scholarly journals Effectiveness of Lilly Connected Care Program (LCCP) App-Based Diabetes Education for Patients With Type 2 Diabetes Treated With Insulin: Retrospective Real-World Study

10.2196/17455 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e17455
Author(s):  
Yiyu Zhang ◽  
Chaoyuan Liu ◽  
Shuoming Luo ◽  
Jin Huang ◽  
Xia Li ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Mobile Apps ◽  
Diabetes Education ◽  
Young Patients ◽  
Care Program ◽  
Regression Analyses ◽  
Group A ◽  
Group B ◽  
Education Courses

Background Diabetes poses heavy economic and social burdens worldwide. Mobile apps show great potential for diabetes self-management education. However, there is limited evidence for the effectiveness of providing general diabetes education through mobile apps. Objective The aim of this study was to clarify the effectiveness of Lilly Connected Care Program (LCCP) app-based diabetes education for glycemic control. Methods This retrospective cohort study included patients with diabetes recruited to the LCCP platform from September 1, 2018, to May 31, 2019. Each patient was followed for 12 weeks. According to the number of diabetes education courses they had completed, the patients were divided into the following three groups: group A (0-4 courses), group B (5-29 courses), and group C (≥30 courses). The main outcomes were the change in blood glucose at the 12th week compared with baseline and the differences in blood glucose at the 12th week among the three groups. The associations of the number of diabetes education courses completed with the average blood glucose and frequency of self-monitoring of blood glucose (SMBG) at the 12th week were assessed by multivariate linear regression analyses controlling for other confounding covariates. Univariate and multivariate linear regression analyses were used to assess factors influencing patients’ engagement in the diabetes education courses. Results A total of 5011 participants were enrolled. Their mean fasting blood glucose (FBG) and postprandial blood glucose (PBG) were significantly lower at the 12th week than at baseline (FBG, 7.46 [standard deviation (SD) 1.95] vs 7.79 [SD 2.18] mmol/L, P<.001; PBG, 8.94 [SD 2.74] vs 9.53 [SD 2.81] mmol/L, P<.001). The groups that completed more diabetes education courses had lower FBG (group B, β=−0.14, 95% CI −0.26 to −0.03; group C, β=−0.29, 95% CI −0.41 to −0.16; P for trend <.001) and PBG (group B, β=−0.29, 95% CI −0.46 to −0.11; group C, β=−0.47, 95% CI −0.66 to −0.28; P for trend <.001) and a higher frequency of SMBG at the 12th week (group B, β=1.17, 95% CI 0.81-1.53; group C, β=4.21, 95% CI 3.81-4.62; P for trend <.001) when compared with the findings in group A. Age and education were related to patients’ engagement in the diabetes education courses. Middle-aged patients (35-59 years old) and elderly patients (≥60 years old) completed more diabetes education courses (middle-aged group, β=2.22, P=.01; elderly group, β=2.42, P=.02) than young patients (18-34 years old). Conclusions LCCP app-based diabetes education is effective for glycemic control and SMBG behavior improvement in patients with type 2 diabetes receiving insulin therapy. Young patients’ engagement in the education courses was relatively low. We need to conduct in-depth interviews with users to further improve the curriculum.

scholarly journals Effectiveness of Lilly Connected Care Program® (LCCP®) App-Based Diabetes Education for Type 2 Diabetic Patients Treated with Insulin: A Retrospective Real-World Study (Preprint)

2019 ◽  
Author(s):  
Yiyu Zhang ◽  
Chaoyuan Liu ◽  
Shuoming Luo ◽  
Jin Huang ◽  
Xia Li ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Mobile Apps ◽  
Diabetes Education ◽  
Young Patients ◽  
Care Program ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Group A ◽  
Group B ◽  
Education Courses

BACKGROUND Diabetes poses a heavy economic and social burden worldwide. Mobile apps show great potential for diabetes self-management education. However, there is limited evidence for the effectiveness of providing general diabetes education through mobile apps. OBJECTIVE The aim of this study was to clarify the effectiveness of the Lilly Connected Care Program® (LCCP®) app-based diabetes education for glycemic control. METHODS This retrospective cohort study included diabetic patients recruited to the LCCP platform from September 1, 2018, to May 31, 2019. Each patient was followed up for 12 weeks. According to the number of diabetes education courses they had completed, the patients were divided into three groups: group A (0-4 courses), group B (5-29 courses) and group C (≥30 courses). The main outcomes were the change in blood glucose at the 12th week compared with baseline and the differences in blood glucose at the 12th week among the three groups. The association between the number of diabetes education courses completed and the average blood glucose and self-monitoring of blood glucose (SMBG) at the 12th week was assessed by multivariate linear regression analysis controlling for other confounding covariates. Univariate and multivariate linear regression analyses were used to assess the factors influencing patients’ engagement in the diabetes education courses. RESULTS A total of 5011 participants were enrolled. Their mean fasting blood glucose (FBG) and postprandial blood glucose (PBG) were significantly lower at the 12th week than at baseline (FBG, 7.46 ± 1.95 vs 7.79 ± 2.18 mmol/L, P <.001; PBG, 8.94 ± 2.74 vs 9.53 ± 2.81 mmol/L, P <.001). Compared with group A, the groups that completed more diabetes education courses had lower FBG (group B, β=-0.15, 95% CI -0.26－-0.03; group C, β= -0.29, 95% CI -0.41－-0.16; P for trend <.001) and PBG (group B, β=-0.29, 95% CI -0.46－-0.11; group C, β= -0.47, 95% CI -0.66－-0.28; P for trend <.001) and a higher frequency of SMBG at the 12th week (group B, β=1.17, 95% CI 0.81－1.53; group C, β = 4.21, 95% CI 3.81－4.62; P for trend <.001). Age and education were related to patients’ engagement in the diabetes education courses. Compared with young patients (18-34 years old), middle-aged patients (35-59 years old) and elderly patients (≥ 60 years old) completed more diabetes education courses (middle-aged group, β=2.22, P=.01; elderly group, β=2.42, P=.02). CONCLUSIONS The app-based diabetes education is effective for glycemic control and SMBG behavior improvement in type 2 diabetic patients with insulin therapy. Young patients' engagement in the education courses is relatively low. We need to conduct in-depth interviews with users to further improve the curriculum.

scholarly journals Effectiveness of Family Portal Function on Lilly Connected Care Program (LCCP) in Patients with Type 2 Diabetes: a Retrospective Cohort Study with Propensity Score Matching (Preprint)

2020 ◽  
Author(s):  
Yiyu Zhang ◽  
Chaoyuan Liu ◽  
Shuoming Luo ◽  
Jin Huang ◽  
Yuxin Yang ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Diabetes Management ◽  
Diabetes Education ◽  
Care Program ◽  
The Family ◽  
Group A ◽  
Baseline Characteristics ◽  
Group B ◽  
Education Courses

BACKGROUND Diabetes is a major health concern worldwide. Family member engagement in diabetes self-management education programmes can improve patients’ diabetes management. However, there is limited evidence that the family portal on diabetes management apps is effective in the glycaemic control of patients with diabetes. OBJECTIVE We aimed to evaluate the effectiveness of family support through the family portal function on Lilly Connected Care Program® (LCCP®) platform. METHODS This retrospective cohort study included patients with type 2 diabetes (T2DM) recruited to the LCCP platform from September 1, 2018 to August 31, 2019. Propensity score matching was used to match family (group A) and non-family (group B) portal use groups with similar baseline characteristics. The patients were followed up for 12 weeks. The main objectives were differences in mean fasting blood glucose (FBG), proportion of patients achieving FBG target < 7mmol/L, mean postprandial blood glucose (PBG), proportion of patients achieving PBG target <10mmol/L, proportion of patients achieving both FBG <7mmol/L and PBG <10mmol/L, self-monitoring of blood glucose (SMBG) frequency at week 12 and the number of diabetes education courses patients completed during the 12 weeks. Moreover, logistic regression analysis was used to explore the baseline factors which may be associated with the use of family portal, and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. RESULTS A total of 6582 adult patients (aged ≥18 years) with T2DM who were treated with insulin were enrolled in the study. Overall, 6.1% (402/6582) of the patients chose to engage their family members to use the family portal. Two groups of 394 patients were well-matched regarding baseline characteristics. After matching, mean FBG and PBG at week 12 were significantly lower in group A than group B (FBG, 7.12 ± 1.70 mmol/L vs. 7.42 ± 1.88 mmol/L, P = .02; PBG, 8.56 ± 2.51 mmol/L vs. 9.10 ± 2.69 mmol/L, P = .002). The proportion of patients achieving both FBG <7mmol and PBG <10mmol/L at week 12 (46.8% vs. 39.4%, P=.04), SMBG frequency at week 12 (8.92 ± 6.77 vs 8.02 ± 5.97 times per week, P = .05) and number of diabetes education courses completed in 12 weeks (23.00 [interquartile range (IQR) 9.00-38.00] vs 15.00 [IQR 4.00-36.00], P<.001) were higher in group A than group B. Besides, multivariate logistic regression analysis showed that higher age (OR=0.987, P=.006) and higher baseline FBG (OR=0.914, P=.004) were correlated with less use of family portal function, while increased baseline SMBG frequency (OR=1.022, P<.001) as well as increased education courses (OR=1.026, P<.001) were associated with more of using family portal function. CONCLUSIONS Family support through the LCCP family portal is effective for glycaemic control and self-management behaviour improvement in T2DM patients.

scholarly journals Effectiveness of the Family Portal Function on the Lilly Connected Care Program (LCCP) for Patients With Type 2 Diabetes: Retrospective Cohort Study With Propensity Score Matching

10.2196/25122 ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. e25122
Author(s):  
Yiyu Zhang ◽  
Chaoyuan Liu ◽  
Shuoming Luo ◽  
Jin Huang ◽  
Yuxin Yang ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Fasting Blood Glucose ◽  
Postprandial Blood Glucose ◽  
Self Monitoring ◽  
The Family ◽  
Group A ◽  
Group B ◽  
Education Courses

Background Diabetes is a major health concern worldwide. Family member engagement in diabetes self-management education programs can improve patients’ diabetes management. However, there is limited evidence that the family portal on diabetes management apps is effective in the glycemic control of patients with diabetes. Objective We aimed to evaluate the effectiveness of family support through the family portal function on Lilly Connected Care Program (LCCP) platform. Methods This retrospective cohort study included patients with type 2 diabetes recruited to the LCCP platform from September 1, 2018, to August 31, 2019. Propensity score matching was used to match family (group A) and non–family (group B) portal use groups with similar baseline characteristics. The patients were followed up with for 12 weeks. The main objectives were differences in mean fasting blood glucose, proportion of patients achieving fasting blood glucose target <7mmol/L, mean postprandial blood glucose, proportion of patients achieving postprandial blood glucose target <10mmol/L, proportion of patients achieving both fasting blood glucose <7mmol/L and postprandial blood glucose <10mmol/L, self-monitoring of blood glucose frequency at week 12 and the number of diabetes education courses patients completed during the 12 weeks. Moreover, logistic regression analysis was used to explore the baseline factors which may be associated with the use of family portal, and odds ratios with 95% confidence intervals were calculated. Results A total of 6582 adult patients (aged ≥18 years) with type 2 diabetes who were receiving insulin therapy were enrolled in the study. Overall, 6.1% (402/6582) of the patients chose to engage their family members to use the family portal. Two groups of 394 patients were well-matched regarding baseline characteristics. After matching, mean fasting blood glucose and postprandial blood glucose at week 12 were significantly lower in group A than in group B (fasting blood glucose: 7.12 mmol/L, SD 1.70 vs 7.42 mmol/L, SD 1.88, respectively, P=.02; postprandial blood glucose: 8.56 mmol/L, SD 2.51 vs 9.10 mmol/L, SD 2.69, respectively, P=.002). When comparing group A to group B, the proportion of patients achieving both fasting blood glucose <7mmol and postprandial blood glucose <10mmol/L at week 12 (46.8% vs 39.4%, respectively, P=.04), self-monitoring of blood glucose frequency at week 12 (8.92 times per week, SD 6.77 vs 8.02 times per week, SD 5.97, respectively, P=.05) and number of diabetes education courses completed in 12 weeks (23.00, IQR9.00-38.00 vs 15.00, IQR 4.00-36.00, respectively, P<.001) was higher. Additionally, multivariate logistic regression analysis showed that higher age (OR=0.987, 95% CI 0.978-0.996, P=.006) and higher baseline fasting blood glucose (OR=0.914, 95% CI 0.859-0.972, P=.004) were correlated with less use of the family portal function, while increased baseline self-monitoring of blood glucose frequency (OR=1.022, 95% CI 1.012-1.032], P<.001) as well as increased education courses (OR=1.026, 95% CI 1.015-1.036, P<.001) were associated with more use of the family portal function. Conclusions Family support through the LCCP family portal is effective for glycemic control and self-management behavior improvement in type 2 diabetes patients.

scholarly journals Clinical appraisal of Lodhradi Kashaya on type 2 diabetes mellitus patients

2017 ◽  
Vol 4 (1) ◽  
pp. 58
Author(s):  
Varun K. Singh ◽  
K. R. C. Reddy
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Blood Glucose ◽  
Dosage Form ◽  
Dose Group ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Lodhradi Kashaya (LKSD) is basically ayurvedic kwath dosage form, described as Madhumehajeet (winner of diabetes mellitus) in ayurvedic classics Basavarajeeyam and the same formulation in Vaidya Chintamani and Charaka Samhita too. The aim of this study was to assess prospectively the drug’s ability in management of type 2 diabetes. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">Total 31 patients were taken following the guideline mention in CCRAS protocol for diabetes mellitus research. They are divided into two groups, group A and B, given LKSD 4 g &amp; 2 g TDS respectively for three-month follow up. They are investigated against their blood glucose, HbA1C and liver profile tests. Patients were also investigated for subjective parameters viz polyurea, polyphagia, exhaustion and constipation and their response has also been noted regarding palatability acceptance and ease of administration.</span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Patients has responded positively for formulation. Decrease in FBS and PPBS were found highly significant (P ˂ 0.001) in both groups but more in higher dose (group A). Decrease in HbA1C is also found highly significant in both groups. In LFT, SGOT level were also decreased more in group B in comparison to group A, and it is significant (P = 0.017 and 0.002). SGPT level were also decreased more in group B in comparison to group A, and it is significant in group B (P= 0.085 and 0.002).  </span></p><p class="abstract"><strong>Conclusions:</strong> LKSD is having astringent taste due to tannins and phenols in it. It was found significant not only in controlling blood sugar but also in management of other factors related to diabetes mellitus.</p>

scholarly journals PPAR-αAgonist Fenofibrate Decreased Serum Irisin Levels in Type 2 Diabetes Patients with Hypertriglyceridemia

PPAR Research ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Xiaomeng Feng ◽  
Xia Gao ◽  
Yumei Jia ◽  
Heng Zhang ◽  
Qingrong Pan ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
High Density Lipoprotein ◽  
Metabolic Disorders ◽  
Fasting Blood Glucose ◽  
Density Lipoprotein ◽  
Group A ◽  
Group B ◽  
Diabetes Patients

Irisin is related to insulin resistance and metabolic disorders. The physiologic effects of irisin are partially mediated through peroxisome proliferator-activated receptor-α(PPAR-α). We investigated the effect of fenofibrate, a PPAR-αagonist, on serum irisin in type 2 diabetes patients with hypertriglyceridemia. This study evaluated cross-sectional and interventional studies of 25 type 2 diabetes patients with hypertriglyceridemia (group A) and 40 controls (group B). Group A was treated with fenofibrate (200 mg/day) for 8 weeks. Serum irisin and clinical characteristics were examined. Serum irisin was significantly higher in group A compared with group B (45.15±10.48versus35.38±9.97 ng/ml,P<0.001) and correlated with body mass index (r=0.314,P=0.011), fasting blood glucose (r=0.399,P=0.001), total cholesterol (r=0.256,P=0.040), and high-density lipoprotein cholesterol (r=0.247,P=0.047). In multiple regression analysis after controlling for confounders, only fasting blood glucose (β=5.615,P<0.001) and high-density lipoprotein cholesterol (β=19.483,P<0.001) were independently related to serum irisin. After 8 weeks of fenofibrate treatment, serum irisin significantly decreased in group A compared with baseline (45.15±10.48versus38.74±12.54 ng/ml,P=0.011). Conclusively, fenofibrate decreased serum irisin in type 2 diabetes patients with hypertriglyceridemia, indicating that PPAR-αagonists may protect against metabolic disorders by improving irisin resistance.

scholarly journals Pengaruh durasi senam diabetes pada penurunan glukosa darah penderita diabetes mellitus tipe II

2018 ◽  
Vol 15 (2) ◽  
pp. 37
Author(s):  
Weni Kurdanti ◽  
Tri Mei Khasana
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Aerobic Exercise ◽  
Blood Sugar ◽  
Significant Difference ◽  
Before And After ◽  
Post Test ◽  
Group A ◽  
Group B

Background: The management of DM focused on four pillars: education, nutrition therapy, physical exercise, and pharmacological interventions. In type 2 diabetes, physical activity functions primarily in controlling diabetes.Objective: This study aims to determine the effect of differences in the duration of aerobic exercise on blood glucose levels.Method: This was quasi-experimental research with pre-post test design. A total of 24 respondents with type 2 diabetes were divided into two groups consisting of groups A that received aerobic exercise with a duration of 30 minutes and group B received aerobic exercise with a duration of 60 minutes for 6 weeks and frequency of exercise 3 times each week. Statistical tests use paired t-tests and independent t-tests.Results: The mean post-test blood sugar level based on HbA1c measurements in group A was 7.92±1.56% while group B was 7.13±0.99%. Mean pre-test - post-test blood sugar levels in the two groups were significantly different (p<0.05). Aerobic exercise for 6 weeks with a frequency of 3 times each week can reduce HbA1c by -2.5±0.96% in group A while group B increased by 0.02±0.29%. There is a significant difference in HbA1c before and after 6 weeks of aerobic exercise between two groups (p=0.021).Conclusion: Aerobic exercise with a duration of 30 minutes for 6 weeks 3 times each week can reduce blood glucose (HbA1c) by -2.5±0.96% while the group duration of aerobic exercise 60 minutes an increase of 0.02±0.29%. There is a significant difference in HbA1c before and after 6 weeks of aerobic exercise between the two groups.

scholarly journals Correlation Between Vitamin D3 and Fasting Blood Sugar in Type 2 Diabetes Mellitus Patients and Normal Individuals in a Bangladeshi Population

2020 ◽  
Vol 9 (2) ◽  
pp. 65-68
Author(s):  
Md. Tazul Islam ◽  
Miliva Mozaffor ◽  
Md. Ehsanul Islam ◽  
Heera Lal Roy
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Blood Glucose ◽  
Vitamin D3 ◽  
Fasting Blood Glucose ◽  
Group A ◽  
Group B ◽  
25 Hydroxycholecalciferol

Background and Aims: Controversies prevail on association of vitamin D level and type 2 diabetes mellitus. The present study aims to compare serum 25-hydroxycholecalciferol (vitamin D3) level and fasting blood glucose in type 2 diabetes mellitus patients and healthy subjects and evaluate their association in both groups. Methods: This cross-sectional, observational study was done in Department of Biochemistry, Sylhet MAG Osmani Medical College, Bangladesh, between July 2015 and June 2016. The patients were selected from medicine out-patients departments (MOPD) of Sylhet MAG Osmani Medical College Hospital and Sylhet Diabetic Hospital, Bangladesh. A total of 135 study subjects were selected following convenient consecutive sampling technique. They grouped into case (Group A) i.e. 65 patients having type 2 diabetes mellitus, and control (Group B), i.e. 70 patients apparently healthy subjects (non-diabetic). Initial evaluation of the patients done by history and clinical examination was recorded in the preformed data collection sheet. Fasting blood glucose was measured by enzymatic method, while serum 25-hydroxycholecalciferol (vitamin D3) was measured by radioimmunoassay (RIA). Results: The mean age of 42.02±3.29 years in case (Group A); while 41.35±3.97 years in control (Group B). There were 33 male (50.76%) and 32 (49.23%) female in group A, while 35 (50%) male and 35 (50%) female in group B. No significant age difference was observed between the groups (p=0.284). Serum 25-hydroxycholecalciferol in cases (Group A) was 55.73±9.02 ng/ml and in controls (Group B) 53.77±10.86 ng/ ml (p=0.255). Fasting blood glucose was 161.98±62.47 mg/dl in cases (Group A) and 86.92±15.74 mg/dl in controls (Group B) (p<0.001). No correlation was found between serum 25-hydroxycholecalciferol and fasting blood glucose in any group: in type 2 diabetic patients (case group) (r=0.010, p=0.943), in healthy controls (r=0.186, p=0.122), and all study subjects together (r=0.095, p=0.268). Conclusions: Our data suggest that serum 25-hydroxycholecalciferol (vitamin D3) was within optimum level in both type 2 diabetic patients and healthy individuals. However, no correlation was found between serum 25-hydroxycholecalciferol and fasting blood glucose in any group.  

scholarly journals A prospective open labelled study of effect of vildagliptin with metformin in patients with type 2 diabetes mellitus

2019 ◽  
Vol 8 (8) ◽  
pp. 1880
Author(s):  
Lavakumar S. ◽  
Jesurun R. S.
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Body Weight ◽  
Blood Glucose ◽  
Serum Urea ◽  
Once Daily ◽  
Group A ◽  
Group B

Background: The pathophysiology of Type 2 Diabetes Mellitus (T2DM) is characterized by deficient insulin activity arising from decreased insulin secretion secondary to beta cell failure, and/or compromised insulin action in peripheral target tissues (insulin resistance).Methods: The patients attending the medicine outpatient department of tertiary care teaching hospital were enrolled in the study. Patients, who fulfilled the selection criteria, were allocated in two treatment groups. Group A was treated with metformin (Sustained release preparation) 500mg once daily and group B was treated with vildagliptin 50mg once daily. Measurement of body weight, fasting blood glucose (FPG), postprandial blood glucose (PPG), glycated haemoglobin (HbA1c), serum urea, creatinine and urine albumin/creatinine ratio was performed at the initial visit and at the end of 12 weeks of treatment.Results: Out of 84 patients screened, 74 were enrolled for the study. Of the 74 patients, 39(52.7%) were male and 35(47.3%) were female. The patients were divided into two groups (group A and group B) consisting 37 patients in each group. Out of 74 patients, 62 completed the study. Out of 12 patients who did not complete the study, 5 patients were lost during follow-up period and 7 patients discontinued treatment due to AEs. The mean age of the patients was 51 and 49years in the groups A and B respectively. There was no statistical difference in the baseline FPG, PPG, HbA1c, serum urea, serum creatinine, urine ACR and body weight between two groups.Conclusions: The study shows that metformin and vildagliptin have similar effect on glycaemic control, but vildagliptin exerts better Reno protective effect and there were no reports of serious adverse events.

scholarly journals TYPE 2 DIABETES MELLITUS;

2019 ◽  
Vol 26 (04) ◽  
Author(s):  
Doctor Dilshad Muhammad ◽  
Masood Javed ◽  
Muzzammal Iftikhar
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Blood Glucose ◽  
Fasting Blood Glucose ◽  
P Value ◽  
Group A ◽  
Group B ◽  
New Onset

Background: Diabetic complications are related to impaired glycemic control. The UK Prospective Diabetes Study (UKPDS) showed that metformin therapy in overweight and obese patients with type 2 diabetes mellitus (T2DM) could reduce HbA1c and complications. So, metformin has been suggested to be the drug of choice after life style modifications in patients with T2DM. Repaglinide, short-acting insulin secretagogues, has excellent anti-hyperglycemic effect and a lower risk of hypoglycemia. However, whether repaglinide can be used as an initial therapy in patients with newly diagnosed T2DM is still unconfirmed. Objectives: The objective of this study was: To compare efficacy of Repaglinide and Metformin in the Treatment of New Onset Type 2 Diabetes Mellitus. Study Design: Randomized Controlled Trial. Setting: District headquarter Hospital, Faisalabad. Period: 6 Months (Jan 2018 to June 2018). Methodology: Patients were randomly divided into two groups (A & B) by using computer generated random number table. Group A was given repaglinide 0.75-1.5 mg/day while group B received metformin 750-1500mg/day. The doses of metformin and repaglinide were adjusted according to blood glucose level. For HbA1C and FBS, blood samples were sent to pathology laboratory at the start of study and after 3 months. Follow up was ensured by reaching the patients through telephonic contact. Data was collected through self-conducted interviews using a standardized Performa. Results: In our study, mean+sd was calculated as 44.54+5.92 years in Group-A and 45.31+6.13 years in Group-B, 42.86%(n=15) in Group-A and 40%(n=14) in Group-B were male whereas 57.14%(n=20) in Group-A and 60%(n=21) in Group-B were females. Baseline mean HbA1c levels of the patients were calculated as 7.51+0.50 mmol/L in Group-A and 7.54+0.52 mmol/L in Group B, p value was 0.81. After treatment, these findings were reduced to 5.57+0.65 in Group-A and 6.4+0.49 in Group-B, p value was 0.0001, At baseline mean fasting blood glucose levels of the patients were calculated as 7.43+0.56 mmol/L in Group-A and 7.46+0.50 mmol/L in Group B, p value was 0.82. After treatment, these findings were reduced to 5.83+0.71 in Group-A and 6.29+0.67 in Group-B, p value was 0.007. Conclusion: We concluded that on comparison of Metformin and Repaglinide monotherapy in the Treatment of New Onset Type 2 Diabetes Mellitus in terms of mean fasting blood glucose and mean HbA1c, both drugs reduced HbA1c and fasting blood sugar but Repaglinide was found significantly better for reduction of HbA1c and fasting blood sugar when compared to Metformin.

An Efficacy and Safety Study of Remogliflozin in Obese Indian Type 2 Diabetes Mellitus Patients Who Were Inadequately Controlled on Insulin glargine plus other oral hypoglycemic agents

2020 ◽  
Vol 17 ◽  
Author(s):  
Anand Shankar
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Glargine ◽  
Therapy Group ◽  
Insulin Dose ◽  
Blood Glucose Control ◽  
Hypoglycemic Agents ◽  
Oral Drug ◽  
Group A ◽  
Group B

Aim & Objective: The objective of this retrospective study was to investigate the efficacy of adding remogliflozin to current insulin glargine plus two oral drug i.e. metformin and teneligliptin therapy in poorly controlled Indian type 2 diabetes. Material and Methods: 173 study participants were initially selected from patient database who continued on their insulin glargine or received an increased dose of insulin glargine along with other OHA based therapy (Group A) and 187 were selected who had received remogliflozin (100 mg BD) (Group B) in addition to insulin glargine along with other OHA based therapy. Glycated haemoglobin (HbA1c), total daily insulin dose, body weight, and the number of hypoglycemic events were recorded at weeks 0, 12 and 24. Result: During the study, mean values of HbA1c, FBG and P2BG were significantly reduced in both groups. Insulin requirements decreased from 45.8 ± 16.7 IU/day to 38.5 ± 13.5 IU/day (P < 0.001) and at week 24 even further decreased to 29.5 ± 14.5 IU/Day . Twenty three patients in group B were able to cease insulin treatment altogether after 24 week treatment. It has been observed to attain tight blood glucose control we need to increase insulin dose in group A from 45.5 ± 16.5 IU/Day to 51.5 ± 14.5 at week 12 (P<0.01) and which further increased to 53.8 ± 12.8 IU/Day at week 24 (P<0.01). Adding remogliflozin showed significant effect on blood pressure (P < 0.001) and weight reduction (P < 0.001). It has been observed that 38% patients has achieves targeted HbA1c (≤7%) in group B where it was 22% in group A. Conclusion: Results demonstrate that in uncontrolled T2DM patients remogliflozin 100 mg BD can successfully lay a foundation for prolonged good glycemic control. Early addition of remogliflozin with insulin glargine plus OHAs may be an alternative compare to intensive up titration of insulin daily dose in people with uncontrolled T2DM. Clinical Trial Registration Number: A 2358

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