Incretin-based therapies encompass two new classes of antidiabetic drugs: glucagon-like peptide-1 (GLP-1) receptor agonists (e.g., liraglutide, exenatide, and exenatide long-acting release), which are structurally related to GLP-1, and the dipeptidyl peptidase-4 (DPP-4) inhibitors (e.g., sitagliptin and saxagliptin), which limit the breakdown of endogenous GLP-1. To evaluate the safety and effectiveness of incretin-based therapies for the treatment of type 2 diabetes mellitus and the role of these therapies in clinical practice, a MEDLINE search (January 1985-November 2009) was conducted. Relevant references from the publications identified were also reviewed. Of 28 studies identified, 22 were randomized controlled trials. Data show that these therapies affect insulin secretion in a glucose-dependent manner, achieving clinically meaningful reductions in hemoglobin A(1c) levels, with very low rates of hypoglycemia. In addition, reductions in body weight have been observed with GLP-1 receptor agonists, which also exert a pronounced effect on systolic blood pressure. Various human and animal studies show that GLP-1 improves beta-cell function and increases beta-cell proliferation in vitro, which may slow disease progression. Thus, incretin-based therapies represent a promising addition to the available treatments for type 2 diabetes.
IntroductionGlucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly being used for the treatment of type 2 diabetes mellitus, but consideration of benefits and potential adverse events is required. This review examines the state of glycemic control, weight loss, blood pressure, and tolerability, as well as the current debate about the safety of GLP-1 RAs, including risk of pancreatitis, pancreatic cancer, and thyroid cancer.MethodsA MEDLINE search (2010-2015) identified publications that discussed longer-acting GLP-1 RAs. Search terms included GLP-1 receptor agonists, liraglutide, exenatide, lixisenatide, semaglutide, dulaglutide, albiglutide, efficacy, safety, pancreatitis, pancreatic cancer, and thyroid cancer. Abstracts from the American Diabetes Association, European Association for the Study of Diabetes, and American Association of Clinical Endocrinologists from 2010 to 2015 were also searched. Efficacy and safety studies, pooled analyses, and meta-analyses were prioritized.ResultsResearch has confirmed that GLP-1 RAs provide robust glycemic control, weight loss, and blood pressure re-duction. Current studies do not prove increased risk of pancreatitis, pancreatic cancer, or thyroid cancer but more trials are needed since publications that indicate safety or suggest increased risk have methodological flaws that prevent firm conclusions to be drawn about these rare, long-term events.ConclusionGLP-1 RA therapy in the context of individualized, patient-centered care continues to be supported by current literature. GLP-1 RA therapy provides robust glycemic control, blood pressure reduction, and weight loss, but studies are still needed to address concerns about tolerability and safety, including pancreatitis and cancer.
Objective. To design an assessment of practice readiness using blended-simulation progress testing. Design. A five-station, blended simulation assessment was developed to evaluate patient care outcomes in first-and third-year pharmacy (P1 and P3) students, as well as first-year postgraduate (PGY1) pharmacy residents. This assessment of practice readiness included knowledge and performance evaluations administered as a progress test. Assessment. Eighteen PGY1 residents, 108 P3 students, and 106 P1 students completed the assessment. P3 students scored significantly higher than P1 students across all evaluations. Third-year pharmacy students scored significantly lower than PGY1 residents in interprofessional communications and attitudes of ownership in a standardized colleague/mannequin model station, and in patient communication in a standardized patient station. Conclusion. Learners demonstrated evolving skills as they progressed through the curriculum. A blended simulation integrated progress test provides data for improvement of individual student clinical skills, informs curricular advancement, and aligns curricular content, process, and outcomes with accreditation standards.
Objective. To develop a comprehensive diabetes management course for pharmacy students that is available to all colleges and schools of pharmacy via the Internet. Design. DM Educate, a Web-based course consisting of 12 topic modules with video lectures, activelearning exercises, and test questions prepared by nationally recognized experts was developed. The modular design allows use as a standalone, 3-credit course or use of individual module content as a supplement to an existing course. Assessment. Two pilot studies found the comprehensive, interprofessional nature of the material beneficial for learners. Students showed a significant increase in knowledge of the subject material by correctly answering 26 of 34 questions on the posttest compared to answering only 14 of 34 questions correctly on the pretest (p , 0.001). Student feedback was positive for the flexibility of the Web-based format. Conclusion. Pilot studies demonstrated the effectiveness of the course, which became available in the 2006-2007 academic year.Keywords: Internet, diabetes, distance instruction INTRODUCTIONEmerging technologies and the accessibility of the Internet have opened up possibilities for providing pharmacy education through innovative strategies. Since the introduction of a commercial browser in 1993, various applications of Internet-based education in pharmacy have been implemented, including courses, course modules, learning resources, mentoring, recitation, combinations with lectures, technique tutorial, remote instruction, and continuing education. [1][2][3][4][5][6][7][8][9][10][11][12][13] In all of these examples of Internet education in pharmacy, the content was developed by faculty members at a particular institution and used only by students enrolled in that institution.In order to fully prepare students for their future role as pharmacists, an in-depth understanding of the various aspects of disease states is needed beyond drug therapy. Diabetes is one such disease state. Information specific to diabetes treatment is often addressed within therapeutics courses with a narrow focus on drug therapy. This may be due to curricular time constraints or availability of faculty at an individual institution. In addition, coverage of diabetes-related material may vary between institutions for the same reasons. As a result, pharmacy students may not have access to resources to learn about detailed aspects of diabetes beyond drug therapy or be receiving consistency in course material covered.The nature of the Internet allows for an innovative approach for creating a course that can be accessible to all colleges and schools of pharmacy in a Web-based format. Through the production of one sharable course, experts in various fields of practice can collaborate in creating courses that provide resources for faculty members to use in part or in their entirety to teach pharmacy courses. This strategy has the potential to efficiently provide a large number of students with high quality education using the most current information availabl...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.