Effects Of Oral Antidiabetic Drugs Research Articles

The Analysis Study of Effects of Oral Antidiabetic Drugs on Tuberculosis Risk and Treatment Outcomes : A Comprehensive Systematic Review

Background: Diabetes mellitus triples the risk of infection, leading to poor clinical outcomes. Hyperglycemia suppresses immune responses, affecting TB and diabetes patients. Modulation of host cell responses and targeting pathogens could improve treatment outcomes and reduce drug resistance. Methods: Following PRISMA 2020 guidelines, this systematic review focused exclusively on full-text articles published in English between 2014 and 2024. Result: The study conducted a comprehensive review of over 600 publications sourced from reputable databases, including ScienceDirect, SagePub, and PubMed. Following an initial screening, eight publications were identified as warranting more in-depth analysis. Consequently, a thorough review of these selected studies was performed to ensure a detailed and rigorous evaluation. Conclusion: Metformin, an oral antidiabetic (OAD) agent, is associated with reduced incidence and mortality from active tuberculosis in patients with diabetes. In contrast, saxagliptin, another oral antidiabetic drug, is linked to an increased risk of active tuberculosis. The continuing examination of the association between metformin and tuberculosis risk highlights the need for further research to better elucidate and validate these associations.

Adherence to antidiabetic drug therapy and reduction of fatal events in elderly frail patients

BackgroundTo evaluate the protective effect of oral antidiabetic drugs in a large cohort of elderly patients with type 2 diabetes differing for age, clinical status, and life expectancy, including patients with multiple comorbidities and short survival.MethodsA nested case–control study was carried out by including the cohort of 188,983 patients from Lombardy (Italy), aged ≥ 65 years, who received ≥ 3 consecutive prescriptions of antidiabetic agents (mostly metformin and other older conventional agents) during 2012. Cases were the 49,201 patients who died for any cause during follow-up (up to 2018). A control was randomly selected for each case. Adherence to drug therapy was measured by considering the proportion of days of the follow-up covered by the drug prescriptions. Conditional logistic regression was used to model the risk of outcome associated with adherence to antidiabetic drugs. The analysis was stratified according to four categories of the clinical status (good, intermediate, poor, and very poor) differing for life expectancy.ResultsThere was a steep increase in comorbidities and a marked reduction of the 6-year survival from the very good to the very poor (or frail) clinical category. Progressive increase in adherence to treatment was associated with a progressive decrease in the risk of all-cause mortality in all clinical categories and at all ages (65–74, 75–84 and ≥ 85 years) except for the frail patient subgroup aged ≥ 85 years. The mortality reduction from lowest to highest adherence level showed a tendency to be lower in frail patients compared to the other categories. Similar although less consistent results were obtained for cardiovascular mortality.ConclusionsIn elderly diabetic patients, increased adherence to antidiabetic drugs is associated with a reduction in the risk of mortality regardless of the patients’ clinical status and age, with the exception of very old patients (age ≥ 85 years) in the very poor or frail clinical category. However, in the frail patient category the benefit of treatment appears to be less than in patients in good clinical conditions.

Effect of Oral Antidiabetic Drugs on Tuberculosis Risk and Treatment Outcomes: Systematic Review and Meta-Analysis.

Tuberculosis and diabetes mellitus are two global pandemics and rising public health problems. Recent studies suggest that oral antidiabetic drugs (OADs) could reduce the risk of tuberculosis and improve clinical outcomes. However, the evidence is controversial. Therefore, we aimed to assess the effect of OADs on the risk of tuberculosis and treatment outcomes. We systematically searched for six databases from inception to 31 August 2022. We followed a predefined PICO/PECO strategy and included two randomized controlled trials and sixteen observational studies. This study collects 1,109,660 participants, 908,211 diabetic patients, and at least 13,841 tuberculosis cases. Our results show that metformin decreases the risk of active tuberculosis by 40% (RR 0.60; 95% CI 0.47-0.77) in diabetic patients. In addition, metformin exhibits a dose-response gradient (medium doses reduce the risk of active tuberculosis by 45%, while high doses reduce this risk by 52%). On the other hand, DPP IV inhibitors increase the risk of active tuberculosis by 43% (RR 1.43; 95% CI 1.02-2.02). Subgroup analysis showed that study design and metformin dose accounted for the heterogeneity. We conclude that metformin significantly protects against active tuberculosis among diabetic patients. On the contrary, DPP IV inhibitors could increase the risk of developing active tuberculosis.

The Effect of Oral Antidiabetic Drugs on Improving the Endocrine and Metabolic States in Women with Polycystic Ovary Syndrome: A Systematic Review and Network Meta-analysis.

Polycystic ovary syndrome (PCOS) is the most common endocrine condition in women, impacting several aspects of a woman's life, including reproductive, mental, cardiovascular, and metabolic health. Antidiabetic drugs may have beneficial effects on the endocrine and metabolic states in women with PCOS. This study aimed to compare the effects of oral antidiabetic drugs on reproductive hormones, metabolic and anthropometric markers, and menstrual frequency, in patients with PCOS using network meta-analysis. PubMed, EMBASE, and CENTRAL were searched for studies published up to May31, 2021. Randomised clinical trials enrolling participants with PCOSwere included, for whichsodium-glucose cotransporter 2 (SGLT-2) inhibitors, metformin (Met), dipeptidyl peptidase 4 (DPP-4) inhibitors, alpha-glucosidase inhibitors, glucagon-like peptide 1 receptor agonists (GLP-1 RAs),and thiazolidinediones (TZDs)(alone or in combination) were compared with either each other, placebo, or no treatment.A network meta-analysis using a Bayesian approach was performed. The outcomes included changes inendocrine outcomes,metabolic results, menstrual frequency,and anthropometric findings.All research was conducted according to a protocol registered in the PROSPERO database (CRD42021248314). In total, we retrieved 3383 studies, of which 47 articles enrolling 2626 participants were included for the network meta-analysis. In comparison to the control groups, Met (MD -0.41, 95% CI -0.73 to -0.09) was more beneficial in reducing serum total testosterone, and GLP-1RAs+Met (MD -5.44, 95% CI -10.06 to -0.89) reduced free androgen index (FAI) more effectively. Thiazolidinediones (MD 9.33, 95% CI 0.15to 17.99) had a greater effect on sex hormone-binding globulin (SHBG) than Met.For decreasing androstenedione, Met (MD -1.87, 95% CI -2.73to -1.01), DPP-4 inhibitors (MD -2.64, 95% CI -4.77to -0.49), GLP-1RAs (MD -3.06, 95% CI -5.53to -0.62), and GLP-1RAs+Met (MD -2.97, 95% CI -5.85to -0.09)were more effective than TZDs.The confidence in evidence was often low or very low. In this network meta-analysis, GLP-1 receptor agonists in combination with metformin appear to be preferable for improving hyperandrogenaemia. Metformin and TZDs offer the added benefit of improving fasting blood glucose (FBG) and low-density lipoprotein-cholesterol (LDL-C) when compared to the control groups. Metformin combined with GLP-1 receptor agonists or TZDs could be associated with a beneficial effect onmenstrual recovery.

НОВЕ СЛОВО В МЕТОДИЦІ ВИГОТОВЛЕННЯ І ВИКОРИСТАННЯ ЕКСПРЕСНОГО ДІАБЕТИЧНОГО МЕДУ З ОЗДОРОВЧОЮ МЕТОЮ

The article is devoted to the problem of making express diabetic honey to prevent and improve health, as well as to treat diabetic individuals. The disease has become extremely widespread both globally and in individual countries. It was registered that over 425 million people have diabetes for the current year. According to this situation, the medical expenses reach up to 727 billion US dollars, which could be spent to the improvement of the quality of living standards. The number of cases of diabetes is about 1.3 million adults against the backdrop of difficult demographic situation in Ukraine. Unfortunately, there is a negative trend in our country towards the spread of the disease among young people and children, even preschoolers. In accordance with a prognostic point of view, the prospect of today's young generation seems highly undesirable – that is, to be among people with this pathology all their lives. Therefore, solving the problem through prevention and healthy lifestyle is important. Due to shortages of medicines and financial support for certain population category, the solution in this case is seen in the expansion of folk remedies for prevention and treatment, the leading place among which are bee products. The aim of the study was to develop a method of making diabetic express honey from blueberries (Vaccinium myrtillus L.), Jerusalem artichoke (Helianthus tuberosus L.), common beans (Phaseolus vulgaris L.) and to study its effect on changes in glucose, total protein and plasma protein fractions (PPF) of diabetics. According to studies of two groups of males (control and experimental) aged 50-70 years with a total of 24 people, it was found that the use of developed by the author's methodology of express diabetic honey from blueberries, Jerusalem artichokes and common beans helps to stabilize blood glucose levels; it has a positive effect on protein metabolism and immunity of diabetics, as well as enhances the effect of oral antidiabetic drugs.

Metformin-Loaded Polymer-Based Microbubbles/Nanoparticles Generated for the Treatment of Type 2 Diabetes Mellitus.

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease that is increasingly common all over the world with a high risk of progressive hyperglycemia and high microvascular and macrovascular complications. The currently used drugs in the treatment of T2DM have insufficient glucose control and can carry detrimental side effects. Several drug delivery systems have been investigated to decrease the side effects and frequency of dosage, and also to increase the effect of oral antidiabetic drugs. In recent years, the use of microbubbles in biomedical applications has greatly increased, and research into microactive carrier bubbles continues to generate more and more clinical interest. In this study, various monodisperse polymer nanoparticles at different concentrations were produced by bursting microbubbles generated using a T-junction microfluidic device. Morphological analysis by scanning electron microscopy, molecular interactions between the components by FTIR, drug release by UV spectroscopy, and physical analysis such as surface tension and viscosity measurement were carried out for the particles generated and solutions used. The microbubbles and nanoparticles had a smooth outer surface. When the microbubbles/nanoparticles were compared, it was observed that they were optimized with 0.3 wt % poly(vinyl alcohol) (PVA) solution, 40 kPa pressure, and a 110 μL/min flow rate, thus the diameters of the bubbles and particles were 100 ± 10 μm and 70 ± 5 nm, respectively. Metformin was successfully loaded into the nanoparticles in these optimized concentrations and characteristics, and no drug crystals and clusters were seen on the surface. Metformin was released in a controlled manner at pH 1.2 for 60 min and at pH 7.4 for 240 min. The process and structures generated offer great potential for the treatment of T2DM.

Harmful versus beneficial effects of using short-term combined oral antidiabetic therapy: ‎An open label comparative clinical trial ‎

Background: Although oral antidiabetic drugs have many beneficial pleiotropic effects, they are ‎not free from adverse reactions that may interfere with glucose homeostasis. This study aimed ‎to assess the effects of oral antidiabetic drugs as add- on-therapy to metformin, on the metabolic, ‎cardiac, and renal determinants. ‎ Material and methods: A total number of seventy-eight type 2 diabetes (T2D) patients who ‎were treated with metformin were allocated to add-on-therapy for 12 weeks, with glimepiride ‎‎(4mg/day, n=26), sitagliptin (100mg/day, n=28), and canagliflozin (300mg/day, n=24). ‎Anthropometric measurements, glycemic indices, lipid, and renal markers, were determined ‎before initiation and after the treatment. ‎ Results: All of the three treatments significantly decreased the glycemic indices, triglyceride-to-glucose index, and non-significantly altered the serum uric acid-to creatinine. Glimepiride ‎significantly increased the waist-to-height ratio (0.630±0.057 versus 0.640±0.057, p=0.040), ‎while sitagliptin and canagliflozin significantly decreased it (0.650±0.058 versus 0.640±0.054, ‎p=0.009, and 0.650±0.041 versus 0.630±0.044, p<0.001). Estimated glomerular filtration index- ‎epidemiology collaboration (ml/min/1.73m2) significantly declined by using glimepiride ‎‎(109.0±10.4 versus 103.6±10.9, p=0.001), and sitagliptin (106.1±12.4 versus 103.3±15.0, ‎p=0.013). ‎ Conclusion: Careful selection of using oral antidiabetic agents can protect T2D patients from ‎harmful events, particularly those related to cardiovascular events and renal function‎

Effects of oral antidiabetic drugs and glucagon-like peptide-1 receptor agonists on left ventricular diastolic function in patients with type 2 diabetes mellitus: a systematic review and network meta-analysis.

The present study aimed to compare the effects of oral antidiabetic drugs (OADs) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) on left ventricular diastolic function in patients with type 2 diabetes mellitus using a network meta-analysis of randomized controlled trials (RCTs). Literature searches were conducted on Medline, the Cochrane Controlled Trials Registry, and ClinicalTrials.gov . RCTs that assessed the effects on left ventricular diastolic function of OADs and GLP-1RAs in patients with type 2 diabetes were included. The outcome was the value (E/e') obtained by dividing peak early diastolic transmitral flow velocity (E) by the mitral annular early diastolic velocity (e'). Standardized mean differences (SMD) and 95% confidence intervals (CIs) were calculated from a random-effects network meta-analysis. Eight RCTs (592 patients) identified in a literature search met the eligibility criteria for this study and were included in the network meta-analysis. Compared with placebo, liraglutide was the only drug that caused a significant improvement in left ventricular diastolic function (SMD, - 0.65; 95% CI, - 1.23 to - 0.08). In addition, when the effects on left ventricular diastolic function were evaluated across drugs, liraglutide alone caused a significant improvement in left ventricular diastolic function compared with OADs (sitagliptin, linagliptin, pioglitazone, rosiglitazone, voglibose, and glimepiride). From the perspective of preventing the onset of heart failure, the administration of liraglutide for type 2 diabetes is promising.

Effects of oral antidiabetic drugs on left ventricular mass in patients with type 2 diabetes mellitus: a network meta-analysis

BackgroundWe used a network meta-analysis of randomized controlled trials (RCTs) to comparatively examine the effects of oral antidiabetic drugs (OADs) on left ventricular mass (LVM) in patients with type 2 diabetes.MethodsDocument searches were implemented using Medline, Cochrane Controlled Trials Registry, and ClinicalTrials.gov. We decided to include RCTs that evaluated the impact of LVM using the administration of OADs to patients with type 2 diabetes. The outcome evaluations used standardized mean difference (SMD) and 95% confidence intervals (CIs). We then performed a comparative examination of LVM related to the administration of OADs using random effects network meta-analysis.ResultsThe document search found 11 RCTs (1410 people) that satisfied the eligibility criteria for this study, and these RCTs were incorporated into the network meta-analysis. The only medication that significantly reduced LVM compared to a placebo was gliclazide (SMD, −1.09; 95% CI, −1.62 to − 0.57). Further, when comparing the impact on LVM between OADs, only gliclazide significantly reduced LVM compared to other OADs (glyburide, voglibose, metformin, pioglitazone, rosiglitazone, and sitagliptin).ConclusionsIn the present study, gliclazide was the only medication that significantly reduced LVM in patients with type 2 diabetes. When considered from the perspective of causing heart failure and preventing recurrence, it is possible that the use of gliclazide in patients with type 2 diabetes will provide multiple benefits.

Long-Term Effects of Oral Antidiabetic Drugs During Pregnancy on Offspring: A Systematic Review and Meta-analysis of Follow-up Studies of RCTs.

IntroductionAntidiabetic drugs (OADs) are increasingly prescribed to treat hyperglycaemia during pregnancy in women with gestational diabetes mellitus (GDM) or polycystic ovary syndrome (PCOS), even though long-term effects on offspring are unknown. This systematic review summarises the evidence of follow-up studies of randomised controlled trials (RCTs) reporting on long-term effects of prenatal exposure to OADs on offspring.MethodsThe MEDLINE, EMBASE and CENTRAL databases were searched from inception to April 2018 for the concepts antidiabetic agents and prenatal exposure (or pregnancy and offspring/child) in combination with an RCT search filter. RCTs evaluating post-neonatal health effects in offspring and comparing maternal treatment with an OAD with no treatment, placebo, an alternative OAD or insulin during pregnancy were eligible for inclusion. Two independent researchers selected, extracted and assessed the data. Meta-analyses were performed using a random effects model and the Cochrane Collaboration’s risk of bias tool was used for quality assessment.ResultsTen studies were included, with a maximal follow-up duration of 9 years, comprising 778 children of mothers with GDM or PCOS who were randomised to either metformin or insulin/placebo during pregnancy. Meta-analysis showed that children prenatally exposed to metformin were heavier compared to controls (standardised mean difference (SMD) 0.26 [95% CI 0.11–0.41]), but not taller (SMD 0.10 [95% CI −0.14–0.33]). Additionally, offspring body mass index (BMI) z scores did not differ according to metformin exposure (mean difference 0.30 [95% CI −0.01–0.61]). Individual small studies reported that prenatal exposure to metformin was associated with greater mid-upper arm, head and waist circumferences, biceps skinfolds, waist-to-height ratio, more arm fat, higher fasting glucose, ferritin and lower LDL cholesterol in offspring.ConclusionPrenatal exposure to metformin is associated with increased offspring weight, but not with height or BMI. Larger follow-up studies are needed to confirm and look into the implications of these findings.Plain Language SummaryPlain language summary available for this article.Electronic supplementary materialThe online version of this article (10.1007/s13300-018-0479-0) contains supplementary material, which is available to authorized users.

Study of lipid lowering effects of oral antidiabetic drugs in type 2 diabetes mellitus patients

Background: Type 2 diabetes mellitus (T2DM) is one of the most common non-communicable diseases associated with ‘atherogenic dyslipidemia’ The treatment of T2DM often is initiated with oral antidiabetic drugs, most of which not only decrease blood sugar levels effectively but also decrease the lipid levels. Hence the current study is aimed to determine the effectiveness of oral hypoglycemic agents in dealing with associated dyslipidemia.Methods: 150 T2DM patients were divided equally into five groups depending upon the oral antidiabetic drugs they received in solo or in combination for 24 weeks, with equal number of males and females in each group. After the written consent, a detail clinical history, clinical examination, Biochemical investigations including, glycosylated haemoglobin and lipid profile, chest X-ray and ECG were done.Results: After 24 weeks of study, the mean total cholesterol and mean triglycerides decreased significantly (p <0.05 to p <0.01) with monotherapy of metformin and teneligliptin as well as with combination of either metformin and glimepiride or metformin and teneligliptin. The decrease of LDL-C and VLDL-C was not statistically significant with any of the OAD drugs in solo or in combination. Similarly, HDL-C increased significantly (p <0.05) in Group I, III, IV and V; but was most effective with combination therapy. The atherogenic index of plasma also decreased (p <0.05) with metformin or its combination with either teneligliptin or glimepiride.Conclusions: Oral antidiabetic drugs are not only affordable and effective hypoglycemic agents but can also decrease serum lipids and thereby aids in the prevention and management of atherosclerosis and its complications in T2DM.

INFLAMMATION-LOWERING EFFECTS OF ORAL ANTIDIABETIC DRUGS IN RHEUMATOID ARTHRITIS

Objective. The primary aim of this study is to underline the inflammation-lowering effect of oral antidiabetic drugs, namely the CRP, ESR and DAS28 levels. The secondary aim was to show that these effects are dependent on the dose of the antidiabetic drug. Methods. The study has an observational, case-control design. The information was gathered from the case reports of the patients that were admitted in Sf. Maria Clinical Hospital in Bucharest, beginning with 2010 and until May 2016. It included a case group of 20 subjects and a control group of 20 subjects who were followed approximately 3 years from the diagnosis of RA. Results. There were no significant group differences at baseline. During the follow-up, the medians of DAS28, CRP and ESR were significantly lower in the group treated with oral glucose lowering agents (p<0.005). Secondly, the presence of metformin both as monotherapy and in combination with other antidiabetic drugs was associated with a statistically significant decrease in the medians of the three mentioned variables (p<0.05). The metformin dose can predict the value of CRP (p=0.005), accounting for 18.9% of the variation of CRP. Moreover, there is a negative correlation between CRP level and metformin, r=-0.434, p=0.003. This negative correlation was also seen between metformin and CRP value (p=0.027), when metformin was used in monotherapy. Conclusion. The main insights achieved in this study relate to the ability of metformin to significantly lower both DAS28 and CRP level in patients with RA and T2DM, when compared to those that are affected only by RA. An element that needs further study is if these benefits can also extend to RA patients without T2DM, but with impaired glucose tolerance or important cardiovascular risk factors.

Effects of Oral Antidiabetic Drugs on Changes in the Liver-to-Spleen Ratio on Computed Tomography and Inflammatory Biomarkers in Patients With Type 2 Diabetes and Nonalcoholic Fatty Liver Disease

PurposeOral antidiabetic drugs (OADs) such as pioglitazone and metformin have beneficial effects in patients with nonalcoholic steatohepatitis. We prospectively assessed the effects of OADs on nonalcoholic fatty liver disease (NAFLD) in 886 men with type 2 diabetes mellitus and in a murine model of NAFLD. MethodsPatients were randomized to receive pioglitazone, metformin, sitagliptin, or a non-OAD (control) for 6 months. All the patients received dietary and exercise guidance once a month during this study. Changes in the liver-to-spleen ratio on computed tomography (CT) and NAFLD-related parameters were measured from baseline to the end of treatment. FindingsThe liver/spleen ratio improved significantly in the pioglitazone and metformin groups compared with the control group (both P < 0.01), but not in the sitagliptin group (P = 0.73). The mean changes from baseline were −3.464 ± 10.156%, 19.236 ± 9.896%, 4.783 ± 1.467%, and 1.328 ± 0.802% in the control, pioglitazone, metformin, and sitagliptin groups, respectively. Multivariable analysis showed that the liver/spleen ratio was strongly correlated with high-sensitivity C-reactive protein concentration in the pioglitazone group (F = 9.973; P < 0.01) and abdominal visceral fat volume in the metformin group (F = 6.049; P < 0.05). ConclusionsPioglitazone elicited the greatest improvements in features of NAFLD in type 2 diabetes mellitus. (Trial Registration: www.isrctn.org/, ISRCTN33414972, http://www.isrctn.org/)

The impact of metformin in the treatment and evolution of oncological patients with type 2 diabetes

Metformin is an oral antidiabetic agent widely used in the treatment of type 2 diabetes mellitus, where it is commonly used as an insulin sensitizer since not only it has a function of lowering blood sugar, but also of reducing insulin resistance associated to hyperinsulinemia. It has been recently demonstrated that the use of metformin as an insulin sensitizer reduces incidence, progression and even mortality through cancer (Evans JM et al., 2005), while insulin and sulphonylureas have been associated with high incidence and mortality. Although the exact mechanism by which metformin has a protective role with respect to neoplasia is not precisely known, it has been established that its role of inhibiting cancerogenesis is due to its impact on the AMPK/LKB1 metabolism. A significant number of studies mention the beneficial effect that metformin has on the treatment and prognosis of certain neoplastic localizations (mammary, pancreas, colorectal, hepatic), most frequently by interfering with cell cycle regulation. Thus, the study of the effects of oral anti-diabetic drugs is worth being continued, as they can bring multiple benefits to administered oncological treatments.

EFFICIENCY AND SAFETY OF THE ORAL HYPOGLYCAEMIC AGENTS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS AND CARDIOVASCULAR DISEASES

Сахарный диабет является важной проблемой здравоохранения во всех странах мира. Наличие сахарного диабета 2-го типа (СД2) способствует развитию атеросклероза и повышает риск сердечно-сосудистых осложнений (ССО). Коррекция уровня гликемии служит важнейшим условием профилактики сосудистых осложнений у больных СД2. Возможности снижения риска ССО на фоне терапии пероральными сахароснижающими препаратами продолжают изучаться. В этом отношении перспективны представители инновационных классов пероральных сахароснижающих препаратов, в том числе ингибиторы дипептидилпептидазы-4.

Oral hypoglycemic agents and the heart failure conundrum: Lessons from and for outcome trials

AimType 2 diabetes is not only an independent risk factor for cardiovascular (CV) disease but is also associated with a greater incidence of heart failure (HF). The aim of this review is to examine the effects of oral antidiabetic drugs on CV disease and HF. Data synthesisTrials of anti-diabetic agents are now designed to assess CV safety, but frequently HF is not included as a primary endpoint. However, HF in patients with diabetes is more frequent than other CV events and seems to be underestimated. A burning question is therefore if the most used trial design to monitor CV safety, i.e. non-inferiority, allows clinical translation of trial findings. Available data further suggest that the CV effects of anti-diabetic drugs may be rather class-specific and are only partly due to their glucose-lowering actions. Metformin, recommended as first line in most guidelines, shows positive CV effects while other classes like thiazolidinediones may precipitate HF. Experimental results on the relatively novel dipeptidyl peptidase IV (DPP IV) inhibitors imply CV protective effects, but the non-inferiority trials published to date show an overall neutral CV outcome and a potential increase in HF by saxagliptin. However, results on sitagliptin of the recently released TECOS indicate that HF is not a class-dependent effect of DPP IV inhibitors. ConclusionFurther basic research and long-term outcome studies to clarify the effects of antidiabetic agents on CV and HF are required so that we can select the optimal antidiabetic therapy for our patients.

Evaluation of the Effect of Perindopril and its Combination with Oral Anti-Diabetic Drugs on Blood Sugar Levels in Diabetic Wistar Rats

It is well known scientifically that ACE (Angiotensin converting enzyme) inhibitors prevent the development and progression of incipient or established nephropathy and delay the progression of diabetic retinopathy hence these drugs are routinely prescribed with the oral anti-diabetic drugs in these conditions. The actual scenario of impact of ACE inhibitors on blood glucose is still controversial therefore current study was undertaken to investigate the effect of Perindopril on blood glucose level and interaction with the oral anti-diabetic drugs in alloxan induced diabetic rats. Rats were classified into Ten groups (n = 6) where group I –II represent normal and group III –X represent diabetic rats. Perindopril doses (0.8 mg/kg body weight) were administered to both normal and diabetic rats. In diabetic groups, the Perindopril was also given with the Oral anti-diabetic drugs to check-out any alteration in blood glucose level .All drugs administered orally once a day for 13 days and then Oral Glucose Tolerance Test (OGTT) was conducted. It was observed that in normal rats the Perindopril insignificantly (P>0.05) reduced the blood glucose level at all time points. In contrast, Perindopril showed significant (P≤0.01 and P≤0.001) anti-hyperglycemic activity at all time points when given either alone or with the Oral anti-diabetic drugs respectively in alloxan-induced diabetic rats. Hence the present study concluded that the Perindopril has anti-hyperglycemic activities which accentuate the effect of oral anti-diabetic drugs in diabetic rats significantly.

Association of PAX4 genetic variants with oral antidiabetic drugs efficacy in Chinese type 2 diabetes patients.

The aim of this study was to investigate the association of PAX4 variants with therapeutic effect of oral antidiabetic drugs in Chinese type 2 diabtes mellitus (T2DM) patients. A total of 209 newly diagnosed T2DM patients were randomly assigned to treatment with repaglinide or rosiglitazone for 48 weeks, and the therapeutic effects were compared. In the rosiglitazone cohort, rs6467136 GA+AA carriers showed greater decrease in 2-h glucose levels (P=0.0063) and higher cumulative attainment rates of target 2-h glucose levels (Plog rank=0.0093) than GG homozygotes. In the subgroup with defective β-cell function, rs6467136 GA+AA carriers exhibited greater decrements of 2-h glucose level and improvement of homeostasis model assessment of insulin resistance (P=0.0143). Moreover, GA+AA carriers were more likely to attain the target fasting and 2-h glucose level (Plog rank=0.0091 and 0.007, respectively). However, these single-nucleotide polymorphisms showed no effect on repaglinide efficacy. In conclusion, PAX4 variant rs6467136 was associated with the therapeutic effect of rosiglitazone in Chinese T2DM patients.

Effects of oral antidiabetic drugs and insulin treatment on ocular surface

Effects of oral antidiabetic drugs and insulin treatment on ocular surface

Immunomodulatory effects of oral antidiabetic drugs in lymphocyte cultures from patients with type 2 diabetes

INTRODUCTION AND OBJECTIVE: It has been suggested that type 2 diabetes is an inflammatory response manifestation. The main drugs used to treat type 2 diabetes are sulphonylureas and biguanides. The aim of this study was to demonstrate the modulatory effects of oral hypoglycemic drugs (chlorpropamide and metformin) on lymphocyte proliferation in vitro and ex vivo. METHODS: Peripheral blood mononuclear cells were isolated from human blood by gradient centrifugation. T-lymphocytes were stimulated by phytohemagglutinin (PHA) and oral hypoglycemic drugs. RESULTS: In both in vitro and ex vivo experiments, there was a reduction in cell proliferation after treatment with oral hypoglycemic drugs. When both drugs were used in combination, a high level of cytotoxicity was observed, which made analysis of immunomodulatory effects unfeasible. DISCUSSION AND CONCLUSION: We demonstrated that diabetes itself may reduce cell proliferation significantly when stimulated by PHA, which may indicate that diabetic patients have difficulties in promoting an efficient inflammatory response. Moreover, the use of oral hypoglycemic drugs may aggravate this situation.