Update on Safety Issues Related to Antihyperglycemic Therapy

Carpio, Gandahari; Fonseca, Vivian

doi:10.2337/diaspect.27.2.92

Cited by 24 publications

(22 citation statements)

References 80 publications

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“…Metformin, a drug that lowers oral blood glucose, is one of the most widely prescribed medications for type 2 diabetes (T2D) patients . However, about 30% of metformin‐treated patients report adverse gastrointestinal effects, including abdominal pain and diarrhoea which may be linked to metformin‐induced dysbiosis …”

Section: Resultsmentioning

confidence: 99%

Systematic review: human gut dysbiosis induced by non‐antibiotic prescription medications

Bastard

Al‐Ghalith

Grégoire

et al. 2017

Aliment Pharmacol Ther

199

131

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Section: Resultsmentioning

confidence: 99%

Systematic review: human gut dysbiosis induced by non‐antibiotic prescription medications

Bastard

Al‐Ghalith

Grégoire

et al. 2017

Aliment Pharmacol Ther

199

131

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“…Therefore, it is important to control not only blood glucose levels but also blood lipid levels. It has been shown that current treatment for diabetes with synthetic hypoglycemic agents can cause adverse effects including hypoglycemia, gastrointestinal disturbances, renal toxicity and hepatotoxicity [6]. Hence, search of plant formulations with minimum toxicity remains a challenge.…”

Section: Introductionmentioning

confidence: 99%

Hypoglycemic and hypolipidemic activities of aqueous extract of flowers from Nycantus arbor-tristis L. in male mice

Rangika

Dayananda

Peiris

2015

BMC Complement Altern Med

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BackgroundBoiled aqueous extract of flowers (AEF) from Nyctanthes arbor-tristis L. are used in Sri Lankan traditional Ayruvedic Medicine to manage diabetes mellitus. AEF has widely been used as a folk medicine for the treatment of various ailments due to its therapeutic activity. However, little is known concerning therapeutic activity of the extract as well as its underline mechanisms and safety. Diabetes is known to increase low-density cholesterol and decrease high-density cholesterol thus triggering coronary diseases. Hence, the primary objective of the present study is to investigate the hypoglycemic and hypolipidemic activities of the AEF.MethodsAEF was prepared and male mice (n = 9 group) were gavaged either with 250, 500 and 750 mg/kg of AEF or distilled water (DW). Subsequently, fasting and random blood glucose concentrations were determined. To investigate mechanisms of actions of AEF, animals were orally administered with 500 mg/kg or the vehicle (DW) and glucose tolerance was performed before and after glucose challenge. For further studies, in vitro alpha-amylase assay and glucose absorption from the gastrointestinal tract were performed using 500 mg/kg of the extract. Additionally, glycogen content in the liver and skeletal muscles, a complete lipid profile assay, and toxicological and biochemical parameters were conducted after a chronic study.ResultsFive hundred mg/kg and 750 mg/kg of AEF significantly (p < 0.01) reduced fasting blood glucose levels respectively by 49 and 39 % at 4 h post-treatment, while 500 mg/kg of AEF also decreased the random blood glucose level significantly (p <0.01) by 32 % at 4 h post-treatment. AEF significantly inhibited glucose absorption by 85 % from the intestine and increased diaphragm uptake of glucose by 64 %. The extract also exhibited inhibition (16.66 %) of alpha-amylase enzyme activity. It also decreased the level of total cholesterol (by 44.8 %), triglyceride (by 53 %) and increased (by 57 %) the high-density lipoprotein cholesterol. Treatment with AEF did not induce any overt signs of toxicity or hepatotoxicity.ConclusionResults the present study indicated that AEF possess hypoglycemic and hypolipdemic properties. Therefore, AEF could be used as an alternative medicine in management of diabetes mellitus.

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“…Moreover, combined effects of SUs and TZDs can delay progression of T2D, the need of exogenous insulin therapy, reduce the risk of CVD as well as shows sustained glycemic control (Hanefeld, 2007). Although having much of the benefits in DM, hepatic metabolism of SUs, possibility of initiation of cancer by TZDs as well as longer duration of therapy as oral hypoglycemic drugs, they might produce detrimental effects on genetic material and DNA termed as genotoxicity (Agius, 2014;Carpio, 2014). Glimepiride (GMP) is the newest drug from SUs category having possible insulin sensitizing effect and longer duration of effect however, pioglitazone (PIO) is well tolerated in patients with renal failure and not associated with hypoglycemia (Craig, 2011;Matsuki, 2007;Richardson, 1976).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of genotoxic potential and effects on body weight of Glimepiride and Pioglitazone combination after 4 weeks in Swiss albino mice

Soni¹,

Patel²

2020

Asian J Pharm Pharmacol

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Objective: Combination of thiazolidinediones and sulfonylureas as antidiabetic treatment is beneficial in terms of delaying the progression of type 2 diabetes that is the need for exogenous insulin therapy and insulin sensitizing effects. However, antidiabetic treatment is needed to be continued for longer period of time, it may interact with DNA & genetic material to produce genotoxic effects. In the present study, genotoxic potential of pioglitazone and glimepiride was evaluated at chromosomal, cellular and germinal level. Material and methods: Genotoxic potential of glimepiride & pioglitazone was evaluated by performing 4 weeks of genotoxicity study with the use of mammalian bone marrow chromosomal aberration assay, mammalian bone marrow erythrocyte assay and sperm abnormality assay. Three different doses of the pioglitazone & glimepiride combination as well as carboxymethylcellulose (0.5 %) as negative control and cyclophosphamide (40 mg/kg) as positive control groups were used in the study. Body weight was also measured to check systemic effects. Results and conclusion: The results revealed that pioglitazone and glimepiride combination produce significant structural chromosomal aberrations as well as sperm abnormalities moreover, the combination induce cytotoxicity only at higher dose. However, no significant changes were observed in numerical chromosomal aberrations in the form of micronucleus formation as well as in case of body weight. This controversial reports stress the need to evaluate the genotoxic potential of the combination after chronic treatment.

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Update on Safety Issues Related to Antihyperglycemic Therapy

Cited by 24 publications

References 80 publications

Systematic review: human gut dysbiosis induced by non‐antibiotic prescription medications

Systematic review: human gut dysbiosis induced by non‐antibiotic prescription medications

Hypoglycemic and hypolipidemic activities of aqueous extract of flowers from Nycantus arbor-tristis L. in male mice

Evaluation of genotoxic potential and effects on body weight of Glimepiride and Pioglitazone combination after 4 weeks in Swiss albino mice

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