DIRECT COMPARISON BETWEEN TWO HYPOGLYCEMIC AGENTS: EFFECTS ON MYOCARDIAL ISCHEMIC PRECONDITIONING IN DIABETIC PATIENTS WITH SYMPTOMATIC CORONARY DISEASE

Abstract. Background: to evaluate the effects of Vitamin D3 on glyco-metabolic control in type 2 diabetic patients with Vitamin D deficiency. Methods: one hundred and seventeen patients were randomized to placebo and 122 patients to Vitamin D3. We evaluated anthropometric parameters, glyco-metabolic control, and parathormone (PTH) value at baseline, after 3, and 6 months. Results: a significant reduction of fasting, and post-prandial glucose was recorded in Vitamin D3 group after 6 months. A significant HbA1c decrease was observed in Vitamin D3 (from 7.6% or 60 mmol/mol to 7.1% or 54 mmol) at 6 months compared to baseline, and to placebo (p < 0.05 for both). At the end of the study period, we noticed a change in the amount in doses of oral or subcutaneous hypoglycemic agents and insulin, respectively. The use of metformin, acarbose, and pioglitazone was significantly lower (p = 0.037, p = 0.048, and p = 0.042, respectively) than at the beginning of the study in the Vitamin D3 therapy group. The units of Lispro, Aspart, and Glargine insulin were lower in the Vitamin D3 group at the end of the study (p = 0.031, p = 0.037, and p = 0.035, respectively) than in the placebo group. Conclusions: in type 2 diabetic patients with Vitamin D deficiency, the restoration of value in the Vitamin D standard has led not only to an improvement in the glyco-metabolic compensation, but also to a reduced posology of some oral hypoglycemic agents and some types of insulin used.

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Oral Sulfonylurea Hypoglycemic Agents Prevent Ischemic Preconditioning in Human Myocardium

Circulation ◽

10.1161/01.cir.96.1.29 ◽

1997 ◽

Vol 96 (1) ◽

pp. 29-32 ◽

Cited By ~ 197

Author(s):

Joseph C. Cleveland ◽

Daniel R. Meldrum ◽

Brian S. Cain ◽

Anirban Banerjee ◽

Alden H. Harken

Keyword(s):

Ischemic Preconditioning ◽

Human Myocardium ◽

Hypoglycemic Agents

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The Diabetic Surgical Patient

10.2310/tywc.2227 ◽

2020 ◽

Author(s):

Cathline Layba ◽

Lance Griffin

Keyword(s):

Diabetes Mellitus ◽

Perioperative Period ◽

The United States ◽

Postoperative Management ◽

Hypoglycemic Agents ◽

Surgical Patient ◽

Diabetic Patients ◽

Preoperative Management ◽

Oral Hypoglycemic Agents ◽

Intraoperative Management

Diabetes mellitus is the seventh leading cause of death in the United States; diabetic patients have a 50% chance of undergoing a surgical procedure during their lifetime, and operations in this patient population have been associated with a reported mortality of 4% to 13%. Careful planning of operative management and perioperative care must be taken into account when scheduling surgery for diabetic patients, especially patients taking insulin or oral hypoglycemic agents. Debate continues and inconsistencies remain regarding the management of both diabetes and hyperglycemia in the surgical setting. The review covers the evaluation of the diabetic patient, preoperative management, intraoperative management, postoperative management, total parenteral nutrition and blood glucose, cardiovascular and renal assessment, infection, and special populations. This review contains 2 figures, 5 tables, and 21 references Keywords: Glucose, Hyperglycemia, perioperative period, surgery, diabetes mellitus, surgical site infection, preoperative management, postoperative management, wound healing

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Percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) in the treatment of diabetic patients with multi-vessel coronary disease: A meta-analysis

Diabetes Research and Clinical Practice ◽

10.1016/j.diabres.2012.03.020 ◽

2012 ◽

Vol 97 (2) ◽

pp. 178-184 ◽

Cited By ~ 11

Author(s):

Fan Zhang ◽

Yuan Yang ◽

Dayi Hu ◽

Han Lei ◽

Yang Wang

Keyword(s):

Percutaneous Coronary Intervention ◽

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Disease ◽

Meta Analysis ◽

Artery Bypass ◽

Coronary Intervention ◽

Diabetic Patients ◽

Bypass Grafting ◽

Percutaneous Coronary

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Frequency of Hepatitis C infection in diabetes mellitus

Annals of King Edward Medical University ◽

10.21649/akemu.v11i4.1109 ◽

2016 ◽

Vol 11 (4) ◽

Author(s):

Masroor A Qazi ◽

Fayyaz M ◽

Hyuddin Ch G Muhyuddin ◽

Aftab Jamil ◽

Malik A H ◽

...

Keyword(s):

Diabetes Mellitus ◽

Hepatitis C ◽

Insulin Therapy ◽

Blood Donors ◽

Hypoglycemic Agents ◽

Diabetic Patients ◽

Type I ◽

Diabetic Mellitus ◽

Hepatitis C Infection ◽

Poor Control

Place and duration of study: The study was conducted at diabetic clinic B.V. Hospital/Q.A.M.C Bahawalpur from December 1st, 2004 to March 15th, 2005. Background: Diabetes mellitus and hepatitis C infections are common and emerging problems of the society. Either diabetes mellitus is common in chronic hepatitis C patients as reported initially by Ellison and co-workers or hepatitis C infection is more frequent in diabetes mellitus. We want to study the frequency of hepatitis c infection in diabetes mellitus. Objectives: To study the frequency of hepatitis C infection in diabetic patients and to note any risk factors of diabetic patients predisposing to hepatitis C infection. Designs: A cross-sectionalObservational-descriptive analytic study. Subjects and Methods: A total of 250 consecutive diabetic patients of either sex were compared with 6574 blood donors for hepatitis c infection .They were evaluated for hepatitis C infection by using Enzyme Linked Immunosorbant Assay (ELISA-3) which is an anti-HCV anti body test. On basis of this test, the patients were divided into two groups, anti-HCV +ve and anti-HCV -ye. Different variables of these patients were studied and compared in these two groups Variables studied were as follows:- Age, Sex, BMI, Mode of therapy area of their residence(rural or urban) Duration of diabetes mellitus, Blood pressure, Nephropathy and Control of diabetes mellitus. Results: Among a total of 250 patients, 120 (48%) were male and 130 (52%) were female. Two hundred and forty-four (97.6%) patients were of type-II DM and 06 (2.4%) patients were of type-I DM. 22 (8.8%) patients were on insulin therapy while 228 (91.2%) were on oral hypoglycemic agents. Anti-HCV test was positive in 69 (27.6%) diabetic patients as compared to blood donors 41 (0.62%). In anti-HCV positive group, longer duration of diabetic mellitus (15yrs 15.94%), poor control of diabetic mellitus(87%), insulin therapy(17.39%) hypertension(91.3%) and nephropathy(94.2%) were the significant vari ables while BMI, age, sex and whether they were belonging to either rural or urban area were not significant in both the groups. Conclusion: Hepatitis C infection is common in diabetic patients as compared to control group (27.6% vs 0.62%). Out of diabetic patients HCV infection is more common with longer duration of diabetic mellitus, poor control of diabetic mellitus, hypertension, nephropathy and insulin therapy.

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Oxidative stress and diabetic cardiovascular disorders: roles of mitochondria and NADPH oxidaseThis review is one of a selection of papers published in a Special Issue on Oxidative Stress in Health and Disease.

Canadian Journal of Physiology and Pharmacology ◽

10.1139/y10-018 ◽

2010 ◽

Vol 88 (3) ◽

pp. 241-248 ◽

Cited By ~ 83

Author(s):

Garry X. Shen

Keyword(s):

Oxidative Stress ◽

Nitric Oxide ◽

Endothelial Cells ◽

Cardiovascular Diseases ◽

Mitochondrial Dysfunction ◽

Cardiovascular Complications ◽

Hypoglycemic Agents ◽

Diabetic Patients ◽

Plasminogen Activator Inhibitor 1 ◽

In Cells

Cardiovascular diseases are the predominant cause of death in patients with diabetes mellitus. Underlying mechanism for the susceptibility of diabetic patients to cardiovascular diseases remains unclear. Elevated oxidative stress was detected in diabetic patients and in animal models of diabetes. Hyperglycemia, oxidatively modified atherogenic lipoproteins, and advanced glycation end products are linked to oxidative stress in diabetes. Mitochondria are one of major sources of reactive oxygen species (ROS) in cells. Mitochondrial dysfunction increases electron leak and the generation of ROS from the mitochondrial respiratory chain (MRC). High levels of glucose and lipids impair the activities of MRC complex enzymes. NADPH oxidase (NOX) generates superoxide from NADPH in cells. Increased NOX activity was detected in diabetic patients. Hyperglycemia and hyperlipidemia increased the expression of NOX in vascular endothelial cells. Accumulated lines of evidence indicate that oxidative stress induced by excessive ROS production is linked to many processes associated with diabetic cardiovascular complications. Overproduction of ROS resulting from mitochondrial dysfunction or NOX activation is associated with uncoupling of endothelial nitric oxide synthase, which leads to reduced production of nitric oxide and endothelial-dependent vasodilation. Gene silence or inhibitor of NOX reduced oxidized or glycated LDL-induced expression of plasminogen activator inhibitor-1 in endothelial cells. Statins, hypoglycemic agents, and exercise may reduce oxidative stress in diabetic patients through the reduction of NOX activity or the improvement of mitochondrial function, which may prevent or postpone the development of cardiovascular complications.

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A Snapshot of Risk Stratification of Diabetic Patients Fasting during the Month of Ramadan

10.53350/pjmhs2115123427 ◽

2021 ◽

Vol 15 (12) ◽

pp. 3427-3429

Author(s):

Asim Hassan ◽

Wedad Abullah Aldahasai ◽

Shayma Abdulatif Alsalmi

Keyword(s):

Diabetes Mellitus ◽

High Risk ◽

Risk Stratification ◽

Armed Forces ◽

Hypoglycemic Agents ◽

Diabetic Patients ◽

Clinical Practices ◽

Oral Hypoglycemic Agents ◽

Hyperosmolar Hyperglycemic State ◽

Risk Patients

Objectives: To get a clinical snapshot of the diabetic patients who planned to fast during the month of Ramadan and to determine the ability of the RRR application to effectively risk-stratify patients. Study Design: Observational study. Place and Duration of Study: Department of Diabetes & Endocrinology, Armed Forces Hospital Al-Hada, Taif, Kingdom of Saudi Arabia from 1st April 2018 to 31st May 2018. Methodology: Ninety six patients over 15 years of age with diabetes mellitus were risk stratified using standardized risk criteria were enrolled. Detailed analysis of the information was performed to paint a clinical landscape of the patients who intended to fast. Results: Seventy four percent of the patients were type 2 diabetics, 11% GDM, 31% were between 60-70 years and 17 % had diabetes for more than 20 years. 17% of participants had serious complications during the last three months before Ramadan including hypoglycemia, Diabetic Ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS). 59% had chronic diabetic complications. 28 % of patients were on both insulin and oral hypoglycemic agents (OHA) together and 16 % on high risk medications. 25% of patients had an HbA1C of more than 10%. Pertaining to the previous Ramadan experience 19% disclosed having serious complications in the past. 6 % were categorized as low risk individuals, 76% as moderate, 6% high and 12 % as very high risk. Conclusions: Astonishingly all the patients advised to refrain from fasting insisted on fasting. Considering the latest IDF numbers the above calculated percentages would translate into very huge numbers who are in serious jeopardy. In order to prevent serious consequences it is highly recommends that evidence based and validated risk stratification strategies are implemented in routine clinical practices. Keywords: Diabetes mellitus, Fast, Hypoglycemia, High risk patients

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The Diabetic Surgical Patient

10.2310/surg.2227 ◽

2020 ◽

Author(s):

Cathline Layba ◽

Lance Griffin

Keyword(s):

Diabetes Mellitus ◽

Perioperative Period ◽

The United States ◽

Postoperative Management ◽

Hypoglycemic Agents ◽

Surgical Patient ◽

Diabetic Patients ◽

Preoperative Management ◽

Oral Hypoglycemic Agents ◽

Intraoperative Management

Diabetes mellitus is the seventh leading cause of death in the United States; diabetic patients have a 50% chance of undergoing a surgical procedure during their lifetime, and operations in this patient population have been associated with a reported mortality of 4% to 13%. Careful planning of operative management and perioperative care must be taken into account when scheduling surgery for diabetic patients, especially patients taking insulin or oral hypoglycemic agents. Debate continues and inconsistencies remain regarding the management of both diabetes and hyperglycemia in the surgical setting. The review covers the evaluation of the diabetic patient, preoperative management, intraoperative management, postoperative management, total parenteral nutrition and blood glucose, cardiovascular and renal assessment, infection, and special populations. This review contains 2 figures, 5 tables, and 21 references Keywords: Glucose, Hyperglycemia, perioperative period, surgery, diabetes mellitus, surgical site infection, preoperative management, postoperative management, wound healing

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COMPARATIVE STUDY OF ORAL HYPOGLYCEMIC AGENTS IN TYPE-2 DIABETES OBESE PATIENTS

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2018.v11i6.25264 ◽

2018 ◽

Vol 11 (6) ◽

pp. 505

Author(s):

Venkateswarlu Konuru ◽

Ram Mohan Reedy T

Keyword(s):

Blood Sugar ◽

Adverse Drug Reactions ◽

Glycosylated Hemoglobin ◽

Dipeptidyl Peptidase ◽

Hypoglycemic Agents ◽

Diabetic Patients ◽

Drug Reactions ◽

Oral Hypoglycemic Agents ◽

Peptidase Inhibitors

Objectives: The aim of this study was to evaluate safety and efficacy of oral hypoglycemic agents in obese Type-2 diabetic patients. The objectives are to compare fasting and postprandial blood sugar (PPBS) levels, to compare body mass index (BMI) in all the groups, and to identify glycosylated hemoglobin levels and adverse drug reactions (if present) in all the groups.Method: This is a prospective observational study conducted in care diabetic center over a period of 1 year. All the patients those are receiving only oral hypoglycemic agents continuously over a period of 3 months and BMI ≥30 were enrolled. The patients receiving insulin were excluded. Patients were followed over a period of 3 months and were reviewed on visit basis (every 30 days). All the necessary information was collected into the data collection form that includes demographic details (age, gender, etc.), past medication history, current treatment charts, and their relevant laboratory reports (fasting blood sugar levels [mg/dl], PPBS levels [mg/dl], glycosylated hemoglobin A1c [HbA1c] (%), and BMI [kg/m2]). Results: A total of 395 patients were recruited into the study and the drugs received by the population were found to be metformin+sulfonylureas (33%), metformin+pioglitazone (26%), and metformin+dipeptidyl peptidase inhibitors (DPI) (23%). A significant reduction in HbA1c was seen in all groups of patients. Adverse drug reactions observed were hypoglycemia, pedal edema, and itching distributed to drugs metformin+DPI, respectively. A significant reduction in BMI was seen in patients receiving DPI and BMI was found to be increased in other groups of patients.Conclusion: Overall, three classes of drugs were found to have similar efficacy. Sulfonylureas were commonly associated with hypoglycemia when compared to other drugs and weight reduction observed in dipeptidyl peptidase inhibitors.

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