scholarly journals The effect of metformin on fasting and postprandial insulin secretion in obese patients with diabetes mellitus type 2

2007 ◽  
Vol 135 (7-8) ◽  
pp. 447-452 ◽  
Author(s):  
Mira Vukovic ◽  
Mirjana Lapcevic ◽  
Nevena Kalezic ◽  
Branislav Gvozdenovic

Introduction The main causes of reduced glucose levels during metformin therapy appear to be an increase in insulin action in peripheral tissues and reduced hepatic glucose output due to inhibition gluconeogenesis. Objective The purpose of the study was to establish the effect of metformin on fasting and postprandial insulin secretion. Method The study carried out was double blind, controlled, comparative, randomized, multicentric, including two groups of out-patient department (OPD) patients. 43 patients were administered metformin (Tefor ICN Canada), and 46 patients were given placebo. Patients enrolled in the study were newly diagnosed with diabetes mellitus (DM) type 2, glycaemia < 12 mmol/l, and had the Body Mass Index (BMI) > 30 kg/m2. Before treatment, blood biochemistry was done: fasting and postprandial glycaemia, glycosylated haemoglobin (HbA1c) value, fasting and postprandial insulinaemia, blood lipids (total cholesterol, total triglycerides, HDL cholesterol, and LDL cholesterol), and gamma glutaryl transferase (GGT) level. BMI was also established. After 42 days of treatment, fasting and postprandial insulinaemia were tested again. Analysis of the effects of therapy, and identification of co-variants for fasting and postprandial insulinaemia, were done by ANOVA two way and ANCOVA method. Results It was shown that metformin accompanied by diet, as compared to placebo accompanied by diet, lowered the fasting insulinaemia value during six weeks of therapy in obese patients with DM type 2 (24.392 mU/l vs. 25.667 mU/l), interacting both with BMI pre-therapy, and interacting with fasting insulinaemia pre-therapy (p<0.001). A significant effect of the interaction of covariants BMI and GGT was defined. As for the effect of therapy on postprandial insulinaemia, it was found that there was a high statistical significance of the effect of BMI interacting with initial values for postprandial insulinaemia before therapy, and interacting with therapy (p<0.01). Adjusted mean values for postprandial insulinaemia after therapy in the placebo group were lower as compared to the metformin group (44.807 mU/l vs. 47.114 mU/l). Conclusion It can be concluded that, as compared to placebo, metformin is more efficient in reducing insulin resistance in obese patients with DM type 2. In addition, as compared to placebo, metformin maintains more efficient productive insulin secretion, indicating that metformin protects the pancreas from beta cell depletion.

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Jinnan Li ◽  
Jinlei Feng ◽  
Hong Wei ◽  
Qunying Liu ◽  
Ting Yang ◽  
...  

Type 2 diabetes mellitus (T2DM) is a chronic disease characterized by hyperglycemia and dyslipidemia caused by impaired insulin secretion and resistance of the peripheral tissues. A major pathogenesis of T2DM is obesity-associated insulin resistance. Gynura divaricata (L.) DC. (GD) is a natural plant and has been reported to have numerous health-promoting effects on both animals and humans. In this study, we aimed to elucidate the regulatory mechanism of GD improving glucose and lipid metabolism in an obesity animal model induced by high-fat and high-sugar diet in combination with low dose of streptozocin and an insulin-resistant HepG2 cell model induced by dexamethasone. The study showed that the water extract of GD (GD extract A) could significantly reduce fasting serum glucose, reverse dyslipidemia and pancreatic damage, and regulate the body weight of mice. We also found that GD extract A had low toxicity in vivo and in vitro. Furthermore, GD extract A may increase glucose consumption in insulin-resistant HepG2 cells, markedly inhibit NF-κB activation, and decrease the impairment in signaling molecules of insulin pathway, such as IRS-1, AKT, and GLUT1. Overall, the results indicate that GD extract A is a promising candidate for the prevention and treatment of T2DM.


2021 ◽  
Vol 17 (4) ◽  
pp. 322-328
Author(s):  
A.V. Кovalchuk ◽  
О.В. Zinych ◽  
V.V. Korpachev ◽  
N.M. Кushnareva ◽  
О.В. Prybyla ◽  
...  

Recent studies have demonstrated the importance of bone as an endocrine organ that produces biologically active substances, which regulate both local bone metabolism and metabolic functions throughout the body. In the process of bone remodeling (formation/destruction), the active cells secrete specific biomarkers that help detect osteometabolic dysfunction. Among bone hormones, osteocalcin plays an important role as a coordinator of bone modeling processes, energy homeostasis, metabolism of glucose, lipids and minerals. Osteocalcin is a structural protein of the bone matrix, which is synthesized by osteoblasts and enters the bloodstream in the process of bone resorption. The level of osteocalcin in the serum is used as a specific marker of bone formation. Osteocalcin promotes pancreatic β-cell proliferation and insulin secretion, and also affects the insulin sensitivity of peripheral tissues. The inverse association of glycemia with the level of osteocalcin was revealed. Patients with type 2 diabetes mellitus usually have normal or even slightly elevated bone mineral density compared to age-appropriate controls. Decreased bone quality and increased risk of fractures are associated with changes in bone microarchitecture and local humoral environment. An imbalance in osteoblast/osteoclast activity may be due to oxidative stress and the accumulation of glycosylation end products, which contributes to chronic inflammation and bone resorbtion in patients with diabetes. It is shown that the level of osteocalcin in the blood serum is significantly reduced compared to healthy controls, both in patients with type 1 diabetes mellitus and, especially, in type 2 diabetes mellitus. Given the importance of developing new approaches to the diagnosis and correction of metabolic disorders in diabetic patients, the study of the influence of bone hormones on hormonal and metabolic parameters and bone status, including the risk of fractures, remains relevant in modern diabetology.


ISRN Obesity ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Maria João Neuparth ◽  
Jorge Brandão Proença ◽  
Alice Santos-Silva ◽  
Susana Coimbra

Aim. Our aim was to study how different BMI scores may influence the levels of inflammation, oxidative stress, adipogenesis, glucose, and lipid metabolism, in lean, overweight, and obese Portuguese patients with type 2 diabetes mellitus (T2DM). Methods. We studied 28 lean, 38 overweight, and 17 obese patients with T2DM and 20 controls (gender and age matched). The circulating levels of oxLDL, CRP, and some adipokines—adiponectin, leptin, and chemerin—and the lipid profile were evaluated. Results. Obese patients presented significantly lower levels of adiponectin and higher leptin, oxLDL, and chemerin levels, as compared to the overweight, lean, and control groups. Overweight, compared to lean and control, subjects showed significantly lower adiponectin and higher leptin and chemerin levels; oxLDL values were significantly higher in overweight than in lean patients. Lean patients presented significantly higher chemerin values than the control. Obese patients presented significantly higher CRP values, as compared to lean patients and the control group. Obese and overweight patients presented significantly higher triglycerides values than lean patients. Except for CRP, all the observed significant changes between control and patients remained significant after statistical adjustment for the body mass index (BMI). Conclusion. The levels of leptin, adiponectin, oxLDL, CRP, and triglycerides in patients with T2DM seem to be more associated with obesity and less with diabetes. Chemerin levels were raised in lean, overweight, and obese patients, suggesting that, independently of BMI, an adipocyte dysfunction occurs. Moreover, chemerin may provide an important early biomarker of adipocyte dysfunction and a link between obesity and type 2 diabetes mellitus.


2020 ◽  
Vol 2 (2) ◽  
pp. 89-93
Author(s):  
Gunardi Gunardi

Diabetes mellitus type 2 (DM Type-2) is a metabolic disease which characterized by hyperglycemia due to failure of insulin secretion, insulin action or both. If DM is not handled properly, then it will arise complications in various organs of the body. The criterias of DM control including HbA1c levels and lipid fractions. Lipid pattern in patients with DM type 2 is very dependent on HbA1c control. High HbA1c is associated with high triglycerides and cholesterol. Research objective to find out the description of Hba1c, cholesterol and triglyceride levels in patients of DM type 2 at the Outpatient Poly of RSUD Tidar Magelang. Research method the research type was descriptive with observational design. Primary data were obtained from levels measurements of HbA1c, cholesterol and triglycerides.. The normal HbA1c levels 4-5,80%, good control 6,1-6,5%, moderate 6,6-7,8%, bad 8,8-14,1% respectively as much as 65,96%, 12,77%, 10,64%, and 10,90%. The normal cholesterol levels 100-160 mg/dL, moderate 200-220 mg/dL, and high 250-300 mg/dL, respectively 74,47%, 10,64%, and 14,89%. The normal triglyceride levels 70-140 mg/dL, high limit 150-165 mg/dL, and high 200-252 mg/dL respectively as much as 63,83%, 19,15% and 17,02%. Based on the age of normal HbA1c levels as much as 65,96%, normal cholesterol 74,47%, and triglycerides 63,83%. The levels of HbA1c, cholesterol, and triglycerides were mostly normal in age groups of elderly, and male. The high levels of HbA1c, cholesterol, and triglycerides were more common in elderly than in other age groups.


2020 ◽  
Vol 23 (3) ◽  
pp. 204-209
Author(s):  
V. V. Gafarov ◽  
E. A. Gromova ◽  
D. O. Panov ◽  
S. V. Mustafina ◽  
L. V. Shcherbakova ◽  
...  

BACKGROUND:Determine the effect of personal anxiety, sleep disorders on the 15-year risk of developing (RR) diabetes mellitus (DM) type 2 among men (M) 45-69 years in Russia / Siberia (Novosibirsk). METHODS:In 20032005 As part of the IV screening of the international epidemiological study HAPIEE, a representative sample of m 4569 years was examined (n=781 M, mean age-56.480.20 years, response 61.00%). The level of personal anxiety (PA) was assessed using the Spielberger scale (HPA high, MPA medium, LPA low). With the help of the scale Knowledge and attitude to ones health, the level of sleep disorders (SD) was assessed. The period of observation of the cohort was 15 years. To check the statistical significance of the differences between the groups, the Pearson 2test was used. For risk assessment, Cox-regression single-factor and multivariate regression proportional hazards model was used (Cox-regression). RESULTS:Among persons with the first occurrence of DM type 2, HPA at the screening was 59.50%, and 63.30% had SD. The combination of HPA and SD was significant among M with the first-onset diabetes mellitus. During the 15-year period, among M with HLA, the risk of developing type 2 diabetes was 1.60 times higher than without. Among people with SD, therisk of developing type 2 diabetes was 2.40 times higher than without. In Cox the proportional multifactor model, each variable had its own independent influence. HPA increased the RR DM of the 2nd type by 1.90 times, and SD by 2.80 times. CONCLUSION:It was established that a high level of PA and SD are independent predictors of type 2 diabetes, moreover, with SD, the risk of developing type 2 diabetes is higher than with a high level of PA.


2020 ◽  
Vol 48 (06) ◽  
pp. 1385-1407
Author(s):  
Dou Niu ◽  
Shujing An ◽  
Xue Chen ◽  
Huailong Bi ◽  
Qiusheng Zhang ◽  
...  

Accumulating evidence suggests that gut microbiota plays a crucial role in the development of metabolic diseases, especially type 2 diabetes mellitus (T2DM). The nutrient-rich resource Cornus Fructus (CF) showed curative effects on diabetes mellitus. However, the mechanism underlying its hyperglycemic activity remains obscure. Herein, the antidiabetic potential of four extracts from CF, including saponin (CTS), iridoid glycoside (CIG), tannin (CT), and alcohol extract (CCA) was evaluated in vivo. The results showed that all four extracts could increase the body weight, decrease the blood glucose levels, and elevate the glucose tolerance. Moreover, insulin sensitivity and lipid profile were significantly improved in fed mice. In the [Formula: see text]-diversity index of samples, compared to the DM group, the diversity and richness of gut microbiota in mice to a certain extent were reduced in both CF extracts and Metformin (PC). Among them, there was statistical significance in PC (ACE, [Formula: see text]) and CCA (ACE, [Formula: see text]; chao1: [Formula: see text]). Beta diversity showed the same trend as the UPGMA clustering trees, which revealed that CF extracts could improve intestinal homeostasis in T2DM mice. Also, CF extracts could elevate the production of short-chain fatty acids, as well as regulate the composition of gut microbiota. The key bacteria related to T2DM including Firmicutes, Bacteroides, Lactobacillus, and Clostridium were modulated by metformin and CF. Altogether, CF is a potential nutrient-rich candidate that can be used in functional foods for the treatment of T2DM, and the change of gut microbiota might be a novel mechanism underlying its hyperglycemic activity.


2020 ◽  
Vol 11 (1) ◽  
pp. 7-10
Author(s):  
Khadiza Begum ◽  
Fahmida Islam ◽  
Farjana Aktar ◽  
Murshida Aziz ◽  
Tohfa E Ayub Tahiya

Background: In recent times much is talked about of serum ferritin, an acute phase reactant a marker of iron stores in the body and its association with diabetes mellitus. Studies implicate that increased body iron stores and subclinical hemochromatosis has been associated with the development of glucose intolerance, type 2 diabetes and its micro as well as macrovascular complications. Material & Methods: This study was carried out to examine and to observe for any relationship between serum ferritin with Type 2 diabetes mellitus. Our study populations were included 163. Among them 81 type 2 diabetes patients as a case (M=49,F=32, mean 44.68 age in years)and 82 normal healthy individual as a control ( M=35, F=47 , mean 34.71 in years). Results: Majority were healthy outpatients who had come for regular checkup and were matched with controls. Serum ferritin and FBS were estimated and other investigations. Results showed that although Serum ferritin was in the normal range value it was increased in type 2 diabetes patients than in controls and was statistically significant, we did get a positive correlation with duration of diabetes. It can be concluded that there were positive associations between serum ferritin and FBG, age, sex among study groups. Conclusion: In conclusion our study shows that there is significant correlation between increased serum ferritin in diabetes compared to individuals with normal blood sugars in this part and hyper ferritinemia may be one of the causes for development of insulin resistance before overt diabetes. Anwer Khan Modern Medical College Journal Vol. 11, No. 1: Jan 2020, P 7-10


2020 ◽  
Author(s):  
Jersy Cardenas ◽  
Gomez Nancy Sanchez ◽  
Sierra Poyatos Roberto Miguel ◽  
Luca Bogdana Luiza ◽  
Mostoles Naiara Modroño ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document