Pioglitazone in addition to metformin improves erythrocyte deformability in patients with Type 2 diabetes mellitus

2010 ◽  
Vol 119 (8) ◽  
pp. 345-351 ◽  
Author(s):  
Thomas Forst ◽  
Matthias M. Weber ◽  
Mirjam Löbig ◽  
Ute Lehmann ◽  
Jürgen Müller ◽  
...  

The aim of the present study was to compare the effect of PIO (pioglitazone) or GLIM (glimepiride) on erythrocyte deformability in T2DM (Type 2 diabetes mellitus). The study covered 23 metformin-treated T2DM patients with an HbA1c (glycated haemoglobin) >6.5%. Patients were randomized to receive either PIO (15 mg, twice a day) or GLIM (1 mg, twice a day) in combination with metformin (850 mg, twice a day) for 6 months. Blood samples were taken for the measurement of fasting glucose, HbA1c, fasting insulin, intact proinsulin, adiponectin and Hct (haematocrit). In addition, the erythrocyte EI (elongation index) was measured using laser diffractoscopy. Both treatments significantly improved HbA1c levels (PIO, −0.9±1.1%; GLIM, −0.6±0.4%; both P<0.05) and resulted in comparable HbA1c levels after 6 months (PIO, 6.5±1.2%; GLIM, 6.2±0.4%) Treatment with PIO reduced fasting insulin levels (−8.7±15.8 milli-units/l; P=0.098), intact proinsulin levels (−11.8±9.5 pmol/l; P<0.05) and Hct (−1.3±2.3%; P=0.09), whereas adiponectin levels increased (8.2±4.9 μg/ml; P<0.05). No significant change in these parameters was observed during GLIM treatment. PIO improved the EI, resulting in a significant increase in EI at all physiological shear stress ranges (0.6–6.0 Pa; P<0.05). The improvement in EI correlated with the increase in adiponectin levels (r=0.74; P<0.001), and inversely with intact proinsulin levels (r=−0.47; P<0.05). This is the first study showing an improvement in EI during treatment with PIO, which was associated with an increase in adiponectin and a decrease in intact proinsulin levels, but independent of glycaemic control.

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Xiaowen Zhang ◽  
Jie Sun ◽  
Wenqing Han ◽  
Yaqiu Jiang ◽  
Shiqiao Peng ◽  
...  

Objective. Type 2 deiodinase (Dio2) is an enzyme responsible for the conversion of T4 to T3. The Thr92Ala polymorphism has been shown related to an increased risk for developing type 2 diabetes mellitus (T2DM). The aim of this study is to assess the association between this polymorphism and glycemic control in T2DM patients as marked by the HbA1C levels.Design and Methods.The terms “rs225014,” “thr92ala,” “T92A,” or “dio2 a/g” were used to search for eligible studies in the PubMed, Embase, and Cochrane databases and Google Scholar. A systematic review and meta-analysis of studies including both polymorphism testing and glycated hemoglobin (HbA1C) assays were performed.Results. Four studies were selected, totaling 2190 subjects. The pooled mean difference of the studies was 0.48% (95% CI, 0.18–0.77%), indicating that type 2 diabetics homozygous for the Dio2 Thr92Ala polymorphism had higher HbA1C levels.Conclusions. Homozygosity for the Dio2 Thr92Ala polymorphism is associated with higher HbA1C levels in T2DM patients. To confirm this conclusion, more studies of larger populations are needed.


Author(s):  
Wirawan Adikusuma ◽  
Nurul Qiyaam

  Objective: Examines the effects of counseling and short messages service (SMS) as a reminder and motivation toward medication adherence improvement and controlled HbA1c levels of type 2 diabetes mellitus (T2DM) patients.Methods: This study used a quasi-experimental method with prospective data retrieval. The subjects of this study were 40 patients with outpatient T2DM in internal disease polyclinic in West Nusa Tenggara Hospital, Indonesia. Patients who fulfilled the inclusion criteria were divided into two groups: The control group (n=20) receiving only the drug care service and the treatment group (n=20) receiving counseling and SMS reminder and motivation from the pharmacist. Data collecting was conducted using the pill count method, and HbA1c levels were taken from the medical record.Results: The results showed that counseling and SMS as reminder and motivation by a pharmacist can improve treatment adherence significantly (p<0.05) by 11.33 ± 8.47 and can decrease HbA1c level significantly (p<0.05) of 1.32 ± 0.72 in the intervention group. There was a positive correlation between T2DM patient treatment adherence to HbA1c levels (r=0.254, p=0.023).Conclusion: The provision of counseling and SMS as a reminder and motivation by the pharmacist can have a positive effect toward medication adherence and control of HbA1c in T2DM patients. 


2021 ◽  
Vol 31 (Supplement_2) ◽  
Author(s):  
Claudio Santos ◽  
Sonia Brito-Costa ◽  
Luis Margalho ◽  
Pedro Monteiro

Abstract Background Type 2 Diabetes Mellitus (T2DM) is the most common form of diabetes in adults, with 90% to 95% of cases. This study aims to establish clusters and have knowledge about the relationship between previous cardiovascular events and pharmacological treatment for T2DM. Methods 191 participants (EG) with T2DM with the average of 70.3 years (SD = 8.3) and 36 with pre-diabetes (CG) with an average of 62 years (SD = 10.3) who participated in clinical trials at Clinical Research Unit in Cardiology of Coimbra Hospital and Universitary Centre without cognitive difficulties, were divided in 5 different clusters. These were established based on six different variables: body mass index (BMI), age of each individual, age at diagnosis of DMT2, glycated haemoglobin value (HbA1c), homeostatic model that estimates the function of β cells (HOMA2-B) and insulin resistance (HOMA2-IR). Results Cluster 1 presented pre-diabetic individuals (15.9%), while diabetic individuals were divided into clusters 2 (1.8%), 3 (17.6%), 4 (21.1%) and 5 (43.6%). Regarding the study of the prevalence of previous cardiovascular events, the majority of individuals present in the different clusters had history of acute myocardial infarction (AMI). As for the prevalence of pharmacological treatment for DMT2, it was found that metformin was the most used drug. It was observed a relationship between previous AMI and metformin administration in clusters 3 (P = 0.0027; P &lt; 0.05) and 5 (P = 0.0059; P &lt; 0.05). Conclusions It was possible to create different clusters in a sample of the Portuguese population and to observe the existence of dependency relationships between different previous cardiovascular events and pharmacological treatment.


2020 ◽  
Vol 8 (2) ◽  
pp. 66-72
Author(s):  
Angiesta Pinakesty ◽  
Restu Noor Azizah

Introduction: Diabetes mellitus (DM) is a non-communicable disease that has increased from year to year. Type 2 diabetes mellitus is not caused by lack of insulin secretion, but is caused by the failure of the body's cells to respond to the hormone insulin (insulin resistance). Insulin resistance was found to be a major contributor to atherogenic dyslipidemia. Dyslipidemia in DM risks 2 to 4 times higher than non-DM. Although dyslipidemia has a great risk for people with type 2 diabetes mellitus, this conventional risk factor only explains a portion (25%) of excess cardiovascular risk in type 2 DM. Discussion: In uncontrolled type 2 DM patients, LDL oxidation occurs faster which results from an increase in chronic blood glucose levels. Glycemic control as a determinant of DM progressivity is determined through HbA1c examination. HbA1c levels are associated with blood triglyceride levels. Meanwhile, triglyceride levels are associated with total cholesterol and HDL cholesterol levels. HbA1c levels are also associated with LDL cholesterol levels. Conclusion: There is a relationship between lipid profile and the progression of type 2 diabetes mellitus.   Keywords: type 2 diabetes mellitus, dyslipidemia, HbA1c, glycemic control, lipid profile


Author(s):  
Dafina Balqis ◽  
Yudhi Adrianto ◽  
Jongky Hendro Prayitno

Strok saat ini menjadi salah satu penyebab utama kematian global. Hubungan antara kejadian strok dengan diabetes telahlama diketahui. Kontrol gula darah, yang dipantau melalui kadar HbA1c, telah menunjukkan hubungan dengan strok dan penyakitkardiovaskular lain. Kajian ini untuk menentukan perbedaan kadar HbA1c antara pasien diabetes melitus tipe 2 dengan dan tanpakejadian strok infark trombotik. Metode penelitian yang digunakan adalah analisis retrospektif menggunakan rekam medis pasienselama 3,5 tahun. Penelitian ini mengumpulkan data kadar HbA1c dari 443 pasien diabetes melitus tipe 2 kemudian membandingkanrerata kadar HbA1c antara pasien diabetes mellitus tipe 2 dengan kejadian strok trombotik (n=74) dan tanpa kejadian strok trombotik(n=369). Perbandingan tingkat HbA1c juga dilakukan secara terpisah antara laki-laki dan perempuan. Kajian ini menemukan reratakadar HbA1c yang tinggi di kedua kelompok sampel (10,49%±2,53% untuk kelompok dengan kejadian strok infark trombotik dan10,44%±2,8% untuk kelompok tanpa kejadian strok infark trombotik) dengan perbandingan sarana p>0,05. Perbandingan yangdilakukan secara terpisah di laki-laki dan perempuan juga menunjukkan hasil yang sama dengan p>0,05. Sebagai simpulan, kadarHbA1c di kedua kelompok penelitian sama-sama tinggi dan tidak ada perbedaan bermakna kadar HbA1c yang ditemukan di pasiendengan diabetes tipe 2 dengan dan tanpa kejadian strok trombotik.


2019 ◽  
Vol 11 (1) ◽  
pp. 19-23
Author(s):  
Ajai Agrawal ◽  
Shubham Ahuja ◽  
Anupam Singh ◽  
Ramanuj Samanta ◽  
Sanjeev Kumar Mittal

Introduction: Patients with diabetes mellitus are at a higher risk of developing primary open angle glaucoma (POAG) as compared to non-diabetic patients. Objectives: To determine whether there is a correlation between hyperglycemic levels and intraocular pressure (IOP) and to identify patients of Type II diabetes mellitus who are at a higher risk of developing glaucoma. Materials and Methods: This was a hospital based, cross sectional study performed on patients with type II diabetes mellitus, at a tertiary health care center in Uttarakhand, India between July, 2018 and September, 2018. 318 eyes of 159 patients with Type2 diabetes mellitus were included in the study. IOP was measured by Goldmannappla nation to no meter and central corneal thickness was measured with specula microscope in all patients, in addition to glycated hemoglobin levels (HbA1c) and fasting and post-prandial blood glucose levels. The data was analysed using SPSS 22 software. Results: Mean IOP was found to be 15.75 ± 3.18 mm Hg in patients with HbA1c levels between 6.5%-12% (Group I) and 17.42 ± 2.67 mm Hg in patients with HbA1c levels more than 12 % (Group II). The difference between the two groups was statistically significant (P =0.013). Out of 159 patients with Type 2 Diabetes mellitus, a total of 11 patients had IOP more than 21mm Hg in one or both the eyes. Conclusion: Hyperglycaemic levels as determined by raised HbA1c levels are associated with higher intraocular pressures in patients with type 2 diabetes mellitus.


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