Effects of Glimepiride versus Saxagliptin on β-Cell Function and Hypoglycemia: A Post Hoc Analysis in Older Patients with Type 2 Diabetes Inadequately Controlled with Metformin

Cook, William J.; Wei, Cheryl; Hirshberg, Boaz

doi:10.1016/j.clinthera.2016.10.006

Cited by 6 publications

(3 citation statements)

References 47 publications

(77 reference statements)

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“…Moreover, in a recent cross‐sectional study, the risk of beta cell stress was nearly 3‐fold higher in subjects with high HbA1c compared with those with lower values. Beta cell function is associated with HbA1c levels both in pre‐diabetic states, where it predicts the progression to T2DM, and in overt diabetes, where it is associated with metabolic control more than with insulin sensitivity …”

Section: Discussionmentioning

confidence: 99%

Beta cell stress in a 4‐year follow‐up of patients with type 2 diabetes: A longitudinal analysis of the BetaDecline Study

Russo

Giorda

Cercone

et al. 2018

Diabetes Metabolism Res

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Section: Discussionmentioning

confidence: 99%

Beta cell stress in a 4‐year follow‐up of patients with type 2 diabetes: A longitudinal analysis of the BetaDecline Study

Russo

Giorda

Cercone

et al. 2018

Diabetes Metabolism Res

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“…The results indicated that the addition of glimepiride to metformin was associated with an increased risk of hypoglycaemia in patients with lower compared with higher beta-cell function, suggesting that sulphonylureas should be used with caution in patients with poor beta-cell function. 43 In contrast, GLP-1 RAs have been associated with improvements in beta-cell function. 39,[44][45][46][47][48] Evidence suggests that GLP-1 RAs can modulate insulin secretion by directly stimulating beta-cells or indirectly through weight loss and enhanced insulin sensitivity.…”

Section: Mode Of Action and Effects On Durability Of Glycaemic Control And Bodyweightmentioning

confidence: 99%

Changing the approach to type 2 diabetes treatment: A comparison of glucagon‐like peptide‐1 receptor agonists and sulphonylureas across the continuum of care

Federici

Gentilella

Corcos

et al. 2021

Diabetes Metabolism Res

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Despite the importance of individualised strategies for patients with type 2 diabetes mellitus (T2DM) and the availability of alternative treatments, including glucagonlike peptide-1 receptor agonists (GLP-1 RAs), sulphonylureas are still widely used in practice. Clinical evidence shows that GLP-1 RAs may provide better and more durable glycaemic control than sulphonylureas, with lower risk of hypoglycaemia.Other reported benefits of GLP-1 RAs include weight loss rather than weight gain (as observed with sulphonylureas), blood pressure reduction and improvement in lipid profiles. In general, the main adverse events with GLP-1 RAs are gastrointestinal in nature. The respective modes of action of GLP-1 RAs and sulphonylureas contribute to differences in the durability of glycaemic control (related to effects on beta-cells) and effects on body weight. Moreover, the glucose-dependent mode of action of GLP-1 RAs, which favours a low incidence of hypoglycaemia, contrasts with the glucose-independent mode of action of sulphonylureas. Evidence from cardiovascular outcomes trials indicates a consistent finding of cardiovascular safety across the GLP-1 RAs and suggests a class benefit for the long-acting GLP-1 RAs in reducing three-point major adverse cardiovascular events, cardiovascular mortality and all-cause mortality. In contrast, potential concerns relating to an increased incidence of adverse cardiovascular events with sulphonylureas have yet to be fully resolved. Recent updates to management guidelines recommend that treatment selection for patients with T2DM should consider clinical trial evidence of cardiovascular safety. Available evidence suggests that this selection should give preference to GLP-1 RAs over sulphonylureas, especially for patients at high cardiovascular risk.

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“…Regarding diabetic pharmacotherapy, metformin is a biguanide approved for management of T2DM, it possess significant anti-inflammatory and anti-oxidant effects that reducing the cardio-metabolic complications [11], additionally, metformin improves endothelial function through regulation of endothelial NO and attenuating the inflammatory-induced vascular endothelial function [12]. Alternatively, glimepiride which is a long acting secretagogus sulfonylurea acts through augmentation of peripheral insulin sensitivity and stimulation of insulin secretion from pancreatic β-cells [13]. Generally, sulfonylurea reduced NO production [14] but it is little known about glimepiride effect on nitrate-nitric-NO pathway.…”

Section: Introductionmentioning

confidence: 99%

Salivary Nitrite in Patients with Type 2 Diabetes Mellitus: Role of Diabetic Pharmacotherapy

Al-Kuraishy¹

2017

GJPPS

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Salivary nitrite is derived from salivary nitrate that obtained from ingested nitrate since 25% of nitrate is secreted through saliva thus; salivary nitrate is 10-20 times higher than plasma nitrate. Nitrate-nitric-NO pathway plays a role in prevention of insulin resistance and progression of diabetes mellitus. Because of salivary nitrite is also generated from NO metabolism therefore, salivary nitrite may reflect the endogenous NO production and endothelial function in various diseases thus; the aim of present study was evaluation of salivary nitrite in controlled and complicated T2DM regarding the current diabetic pharmacotherapy. In this study a total number of 50 patients with T2DM were selected randomly compared with 27 healthy subjects. 10ml of venous blood from all patients and healthy subjects after an overnight fasting was drawn, lipid profile, fasting blood glucose, plasma nitrate, plasma nitrite, nitric oxide NO and salivary nitrite were determined in patients with T2DM regarding specific diabetic pharmacotherapy and complications compared to healthy control. Salivary nitrite was high in patient with complications p=0.04 compared with control and near normal in diabetic patient without complications. Metformin increases salivary nitrite more than glimepiride but combination of metformin plus glimepiride produced significant amelioration in salivary nitrite levels. Conclusion:Salivary nitrite levels were high in complicated T2DM and low in controlled T2DM compared to the control. Metformin increases salivary nitrite levels whereas glimepiride alone or in combination with metformin reduce salivary nitrite levels in T2DM patients.

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Effects of Glimepiride versus Saxagliptin on β-Cell Function and Hypoglycemia: A Post Hoc Analysis in Older Patients with Type 2 Diabetes Inadequately Controlled with Metformin

Cited by 6 publications

References 47 publications

Beta cell stress in a 4‐year follow‐up of patients with type 2 diabetes: A longitudinal analysis of the BetaDecline Study

Beta cell stress in a 4‐year follow‐up of patients with type 2 diabetes: A longitudinal analysis of the BetaDecline Study

Changing the approach to type 2 diabetes treatment: A comparison of glucagon‐like peptide‐1 receptor agonists and sulphonylureas across the continuum of care

Salivary Nitrite in Patients with Type 2 Diabetes Mellitus: Role of Diabetic Pharmacotherapy

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