Treatment of type 2 diabetes mellitus in elderly patients

Gómez‐Huelgas, Ricardo; Peralta, Fernando Gómez; Mañas, Leocadio Rodríguez; Formiga, Francesç; Domingo, Manuel Puig; Bravo, José Javier Mediavilla; Miranda, Cesare; Ena, Javier

doi:10.1016/j.rceng.2017.12.004

Cited by 31 publications

(43 citation statements)

References 174 publications

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“…8,10 The main guidelines and position statements recommend avoiding their use or a very cautious use in elderly patients due to high risk of hypoglycemia. [3][4][5] The results of our study suggest potential overtreatment of a significant proportion of elderly patients.…”

Section: Research Lettermentioning

confidence: 78%

“…Owing to the benefit it offers of reducing major complications of T2D and its low risk of hypoglycemia, it has been recommended as a first -line drug for elderly patients with T2D. 4,5 In our study, most patients were treated with metformin, in accordance with the current guidelines. 3-5 However, 48.8% of patients were treated with agents associated with high risk of hypoglycemia, with the rate rising to 56.7% in patients who had tight glycemic control.…”

Section: Research Lettermentioning

confidence: 96%

“…2 Glycemic management in elderly patients recommended by most current guidelines includes a comprehensive geriatric assessment in order to establish the most adequate therapeutic strategy with the lowest risk of drug -induced hypoglycemia. [3][4][5] Vulnerable elderly patients are less likely to experience benefits and more likely to suffer from adverse events related to tight glycemic control, particularly hypoglycemia. 5,6 In the recent years, several reports have emphasized that a substantial proportion of older patients with complex health status (CHS) and tight glycemic control are potentially overtreated with secretagogues or insulin therapies and are thus highly exposed to hypoglycemia.…”

mentioning

confidence: 99%

“…[3][4][5] Vulnerable elderly patients are less likely to experience benefits and more likely to suffer from adverse events related to tight glycemic control, particularly hypoglycemia. 5,6 In the recent years, several reports have emphasized that a substantial proportion of older patients with complex health status (CHS) and tight glycemic control are potentially overtreated with secretagogues or insulin therapies and are thus highly exposed to hypoglycemia. 7,8 Considering these findings, recommendations from guidelines, and growing challenges in the treatment of elderly patients with T2D, 3-6 the aim of this study was to examine the management of these patients in LTC and skilled nursing facilities according to glycemic control and to identify factors associated with tight glycemic control.…”

mentioning

confidence: 99%

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Management of elderly patients with type 2 diabetes in long-term care and skilled-nursing facilities

Gómez‐Huelgas

Pérez‐Belmonte

Rivera-Cabeo

et al. 2018

Polish Archives of Internal Medicine

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Section: Research Lettermentioning

confidence: 78%

Section: Research Lettermentioning

confidence: 96%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Management of elderly patients with type 2 diabetes in long-term care and skilled-nursing facilities

Gómez‐Huelgas

Pérez‐Belmonte

Rivera-Cabeo

et al. 2018

Polish Archives of Internal Medicine

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“…2 Currently several anti-diabetic synthetic drugs with the DPP-4 inhibitor working mechanism have been marketed, such as sitagliptin, vidagliptin, saxagliptin, linagliptin and alogliptin. 3 Although DPP-4 inhibiting agents have advantages such as not causing hypoglycemia and weight loss, and can be used as monotherapy or in combination with other anti-diabetic agents, these synthetic drugs have several side effects such as headache, diarrhea, joint pain, sore throat, nasal congestion and serious side effects, namely heart failure. [3][4][5] So it is necessary to develop other sources that have DPP-4 inhibiting activities that are safer such as from natural ingredients.…”

Section: Introductionmentioning

confidence: 99%

Difference of Acidic Adding Effect in Ethanol Extraction of White Mulberry Stem Bark (Morus alba) and DPP-4 Inhibiting Activity Screening for Identifying its Antidiabetic Potential

Agusfina¹,

Saputri²,

Sakti³

et al. 2019

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The classification of the ITS sequences of known interspecific hybrid clones into both the maternal and the maternal indicated that it was sufficient to distinguish interspecific hybrids in the genus Morus. Nanang Sasmita, et al. 2019's research states that the Adaptation of Morus alba and Morus cathayana plants in different climate and environment ABSTRACT Objective: Murberry (Morus alba) is one of the plants that can be used to treat diabetes and bioactive compounds that play a role are apigenin. Apigenin compounds have been reported to have an antidiabetic effect and are found in the form of glycosides. To separate apigenin from its glycosides, it takes the process of hydrolysis using acid. This study aims to look at the differences between ethanol extracts without hydrolysis with acids and ethanol extracts which are hydrolyzed by acid and determine their activity as dipeptidyl peptidase-4 (DPP-4) inhibitors in vitro. Methods: Morus alba stem bark dry powder was extracted MAE using 96% ethanol with acid hydrolysis using HCl 2 N and extracted without acid hydrolysis then apigenin levels can be measured by each extraction process using HPLC. DPP-4 activity was evaluated using glycyl-prolyl-7-amino-4-methyl coumarin (Gly-Pro-AMC) substrate then the inhibitory effect of extracts was determined based on the number of free AMCs by measuring fluorescence at excitation wavelengths of 350-360 nm and emission wavelengths of 450-465 nm using micro-plate readers. Sitagliptin is used as a positive control of DPP-4 inhibition in this test. Result: The ethanol extraction method with acid hydrolysis can attract more apigenin compounds than the ethanol extraction method without acid hydrolysis. The level of apigenin in the sample of ethanol extract with acid hydrolysis was 0.16%, and in the ethanol extract without acid hydrolysis was 0.04%. The amount of inhibitory activity of DPP-4 Morus alba stem bark extract was 23%, which is 0.33 times the inhibition of sitagliptin activity. Conclusion: Extraction methods with acid hydrolysis are more effective in attracting apigenin compounds than without acid hydrolysis. Morus alba stem bark extract has an anti-diabetic effect through the mechanism of action of DPP-4 inhibitors can be used as a reference for therapy of diabetes mellitus from natural ingredients.

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A comprehensive review on the antidiabetic attributes of thiazolidine‐4‐ones: Synthetic strategies and structure–activity relationships

Pradhan

Gupta

Kumar

et al. 2022

Archiv der Pharmazie

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The thiazolidine-4-one scaffold has recently emerged as a potential pharmacophore having clinical significance for medicinal chemists. This heterocyclic ring has been reported to possess a plethora of biological activities, including antidiabetic activity that has inspired researchers to integrate this core with different pharmacophoric fragments to design novel and effective antidiabetic leads. The antidiabetic activity has been observed due to the ability of the thiazolidine-4-one nucleus to interact with different biological targets, including peroxisome proliferator-activated receptor γ, protein tyrosine phosphatase 1B, aldose reductase, α-glucosidase, and α-amylase. The present review discusses the mode of action of thiazolidine-4-ones through these antidiabetic drug targets. This review attempts to summarize and analyze the recent developments with regard to the antidiabetic potential of thiazolidine-4-ones covering different synthetic strategies, structure-activity relationships, and docking studies reported in the literature. The significance of various structural modifications at C-2, N-3, and C-5 of the thiazolidine-4-one ring has also been discussed in this manuscript. This comprehensive compilation will provide an inevitable scope for the design and development of potential antidiabetic drug candidates having a thiazolidine-4-one core.

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Treatment of type 2 diabetes mellitus in elderly patients

Cited by 31 publications

References 174 publications

Management of elderly patients with type 2 diabetes in long-term care and skilled-nursing facilities

Management of elderly patients with type 2 diabetes in long-term care and skilled-nursing facilities

Difference of Acidic Adding Effect in Ethanol Extraction of White Mulberry Stem Bark (Morus alba) and DPP-4 Inhibiting Activity Screening for Identifying its Antidiabetic Potential

A comprehensive review on the antidiabetic attributes of thiazolidine‐4‐ones: Synthetic strategies and structure–activity relationships

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