3. BLOOD GLUCOSE-LOWERING THERAPIES – NON-INSULIN OPTIONS FOR TYPE 2 DIABETES

Diabetes Research and Clinical Practice, Год журнала: 2025, Номер unknown, С. 112147 - 112147

Опубликована: Апрель 1, 2025

Язык: Английский

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A multi-state analysis of disease trajectories and mental health transitions in patients with type 2 diabetes: A population-based retrospective cohort study utilizing health administrative data

Diabetes Research and Clinical Practice, Год журнала: 2024, Номер 209, С. 111561 - 111561

Опубликована: Фев. 5, 2024

To investigate the risk of major depression and dementia in patients with type 2 diabetes, including resulting from depression, their impact on diabetes-related complications mortality.

Язык: Английский

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Treating Type 2 Diabetes With Early, Intensive, Multimodal Pharmacotherapy: Real-World Evidence From an International Collaborative Database

Journal of Diabetes Research, Год журнала: 2024, Номер 2024, С. 1 - 11

Опубликована: Май 30, 2024

Aims: We compared the glycaemic and cardiorenal effects of combination therapy involving metformin, pioglitazone, sodium-glucose-linked-cotransporter-2 inhibitor (SGLT2i), glucagon-like peptide-1 receptor agonist (GLP-1RA) versus a more conventional glucocentric treatment approach combining sulphonylureas (SU) insulin from point type 2 diabetes (T2D) diagnosis.Methods: performed retrospective cohort study using Global Collaborative Network in TriNetX. included individuals prescribed an SGLT2i, GLP-1 RA for at least 1-year duration, within 3 years T2D diagnosis, with SU same temporal pattern. Individuals were followed up years.Results: propensity score-matched (PSM) 26 variables. A total 1762 final analysis ( n=881 per cohort). At 3-years, to insulin/SU group, metformin/pioglitazone/SGLT2i/GLP-1 group had lower risk heart failure (HR 0.34, 95% CI 0.13–0.87, p=0.018 ), acute coronary syndrome 0.29, 0.12–0.67, p=0.002 stroke 0.17, 0.06–0.49, p<0.001 chronic kidney disease 0.50, 0.25–0.99, p=0.042 hospitalisation 0.59, 0.46–0.77, p<0.001 ).Conclusions: In this real-world study, early, intensive polytherapy, targeting distinct pathophysiological defects T2D, is associated significantly favourable outcomes, therapy.

Язык: Английский

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Open questions on basal insulin therapy in T2D: a Delphi consensus

Acta Diabetologica, Год журнала: 2024, Номер 61(10), С. 1267 - 1281

Опубликована: Май 20, 2024

Abstract Aims The revolution in the therapeutic approach to type 2 diabetes (T2D) requires a rethinking of positioning basal insulin (BI) therapy. Given considerable number open questions, group experts was convened with aim providing, through Delphi consensus method, practical guidance for doctors. Methods A 6 developed series 29 statements on: role metabolic control light most recent guidelines; BI intensification strategies: (1) add-on versus switch; (2) inertia starting and titrating; (3) free fixed ratio combination; basal-bolus de-intensification strategies; second generation analogues (2BI). panel 31 diabetologists, by accessing dedicated website, assigned each statement relevance score on 9-point scale. RAND/UCLA Appropriateness Method adopted assess existence disagreement among participants. Results Panelists showed agreement all statements, which 26 were considered relevant, one not relevant two uncertain relevance. agreed that availability new classes drugs often allows postponement simplification It remains essential promptly initiate titrate when required. should always, unless contraindicated, be started addition to, as replacement, ongoing treatments cardiorenal benefits. 2BIs preferred their pharmacological profile, greater ease self-titration flexibility administration. Conclusion In continuously evolving scenario, therapy still represents an important option management T2D patients.

Язык: Английский

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Influence of early use of sodium-glucose transport protein 2 inhibitors, glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors on the legacy effect of hyperglycemia

Frontiers in Endocrinology, Год журнала: 2024, Номер 15

Опубликована: Май 13, 2024

Background A phenomenon known as legacy effect was observed that poor glycemic control at early stage of patients with newly-diagnosed type 2 diabetes (T2D) increases the risk subsequent cardiovascular diseases (CVD). Early use some novel anti-hyperglycemic agents, such sodium-glucose transport protein inhibitors (SGLT-2i), may attenuate this effect, but evidence is limited. Methods Two retrospective cohorts newly diagnosed T2D from 2010–2023 were assembled using Yinzhou Regional Health Care Database (YRHCD) different definitions exposure period - 1-year cohort and 2-year cohort, which comprised subjects who had HbA1c measurement data within 1 year years after their diagnosis, respectively. Using Cox proportional hazards models, we examined association between high level (HbA1c&gt;7%) during CVD. This analysis performed in overall three subpopulations treatments period, including initiating SGLT-2i or glucagon-like peptide-1 receptor agonists (GLP-1RA), dipeptidyl peptidase-4 (DPP-4i), without SGLT-2i, GLP-1RA, DPP-4i. Besides, subgroup analyses by stratifying into age &lt;55 ≥55 years. Results total 21,477 22,493 included two final cohorts. Compared mean ≤ 7% those HbA1c&gt;7% higher risks incident CVD, a HR 1.165 (95%CI, 1.056–1.285) 1.143 1.044–1.252) cohort. to non-users, SGLT-2i/GLP-1RA baseline not associated CVD both In analyses, results generally consistent main analysis. Conclusions Poor increased later Chinese adults T2D. smaller non-significant receiving T2D, indicating these drugs have potential mitigate effects hyperglycemia.

Язык: Английский

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Burden of Disease in Refugee Patients with Diabetes on the Island of Lesvos—The Experience of a Frontline General Hospital

International Journal of Environmental Research and Public Health, Год журнала: 2024, Номер 21(7), С. 828 - 828

Опубликована: Июнь 25, 2024

Diabetes mellitus is a non-communicable disease which poses great burden on refugee populations, who are confronted with limited access to healthcare services and disruption of pre-existing pharmacological treatment. Aims: We sought evaluate the degree hyperglycaemia in refugees known or recently diagnosed diabetes, assess cardiovascular comorbidities diabetes complications, review provide available therapeutic options, compare, if possible, situation Lesvos other locations hosting thus raising our awareness towards barriers accessing managing these vulnerable populations propose follow-up strategies. Methods: retrospectively studied 69 patients (68% Afghan origin, 64% female) (81% type 2 diabetes), were referred outpatient clinics General Hospital Mytilene, Lesvos, Greece, between June 2019 December 2020. Age, Body Mass Index, duration, glycaemic control (HbA1c random glucose), blood pressure, estimated renal function, lipid profile, complications current medication documented at presentation during subsequent visits. Results: For all 1 age was 17.7 48.1 years, BMI 19.6 kg/m2 28.9 HbA1c 9.6% 8.7%, respectively (all medians). One-third (29%) presented either interrupted no previous Insulin administered only 21% poorly controlled diabetes. Only half (48%) hypertension taking antihypertensive one-sixth (17%) lipid-lowering medication. Forty-two per cent (42%) lost follow-up. Conclusions: Our results showed that significant portion have treatment had their discontinued, insulin still underutilised It essential enhance ability identify may be risk developing experiencing related disease. Additionally, it important expand crucial monitoring services. By improving policies for diseases, we can better support health well-being populations. Furthermore, vital recognize Greece cannot bear crisis alone; international collaboration necessary address challenges effectively.

Язык: Английский

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Is glycaemic control still central in the hierarchy of priorities in type 2 diabetes management? The way forward is to combine glucose control and the prevention of cardiorenal complications

Diabetologia, Год журнала: 2024, Номер unknown

Опубликована: Окт. 4, 2024

Язык: Английский

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Generalizability of kidney and cardiovascular protection by finerenone to the real world in Italy: insights from Fidelio and Figaro studies

Journal of Nephrology, Год журнала: 2024, Номер unknown

Опубликована: Дек. 15, 2024

Язык: Английский

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SGLT-2-Inhibitoren – Eine Standortbestimmung in der deutschen oralen Therapielandschaft für Menschen mit Typ-2-Diabetes

Diabetologie und Stoffwechsel, Год журнала: 2024, Номер unknown

Опубликована: Дек. 16, 2024

Zusammenfassung Wie aus zahlreichen umfangreichen Studien hervorgeht, haben SGLT-2-Inhibitoren nicht nur positive Effekte auf den Glukosestoffwechsel, sondern darüber hinaus eine ausgeprägte protektive Wirkung Herz und Nieren. Damit kommt dieser Wirkstoffklasse wichtige Rolle in der Primär- Sekundärprävention diabetes-assoziierter Komorbiditäten zu. Leitlinien sprechen Basis Evidenz für Empfehlung deren frühen Einsatz bei Menschen mit Typ-2-Diabetes gleichzeitigem hohen Risiko kardiovaskuläre und/oder renale Ereignisse aus. Verordnungszahlen zeigen jedoch, dass diese Empfehlungen aktuell umgesetzt werden deutlich mehr von einer organprotektiven Therapie profitieren könnten. Daher soll Übersichtsarbeit Stellenwert im Vergleich zu anderen oralen Therapieansätzen die Behandlung des dargestellt werden.

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Diabetes: Recent Advances and Future Perspectives

Biomedicines, Год журнала: 2024, Номер 12(12), С. 2875 - 2875

Опубликована: Дек. 18, 2024

Diabetes is a chronic metabolic disorder distinguished by persistent hyperglycemia [...]

Язык: Английский

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