Practice section, and non-adherence reasons) was developed. In total 324 diabetic patients were surveyed via telephone. The evaluation of patient adherence included both direct questions on adherence and a summary of patient responses to non-adherence comments. The analysis was performed on StataCorp Stata 14.2, and included descriptive analysis, simple and multivariate logistic regression.&lt;br /&gt; &lt;b&gt;Findings:&lt;/b&gt; Among the sociodemographic variables, age group, work level, and alcohol consumption may influence medication adherence. The comorbidity status of patients was also of relevance. Both variables had stronger relationships with adherence to anti-diabetic treatments compared to those with no comorbidities or no additional medicines. A strength of the study is that it addresses various medical diseases and attitudes about them, as well as a wide range of causes for non-adherence to non-diabetic medications.

Diabetes and chronic kidney disease in Chinese adults: a population-based cohort study

IntroductionCohort evidence of the association of diabetes mellitus (DM) with chronic kidney disease (CKD) is limited. Previous studies often describe patients with kidney disease and diabetes as diabetic kidney disease...

Development of explicit definitions of potentially inappropriate prescriptions for antidiabetic drugs in patients with type 2 diabetes: A multidisciplinary qualitative study.

The management of type 2 diabetes mellitus patients has changed over the past decade, and a large number of antidiabetic drug treatment options are now available. This complexity poses challenges for healthcare professionals and may result in potentially inappropriate prescriptions of antidiabetic drugs in patients with type 2 diabetes mellitus which can be limited using screening tools. The effectiveness of explicit tools such as lists of potentially inappropriate prescriptions has been widely demonstrated. The aim was to set up nominal groups of healthcare professionals from several disciplines and develop a list of explicit definition of potentially inappropriate prescriptions of antidiabetic drugs. In a qualitative, nominal-groups approach, 30 diabetologists, general practitioners, and pharmacists in France developed explicit definitions of potentially inappropriate prescriptions of antidiabetic drugs in patients with type 2 diabetes mellitus. A nominal group technique is a structured method that encourages all the participants to contribute and makes it easier to reach an agreement quickly. Each meeting lasted for two hours. The three nominal groups comprised 14 pharmacists, 10 diabetologists, and 6 general practitioners and generated 89 explicit definitions. These definitions were subsequently merged and validated by the steering committee and nominal group participants, resulting in 38 validated explicit definitions of potentially inappropriate prescriptions of antidiabetic drugs. The definitions encompassed four contexts: (i) the temporary discontinuation of a medication during acute illness (n = 9; 24%), (ii) dose level adjustments (n = 23; 60%), (iii) inappropriate treatment initiation (n = 3; 8%), and (iv) the need for further monitoring in the management of type 2 diabetes mellitus (n = 3; 8%). The results of our qualitative study show that it is possible to develop a specific list of explicit definitions of potentially inappropriate prescriptions of antidiabetic drugs in patients with type 2 diabetes mellitus by gathering the opinions of healthcare professionals caring for these patients. This list of 38 explicit definitions necessitates additional confirmation by expert consensus before use in clinical practice.