What's next after metformin? focus on sulphonylurea: add-on or combination therapy

Choudhary

Int J Basic Clin Pharmacol

et al. 2019

Background: Diabetes mellitus (DM) is one of the major causes of mortality & morbidity, and patient’s with better control of glycaemic parameters have lesser chronic complications associated with it. Though monotherapy with metformin is first choice for T2DM but is effective in less than 50% of patient and they should be managed with two drug therapy. Both Glimepiride and Sitagliptin are effective with metformin but there has been no study done in this region hence, we planned to study comparison of effects of glimepiride and sitagliptin with metformin in patient of T2DM.Methods: This prospective, open-label, randomized study was done in all patient diagnosed with T2DM, not adequately managed by metformin alone. The patient was divided into two group G (Glimepiride with Metformin) and Group S (Sitagliptin with Metformin) and had a follow up at 3 and 6 months. The biochemical parameters were assessed at 12 weeks and 24 weeks.Results: The result of this study show that both glimepiride and sitagliptin with metformin significantly (p<0.05) lowered both the fasting blood sugar as well as postprandial blood glucose at 3 and 6 months. Glimepiride was more effective in lowering (p<0.05) the plasma glucose at 3 months but both the drugs had comparable result at 6 months. This study also showed that glycosylated haemoglobin was lowered in both groups at three and six months as compared to Day 0 (p<0.05), with glimepiride having better control of glycosylated haemoglobin at 3 months with both groups having comparable result at 6 months.Conclusions: To conclude, this study compared effects of sitagliptin and glimepiride on glycaemic parameters in patients of T2DM and found that both drugs had comparable results.

mentioning

confidence: 99%

Comparison of metabolic effects of glimepride and sitagliptin with metformin in patients suffering from type 2 diabetes mellitus in a tertiary care hospital

Choudhary

Int J Basic Clin Pharmacol

et al. 2019

Asian J Biomed Pharmaceut Sci

“…Hence, the use of SU should be combined with metformin to reverse weight gain ("Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group," 1998; Lim & Chong, 2015).…”

Section: Insulinmentioning

confidence: 99%

Biochemical and Biological Effects of Irisin in a Model of Diabetes Mellitus

Mahgoub¹,

Adeghate²

2018

Diabetes mellitus (DM) is a highly prevalent health problem affecting more than 425 million people worldwide. It is associated with several detrimental complications such as neuropathy, nephropathy, retinopathy and cardiovascular diseases. Irisin is a novel hormone that plays a role in metabolism by stimulating the browning of white adipose tissue (WAT) into beige adipose tissue which acquires properties that are similar to those of brown adipose tissue (BAT). Several studies have attempted to characterize the roles of irisin in DM and obesity, however, contradictory results have been reported and physiological roles of irisin have been questioned by several researchers. In our study, we investigated the role of irisin in controlling glucose levels and insulin secretion in STZ-induced DM model and the mechanism by which irisin exerts its beneficial effects both in vivo and in vitro, using a variety of biochemical, morphological and cell biology techniques. We showed that irisin did not cause any significant reduction in weight or fasting blood glucose, however, it caused a significant glucose reduction 30 minutes after glucose challenge. Our data also showed that irisin co-localizes with insulin in pancreatic β-cells in both normal and diabetic animals while it co-localizes with glucagon only in diabetic animals. Moreover, irisin was also detected in skeletal muscle, visceral and subcutaneous adipose tissues. Irisin also reduced triglycerides and increased the level of high density lipoprotein (HDL) and total protein. We also provided evidence that irisin treatment can modulate the tissue level of different peptide hormones such as insulin, glucagon, incretins and leptin. In addition, irisin possesses a potent antioxidant activity and reversed the oxidative stress induced by DM. Our in vitro investigations showed that irisin can stimulate the release of insulin from pancreatic β-cells. Irisin could be a potential therapeutic agent in the management of DM.

Mìžnarodnij endokrinologìčnij žurnal

“…Перевагами глімепіриду також є висока біодоступність, що практично не залежить від прийому їжі, і великий період напіввиведення, що дозволяє приймати повну дозу препарату 1 раз на добу [10].…”

unclassified

“…Лекція /Lecture/ кардіоміоцитів, і не впливає на прекондиціювання міокарда [10]. Ця відмінність глімепіриду від інших ПСС дозволяє розглядати його як препарат вибору в кардіологічного хворого.…”

unclassified

Місце Похідного Сульфонілсечовини ІІІ Покоління Глімепіриду В Сучасній Терапії Цукрового Діабету 2-Го Типу

Zhuravlyova¹,

Filonenko²

2021

Резюме. У лекції розглянуті фармакологічні й клінічні аспекти використання глімепіриду, препарату сульфонілсечовини ІІІ покоління, у сучасній терапії цукрового діабету 2-го типу. Препарат має доведену ефективність і безпеку, є економічно доступним, характеризується низкою сприятливих позапанкреатичних ефектів, у тому числі кардіопротективними властивостями, що дозволяє з упевненістю рекомендувати його для лікування цукрового діабету 2-го типу.