scholarly journals Acute and long-term effects of saxagliptin on post-prandial glycemic response in obese patients with impaired glucose tolerance

2020 ◽  
Author(s):  
Amel Rezki ◽  
Marinos Fysekidis ◽  
Sabrina Chiheb ◽  
Eric Vicaut ◽  
Emmanuel Cosson ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Impaired Glucose Tolerance ◽  
Obese Patients ◽  
Glycemic Response ◽  
Long Term Effects

scholarly journals Acute and Long-term Effects of Saxagliptin on a Set of Cardiovascular Targets Measured at Fasting and Post-prandially in Obese Patients With Impaired Glucose Tolerance: a Randomized, Placebo-controlled, Double-blind Study

2020 ◽  
Author(s):  
Amel Rezki ◽  
Emmanuel Cosson ◽  
Marinos Fysekidis ◽  
Sabrina Chiheb ◽  
Eric Vicaut ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Impaired Glucose Tolerance ◽  
Augmentation Index ◽  
Double Blind Study ◽  
Vagal Activity ◽  
Large Set ◽  
Obese Patients ◽  
Long Term Effects ◽  
Double Blind

Abstract Background: Studies of dipeptidyl peptidase inhibitors (DPP4is) report heterogeneous effects on cardiovascular targets in type 2 diabetes. Little is known about the cardiovascular effects of DPP4is in patients with impaired glucose tolerance (IGT) in particular during the post-prandial state. Methods: In this randomized, placebo-controlled, double-blind, single-center pilot study, we included obese individuals with IGT. Participants were randomized to receive for 12 weeks either saxagliptin 5mg a day or placebo. They were explored non-invasively before and after a standardized breakfast for biological markers; microcirculatory blood flow at baseline and after transcutaneous administration of acetylcholine (Periflux System 5000® PERIMED); post-occlusive digital reactive hyperhemia (Endopat2000®); pulse wave velocity, augmentation index, central pulse pressure and subendocardial viability ratio (Sphygmocor®); cardiac hemodynamic parameters and cardiovascular autonomic nervous system activity (Task force monitor®). Results: We investigated 24 individuals (mean body mass index 36.8±4.8 kg/m2, hypertension 33.3%). The results of all the investigations were similar after breakfast in the two groups at Visit 1 (acute post-prandial effects, after the first tablet) and Visit 2 (long-term post-prandial effects), and at fasting at Visit 1 and 2 (long-term effects, after 12 weeks of treatment). Only at Visit 2 the decrease in cardiac vagal activity occurring after breakfast was more sustained in the saxagliptin group than in the placebo group (interaction between treatment and time effect: p=0.016).Conclusion: In obese patients with IGT, among the large set of cardiovascular parameters we measured in the fasting and post-prandial state, the unique change induced by saxagliptin consisted in a more marked post-prandial depression of vagal activity. Clinical Trial Registration number: NCT01521312

Long-Term Effects of Combined Chelation Therapy on Glucose Metabolism of Thalassemic Patients.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2770-2770
Author(s):  
Kalistheni Farmaki ◽  
Nicholas Angelopoulos ◽  
Vasilios Berdoukas ◽  
Ioanna Tsoumari ◽  
Christina Pappa ◽  
...  
Keyword(s):  
Insulin Sensitivity ◽  
Glucose Metabolism ◽  
Glucose Tolerance ◽  
Impaired Glucose Tolerance ◽  
Chelation Therapy ◽  
Fasting Glucose ◽  
Long Term Effects ◽  
Glucose Response

Abstract • The incidence of impaired glucose tolerance and diabetes in thalassemiamajor patients varied from 9% to 15%, depending on the age of assessment and intensity (and compliance) of chelation and transfusion. It is uncertain whether early assessment and tailored chelation can prevent diabetes and preserve pancreatic reserve. There are now reports of endocrine improvements with intense chelation in regards to glucose metabolism which are limited to 3 years of follow up. However, whether the pancreas may regenerate or remodel even with reduction in hemosiderosis is unknown and questions have arisen whether these are lasting improvements reflecting an overtime advantage earned by the intensification of chelation. The aim was to determine the long-term effects of combined chelation therapy on glucose metabolism in beta-thalassaemic patients • From January 2001 to October 2003, 42 thalassemic patients (initially treated with deferoxamine DFO monotherapy) were gradually switched to an individually tailored combined regimen with DFO and deferiprone. Glucose metabolism characteristics were evaluated by Oral glucose tolerance test (OGTT). Each patient was assessed separately before initiating combined therapy, and all patients were thereafter yearly reassessed (June 2005, June 2006 and June 2007). Full biochemical data (4 consecutive measurements) were available in 30 patients (3 got pregnant during this period, 5 denied repeated OGTT and 4 patients with severe and sustained hyperglycaemia started antidiabetic drugs after the second assessment in 2006). Insulin sensitivity and beta-cell function were assessed by calculated indices, using the most widely applied insulin sensitivity index - the homeostasis assessment model (ISI HOMA) which is based on fasting glucose and insulin alone. The area under the curve (AUC) was also calculated for estimating integrated response during OGTT for both glucose and insulin. Significant variations over time for each parameter were examined with ANOVA (general linear model) for repeated measurements. Ferritin levels were significantly decreased (P<0.01),AUCglu decreased (P=0.002)and SCHoma increased (P=0.004) as illustrated in Table 1. 70% of patients had abnormal glucose response during the first OGTT (diabetic response, Impaired glucose tolerance or impaired fasting glucose, according to the latest criteria of the American Diabetes Association published in September 2005). In May 2007, only 20% exhibited abnormal glucose response with the same provocative test (P<0.001,non-parametric McNemar test). Our 6-year follow-up demonstrates that use of combined chelation therapy continues to be of benefit in terms of glucose metabolism in thalassemic patients. Parameters (Mean value) 1st assessment 2005 2006 2007 Ferritin 2960 551 585 629 SCHoma 133.4 215.6 200.6 209.9 ISI Homa 1.101 0.964 1.085 0.886 AUCglucose 18217 16166 16526 15655

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