scholarly journals Lack of association between KCNJ11 (rs5219) and ABCC8 (rs757110) polymorphisms and sulphonylurea treatment response in type 2 diabetes patients in Novosibirsk region

2015 ◽  
Vol 18 (1) ◽  
pp. 42-47
Author(s):  
Irina Arkad'evna Bondar ◽  
Maksim Leonidovich Filipenko ◽  
Olesya Yur'evna Shabel'nikova ◽  
Ekaterina Alexeevna Sokolova
Keyword(s):  
Type 2 Diabetes ◽  
Poor Response ◽  
Abcc8 Gene ◽  
Novosibirsk Region ◽  
Kcnj11 Gene ◽  
Sulphonylurea Treatment ◽  
Term Response ◽  
Hba1c Levels

Aim. Sulfonylureas (SU) are widely used in everyday clinical practice in treatment of patients with type 2 diabetes mellitus (T2DM). There is a considerable variability in SU effects, which may be caused by psychological, social, biological and genetic factors. The aim of the study was to investigate the association between rs5219 KCNJ11 gene and rs757110 ABCC8 gene polymorphism and long-term response to SU-drugs of second and third generation in the Novosibirsk region. Materials and Methods. 326 patients with type 2 diabetes in the Novosibirsk region were examined. Patients were divided into 2 groups, depending on HbA1c level. The first group included patients with target HbA1c levels on SU monotherapy. The second group included patients who did not reach target HbA1c levels on the highest dose of SU. Genotyping of KCNJ11 (rs5219) and ABCC8 (rs757110) was performed by TaqMan real-time PCR (ICBFM SB RAS, Novosibirsk, Russia). Results. Patients with type 2 diabetes with a good response to SU-therapy compared to the group of patients with a poor response to SU-therapy were older (65.8?9.1 years vs. 61.6?7.9 years, p

scholarly journals Long-term HbA1c variability and the development and progression of diabetic retinopathy in subjects with type 2 diabetes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Han Ul Kim ◽  
Sung Pyo Park ◽  
Yong-Kyu Kim
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Hba1c Level ◽  
Cox Proportional Hazards ◽  
Progression Rate ◽  
Absolute Increase ◽  
Hba1c Variability ◽  
Hba1c Levels

AbstractThis study aimed to investigate whether long-term HbA1c variability is associated with the development and progression of diabetic retinopathy (DR) in subjects with type 2 diabetes. We retrospectively reviewed 434 type 2 diabetes subjects without DR who underwent regular DR screening. We reviewed fundus findings, collected HbA1c levels, and calculated the coefficient of variation (CV) and average real variability (ARV) of each subject’s HbA1c level. DR was developed in 55 subjects and progressed to moderate nonproliferative DR or worse DR in 23 subjects. On Cox proportional hazards regression analysis, HbA1c ARV, but not HbA1c CV, was significantly associated with DR development. However, the association between HbA1c variability and the DR progression rate to moderate nonproliferative DR or worse DR was not significant. The inter-visit HbA1c difference value on consecutive examination predicted DR development well and more careful screening for DR is needed for those with an absolute value change of 2.05%, an absolute increase of 1.75%, and an absolute decrease of 1.45% in HbA1c levels on consecutive examination. These results indicate that long-term glucose variability measured by HbA1c ARV might be an independent risk factor for DR development in addition to the mean HbA1c level in early diabetic subjects.

scholarly journals Lifestyle medicine for type 2 diabetes: practice-based evidence for long-term efficacy of a multicomponent lifestyle intervention (Reverse Diabetes2 Now)

2020 ◽  
pp. bmjnph-2020-000081
Author(s):  
Gerda K Pot ◽  
Marieke CE Battjes-Fries ◽  
Olga N Patijn ◽  
Nynke van der Zijl ◽  
Hanno Pijl ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Type 2 Diabetes ◽  
Real Life ◽  
Density Lipoprotein ◽  
Lifestyle Interventions ◽  
Cholesterol Levels ◽  
Hba1c Levels

IntroductionA wealth of evidence supports short-term efficacy of lifestyle interventions in type 2 diabetes (T2D). However, little is known about long-term effects of lifestyle interventions in real-life settings.MethodsThis observational, single-arm study evaluated long-term impact of ‘Voeding Leeft: Reverse-Diabetes2-Now’, a 6-month multicomponent lifestyle programme, on glycaemic control and glucose-lowering medication (GLmed) use, other T2D parameters and quality of life in 438 T2D participants at 6, 12, 18 and 24 months using paired sample t-tests, χ2 and generalised linear models.ResultsAt 24 months, 234 participants provided information on GLmed and HbA1c (‘responders’). 67% of the responders used less GLmed, and 28% ceased all GLmed. Notably, 71% of insulin users at baseline (n=47 of 66 insulin users) were off insulin at 24 months. Mean HbA1c levels were similar at 24 months compared with baseline (55.6±12.8 vs. 56.3±10.5 mmol/mol, p=0.43), but more responders had HbA1c levels ≤53 mmol/mol at 24 months (53% vs 45% at baseline). Furthermore, triglyceride levels (−0.34±1.02 mmol/L, p=0.004), body weight (−7.0±6.8 kg, p<0.001), waist circumference (−7.9±8.2 cm, p<0.001), body mass index (−2.4±2.3 kg/m2, p<0.001) and total cholesterol/high-density lipoprotein (HDL) ratio (−0.22±1.24, p=0.044) were lower, while HDL (+0.17 ± 0.53 mmol/L, p<0.001) and low-density lipoprotein-cholesterol levels (+0.18 ± 1.06 mmol/L, p=0.040) were slightly higher. No differences were observed in fasting glucose or total cholesterol levels. Quality of life and self-reported health significantly improved.ConclusionThis study indicates robust, durable real-life benefits of this lifestyle group programme after up to 24 months of follow-up, particularly in terms of medication use, body weight and quality of life in T2D patients.

scholarly journals Soliqua (Lixi Lan): Sustained Long Term Cost Efficacy and Safety When Used in Combination with Metformin and Glimepiride

2021 ◽  
pp. 15-21
Author(s):  
Udaya M. Kabadi ◽  
Sarah Exley
Keyword(s):  
Type 2 Diabetes ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Basal Insulin ◽  
Efficacy And Safety ◽  
Fasting Plasma ◽  
Daily Dose ◽  
Hba1c Levels

Background: Previous studies using basal insulin documented the lowest daily dose and least hypoglycemic events when combined with Glimepiride and Metformin while attaining desirable glycemic control. However, Pivotal trials with Soliqua excluded Glimepiride as a part of therapy as well as subjects with moderate obesity (BMI > 35kg/m2). Moreover, these trials were relatively short term. Objective: Assess long term efficacy and safety of Soliqua in combination with Glimepiride and Metformin in subjects with type 2 diabetes irrespective of BMI in ‘real world’ experience. Subjects: 30 adults with type 2 diabetes, age range 32-72 years with HbA1C >7.5% while receiving therapy with 1) Glimepiride, Metformin and Basal insulin and 2) Metformin and/or DPP 4 inhibitors and/or other SUs and /or GLP1 RA and/or Basal insulin and/or prandial insulin. Type 2 diabetes was confirmed by presence of C-peptide. Subjects with history of gastroparesis, Triglycerides over 300 mg/dl and pancreatitis were excluded. Subjects with elevated liver enzymes, over 2.5 times normal and EGFR < 30 ml/min were excluded as well. Methods: All prior therapies were discontinued. All subjects were started on Glimepiride 8 mg, Metformin 1000-2000 mg and SC Soliqua was initiated prior to breakfast with daily dose 15 or 30 units as recommended. Daily dose was increased by 2 units every 3 days until AM fasting plasma glucose of 80-130 mg/dl was attained or the dose of 60 units was reached. The stable daily dose of Soliqua was continued until the time of analysis. Comparisons were conducted between body weights (kg), fasting plasma glucose (FPG) and HbA1C prior to initiation of combination therapy (pre Rx) and every 3-6 months until the time of analysis (post Rx). Results: BMI ranged between 22-67 kg/m2. Duration of diabetes was 5-25 years. Duration of therapy with the combination therapy range, 7-56 months. Subjects were divided into 2 groups according to desirable HbA1C levels as per recommendations by ADA: 1) desirable HbA1C is < 7.0%, 2) desirable HbA1C 7-8 %. Both Fasting plasma glucose (mg/dl) and HbA1C (%) declined from 167 ± 10 and 9.7 ± 0.8 to 114 ± 4 and 7.6± 0.3 at the time of analyses (post Rx) respectively in the whole cohort. In 4 (0.13 %) morbidly obese subjects, FPG and HbA1C levels declined though not achieving desirable glycemic goals despite receiving maximal daily dose, 60 units of Soliqua. All four belonged to group 1. In the remaining 17 subjects desirable glycemic levels were attained and maintained. In group 2, desirable glycemia was reached in all 9 subjects. Symptomatic hypoglycemic events confirmed by blood sugar <70 mg/dl were reported by 4 subjects, none requiring secondary assistance. No severe hypoglycemia was reported. Mean daily dose of Soliqua was lower when compared to the pivotal trials. Conclusion: Soliqua is effective and safe in the long term in all subjects irrespective of BMI when administered in combination with Glimepiride and Metformin. Moreover, lesser daily dose required to attain desirable glycemia with this oral combination may render it to be effective without attaining maximum daily dose in subjects with higher BMIs documented in pivotal trials using Metformin alone.

scholarly journals HbA1c –Marker for Long Term Glycemic Control

2020 ◽  
Vol 9 (1) ◽  
pp. BC01-BC03
Author(s):  
Ajay Puri ◽  
Jyoti Kohli ◽  
V.J. Chrunjoo
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Blood Glucose ◽  
Protein Glycation ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Hba1c Levels

Background: Protein glycation is a spontaneous reaction that is believed to play a key role in the pathogenesis of many clinical disorders. The glycation of proteins is enhanced by elevated blood glucose concentrations. The major form of protein glycation with a clinical consideration is glycatedhaemoglobin (HbA1c). HbA1c is majorly affected by the blood glucose levels alone. Diabetes mellitus is a metabolic disorder characterized by hyperglycemia. Studies have suggested that HbA1c levels in type-2 diabetes mellitus patients mostly remains elevated, yet some such patients, with or without tight glycemic control, have HbA1c levels nearly close to or within the normal reference range.Subjects and Methods:In this study HbA1c, fasting blood glucose levels and post prandial blood glucose levels in normal subjects as well as in patients with Type-2 diabetes mellitus excluding the complicated ones were studied.Results:The present study confirms earlier studies that all these levels are tightly correlated and the corresponding p values were < 0.001 which were significant and was estimated by using student t-test.Conclusion: Thus indicating that glycated hemoglobin (HbA1c) can be used to assess the glycemic status of an individual for attaining the treatment goal of preventing long term complications of diabetes mellitus.

scholarly journals Time to insulin initiation and long-term effects of initiating insulin in people with type 2 diabetes mellitus: the Hoorn Diabetes Care System Cohort Study

2016 ◽  
Vol 174 (5) ◽  
pp. 563-571 ◽  
Author(s):  
Ruth Mast ◽  
A P Danielle Jansen ◽  
Iris Walraven ◽  
Simone P Rauh ◽  
Amber A W A van der Heijden ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Oral Glucose ◽  
Long Term Effects ◽  
Insulin Initiation ◽  
Glucose Lowering ◽  
Hba1c Levels

ObjectiveThe aim of this study was to assess the time to insulin initiation in type 2 diabetes mellitus (T2DM) patients treated with oral glucose-lowering agents and to determine the baseline characteristics associated with time to insulin initiation. This was evaluated in T2DM patients with HbA1c levels consistently ≥7.0% during total follow up and in those with fluctuating HbA1c levels around 7.0%.Design and methodsProspective, observational study was performed, comprising 2418 persons with T2DM aged ≥40 years who entered the Diabetes Care System between 1998 and 2012 with a minimum follow up of at least 3 years, following the first HbA1c level ≥7.0%. Cox regression analyses were performed to assess the determinants of time to insulin initiation. Data related to long-term effects of insulin initiation were studied at baseline and at the end of follow up using descriptive summary statistics.ResultsTwo-thirds of the patients initiated insulin during follow up. The time to insulin varied from 1.2 years (range 0.3–3.1) in patients with HbA1c levels consistently ≥7.0% to 5.4 years (range 3.0–7.5) in patients with fluctuating HbA1c levels around 7.0%. Longer diabetes duration (hazard ratio (HR) 1.04 95% CI 1.03–1.05) and lower age (HR 1.00 95% CI 0.99–1.00) at baseline were associated with a shorter time to initiation. More insulin initiators had retinopathy compared with patients that remained on oral glucose-lowering agents during follow up.ConclusionThe time to insulin initiation was short, and most of the patients with HbA1c levels consistently ≥7.0% were initiating insulin. Longer diabetes duration and younger age shortened the time to insulin.

Abstract #238: Improved Short Term and Long Term Outcomes of Early Insulin Initiation in Type 2 Diabetes Over 10 Years

2017 ◽  
Vol 23 ◽  
pp. 50
Author(s):  
Jothydev Kesavadev ◽  
Shashank Joshi ◽  
Banshi Saboo ◽  
Hemant Thacker ◽  
Arun Shankar ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Initiation ◽  
Long Term Outcomes ◽  
Short Term
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