Oral antihyperglycemic therapy for type 2 diabetes mellitus

Cheng, Alice; Fantus, I. George

doi:10.1503/cmaj.1031414

Cited by 400 publications

(298 citation statements)

References 77 publications

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“…Several studies have indeed shown that TZDs increase fracture risk (10,11). In contrast, metformin, another widely prescribed anti-diabetic drug (12), is osteogenic in vitro (13,14) and reduces the risk of fracture in DM patients (15), as well as inhibiting the bone loss induced by ovariectomy (OVX) in rats (16,17). However, our recent studies showed no beneficial effect of metformin on bone mass and fracture healing in rodents (18).…”

Section: Introductionmentioning

confidence: 99%

Chronic administration of Glucagon-like peptide-1 receptor agonists improves trabecular bone mass and architecture in ovariectomised mice

Pereira

Jeyabalan

Jorgensen

et al. 2015

Bone

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Section: Introductionmentioning

confidence: 99%

Chronic administration of Glucagon-like peptide-1 receptor agonists improves trabecular bone mass and architecture in ovariectomised mice

Pereira

Jeyabalan

Jorgensen

et al. 2015

Bone

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“…Metformin (MET) monotherapy is the standard first-line AHA; however, its use is limited in some patients due to poor gastrointestinal tolerability (1). In addition, patients with elevated baseline HbA 1c may have difficulty meeting glycemic targets with a single AHA (5,6). Thus, many people will require combination therapy with two or three AHAs to achieve individualized glycemic targets (1).…”

mentioning

confidence: 99%

Initial Combination Therapy With Canagliflozin Plus Metformin Versus Each Component as Monotherapy for Drug-Naïve Type 2 Diabetes

et al. 2016

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OBJECTIVE This study assessed the efficacy/safety of canagliflozin (CANA), a sodium–glucose cotransporter 2 (SGLT2) inhibitor, plus metformin extended-release (MET) initial therapy in drug-naïve type 2 diabetes. RESEARCH DESIGN AND METHODS This 26-week, double-blind, phase 3 study randomized 1,186 patients to CANA 100 mg (CANA100)/MET, CANA 300 mg (CANA300)/MET, CANA100, CANA300, or MET. Primary end point was change in HbA1c at week 26 for combinations versus monotherapies. Secondary end points included noninferiority in HbA1c lowering with CANA monotherapy versus MET; changes in fasting plasma glucose, body weight, and blood pressure; and proportion of patients achieving HbA1c <7.0% (<53 mmol/mol). RESULTS From mean baseline HbA1c of 8.8% (73 mmol/mol), CANA100/MET and CANA300/MET significantly lowered HbA1c versus MET (median dose, 2,000 mg/day) by –1.77%, –1.78%, and –1.30% (–19.3, –19.5, and –14.2 mmol/mol; differences of −0.46% and –0.48% [–5.0 and –5.2 mmol/mol]; P = 0.001) and versus CANA100 and CANA300 by –1.37% and –1.42% (–15.0 and –15.5 mmol/mol; differences of –0.40% and –0.36% [–4.4 and –3.9 mmol/mol]; P = 0.001). CANA100 and CANA300 monotherapy met noninferiority for HbA1c lowering and had significantly more weight loss versus MET (–2.8, –3.7, and –1.9 kg [–3.0%, –3.9%, and –2.1%]; P = 0.016 and P = 0.002). Greater attainment of HbA1c <7.0% (50%, 57%, and 43%) and significantly more weight loss (–3.2, –3.9, and –1.9 kg [–3.5%, –4.2%, and –2.1%]; P = 0.001) occurred with CANA100/MET and CANA300/MET versus MET. The incidence of adverse events (AEs) related to SGLT2 inhibition (genital mycotic infections, osmotic diuresis– and volume depletion–related AEs) was higher in the CANA arms (0.4–4.4%) versus MET (0–0.8%). AE-related discontinuation rates were 1.3–3.0% across groups. The incidence of hypoglycemia was 3.0–5.5% in the CANA arms and 4.6% with MET. CONCLUSIONS Initial therapy with CANA plus MET was more effective and generally well tolerated versus each monotherapy in drug-naïve type 2 diabetes. CANA monotherapy demonstrated noninferior HbA1c lowering versus MET.

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“…The mechanisms of action of these drugs include: reduction in hepatic glucose release, enhancement of insulin secretion and sensitivity as well as inhibition of intestinal glucose absorp-tion. [66] Although the present study has shown that extracts of V. amygdalina, A. indica and M. oleifera caused marginal short-term efficacy, oral administration of ethanolic extract of Berberis lyceum (Royle) has previously been demonstrated to possessing substantial short-term acting capacity to ameliorate elevated blood glucose in alloxan induced diabetic rats within 180 min. [67] They further noted that ethanol extracts of B. lyceum yielded slightly better results compared to equivalent aqueous extracts.…”

Section: Discussionmentioning

confidence: 74%

Comparative Proximate Composition and Hypoglycemic Properties of Three Medicinal Plants (Verononia amygdalina, Azadirachta indica and Moringa oleifera).

Okey¹,

Chidoka²

2014

Phcog Commn.

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Oral antihyperglycemic therapy for type 2 diabetes mellitus

Cited by 400 publications

References 77 publications

Chronic administration of Glucagon-like peptide-1 receptor agonists improves trabecular bone mass and architecture in ovariectomised mice

Chronic administration of Glucagon-like peptide-1 receptor agonists improves trabecular bone mass and architecture in ovariectomised mice

Initial Combination Therapy With Canagliflozin Plus Metformin Versus Each Component as Monotherapy for Drug-Naïve Type 2 Diabetes

Comparative Proximate Composition and Hypoglycemic Properties of Three Medicinal Plants (Verononia amygdalina, Azadirachta indica and Moringa oleifera).

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