This study compared the effects of two treatment regimens for type 2 diabetes: dual therapy of metformin and glimepiride (Group A) versus triple therapy of metformin, glimepiride, and voglibose (Group B). Both regimens led to significant decreases in BMI, fasting blood glucose, post-prandial blood glucose, and HbA1c after 3 months of treatment. However, the triple therapy was more effective at lowering post-prandial glucose and had protective effects on kidney function. The results suggest that adding voglibose to metformin and glimepiride dual therapy provides better glucose control and management of diabetes.
ABSTRACT
Over the last decade, diabetes mellitus has emerged as an important clinical and public health
problem throughout the world. The aim of the study is perceive the Potentiality of a newer oral
Antihyperglycemic combination therapy over conventional therapy in type 2 diabetes. The
prospective study was conducted over a period of six months in the department of Medicine,
Guntur City Hospital. The prevalence of type2 diabetes was high in male 65.79 % than female
34.21%. Majority of the patients (23.68 %) belonged to age group of 51–55 years. Majority of
patients (55.26%) having a family history of Diabetes. Majority of patients receiving Combination
of Glibenclamide + Metformin (60.53%), evaluated for effect on FPG for both combinations. The
mean changes in FPG were noted. In the same way effect on HbA1c also noted. Mean changes in
for every month HbA1c will be noted. Our study reveals that Combination therapy with Metformin
plus Glimepiride is more effective than Glibenclamide plus Metformin; in improving glycemic
control in type 2 diabetes, while also allowing a reduction of the dosage of each drug.
Diabetese- One reason not to Worry ! A new Clinically researched NATURAL PROD...VISHAL CHANDRA
DBC-24 is a new researched product from TULIP LAB.
Clinical Trail has established good efficacy and safety of the product in lowering blood glucose levels and reducing insulin resistance with regular usage.
The product is devoid of side effects of Chemical based Drugs.
The product is also effective in management of Irregular menstrual cycle on account of Cyst formation in Ovaries
( Poly Cystic Ovarian Syndrome- PCOS )
International level clinical trail has been registered on WHO PORTAL : See the link in the slides
For
ABSTRACT
Over the last decade, diabetes mellitus has emerged as an important clinical and public health
problem throughout the world. The aim of the study is perceive the Potentiality of a newer oral
Antihyperglycemic combination therapy over conventional therapy in type 2 diabetes. The
prospective study was conducted over a period of six months in the department of Medicine,
Guntur City Hospital. The prevalence of type2 diabetes was high in male 65.79 % than female
34.21%. Majority of the patients (23.68 %) belonged to age group of 51–55 years. Majority of
patients (55.26%) having a family history of Diabetes. Majority of patients receiving Combination
of Glibenclamide + Metformin (60.53%), evaluated for effect on FPG for both combinations. The
mean changes in FPG were noted. In the same way effect on HbA1c also noted. Mean changes in
for every month HbA1c will be noted. Our study reveals that Combination therapy with Metformin
plus Glimepiride is more effective than Glibenclamide plus Metformin; in improving glycemic
control in type 2 diabetes, while also allowing a reduction of the dosage of each drug.
Diabetese- One reason not to Worry ! A new Clinically researched NATURAL PROD...VISHAL CHANDRA
DBC-24 is a new researched product from TULIP LAB.
Clinical Trail has established good efficacy and safety of the product in lowering blood glucose levels and reducing insulin resistance with regular usage.
The product is devoid of side effects of Chemical based Drugs.
The product is also effective in management of Irregular menstrual cycle on account of Cyst formation in Ovaries
( Poly Cystic Ovarian Syndrome- PCOS )
International level clinical trail has been registered on WHO PORTAL : See the link in the slides
For
Transglucosidase improves the gut microbiota profile of type 2 diabetes melli...Enrique Moreno Gonzalez
Recently, the relationship between gut microbiota and obesity has been highlighted. The
present randomized, double-blind, placebo-controlled study aimed to evaluate the efficacy of
transglucosidase (TGD) in modulating blood glucose levels and body weight gain in patients
with type 2 diabetes mellitus (T2DM) and to clarify the underlying mechanism by analyzing
the gut microbiota of T2DM patients.
Complementary and Alternative Medicine in Association with Type 2 Diabetes Me...PranatiChavan
Type 2 Diabetes Mellitus is a clinical condition that is associated with energy metabolism, particularly carbohydrate and fat management in the organism. An increase in the prevalence of diabetic population and the association of decreasing patient compliance and medication adherence leads to prefer a new concept for the management of disease complications.
The use of complementary and alternative medicine (CAM) has proved to be effective for controlling diabetes.
Objectives: The purpose of this review is to perform an overview of CAM use, to emphasize its importance for managing diabetic complications and to get outfits of CAM.
Discussion: A literature survey was done by using various articles related to CAM and Diabetes mellitus. The focus was kept on
the frequency of CAM use, the methods they use, the factors related to the use of CAM, the sources of information about CAM
treatment, and the effect of the method used for disease management.
Conclusion: This review concluded that CAM therapy found to have adept at reducing blood glucose, maintaining a healthy
body, and relieving symptoms of DM. From the study, the relevance of CAM for managing Diabetic complications was verified
And the future need to perform scientific researches on CAM use was analyzed.
Semaglutide brings breakthroughs in weight management for type 2 diabetes bio...DoriaFang
On March 2, "The Lancet" published an important study of semaglutide in patients with type 2 diabetes. In the STEP-2 trial, medication once a week can help overweight or obese type 2 diabetic patients lose an average of nearly 10 kg in weight, and more than a quarter of the patients lose more than 15%, which is much higher than the existing drugs in diabetic patients. At the same time, this also significantly improves overall health conditions including blood sugar, blood pressure, and blood lipids.
Purpose: The purpose of this study was to compare the safety and efficacy of DPP-4 inhibitors versus sulfonylurea as adjunctive second-line therapy in patients with type 2 diabetes mellitus, inadequately controlled with metformin mono-therapy.
(PDF) Safety and efficacy of dipeptidyl peptidase-4 inhibitors vs sulfonylurea in metformin-based combination therapy for type 2 diabetes mellitus: Systematic review and meta-analysis. Available from: https://www.researchgate.net/publication/301553548_Safety_and_efficacy_of_dipeptidyl_peptidase-4_inhibitors_vs_sulfonylurea_in_metformin-based_combination_therapy_for_type_2_diabetes_mellitus_Systematic_review_and_meta-analysis#fullTextFileContent [accessed May 09 2020].
Moringa is a plantfood of high nutritional value, ecologically and economically beneficial and readily available in the countries hardest hit by the food crisis. http://miracletrees.org/ http://moringatrees.org/
Pharmacokinetics of High-Dose Methotrexate in Egyptian Children with Acute Ly...iosrphr_editor
Aim:Since several factors have been shown to influence the clearance of methotrexate, the purpose of this study
was to identify potential relationships between patient covariates and the methotrexate clearance estimates and
deduce a pharmacokinetic model for the estimation of methotrexate clearance in Egyptian pediatric ALL
patients that may help dosage adjustment and achieve target steady-state plasma concentrations in a similar
sittings.
Patients and methods: A total of 94 pediatric patients with B-cell ALL, of whom 70 were the studied population
and 24 were the test population, were treated with four courses of HDMTX doses 2.5 gm/m2
(low-risk arm) or 5
gm/m2
(standard-/high-risk arm) given every other week by intermittent intravenous infusions over 24 hours as
a part of their treatment protocol. Patients were monitored for the 24 hour MTX concentration and the systemic
methotrexate clearance was calculated for each methotrexate dose
On DPP-Inhibitor ,case study on Linagliptin,Safe and affective class of drug for Management of Type II Diabetes as Monotherapy and add on therapy with OHA and Insulin,It can be added to SGLT2 Inhibitor also.
Slides to Guide Reducing Cardiovascular Risk in Type 2 Diabetes: What I Do an...hivlifeinfo
Slides to Guide Reducing Cardiovascular Risk in Type 2 Diabetes: What I Do and Why.2018
Zachary T. Bloomgarden, MD, MACE
Program Director
Mikhail N. Kosiborod, MD
Pamela Kushner, MD, FAAFP
Format: Microsoft PowerPoint (.ppt)
File Size: 923 KB
Released: June 29, 2018
Transglucosidase improves the gut microbiota profile of type 2 diabetes melli...Enrique Moreno Gonzalez
Recently, the relationship between gut microbiota and obesity has been highlighted. The
present randomized, double-blind, placebo-controlled study aimed to evaluate the efficacy of
transglucosidase (TGD) in modulating blood glucose levels and body weight gain in patients
with type 2 diabetes mellitus (T2DM) and to clarify the underlying mechanism by analyzing
the gut microbiota of T2DM patients.
Complementary and Alternative Medicine in Association with Type 2 Diabetes Me...PranatiChavan
Type 2 Diabetes Mellitus is a clinical condition that is associated with energy metabolism, particularly carbohydrate and fat management in the organism. An increase in the prevalence of diabetic population and the association of decreasing patient compliance and medication adherence leads to prefer a new concept for the management of disease complications.
The use of complementary and alternative medicine (CAM) has proved to be effective for controlling diabetes.
Objectives: The purpose of this review is to perform an overview of CAM use, to emphasize its importance for managing diabetic complications and to get outfits of CAM.
Discussion: A literature survey was done by using various articles related to CAM and Diabetes mellitus. The focus was kept on
the frequency of CAM use, the methods they use, the factors related to the use of CAM, the sources of information about CAM
treatment, and the effect of the method used for disease management.
Conclusion: This review concluded that CAM therapy found to have adept at reducing blood glucose, maintaining a healthy
body, and relieving symptoms of DM. From the study, the relevance of CAM for managing Diabetic complications was verified
And the future need to perform scientific researches on CAM use was analyzed.
Semaglutide brings breakthroughs in weight management for type 2 diabetes bio...DoriaFang
On March 2, "The Lancet" published an important study of semaglutide in patients with type 2 diabetes. In the STEP-2 trial, medication once a week can help overweight or obese type 2 diabetic patients lose an average of nearly 10 kg in weight, and more than a quarter of the patients lose more than 15%, which is much higher than the existing drugs in diabetic patients. At the same time, this also significantly improves overall health conditions including blood sugar, blood pressure, and blood lipids.
Purpose: The purpose of this study was to compare the safety and efficacy of DPP-4 inhibitors versus sulfonylurea as adjunctive second-line therapy in patients with type 2 diabetes mellitus, inadequately controlled with metformin mono-therapy.
(PDF) Safety and efficacy of dipeptidyl peptidase-4 inhibitors vs sulfonylurea in metformin-based combination therapy for type 2 diabetes mellitus: Systematic review and meta-analysis. Available from: https://www.researchgate.net/publication/301553548_Safety_and_efficacy_of_dipeptidyl_peptidase-4_inhibitors_vs_sulfonylurea_in_metformin-based_combination_therapy_for_type_2_diabetes_mellitus_Systematic_review_and_meta-analysis#fullTextFileContent [accessed May 09 2020].
Moringa is a plantfood of high nutritional value, ecologically and economically beneficial and readily available in the countries hardest hit by the food crisis. http://miracletrees.org/ http://moringatrees.org/
Pharmacokinetics of High-Dose Methotrexate in Egyptian Children with Acute Ly...iosrphr_editor
Aim:Since several factors have been shown to influence the clearance of methotrexate, the purpose of this study
was to identify potential relationships between patient covariates and the methotrexate clearance estimates and
deduce a pharmacokinetic model for the estimation of methotrexate clearance in Egyptian pediatric ALL
patients that may help dosage adjustment and achieve target steady-state plasma concentrations in a similar
sittings.
Patients and methods: A total of 94 pediatric patients with B-cell ALL, of whom 70 were the studied population
and 24 were the test population, were treated with four courses of HDMTX doses 2.5 gm/m2
(low-risk arm) or 5
gm/m2
(standard-/high-risk arm) given every other week by intermittent intravenous infusions over 24 hours as
a part of their treatment protocol. Patients were monitored for the 24 hour MTX concentration and the systemic
methotrexate clearance was calculated for each methotrexate dose
On DPP-Inhibitor ,case study on Linagliptin,Safe and affective class of drug for Management of Type II Diabetes as Monotherapy and add on therapy with OHA and Insulin,It can be added to SGLT2 Inhibitor also.
Slides to Guide Reducing Cardiovascular Risk in Type 2 Diabetes: What I Do an...hivlifeinfo
Slides to Guide Reducing Cardiovascular Risk in Type 2 Diabetes: What I Do and Why.2018
Zachary T. Bloomgarden, MD, MACE
Program Director
Mikhail N. Kosiborod, MD
Pamela Kushner, MD, FAAFP
Format: Microsoft PowerPoint (.ppt)
File Size: 923 KB
Released: June 29, 2018
Oracle Mobile Sales Assistant At Work 2008Ruth donohue
Oracle Mobile Sales Assistant presentation given by Hody Crouch, product strategy manager at Oracle. Learn how this mobile application works the way salespeople work to increase sales productivity while out of the office. Fall 2008.
The executives polled on this survey’s five-year anniversary are sounding a decided note of caution—while growth in most business metrics continues, the pace is more moderate than seen in recent years. For more information, please visit http://www2.deloitte.com/us/en/pages/deloitte-growth-enterprise-services/articles/americas-economic-engine-tapping-the-brakes.html
Safety and Efficacy of Sulfonylurea Drugs in Type 2 Diabetes MellitusApollo Hospitals
In subjects with type 2 diabetes mellitus, glycemic control will be established while patients use sulfonylurea drugs during the course of the disease. However, data regarding direct comparison between various sulfonylureas in this regard are lacking. Weight loss usually improves blood glucose levels for people with type 2 diabetes. However, many also need oral medications or insulin.
Effect of emulin on blood glucose in type 2 diabetics - https://emulincanada.comAj Martirano
Effect of Emulin on Blood Glucose in Type 2 Diabetics https://emulincanada.com
,effect of emulin on blood glucose in type 2 diabet ,emulin diabetes ,igalen emulin diabetes ,emulin type 2 diabetes
EVALUATION OF GLYCEMIC RESPONSE OF ADDITION OF PIOGLITAZONE TO GLIBENCLAMIDE...Nani Karnam Vinayakam
Retrospective study of Antidiabetic drugs in Diabetes Mellitus patients. It help in for Pharmacy graduates, Pharm D Students, M Pharm -pharmacy practice students , hospital pharmacists & Clinical Pharmacists around the globe.
Alicia Wong1
, Wan Chien Han1
, Elsie Low1
,Chai Xiang Goh1
, Siew Li Ng1
,
Lee Kuan Kwan1
1Alpro Academy, Lot 45880, Jalan Techvalley 3/2, Sendayan Techvally, 71950 Bandar Sri Sendayan, Negeri Sembilan,
Malaysia.
Abstract: Glycemic index (GI) describes the blood glucose response after consumption of a carbohydrate
containing test food relative to a carbohydrate containing reference food, typically glucose or white bread. GI was
originally designed for people with diabetes as a guide to food selection, and advice being given to select foods with
a low GI. Nonetheless low GI food should not be limited to diabetes patients but healthy individuals too as more
recent recommendations on the potential of low GI diets to reduce the risk of chronic diseases and to treat other
metabolic syndromes. This study aims to evaluate the GI of 2 oral nutritional supplements, Metabolic Recovery
and Metabolic Relievve in healthy adults. Fasted subjects consumed one of the 2 oral nutritional supplements at
each visit, with a two day wash out period between visits. Every subject received both oral nutritional supplements
and blood glucose at 0, 15, 30, 45, 60, 90 and 120 mins were measured after the consumption of oral nutritional
supplements which all containing 50g carbohydrates per serving. The trapezium method was used to compute the
area under the curve for blood glucose and GI of both oral nutritional supplements were determined with
reference to glucolin. The results show that both oral nutritional supplements has low GI, with Metabolic Recovery
having the GI of 46.7 ± 16.4 and Metabolic Relievve with GI of 45.2 ± 16.4. Therefore, both Metabolic Recovery
and Metabolic Relievve can be the preferred option for nutritional management of diabetic patients and healthy
individuals in need of nutritional support.
Keywords: Oral nutritional supplements, glycemic index, blood sugar level, diabetes, meal replacement.
Alicia Wong1
, Wan Chien Han1
, Elsie Low1
,
Chai Xiang Goh1
,
Siew Li Ng1
,
Lee Kuan Kwan1
Abstract: Diabetes-specific formulas have shown to be effective at improving glucose control with additional
nutritional benefits. Furthermore, diabetes-specific formulas are commonly used for diabetic patients with
insufficient oral intake. However, not much diabetes-specific formulas in the market shows the GI of these
formulas, which is clinically useful on glycemic control in patients with diabetes. The aim of this study was to
assess the GI of a newly developed diabetes-specific formula, Contro eazy NOW. The open labelled, single center
study involved 11 individuals from a pool of 18 healthy subjects. After an overnight fast, volunteers were given
Contro eazy NOW containing 50g of carbohydrate or the reference drink (glucolin) on different occasions in
random order. Postprandial blood glucose levels were measured in finger pricked capillary blood for two hours
after intake of the beverages and positive incremental area under the curve (AUC) was calculated for both Contro
eazy NOW and reference drink. The GI of Contro eazy NOW was determined by dividing AUC (Contro eazy
NOW) by the AUC (reference drink). The results show that the diabetes-specific formula has the GI of 38.4, which
is categorized as low GI. Therefore, Contro eazy NOW with low GI can be the preferred option for nutritional
management of diabetic patients in need of nutritional support.
Keywords: diabetes-specific formula, diabetes, low glycemic index, medical nutrition therapy.
ABSTRACT- Introduction: Importance of measurement of glycated hemoglobin (HbA1c) has been recommended for
the diagnosis of diabetes and pre-diabetes. However, various epidemiological studies conducted different parts of the
universe have shown significant discordance between HbA1c and glucose-based tests. Glycated hemoglobin (HbA1c) is
assumed to be the gold standard for monitoring glycemic control in patients with diabetes mellitus disorder. The Glycated
hemoglobin (HbA1c) assay provided an accurate, precise measure of chronic glycemic levels, and associates with the risk
of diabetes complications.
Materials and Methods: This is a cross sectional prospective study. A total of 868 individuals attended to the medicine
outpatient clinic at Lord Buddha Koshi Medical College, Saharsa, Bihar between Jan 2016 to Dec 2016 were selected for
the study after screening a large cohort visited OPD. The results of FPG, OGTT, and HbA1c for 868 individual were
analyzed as well as all grouped as diabetic patients, glucose intolerant (pre-diabetes) patients, and non-diabetic patients
according to new ADA criteria for the diagnosis of diabetes.
Results: Diagnostic sensitivity of all diabetic criteria were 80.33% for A1c; 75% for OGTT and only 41.87% for FPG
respectively.
Conclusion: The proposed A1c diagnostic criteria have greater diagnostic than FPG and 2-h OGTT regarding a diagnosis
of diabetes mellitus disorder.
Key-words- Glycated Hemoglobin, Fasting Plasma Glucose, Oral glucose tolerances test (OGTT), Diabetes Mellitus,
and Pre- diabetes
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
—Gestational Diabetes Mellitus (GDM) is a problem which may occur during pregnancy. For treatment of GDM either the Metformin or Insulin is used. So this prospective randomized multicenter trial in women with GDM was conducted to compare the treatment outcomes of metformin and insulin. This study was conducted at Rajkiya Mahila Chikitsalaya, in Obstetrics & Gynaecology Department of Jawaharlal Nehru Medical College, Ajmer. This study was done on 110 women who were diagnosed GDM by DIPSI criteria with a singleton pregnancy and meet entry criteria are randomized to insulin or metformin treatment (55 cases in each group).It was observed that metformin is equally efficacious and safe as insulin with a lot of advantages like less costly, better compliance, less weight gain, less change of hypoglycaemic attack and more feasible as insulin require several daily injection with not much difference in perinatal outcome except statistically significant difference in baby weight, mean cord blood sugar level at birth, large for gestation age. So it can be concluded that Metformin treatment is suitable for non-obese as well as obese type 2 diabetes patients in pregnancy without complications. Metformin is a safer alternate to insulin in GDM management with no adverse maternal and fetal outcome.
161021 653 Improving type 2 diabetes mellitus glycaemic conAnastaciaShadelb
16/10/21 6:53 Improving type 2 diabetes mellitus glycaemic control through lifestyle modi...: GCU Library Resources - All Subjects
https://eds-b-ebscohost-com.lopes.idm.oclc.org/eds/detail/detail?vid=0&sid=856ca9c2-b97c-435c-a478-b4de72580cde%40pdc-v-sessmgr03&bdata=… 1/25
Authors:
Source:
Language:
Subject Terms:
Keyword(s):
Abstract:
Improving type 2 diabetes mellitus glycaemic
control through lifestyle modification
implementing diet intervention: a systematic
review and meta-analysis.
García-Molina, Laura [email protected]
Lewis-Mikhael, Anne-Mary
Riquelme-Gallego, Blanca
Cano-Ibáñez, Naomi
Oliveras-López, María-Jesús
Bueno-Cavanillas, Aurora
European Journal of Nutrition Jun2020, Vol. 59 Issue 4, p1313 16p.
English
*HEALTH behavior
*MEDICAL care
*MEDLINE
*TYPE 2 diabetes
*PATIENTS
*WEIGHT loss
*EVIDENCE-based medicine
*TREATMENT effectiveness
*GLYCEMIC control
BEHAVIOR modification
GLYCOSYLATED hemoglobin
INFORMATION storage & retrieval systems
META-analysis
ONLINE information services
PRIMARY health care
SYSTEMATIC reviews (Medical research)
Diet; Glycaemic control; Lifestyle intervention; Meta-analysis; Systematic review; Type 2
diabetes mellitus
Purpose: Type 2 diabetes mellitus represents a significant health problem. Many studies
have reported that intensive nutritional intervention by itself or in addition to medications
is the best method to improve glycaemic control in type 2 diabetes mellitus. However, in
clinical practice, dietary education is not implemented as an integral part in the
management of type 2 diabetes mellitus. The purpose of this systematic review and
meta-analysis is to analyse the scientific evidence concerning the role of nutritional
intervention in the glycaemic control of type 2 diabetes mellitus. Methods: We searched
Pubmed, Scopus, Cochrane Library and Web of Science databases from inception till
1,2
3,4
1,5
1,2
6
1,2,7
javascript:__doLinkPostBack('','ss~~AR%20%22Garc%C3%ADa-Molina%2C%20Laura%22%7C%7Csl~~rl','');
javascript:__doLinkPostBack('','ss~~AR%20%22Lewis-Mikhael%2C%20Anne-Mary%22%7C%7Csl~~rl','');
javascript:__doLinkPostBack('','ss~~AR%20%22Riquelme-Gallego%2C%20Blanca%22%7C%7Csl~~rl','');
javascript:__doLinkPostBack('','ss~~AR%20%22Cano-Ib%C3%A1%C3%B1ez%2C%20Naomi%22%7C%7Csl~~rl','');
javascript:__doLinkPostBack('','ss~~AR%20%22Oliveras-L%C3%B3pez%2C%20Mar%C3%ADa-Jes%C3%BAs%22%7C%7Csl~~rl','');
javascript:__doLinkPostBack('','ss~~AR%20%22Bueno-Cavanillas%2C%20Aurora%22%7C%7Csl~~rl','');
javascript:__doLinkPostBack('','mdb~~s3h%7C%7Cjdb~~s3hjnh%7C%7Css~~JN%20%22European%20Journal%20of%20Nutrition%22%7C%7Csl~~jh','');
javascript:__doLinkPostBack('','ss~~DE%20%22HEALTH%20behavior%22%7C%7Csl~~rl','');
javascript:__doLinkPostBack('','ss~~DE%20%22MEDICAL%20care%22%7C%7Csl~~rl','');
javascript:__doLinkPostBack('','ss~~DE%20%22MEDLINE%22%7C%7Csl~~rl','');
javascript:__doLinkPostBack('','ss~~DE%20%22TYPE%202%20diabetes%22%7C%7Csl~~rl','');
javascript:__doLinkPostB ...
161021 653 Improving type 2 diabetes mellitus glycaemic conKiyokoSlagleis
16/10/21 6:53 Improving type 2 diabetes mellitus glycaemic control through lifestyle modi...: GCU Library Resources - All Subjects
https://eds-b-ebscohost-com.lopes.idm.oclc.org/eds/detail/detail?vid=0&sid=856ca9c2-b97c-435c-a478-b4de72580cde%40pdc-v-sessmgr03&bdata=… 1/25
Authors:
Source:
Language:
Subject Terms:
Keyword(s):
Abstract:
Improving type 2 diabetes mellitus glycaemic
control through lifestyle modification
implementing diet intervention: a systematic
review and meta-analysis.
García-Molina, Laura [email protected]
Lewis-Mikhael, Anne-Mary
Riquelme-Gallego, Blanca
Cano-Ibáñez, Naomi
Oliveras-López, María-Jesús
Bueno-Cavanillas, Aurora
European Journal of Nutrition Jun2020, Vol. 59 Issue 4, p1313 16p.
English
*HEALTH behavior
*MEDICAL care
*MEDLINE
*TYPE 2 diabetes
*PATIENTS
*WEIGHT loss
*EVIDENCE-based medicine
*TREATMENT effectiveness
*GLYCEMIC control
BEHAVIOR modification
GLYCOSYLATED hemoglobin
INFORMATION storage & retrieval systems
META-analysis
ONLINE information services
PRIMARY health care
SYSTEMATIC reviews (Medical research)
Diet; Glycaemic control; Lifestyle intervention; Meta-analysis; Systematic review; Type 2
diabetes mellitus
Purpose: Type 2 diabetes mellitus represents a significant health problem. Many studies
have reported that intensive nutritional intervention by itself or in addition to medications
is the best method to improve glycaemic control in type 2 diabetes mellitus. However, in
clinical practice, dietary education is not implemented as an integral part in the
management of type 2 diabetes mellitus. The purpose of this systematic review and
meta-analysis is to analyse the scientific evidence concerning the role of nutritional
intervention in the glycaemic control of type 2 diabetes mellitus. Methods: We searched
Pubmed, Scopus, Cochrane Library and Web of Science databases from inception till
1,2
3,4
1,5
1,2
6
1,2,7
javascript:__doLinkPostBack('','ss~~AR%20%22Garc%C3%ADa-Molina%2C%20Laura%22%7C%7Csl~~rl','');
javascript:__doLinkPostBack('','ss~~AR%20%22Lewis-Mikhael%2C%20Anne-Mary%22%7C%7Csl~~rl','');
javascript:__doLinkPostBack('','ss~~AR%20%22Riquelme-Gallego%2C%20Blanca%22%7C%7Csl~~rl','');
javascript:__doLinkPostBack('','ss~~AR%20%22Cano-Ib%C3%A1%C3%B1ez%2C%20Naomi%22%7C%7Csl~~rl','');
javascript:__doLinkPostBack('','ss~~AR%20%22Oliveras-L%C3%B3pez%2C%20Mar%C3%ADa-Jes%C3%BAs%22%7C%7Csl~~rl','');
javascript:__doLinkPostBack('','ss~~AR%20%22Bueno-Cavanillas%2C%20Aurora%22%7C%7Csl~~rl','');
javascript:__doLinkPostBack('','mdb~~s3h%7C%7Cjdb~~s3hjnh%7C%7Css~~JN%20%22European%20Journal%20of%20Nutrition%22%7C%7Csl~~jh','');
javascript:__doLinkPostBack('','ss~~DE%20%22HEALTH%20behavior%22%7C%7Csl~~rl','');
javascript:__doLinkPostBack('','ss~~DE%20%22MEDICAL%20care%22%7C%7Csl~~rl','');
javascript:__doLinkPostBack('','ss~~DE%20%22MEDLINE%22%7C%7Csl~~rl','');
javascript:__doLinkPostBack('','ss~~DE%20%22TYPE%202%20diabetes%22%7C%7Csl~~rl','');
javascript:__doLinkPostB ...
Comparative Evaluation of the Effect of Doxycycline As An Adjunct to Non-Surg...QUESTJOURNAL
Background: The association between diabetes and periodontal disease has long been discussed with conflicting conclusions. Earlier studies demonstrating the relationship between diabetes and severity of periodontal disease has been equivocal. However, recent studies have clearly proven that diabetes increases the risk of periodontal disease progression. Less clear is the impact of periodontal disease on diabetes. It has been hypothesised that periodontal therapy may improve the metabolic control of diabetes. Aim: To determine the effect of doxycycline as an adjunct to non-surgical periodontal therapy in improving the metabolic control of poorly controlled type 2 diabetic subjects with chronic generalized periodontitis. Method: 30 poorly controlled type 2 diabetic subjects with chronic generalized periodontitis and receiving antidiabetic therapy were selected for the study. The subjects were randomly allotted to either of two treatment groups containing 15 subjects each: Group 1 (scaling and root planing(SRP)+ 15 days Doxycycline) or Group 2 (scaling and root planing(SRP). The Glycated haemoglobin (HbA1c) values, Gingival Index(GI), and Probing pocket depth of both the groups were assessed at baseline and after 3 months. Results: Both the treatment groups exhibited reductions in HbA1c, G I and Probing pocket depth compared to baseline over time. The amount of reduction in the glycated haemoglobin and gingival parameters was higher in Group I compared to group 2 after 3 months. Conclusion: Both treatments improved glycemic control in patients with type 2 diabetes; however, the reduction in HbA1c values reached statistical significance only in the group receiving doxycycline as an adjunct to scaling and root planing.
3. Int. J. Pharmacol., 12 (4): 422-428, 2016
INTRODUCTION
Type II diabetes mellitus is one of the most common
metabolic diseases with its prevalence increasing worldwide
and despite the availability of newer antidiabetic drugs
physician s not able to control blood glucose level
satisfactorily (Nathan et al., 1996; IDF., 2013). For preventing
macrovascular and microvascular complications in patients
with type II diabetes, management of hyperglycaemia is
crucial.Controllingblood-glucoselevelsoftenrequiresseveral
strategies, including weight loss if needed, dietary control,
increased physical activity and antidiabetic medications
(Ramachandran et al., 2012). It is expected that if diabetes is
notcontrolledthen itmay be projectedto300 milliondiabetic
patients by 2025 (Pradeepa et al., 2002). This needs various
strategies,suchassingledrugandmultipledrugsfromvarious
categories of antidiabetic drugs. Risk benefit ratio must be
considered, while choosing combination therapy in type II
diabetic patients.
The present topic of debate is contribution of
postprandial glucose levels to overall glycaemic control and
the role of postprandial glucose targets in disease
management (Ceriello, 2010). As a thumb rule for good
glycaemic control, it has been agreed that patient is generally
considered tohave achieved successful disease control,when
their HbA1C is <7% (American Diabetes Association, 2008;
Canadian DiabetesAssociation,2008; Rydenetal.,2007).With
evidence of earlier studies, it is clear that physicians are likely
toconsiderplasmaglucoselevelsbothaftertheovernightfast
(pre-prandial) and after meals (postprandial) as well as the
variability of glucose levels, in order to achieve optimal
glycaemic control for each patient. Therefore, at the initiation
of treatment physicians must need to consider the selection
of agents that target both fasting and postprandial
hyperglycaemia. At times it has been also observed that
HbA1c goal is achieved, but both fasting and postprandial
glucose levels are not adequately controlled due to
inappropriate drug combinations and life style modification.
International Diabetes Federation (IDF) guidelines for the
management of post meal (postprandial) glucose state
that the goal of diabetes therapy should be to achieve
glycaemic status as near to normal as safely possible in
all three measures of glycaemic control i.e., HbA1c,
fasting (pre-prandial glucose) and postprandial glucose
(Currie et al., 2010; Ceriello et al., 2007). Treatment of both
fasting and postprandial hyperglycaemia should be initiated
simultaneously at all levels of HbA1c above agreed levels.
Earliertreatmentwithbiaguanidesandthiozolidinediones
has shown reduction in fasting plasma glucose level.
Sulphonylureas administered in morning do lowers
posprandial glucose levels during day time and also exerts
reduction in fasting plasma glucose level overnight. Selective
antidiabetic agents are available, which preferentially lowers
postprandial glucose level, such as "-glucosidase inhibitors,
incretin mimetics,dipeptidylpeptidase (DPP)-4inhibitorsand
rapidactinginsulin.Combinationtherapyseemstobejustified
in controlling glucose triad level. Several of the available oral
agents have been studied in combination and have been
shown to further improve glycaemic control when compared
to monotherapy (Riddle, 2000).
Advocating the therapy combining three oral agents
(sulfonylurea, metformin, "-glucosidase inhibitor or
sulfonylurea, metformin and thiazolidinedione) in the
management oftype II diabetes seems to be a good approach
(Ovalle and Bell, 1998). Thus the study was conducted to
evaluate the efficacy of voglibose used as an add on therapy
to glimepiride-metformin combination by comparing with
glimepiride-metformin alone and its impact on glucose triad
to optimise the best drug combination therapy. The goal of
this comparative study will enhance physician clinical
judgement to provide the right treatment at the right time.
MATERIALS AND METHODS
Study population and design: The study was carried out at
out-patient department of Rajendra Memorial Research
Institute of Medical sciences (RMRIMS), Indian Council of
Medical Research (ICMR), Agamkuan, Patna, India. The study
was a prospective, parallel-group, open-label comparative
studyconductedfromAugust,2014toMay,2015(10months).
The patients who were >18 years of age had diagnosed
with type II diabetes of either sex and confirmed with
postprandial hyperglycaemia were eligible to be included in
the study design. Enrolled patients gave informed consent
and were divided into two groups. Group A was taking dual
therapy of glimepiride 1 mg and metformin 500 mg. Group B
was taking voglibose 0.3 mg as add on to above dual therapy.
Total 100 patients were included for the study i.e., 50 subjects
in each group but due to loss of follow-up 30 subjects
excluded fromthestudy.Finally70typeIIdiabeticpatientsi.e.,
35 in each group were successfully enrolled during the study
period.
Efficacy and safety evaluation: The primary objective was
glucose triad (HbA1c, fasting glucose and post-prandial
glucose level) change from baseline to 3 months after
treatment.Secondaryobjectiveswereserumcreatinine,blood
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4. Int. J. Pharmacol., 12 (4): 422-428, 2016
urea, GFR and lipid profile (TC, TGs, LDL and HDL). Other
demographic details like age, sex, height, weight, Body Mass
Index (BMI), duration of disease and family history also
recorded. Then follow-up of all these parameters were carried
out after successful completion of 3 months of treatment. The
BMI was calculated by using metric imperial BMI formula.
Estimationofbloodglucosebothfastingandpostprandial
along with blood urea and serum creatinine, lipid profiles
analysis were done by Merck s auto analyser instrument in
clinical biochemistry laboratory of Rajendra Memorial
ResearchInstituteofMedicalSciences,Patna,India.TheHbA1c
was calculated by Affinion s auto analyser of HbA1c and
Alere s catridge was used.
The GFR is generally considered to be the best index of
renal function in health and disease. The GFR was estimated
by prediction equations that take into account serum
creatinine concentration and some or all of the following
variables: Age, sex, race and body size. The recommended
equation by the national kidney foundation is that of the
Modified Diet in Renal Disease (MDRD).
Statistical methods: The analysis of all the parameters were
carried out by using SPSS 22.0 and analysis done by applying
paired t-test. Value of p<0.05 was considered significant.
RESULTS
The demographic and clinical measurements in both the
groups i.e., group A and B of randomized patients are
mentioned below.
Demographic characteristics of the study subjects: Age
distributions of patients are summarized in Table 1. Group A
was having 1 patient of age between (30-39 years), 8 patients
of age between (40-49 years), 10 patients of age between
(50-59 years), 15 patients of age between (60-69 years)
and 1 patient of age more than 70 years. Group B were
having 2 patients of age between (30-39 years), 8 patients
of age between (40-49 years), 6 patients of age between
(50-59 years), 15 patients of age between (60-69 years)
and4patientsofagemorethan 70years. Genderdistributions
of patients are summarized in Table 2. Group A had 22 males
and 13 females and group B had 14 males and 21 females.
Percentage was calculated and it was found that group A
contain 62.8% of male and 37.1% of female and group B
contain 40.0% of male and 60.0% of female. Distributions
according to duration of diabetes are summarized in Table 3.
Group A was having 12 patients of duration of diabetes
between (0-1 years), 16 patients of duration of diabetes
Table 1: Age distribution of patients
Groups
----------------------------------------------------------
Age (years) A (%) B (%)
30-39 1 (2.8) 2 (5.7)
40-49 8 (22.8) 8 (22.8)
50-59 10 (28.6) 6 (17.1)
60-69 15 (42.8) 15 (42.8)
$70 1 (2.8) 4 (11.4)
Table 2: Gender distribution of patients
No. of patients in groups
---------------------------------------------------------
Gender A (%) B (%)
Male 22 (62.8) 14 (40.0)
Female 13 (37.1) 21 (60.0)
Total 35 35
Table 3: Distribution according to duration of diabetes
Groups
---------------------------------------------------
Duration of diabetes (years) A (%) B (%)
0-1 12 (34.3) 8 (22.9)
1-5 16 (45.7) 18 (51.4)
5-10 3 (8.6) 4 (11.4)
$10 4 (11.4) 5 (14.3)
between (1-5 years), 3 patients of duration of diabetes
between (5-10 years) and 4 patients of duration of diabetes
more than 10 years. Group B was having 8 patients ofduration
of diabetes between (0-1 year), 18 patients of duration of
diabetes between (1-5 years), 4 patients of duration of
diabetes between (5-10 years) and 5 patients of duration of
diabetes between more than 10 years.
In this study, it has been found 46 (65.71%) patients
out of 70 patients having primary relative in their family
having diabetes. Figure 1 shows family history of the enrolled
patients.
Physiologicalandbiochemicalmeasurements:Thechanges
in all the clinical parameters evaluated are enlisted in
Table 4 and 5 for group A and B, respectively.
Group A and B was having significant decrease in BMI
with p<0.017 and p<0.049, respectively as shown in Fig 2.
Group A was having average fasting blood glucose
183.97 mg dLG1
before treatment and 145.65 mg dLG1
at the
end of the treatment (p<0.000). Group B was having average
fasting blood glucose 186.24 mg dLG1
before treatment
and 146.37 mg dLG1
at the end of the treatment (p<0.000) as
shown in Fig. 3. Group A was having average postprandial
blood glucose 266.88 mg dLG1
before treatment and
227.51 mg dLG1
at the end of the treatment (p<0.006). Group
B was having average postprandial blood glucose
273.40 mg dLG1
before treatment and 176.51 mg dLG1
at the
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5. Int. J. Pharmacol., 12 (4): 422-428, 2016
Patients having family history of diabetes
Patients not having family history of diabetes
34%
66%
26
25.5
25
24.5
25.75 25.76
24.98
25.18
Before treatment After treatment
Group A
Group B
Before treatment After treatment
266.88
273.4
227.51
176.51
Group A Group B
After treatment
Group A
Group B
9.5
9.0
8.5
8.0
7.5
7.0
6.5
Before treatment
Group A Group B
After treatment
183.97
186.24
145.65
146.37
Before treatment
Fig. 1: Family history of diabetes, data represents that 66% of
the enrolled patients were having family history of
diabetes, whereas 34% were not having any family
history
Fig. 2: Change in BMI before and after treatment, data shows
that Body Mass Index (BMI) of group A and B before and
after the treatment
Fig. 3: Change in fasting plasma glucose before and after
treatment, graphical data represents the Mean±SE in
fasting blood glucose in group A and B
end of the treatment (p<0.000) as shown in Fig. 4. Group A
was having average HbA1c 8.19% before treatment and
7.60% at the end of the treatment (p<0.002). Group B was
having average HbA1c 9.01% before treatment and 7.81% at
the end of the treatment (p<0.000) as evident in Fig. 5. Overall
Fig. 4: Change in postprandial blood glucose before and after
treatment, graphical data represents the Mean±SE in
post-prandial blood glucose in group A and B
Fig. 5: Change in HbA1c before and after treatment, graphical
data represents the Mean±SE in glycosylated
haemoglobin (HBA1c) in group A and B
the glucose triad levels (Fasting blood glucose, post-prandial
blood glucose and glycosylated haemoglobin) were better
with voglibose as add on therapy in group B. There was no
significant effect observed on blood urea in both the groups
i.e., group A and B as data interpreted in the Table 4 and 5. In
both the groups serum creatinine was increased slightly with
p<0.002 and p<0.937, respectively.
The GFR was calculated by using serum creatinine level
and found decreased with p<0.002, group A was having
average total cholesterol 135.56 mg dLG1
before treatment
and 129.17 mg dLG1
after treatment (p<0.060) and group B
was having average total cholesterol 152.28 mg dLG1
before
treatment and 141.68 mg dLG1
after treatment (p<0.023)
and p<0.538 for group A and B, respectively. Group A was
having average triglyceride 121.88 mg dLG1
before
treatment and 111.74 mg dLG1
after treatment (p<0.103).
Group B was having average triglyceride 132.84 mg dLG1
before treatment and 120.14 mg dLG1
after treatment
(p<0.043). Group A was having average LDL 84.29 mg dLG1
beforetreatmentand70.88mgdLG1
aftertreatment(p<0.000)
and group B was having average LDL 97.52 mg dLG1
before
treatmen and 88.18 mg dLG1
after treatment, which was
statisticallysignificant(p<0.011).GroupAwashaving average
HDL 36.69 mg dLG1
before treatment and 36.71 mg dLG1
after
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6. Int. J. Pharmacol., 12 (4): 422-428, 2016
200
150
100
50
0
TG LDL HDL TC TG LDL HDLTC
After treatmentBefore treatment
Lipidprofile(mgdL)G
1
Group A
Group B
Table 4: Changes in physiological and biochemical parameters for group A
Parameters Before treatment (Mean±SE) After treatment (Mean±SE) p-value
BMI 25.75±0.68 24.98±0.58 0.017
Fasting blood glucose level 183.97±13.73 145.65±6.19 0.000
PP blood glucoselevel 266.88±21.68 227.51±14.62 0.006
HbA1c 8.19±0.35 7.60±0.28 0.002
Blood urea 29.91±0.73 28.80±0.69 0.080
Serum creatinine 0.97±0.03 1.08±0.03 0.002
GFR 79.72±2.80 71.11±2.95 0.002
Total cholesterol 135.56±6.43 129.17±4.78 0.060
Triglyceride 121.88±9.77 111.74±7.15 0.103
LDL 84.29±4.89 70.88±3.95 0.000
HDL 36.69±1.93 36.71±1.54 0.991
BMI: Body mass index, HbA1c: Glycosylated haemoglobin, GFR: Glomerular filtration rate, LDL: Low density lipoprotein and HDL: High density lipoprotein
Table 5: Changes in physiological and biochemical parameters for group B
Parameters Before treatment (Mean±SE) After treatment (Mean±SE) p-value
BMI 25.76±0.66 25.18±0.67 0.049
Fasting blood glucose level 186.24±11.44 146.37±5.59 0.000
PP blood glucose level 273.40±16.23 176.51±8.38 0.000
HbA1c 9.01±0.33 7.81±0.22 0.000
Blood urea 28.54±0.60 28.37±0.61 0.750
Serum creatinine 1.01±0.03 1.02±0.02 0.937
GFR 71.13±3.49 69.46±2.61 0.538
Total cholesterol 151.28±5.60 141.68±4.44 0.023
Triglyceride 132.84±9.35 120.14±5.89 0.043
LDL 97.52±5.53 88.18±4.47 0.011
HDL 38.98±1.17 39.38±1.32 0.000
BMI: Body mass index, HbA1c: Glycosylated haemoglobin, GFR: Glomerular filtration rate, LDL: Low density lipoprotein and HDL: High density lipoprotein
Fig. 6: Change in lipid profile before and after treatment,
graphical data represents the Mean±SE in lipid profile
in group A and B before and after treatment, TC: Total
cholesterol, TG: Triglycerides, LDL: Low density
lipoprotein, HDL: High density lipoprotein
treatment (p<0.991). Group B was having average
HDL 38.98 mg dLG1
before treatment and 39.38 mg dLG1
after
treatment, which was again statistically significant (p<0.000)
as shown in Fig. 6.
DISCUSSION
Higher level of post-prandial and discrepancy between
fasting and post-prandial glucose are significantly associated
with macrovascular and microvascular complications even
after control of all other factors. The patients are on the higher
risk for development of cardiovascular disorder. However,
higherfastinghyperglycaemiawasnotsignificantlyassociated
with CVD risk. Post-prandial glucose, similar to post-challenge
glucosewas related to CVD than fastingglucose(TheDECODE
Study Group on Behalf of the Europe an Diabetes
Epidemiology Group, 1999; DECODE Study Group on Behalf
of the European Diabetes Epidemiology Group, 2001;
Cavalot et al., 2005). On the other hand, it is evident that
fasting hyperglycaemia is associated with beta cell
dysfunction, whereas post-challenge hyperglycaemia is
associated with insulin resistance, hypertension, obesity and
dyslipidaemia (Chien et al., 2009). In clinical management of
typeIIdiabeteswithlifestylemodificationsandpharmacologic
interventions, post-prandial glucose must be appreciated as
a target (Yamagishi et al., 2005).
But in modern clinical approach, it is now recommended
that for the optimal management of type II diabetes, there is
the requirement to understand the relationships between
glycosylated haemoglobin (HbA1c), fasting plasma glucose
and post-prandial glucose (the glucose triad). When
antidiabetic therapy is initiated, physicians may need to
consider selection of agents that target both fasting and
post-prandial hyperglycaemia.
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7. Int. J. Pharmacol., 12 (4): 422-428, 2016
In this study if the results of glucose triads (i.e., fasting,
post-prandial and HbA1c values), a very satisfactory result
was got. Group A was having average fasting blood glucose
183.97±13.73 mg dLG1
before treatment and was having
145.65±6.19 mg dLG1
at the end of the treatment, indicates
significant difference. Group B was having average fasting
blood glucose 186.24±11.44 mg dLG1
before treatment and
was having 146.37±5.59 mg dLG1
at the end of the
treatment. Group A was having average post-prandial blood
glucose 266.88±21.68 mg dLG1
before treatment and was
having 227.51±14.62 mg dLG1
at the end of the treatment.
The p<0.006, which was considered significant. Group
B was having average postprandial blood glucose
273.40±16.23 mg dLG1
before treatment and was having
176.51±8.38 mg dLG1
at the end of the treatment. The
p<0.000, which was statistically significant. Reduction of
post-prandial blood glucose was more in this case. Group A
was having average HbA1c 8.19±0.35% before treatment
and was having 7.60±0.28% at the end of the treatment. The
p<0.002, which was considered significant. Group B was
havingaverageHbA1c9.01±0.33%beforetreatmentandwas
having 7.81±0.22% at the end of the treatment. The p<0.000,
which was again considered significant. Observation in
decrease of HbA1c was also more in case of triple drug
therapy. From the above result it was confirmed that
additionofvoglibosehasmorebeneficialeffectoncontrolling
post-prandial hyperglycaemia as well as very good reduction
in HbA1c level.
Group A was having average blood urea 29.91 mg dLG1
before treatment and 28.80 mg dLG1
at the end of
the treatment. The p<0.080, which was statistically
non-significant. Group B was having average blood urea
28.54 mg dLG1
before treatment and 28.37 mg dLG1
at the
endofthetreatment.Thep=0.750, whichwasnotconsidered
significant. From this it can be concluded that there was no
effect on blood urea of these two regimens. It had been seen
that there was a significant decrease in GFR when the patients
were on dual drug therapy, because a significant increase in
serum creatinine had been seen. But in case of triple drug
therapy the increase in the level of serum creatinine was not
significant so, the addition of voglibose to the treatment
schedule was able toprevent regulardecrease inGFR,thereby
protecting kidney function.
While comparing the lipid profiles a very good
control with triple drug therapy was observed. In group A it
was observed that the Total Cholesterol (TC), triglyceride (TG)
and Low Density Lipoproteins (LDL) levels were
decreased. Slight increase in HDL was also observed but
p-value was not significant. But in group B it had been seen
that total cholesterol, triglycerides and LDL levels were
decreased significantly and HDL increased significantly.
Therefore, it can be concluded with the statement that
voglibose was having the efficacy to control the lipid levels
also.Therefore,resultantdatafromgroupBwascomparatively
significant than group A in terms of reduction in glucose triad
levels, lipid levels and to some extent protecting kidney
functions.
CONCLUSION
The add-on therapy using voglibose in dual therapy
including glimepiride and metformin showed a very
significant benefit in controlling the glucose triad levels when
comparedtodualtherapy.Voglibosehasaneffecttodecrease
TC, TG and LDL level and increase HDL significantly. No effect
was found on blood urea level. Hence, this add-on therapy of
voglibose to dual drug therapy of glimepiride and metformin
will be the best option for managing hyperglycaemia.
ACKNOWLEDGMENTS
We are very much thankful to Director, NIPER-Hajipur for
giving us permission to conduct the research work and also
Mr.Naresh KumarSinha for giving constant technical support.
We are also thankful to Ministry of Chemicals and Fertilizers,
Department of Pharmaceuticals, Government of India for
funding this project work.
REFERENCES
AmericanDiabetesAssociation,2008.Standardsofmedicalcarein
diabetes-2008. Diabetes Care, 31: S12-S54.
Canadian Diabetes Association, 2008. Canadian diabetes
association 2008 clinical practice guidelines for the
prevention and management of diabetes in Canada. Can.
J. Diabetes, 32: S1-S201.
Cavalot, F., A. Petrelli, M. Traversa, K. Bonomo and E. Fiora et al.,
2005. Postprandial blood glucose is a stronger predictor of
cardiovascular events than fasting blood glucose in type II
diabetes mellitus, particularly in women: Lessons from the
San Luigi Gonzaga diabetes study. J. Clin. Endocrinol. Metab.,
91: 813-819.
Ceriello, A., S. Colagiuri, J. Gerich and J. Tuomilehto, 2007.
Guideline for management of postmeal glucose.
International Diabetes Federation, Brussels, Belgium,
October, 2007, pp: 1-29.
Ceriello, A., 2010. The glucose triad and its role in comprehensive
glycaemic control: Current status, future management.
Int. J. Clin. Pract., 64: 1705-1711.
427
8. Int. J. Pharmacol., 12 (4): 422-428, 2016
Chien, K.L., B.C. Lee, H.J. Lin, H.C. Hsu and M.F. Chen, 2009.
Association of fasting and post-prandial hyperglycemia on
the risk of cardiovascular and all-cause death among
non-diabetic Chinese. Diabetes Res. Clin. Pract., 83: e47-e50.
Currie, C.J., J.R. Peters, A. Tynan, M. Evans and R.J. Heine et al.,
2010. Survival as a function of HbA1c in people with
type II diabetes: A retrospective cohort study. Lancet,
375: 481-489.
DECODE Study Group on Behalf of the European Diabetes
Epidemiology Group, 2001. Glucose tolerance and
cardiovascular mortality comparison of fasting and 2-h
diagnostic criteria. Arch. Internal Med., 161: 397-405.
IDF., 2013. IDF Diabetes Atlas. 6th Edn., International
Diabetes Federation, Brussels, Belgium, ISBN: 2-930229-85-3,
Pages: 160.
Nathan, D.M., C. McKitrick, M. Larkin, R. Schaffran and D.E. Singer,
1996. Glycemic control in diabetes mellitus: Have changes in
therapy made a difference? Am. J. Med., 100: 157-163.
Ovalle, F. and D.S. Bell, 1998. Triple oral antidiabetic therapy in
type 2 diabetes mellitus. Endocrine Pract., 4: 146-147.
Pradeepa, R., R. Deepa and V. Mohan, 2002. Epidemiology of
diabetesinIndia--currentperspectiveandfutureprojections.
J. Indian Med. Assoc., 100: 144-148.
Ramachandran, A., C. Snehalatha, A.S. Shetty and A. Nanditha,
2012. Trends in prevalence of diabetes in Asian countries.
World J. Diabetes, 3: 110-117.
Riddle, M., 2000. Combining sulfonylureas and other oral agents.
Am. J. Med., 108: 15-22.
Ryden, L., E. Standl, M. Bartnik, G. Van den Berghe and
J.Betteridgeetal.,2007. Guidelinesondiabetes,pre-diabetes
and cardiovascular diseases: Executive summary: The task
force on diabetes and cardiovascular diseases of the
European Society of Cardiology (ESC) and of the European
Association for the Study of Diabetes (EASD). Eur. Heart
J., 28: 88-136.
The DECODE Study Group on Behalf of the Europe an Diabetes
Epidemiology Group, 1999. Glucose tolerance and mortality:
comparison of WHO and American Diabetic Association
diagnostic criteria. Lancet, 354: 617-621.
Yamagishi, S., K. Nakamura and M. Takeuchi, 2005. Inhibition of
postprandial hyperglycemia by acarbose is a promising
therapeutic strategy for the treatment of patients with the
metabolic syndrome. Med. Hypotheses, 65: 152-154.
428