scholarly journals Clinically relevant drug‐drug interactions and the risk for drug adverse effects among home‐dwelling older persons with and without type 2 diabetes

2019 ◽  
Vol 44 (5) ◽  
pp. 735-741 ◽  
Author(s):  
Ilona Ikäheimo ◽  
Merja Karjalainen ◽  
Miia Tiihonen ◽  
Maija Haanpää ◽  
Hannu Kautiainen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Adverse Effects ◽  
Drug Interactions ◽  
Older Persons ◽  
Drug Adverse Effects

Lack of effect of the SLC47A1 and SLC47A2 gene polymorphisms on the glycemic response to metformin in type 2 diabetes mellitus patients

2018 ◽  
Vol 33 (4) ◽  
pp. 175-185 ◽  
Author(s):  
Gerard Marshall Raj ◽  
Jayanthi Mathaiyan ◽  
Mukta Wyawahare ◽  
Rekha Priyadarshini
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Adverse Effects ◽  
Assay Method ◽  
Glycemic Response ◽  
Dose Requirement ◽  
Eligibility Criteria ◽  
Significant Difference

Abstract Background This work aimed to evaluate the influence of single nucleotide polymorphisms (SNPs) in the SLC47A1 (922-158G>A; rs2289669) and SLC47A2 (−130G>A; rs12943590) genes on the relative change in HbA1c in type 2 diabetes mellitus (T2DM) patients of South India who are taking metformin as monotherapy. It also aims to study the effects of these SNPs on the dose requirement of metformin for glycemic control and the adverse effects of metformin. Methods Diabetes patients on metformin monotherapy were recruited based on the eligibility criteria (n=105). DNA was extracted and genotyping was performed with a real-time PCR system using TaqMan® SNP genotyping assay method. The HbA1c levels were measured using Bio-Rad D-10™ Hemoglobin Analyzer. Results After adjusting for multiple comparisons (Bonferroni correction) the difference found in the glycemic response between the “GG” genotype and “AG/AA” genotype groups of the SLC47A2 gene was not significant (p=0.027; which was greater than the critical value of 0.025). Patients with “GG” genotype showed a 5.5% decrease in HbA1c from baseline compared to those with the “AG/AA” genotype (0.1% increase). The SNP in the SLC47A1 gene also did not influence the glycemic response to metformin (p=0.079). The median dose requirements based on the genotypes of the rs12943590 variant (p=0.357) or rs2289669 variant (p=0.580) were not significantly different. Similarly, there was no significant difference in the occurrence of adverse effects across the genotypes in both the SLC47A1 (p=0.615) and SLC47A2 (p=0.309) genes. Conclusions The clinical response to metformin was not associated with the SNPs in the SLC47A1 and SLC47A2 genes coding for the multidrug and toxin extrusion protein (MATE) transporters. Furthermore, the studied SNPs had no influence on the dose requirement or adverse effects of metformin.

Cardiovascular events in patients with type 2 diabetes

2002 ◽  
Vol 2 (1_suppl) ◽  
pp. S4-S8
Author(s):  
Erland Erdmann
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Risk Factor ◽  
Adverse Effects ◽  
Cardiovascular Events ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Increased Risk

Diabetes is a common risk factor for cardiovascular disease. Coronary heart disease and left ventricular dysfunction are more common in diabetic patients than in non-diabetic patients, and diabetic patients benefit less from revascularisation procedures. This increased risk can only partly be explained by the adverse effects of diabetes on established risk factors; hence, a substantial part of the excess risk must be attributable to direct effects of hyperglycaemia and diabetes. In type 2 diabetes, hyperinsulinaemia, insulin resistance and hyperglycaemia have a number of potential adverse effects, including effects on endothelial function and coagulation. Risk factor modification has been shown to reduce the occurrence of cardiovascular events in patients with diabetes; indeed, diabetic patients appear to benefit more in absolute terms than non-diabetic patients. There is thus a strong case for intensive treatment of risk factors, including insulin resistance and hyperglycaemia, in patients with type 2 diabetes.

scholarly journals SODIUM-GLUCOSE LINKED COTRANSPORTER 2 INHIBITOR: A NEW HORIZON IN THE TREATMENT OF TYPE-2 DIABETES

2021 ◽  
pp. 45-48
Author(s):  
REKHA BISHT
Keyword(s):  
Type 2 Diabetes ◽  
Adverse Effects ◽  
Antidiabetic Drugs ◽  
Diabetic Patients ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Sodium Glucose Cotransporter ◽  
Glucose Reabsorption ◽  
Glycemic Targets

Hyperglycemia is a key therapeutic focus in the management of patients with type 2 diabetes (T2D) mellitus. The various therapeutic classes of antidiabetic drugs presently existing in the market are not sufficiently effective in maintaining long-term glycemic control in most of the diabetic patients, even when used in combination. The undesirable adverse effects of these drugs, such as hypoglycemia, weight gain, and hepatic and renal toxicity, have escalated the demand for the discovery of new and safer antidiabetic drugs. The progressive nature of T2D requires practitioners to periodically evaluate patients and intensify glucose-lowering treatment once glycemic targets are not attained. Sodium-glucose cotransporter 2 inhibitors (SGLT2-is) are the new class of antidiabetic medications that are approved (2013) by the Food and Drug Administration recently for treating diabetes. These inhibitors block the SGLT2 protein involved in glucose reabsorption from the proximal renal tubule resulting in escalated glucose excretion and lower blood glucose levels. These inhibitors exhibit favorable effects beyond glucose control, such as consistent body weight, blood pressure, and serum uric acid reductions. This review highlighted the brief updates of SGLT2-i, their benefits, and adverse effects.

scholarly journals Sex-related differences in frailty factors in older persons with type 2 diabetes: a cross-sectional study

2019 ◽  
Vol 10 ◽  
pp. 204201881983330 ◽  
Author(s):  
Akiko Nishimura ◽  
Shin-ichi Harashima ◽  
Kiminori Hosoda ◽  
Hidenori Arai ◽  
Nobuya Inagaki
Keyword(s):  
Type 2 Diabetes ◽  
Skeletal Muscle ◽  
Older Persons ◽  
Skeletal Muscle Mass ◽  
Cross Sectional Study ◽  
Living Alone ◽  
Sectional Study ◽  
Cross Sectional ◽  
Diet Score

Background: This cross-sectional study aimed to describe sex-related differences in diabetes-specific factors underlying the development of frailty in older persons with type 2 diabetes. Methods: Older persons aged 60–80 years were sequentially enrolled. Frailty and sarcopenia were evaluated using the validated Kihon checklist (KCL) and Asian Working Group for Sarcopenia algorithm, respectively. Physical function and characteristics were measured by trained nurses independently. Results: This study included 213 participants. The mean age, body mass index (BMI), and glycated hemoglobin (HbA1c) level were 70.4 years, 24.3 kg/m2, and 7.4%, respectively. Prevalence of frailty was higher in women. Social and cognitive functions were lower in the prefrailty stage, while physical function was lower in the frailty stage, although there was no decrease in skeletal muscle mass. After adjustment for age, the KCL score was significantly associated with peripheral neuropathy, diet score, and coronary artery disease (CAD); frailty, with CAD and inoccupation; prefrailty, with diet score; and sarcopenia, with living alone in men. Meanwhile, the KCL score was significantly associated with living alone and skeletal muscle percentage; prefrailty, with peripheral neuropathy; and sarcopenia, with diabetes duration, LDL-cholesterol level, diet score, and irregular lifestyle in women. Conclusions: Sex differences in the risk factors of frailty should be considered when selecting preventive strategies for older persons with type 2 diabetes, early in the prefrailty stage. In particular, it is important to evaluate social participation and diet therapy in men and skeletal muscle mass and psychosocial function in women.

scholarly journals “I Did Not Believe You Could Get Better”—Reversal of Diabetes Risk Through Dietary Changes in Older Persons with Prediabetes in Region Stockholm

Nutrients ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 2658
Author(s):  
Linda Timm ◽  
Meena Daivadanam ◽  
Anton Lager ◽  
Birger Forsberg ◽  
Claes-Göran Östenson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Persons ◽  
Lifestyle Modification ◽  
Qualitative Content Analysis ◽  
Diabetes Risk ◽  
Main Theme ◽  
Lifestyle Modifications ◽  
Activity Data ◽  
Dietary Changes

Diabetes risk can be controlled and even reversed by making dietary changes. The aim of this study was to improve the understanding of how older persons with a high risk of developing Type 2 diabetes manage and relate to information about diabetes risk over a ten-year period. Fifteen qualitative interviews were conducted among participants from the Stockholm Diabetes Prevention Program (SDPP). The participants were asked to recall the health examinations conducted by the SDPP related to their prediabetes and to describe their experiences and potential changes related to diet and physical activity. Data were analyzed using qualitative content analysis. The main theme found was that T2D (type 2 diabetes) risk is not perceived as concrete enough to motivate lifestyle modifications, such as changing dietary patterns, without other external triggers. Diagnosis was recognized as a reason to modify diet, and social interactions were found to be important for managing behavior change. Diagnosis was also a contributing factor to lifestyle modification, while prognosis of risk was not associated with efforts to change habits. The results from this study suggest that the potential of reversing prediabetes needs to be highlighted and more clearly defined for older persons to serve as motivators for lifestyle modification.

scholarly journals May the Mediterranean diet attenuate the risk of type 2 diabetes associated with obesity: the Seguimiento Universidad de Navarra (SUN) cohort

2017 ◽  
Vol 117 (10) ◽  
pp. 1478-1485 ◽  
Author(s):  
Sonia Eguaras ◽  
Maira Bes-Rastrollo ◽  
Miguel Ruiz-Canela ◽  
Silvia Carlos ◽  
Pedro de la Rosa ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Adverse Effects ◽  
Mediterranean Diet ◽  
Weight Changes ◽  
Product Term ◽  
Hazard Ratios ◽  
The Mediterranean ◽  
Incident Cases

AbstractIt is likely that the Mediterranean diet (MedDiet) may mitigate the adverse effects of obesity on the incidence of type 2 diabetes mellitus (T2DM). We assessed this hypothesis in a cohort of 18 225 participants initially free of diabetes (mean age: 38 years, 61 % women). A validated semi-quantitative 136-item FFQ was used to assess dietary intake and to build a 0–9 score of adherence to MedDiet. After a median of 9·5-year follow-up, 136 incident cases of T2DM were confirmed during 173 591 person-years follow-up. When MedDiet adherence was low (≤4 points), the multivariable-adjusted hazard ratios (HR) were 4·07 (95 % CI 1·58, 10·50) for participants with BMI 25–29·99 kg/m2 and 17·70 (95 % CI 6·29, 49·78) kg/m2 for participants with BMI≥30 kg/m2, (v.<25 kg/m2). In the group with better adherence to the MedDiet (>4 points), these multivariable-adjusted HR were 3·13 (95 % CI 1·63, 6·01) and 10·70 (95 % CI 4·98, 22·99) for BMI 25–30 and ≥30 kg/m2, respectively. The P value for the interaction was statistically significant (P=0·002). When we assessed both variables (BMI and MedDiet) as continuous, the P value for their interaction product-term was marginally significant (P=0·051) in fully adjusted models. This effect modification was not explained by weight changes during follow-up. Our results suggest that the MedDiet may attenuate the adverse effects of obesity on the risk of T2DM.

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