Optimal therapy of type 2 diabetes: a controversial challenge

Dardano, Angela; Penno, Giuseppe; Prato, Stefano Del; Miccoli, Roberto

doi:10.18632/aging.100646

Cited by 40 publications

(28 citation statements)

References 192 publications

(242 reference statements)

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“…In addition, very little is known about the association of disability with glucose‐lowering medication, glycemic control, and duration of diabetes . Further research into each of these areas will help to more accurately establish the burden of functional disability associated with diabetes in older adults and may inform ongoing debates regarding the optimal clinical care of older adults with the disease …”

Section: Introductionmentioning

confidence: 99%

Diabetes, hyperglycemia, and the burden of functional disability among older adults in a community-based study

et al. 2016

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BACKGROUND There is a need for continued surveillance of diabetes-related functional disability. We examined associations between diabetes, hyperglycemia, and the burden of functional disability in a community-based population. METHODS We conducted a cross-sectional analysis of 5,035 participants who attended visit 5 (2011–2013) of the Atherosclerosis Risk in Communities study. Functional disability was dichotomously defined by any self-reported difficulty performing 12 tasks essential to independent living grouped into four functional domains. We evaluated associations of diagnosed diabetes (via self-report), and undiagnosed diabetes and prediabetes (via HbA1c), with functional disability using Poisson regression. RESULTS Participants had a mean age of 75 years, 42% were male, 22% were black, and 31% had diagnosed diabetes. Those with diagnosed diabetes had a significantly greater burden of functional disability compared to those without diabetes even after adjustment for demographics, health behaviors, and comorbidities: prevalence ratios (95% CIs) were 1.24 (1.15, 1.34) for lower extremity mobility; 1.14 (1.07, 1.21) for general physical activities; 1.33 (1.16, 1.52) for instrumental activities of daily living; and 1.46 (1.24, 1.73) for activities of daily living (all P < 0.05). The associations of undiagnosed diabetes and prediabetes with disability were not statistically significant (all P < 0.05). CONCLUSIONS Among older adults, the burden of functional disability associated with diabetes was not entirely explained by known risk factors including comorbidities. Hyperglycemia below the threshold for the diagnosis of diabetes was not associated with disability. Research into effective strategies for the prevention of functional disability among older adults with diabetes is needed.

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“…As metformin is the leading oral hypoglycemic agents and associated with a reduced odds of diabetes‐related complications, metformin is particularly encouraged in the older patients . However, in the older diabetic patients a high proportion have impaired renal function, so it may be necessary to use dose reduction because of changes in several pharmacokinetic and pharmacodynamic parameters …”

Section: Discussionmentioning

confidence: 99%

Epidemiology of lactic acidosis in type 2 diabetes patients with metformin in Japan

Chang

Sakaguchi

Dolin

2016

Pharmacoepidemiol Drug Saf

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PurposeTo estimate the incidence of lactic acidosis (LA) and role of metformin in Japanese patients with type 2 diabetes mellitus (T2DM) treated with anti‐diabetes drugs.MethodsThis retrospective propensity score matched cohort study was conducted using the Japanese Medical Data Vision claims database. T2DM patients aged 18 or above who received diabetes drugs during January 2010 through August 2014 were identified. Cases of LA were identified based on reimbursement codes and confirmed by lactic acid test and subsequent treatment by hemodialysis or intravenous sodium bicarbonate. Poisson regression and Cox proportional hazard models were used to estimate the incidence and assess if metformin use was associated with increased risk of LA.ResultsThirty cases of LA were identified among 283 491 treated T2DM patients with 504 169 patient‐years of follow‐up. Crude incidence of LA was 5.95 per 100 000 patient‐years. T2DM patients with chronic kidney disease (CKD) were seven‐fold more likely to develop LA than those without CKD (adjusted hazard ratio (aHR), 7.33, 95%CI, 3.17–16.96). Use of metformin was not associated with risk of LA in the study population (aHR, 0.92, 95%CI, 0.33–2.55), and in the propensity score matched cohort (aHR, 0.90, 95%CI, 0.26–3.11). Similar findings were observed among diabetes patients with chronic liver disease (CLD) and CKD. The age‐sex adjusted incidence rates in metformin users and non‐users were 5.80 and 5.78 per 100 000 person‐years, respectively (Incidence rate ratio, 1.00, p = 0.99).ConclusionsThis study found that use of metformin was not associated with increased risk of LA in diabetic patients including those with CKD or CLD. © 2016 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons Ltd.

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“…Current treatment typically begins with lifestyle modifications, with the subsequent addition of antidiabetic agents such as insulin, biguanides metformin, sulphonylureas, thiazolidinediones, α-glucosidase inhibitors, incretin analogues, dipeptidyl peptidase-4 inhibitors, and sodium-glucose co-transporter inhibitors (Bailey, 2005;Dardano et al, 2014;Donath, 2014;Kim and Egan, 2008). These medications decrease glucose levels by improving β-cell function and mass, improving insulin sensitivity, or providing exogenous insulin.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, most antidiabetic agents are associated with undesirable side effects. These include weight gain and hypoglycemia for sulphonylureas or insulin; gastrointestinal symptoms for biguanides; and weight gain, peripheral edema, and bone fractures for thiazolidinediones (Dardano et al, 2014). Therefore, new treatments for In this review, we focus on the roles of inflammasomes and DAMPs and their pathological relevance to the development of diabetes.…”

Section: Introductionmentioning

confidence: 99%

Damage-associated molecular patterns and their pathological relevance in diabetes mellitus

Shin

Lee

Park

et al. 2015

Ageing Research Reviews

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“…Durante la última década, la prevalencia de diabetes ha aumentado más rápidamente en los países con ingresos bajos y medios que en los países de ingresos altos. Este aumento constante es debido al crecimiento de la población, el aumento de la esperanza de vida y el aumento del riesgo de desarrollar DM2 con la edad avanzada [7,8].…”

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Impacto de un programa educativo en el control de la diabetes mellitus tipo 2

Altava¹

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Optimal therapy of type 2 diabetes: a controversial challenge

Cited by 40 publications

References 192 publications

Diabetes, hyperglycemia, and the burden of functional disability among older adults in a community-based study

Epidemiology of lactic acidosis in type 2 diabetes patients with metformin in Japan

Damage-associated molecular patterns and their pathological relevance in diabetes mellitus

Impacto de un programa educativo en el control de la diabetes mellitus tipo 2

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