scholarly journals Use of SGLT-2 inhibitors in the treatment of type 2 diabetes mellitus

2017 ◽  
Vol 63 (7) ◽  
pp. 636-641 ◽  
Author(s):  
Leyna Leite Santos ◽  
Fernando José Camello de Lima ◽  
Célio Fernando de Sousa-Rodrigues ◽  
Fabiano Timbó Barbosa
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Blood Glucose ◽  
High Morbidity ◽  
Oral Antidiabetic Agents ◽  
Oral Antidiabetic ◽  
Pubmed Database ◽  
Progression Of Kidney Disease

Summary Introduction: Diabetes mellitus is one of the most common chronic diseases in the world, with high morbidity and mortality rates, resulting in a greatly negative socioeconomic impact. Although there are several classes of oral antidiabetic agents, most of the patients are outside the therapeutic goal range. Objective: To review the use of SGLT-2 inhibitors in the treatment of type 2 diabetes mellitus, focusing on their favorable and unfavorable effects, as well as on cardiovascular profile. Method: A literature search on Pubmed database was performed using the following keywords: "SGLT-2 inhibitors," "dapagliflozin," "empagliflozin," "canagliflozin." Results: SGLT-2 inhibitors are a class of oral antidiabetic drugs directed to the kidney. Their mechanism of action is to reduce blood glucose by inducing glycosuria. Extra-glycemic benefits have been described, such as weight loss, decline in blood pressure and levels of triglycerides and uric acid, and they can slow the progression of kidney disease. Genitourinary infections are the main side effects. There is a low risk of hypotension and hypoglycemia. Diabetic ketoacidosis is a serious adverse effect, although rare. Empagliflozin has already had its cardiovascular benefit demonstrated and studies with other drugs are currently being performed. Conclusion: SGLT-2 inhibitors are a new treatment option for type 2 diabetes mellitus, acting independently of insulin. They have potential benefits other than the reduction of blood glucose, but also carry a risk for adverse effects.

DLBS3233, a combined bioactive fraction of Cinnamomum burmanii and Lagerstroemia speciosa, in type-2 diabetes mellitus patients inadequately controlled by metformin and other oral antidiabetic agents

2016 ◽  
Vol 13 (4) ◽  
Author(s):  
Askandar Tjokroprawiro ◽  
Sri Murtiwi ◽  
Raymond R. Tjandrawinata
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Prospective Clinical Study ◽  
Oral Antidiabetic Agents ◽  
Antidiabetic Agents ◽  
Oral Antidiabetic ◽  
Enhance Insulin Sensitivity ◽  
Bioactive Fraction

AbstractBackgroundDLBS3233, a combined bioactive fraction ofMethodsThis was an open and prospective clinical study for 12 weeks of therapy, involving type-2 diabetes mellitus patients who had been treated with two oral antidiabetic agents for at least 3 months prior to screening, yet, with HbAResultsAfter 12 weeks of treatment, the HbAConclusionsThe add-on oral antidiabetes therapy with DLBS3233 at the dose of 100 mg once daily helped type-2 diabetes mellitus patients to improve their glycemic control, enhance insulin sensitivity, lipid profile, and adiponectin level. In addition, DLBS3233 treatment concomitantly with other oral antidiabetic agents was proven safe and tolerable in type-2 diabetes subjects.

scholarly journals Cardiovascular safety of oral antidiabetic therapy in type 2 diabetes mellitus- review article

2017 ◽  
Vol 5 (5) ◽  
pp. 1742
Author(s):  
P. S. Singh ◽  
Sudhir K. Yadav ◽  
Himanshu Sharma ◽  
Manoj Kumar
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
New Drugs ◽  
Diabetic Patients ◽  
Cardiovascular Safety ◽  
Oral Antidiabetic Agents ◽  
Oral Antidiabetic ◽  
Increased Risk

Cardiovascular disease is the leading cause of morbidity and mortality among patients with type 2 diabetes mellitus (DM). There is twofold increased risk of cardiovascular (CV) mortality among diabetic patients as compared with nondiabetic patients. The glycemic efficacy of anti-diabetic drugs does not necessarily provide cardiovascular safety. Since 2008, US Food and Drug Administration has recommended that new drugs for type 2 DM should undergo clinical trials to demonstrate cardiovascular safety in addition to glycemic benefit. In 2012, European medicine agencies issued a similar recommendation. In this review, we have tried to examine the cardiovascular safety of oral antidiabetic agents in major published trials. Metformin remains the initial drug of choice in type2 DM till date. The sulfonylureas, one of oldest oral anti-diabetic drugs, have adverse cardiovascular events and are gradually being out classed by other second line drugs. The glitazones have been found to have adverse outcome in heart failure. The incretin based drugs have been found to have cardiovascular safety in various trials in recent past and their performances have been reassuring. There is lack of enough cardiovascular outcome data for meglitinides and glucosidase inhibitors. Various current trials have found sodium glucose cotransporter-2 inhibitors to have a potential for cardiovascular benefit. Careful selection of drug therapy with special attention for cardiovascular risk is important in selection and optimization of diabetic therapy.

scholarly journals Comparative Study on Dual and Triple Therapy Using Oral Antidiabetic Drugs in Treatment of Type 2 Diabetes Mellitus

2017 ◽  
Vol 3 (2) ◽  
pp. 128-137
Author(s):  
Sangita Shakya ◽  
Smrity Bajracharya ◽  
Amit Shakya ◽  
Santosh Shakya ◽  
Shailendra Chaudhary ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Blood Glucose ◽  
Triple Therapy ◽  
Dual Therapy ◽  
Antidiabetic Drugs ◽  
Oral Antidiabetic Drugs ◽  
Oral Antidiabetic

Introduction: Type 2 diabetes mellitus is a progressive complex disorder so most patients require dual and triple therapy using glucose- lowering agents.Purpose: To find the effectiveness of the dual therapy [glimepiride and metformin] and triple therapy [glimepiride, metformin and pioglitazone] for glycemic control.Method: The prospective study was conducted in Diabetes and Endocrinology Centre including 112 patients with Type 2 diabetes treating with oral antidiabetic drugs. Patients, age group between 30-70 years having pre- prandial blood glucose [≥ 110 mg/dl] and post-prandial blood glucose [≥ 140 mg/dl] were included. They were grouped into dual and triple therapy according to treatment they received. The blood glucose level was examined after one week of initial drug therapy. Patients taking oral antidiabetic drugs along with insulin therapy were excluded.Result: Type 2 diabetes mellitus was prevalent in the age group between 50- 60years. The reduction in pre-prandial blood glucose with dual therapy and triple therapy were 26.5 % and 27.1 % respectively and reduction in post-prandial blood sugar were 32.6 % and 30.5 % respectively. Hence the effectiveness of the dual therapy (p=0.827) and triple therapy (p=0.949) was similar in pre and post glycemic control .Conclusion: The dual and triple therapy may be equally effective for the treatment of type 2 DM.Journal of Advanced Academic Research Vol. 3, No. 2, 2016, Page: 128-137

scholarly journals The Effects of Once-Weekly Dulaglutide and Insulin Glargine on Glucose Fluctuation in Poorly Oral-Antidiabetic Controlled Patients with Type 2 Diabetes Mellitus

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Jie Wang ◽  
Hui-qin Li ◽  
Xiao-hua Xu ◽  
Xiao-cen Kong ◽  
Rui Sun ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Blood Glucose ◽  
Treatment Protocol ◽  
Mean Amplitude ◽  
Once Daily ◽  
Glucose Fluctuation ◽  
Oral Antidiabetic

Aim. To compare the effects of once-weekly Dulaglutide with once-daily glargine in poorly oral-antidiabetic controlled patients with type 2 diabetes mellitus (T2DM). Method. A total of 25 patients with T2DM admitted into Department of Endocrinology from December 2012 to August 2013 were randomly assigned into two groups: Dulaglutide group (n=16) and glargine group (n=9). All patients received either Dulaglutide or glargine treatments for 52 weeks. Continuous glucose monitoring systems (CGMS) were applied to them for two 72 h periods at before and after the treatment each. Patient general clinical data were collected and analyzed. Result. Fast blood glucose (FBG) of the glargine group declined more significantly than the Dulaglutide group after treatment (p<0.05). The mean blood glucose (MBG), standard deviation of blood glucose (SDBG), mean amplitude of glycemic excursion (MAGE) within a day, the largest amplitude of glycemic excursion (LAGE), M-value, absolute means of daily difference (MODD) of glycemic excursion, the percentage of time (≤2.8 mmol/L, ≤3.9 mmol/L, ≥10.0 mmol/L, ≥13.9 mmol/L, 3.9–7.8 mmol/L, and 9–10.0 mmol/L), maximum glycemic value, and minimum glycemic value were similar between the two groups (p>0.05). The incidence of hypoglycemia was also similar between the two groups (p>0.05). Though serum levels of TNF-α, IL-6, and 8-PGF2α all decreased, significant reduction was found in TNF-α and 8-PGF2α. TNF-α was only significantly reduced in the Dulaglutide group, while 8-PGF2α was seen in both groups. Conclusion. For T2DM patients with poorly controlled oral antidiabetic drugs, once-weekly Dulaglutide not only has the same effect on glucose fluctuation as once-daily glargine but also significantly reduced TNF-α and 8-PGF2α after a 52 week treatment protocol. This trial is registered with ClinicalTrials.gov NCT01648582.

Oral Antidiabetic Agents: A Comparative Review

2004 ◽  
Vol 17 (1) ◽  
pp. 39-48 ◽  
Author(s):  
Renee R. Koski
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
The United States ◽  
Oral Antidiabetic Agents ◽  
Antidiabetic Agents ◽  
Oral Antidiabetic ◽  
Oral Agents ◽  
Comparative Review

Type 2 diabetes mellitus is a chronic disease characterized by insulin resistance, impaired insulin secretion, and/or increased hepatic glucose production. The mainstays of drug treatment are the oral antidiabetic agents. Insulin is usually reserved for patients who do not achieve fasting plasma glucose or A1C goals with or cannot tolerate the oral antidiabetic agents. There are 5 classes of oral antidiabetic agents available in the United States: sulfonylureas, biguanides, alpha-glucosidase inhibitors, thiazolidinediones, and nonsulfonylurea secretagogues. They have differences and similarities with respect to their pharmacology and role in diabetes. This article reviews the pharmacology, efficacy, safety, and selection of the oral agents used to treat type 2 diabetes mellitus.

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