Therapy of Type 2 Diabetes

Landgraf, R.; Aberle, Jens; Birkenfeld, Andreas L.; Gallwitz, Baptist; Kellerer, Monika; Klein, Harald; Müller‐Wieland, Dirk; Nauck, Michael A.; Reuter, Hans-Martin; Siegel, Erhard

doi:10.1055/a-1018-9106

Cited by 42 publications

(25 citation statements)

References 140 publications

(146 reference statements)

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“…DPP4i are often prescribed together or provided as a dual therapy when metformin is not sufficient to maintain euglycemia. [67][68][69][70][71][72][73] Patients who receive dual therapy experience additive glucose-lowering and superior improvements in HbA1c. 74 Metformin has been demonstrated to mediate significant metabolic effects through its action within the gastrointestinal tract.…”

Section: Dpp4 Inhibitors In Combination With Metforminmentioning

confidence: 99%

Dipeptidyl Peptidase-4 at the Interface Between Inflammation and Metabolism

Trzaskalski

Fadzeyeva

Mulvihill

2020

Clin Med Insights Endocrinol Diabetes

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Dipeptidyl peptidase-4 (DPP4) is a serine protease that rapidly inactivates the incretin peptides, glucagon-like peptide-1, and glucose-dependent insulinotropic polypeptide to modulate postprandial islet hormone secretion and glycemia. Dipeptidyl peptidase-4 also has nonglycemic effects by controlling the progression of inflammation, which may be mediated more through direct protein-protein interactions than catalytic activity in the context of nonalcoholic fatty liver disease (NAFLD), obesity, and type 2 diabetes (T2D). Failure to resolve inflammation resulting in chronic subclinical activation of the immune system may influence the development of metabolic dysregulation. Thus, through both its cleavage and regulation of the bioactivity of peptide hormones and its influence on inflammation, DPP4 exhibits a diverse array of effects that can influence the progression of metabolic disease. Here, we highlight our current understanding of the complex biology of DPP4 at the intersection of inflammation, obesity, T2D, and NAFLD. We compare and review new mechanisms identified in basic laboratory and clinical studies, which may have therapeutic application and relevance to the pathogenesis of obesity and T2D.

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Section: Dpp4 Inhibitors In Combination With Metforminmentioning

confidence: 99%

Dipeptidyl Peptidase-4 at the Interface Between Inflammation and Metabolism

Trzaskalski

Fadzeyeva

Mulvihill

2020

Clin Med Insights Endocrinol Diabetes

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“…The HbA1c value was above 7.0% in 57% (40/70 patients) and above 8.0% in 23% of the patients (type 1 diabetes cohort: 31%, (4/13 patients) and type 2 diabetes cohort: 21% (12/57 patients)). Fasting glucose was above the recommended therapy target of 6.9 mmol/l in 78% (56/72 patients) [ 13 ]. In 83% of the cohort (60/72 patients) the glomerular filtration rate (GFR) was ≤ 90 ml/min/1.73m 2 .…”

Section: Resultsmentioning

confidence: 99%

General health of patients with diabetic macular edema—The LIPSIA study

et al. 2021

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Purpose Cardiovascular risk factors such as hypertension or dyslipidemia can influence the incidence and progression of diabetic retinopathy (DR) and diabetic macular edema (DME). The aim of this study is to describe the comorbidities in patients with DME. Methods Prospective, monocentric observational study. Patients presenting for the treatment of DME received laboratory and clinical examinations including 24-hour blood pressure measurement. Results Seventy-five consecutive patients were included in the study. The mean age was 61.0 ± 14.5 years, and 83% had type 2 diabetes. The mean body mass index (BMI) was 32.8 ± 6.0 kg/m2. Overweight (BMI ≥ 25 kg/m2) was present in 92% of all patients. HbA1c values were > 7.0% in 57%. Although 87% of the patients already received antihypertensive therapy, the blood pressure (BP) of 82% was still above the recommended target values of systolic < 140 mmHg and diastolic < 80 mmHg. An insufficient nocturnal fall of the systolic BP (< 10%, non-dipping or reverse dipping) was observed in 62%. In 83% of the patients the glomerular filtration rate was ≤ 90 ml/min/1.73m2. Despite 65% of the cohort already receiving lipid-lowering therapy, LDL cholesterol was above the target value of 1.4 mmol/l in 93%. All patients had at least one cardiovascular risk factor in addition to diabetes (overweight, hypertension, insufficient nocturnal BP fall, dyslipidemia, or renal dysfunction) and 86% had ≥ 3 risk factors. Conclusion DME patients are characterized by highly prevalent cardiovascular risk factors that are poorly controlled. These comorbidities reduce the prognosis and negatively influence existing DR and DME. The data reveal an important opportunity for improving patient care by interaction of the ophthalmologist with the general practitioner and internal specialists for the detection and treatment of these conditions.

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“…GLP-1 agonists often cause diarrhea, vomiting, and transient adverse effects of nausea. 29,32 Clinical guidelines recommend SGLT2 inhibitors as a potential pharmacological approach for second-line treatment after metformin failure or intolerance. 33 However, the increased risks of urinary tract infection with SGLT-2 inhibitors were noted in some studies.…”

Section: Treatment Of Diabetes Mellitusmentioning

confidence: 99%