This study examined prescribing patterns for antidiabetic medications in France and explored the relationships between those patterns and changes in patient characteristics. Data were obtained from the IMS Disease Analyzer-Mediplus France Database (IMS Health Incorporated, London, United Kingdom). Patients were included in the study if they were identified as having ...

PURPOSE: The purposes of this study are threefold: to determine what components of the metabolic syndrome are present in obese adolescents, to determine what differences exist in the effects of lifestyle intervention versus lifestyle intervention plus metformin on weight management and select markers of metabolic syndrome in obese adolescents, and ...

BACKGROUND: Dyslipidemia and type 2 diabetes mellitus (T2DM) increase atherosclerotic coronary heart disease (CHD) risk. In patients with T2DM, improving lipid parameters reduces CHD risk, while optimizing glucose levels reduces microvascular complications and, possibly, macrovascular disease such as CHD. Unfortunately, many patients with T2DM do not achieve either lipid or ...

OBJECTIVE: This 16-week study explored the safety of substituting exenatide for insulin in patients with type 2 diabetes using insulin in combination with oral antidiabetes agents. RESEARCH DESIGN AND METHODS: Successful maintenance of glycemic control was predefined as an A1C increase of < 0.5%. A total of 49 patients (aged ...

We investigated MMP-9 levels and inflammatory markers during pioglitazone treatment in type 2 diabetic patients with cardiovascular disease. In this randomized multicenter, double blinded, placebo controlled study, 92 type 2 diabetic patients with angiographically proven CHD were randomly assigned to pioglitazone or placebo treatment. At baseline and during a 28 ...

The objective of the study was to demonstrate the effect of pioglitazone and pioglitazone in combination with statin on East Indian patients with hyperinsulinemia and hyperlipidemia. It was a randomized, placebo-controlled, double-blind study with a parallel-group design comprising 83 patients. Patients of either sex with cardiac complications, including hyperlipidemia and ...

BACKGROUND: Guidelines and regulatory documents reflect the potential for chronic kidney disease to impact the efficacy and safety profiles of antidiabetic regimens. We describe the influence of impaired kidney function and its perception by practitioners on the pattern of antidiabetic use in Australian primary care. METHODS: Antidiabetic agent prescribing was ...

In clinical setting, uncomplicated diabetes mellitus type 2 is managed with anti-oxidants (e.g. ascorbic acid, alpha-tocopherol, etc.) with standard oral hypoglycaemic agents, which is aimed at limiting its glucose auto-oxidation and lipid peroxidation complications. The current study is an experimental animal study aimed at investigating the effect of co-administration of ...

Current approaches to pharmacotherapy of type 2 diabetes focus on two key aspects of hyperglycaemia - insulin secretory dysfunction and insulin resistance. Combining drugs that target both these defects via different mechanisms of action improves long-term glycaemic control and offers a number of additional benefits. A fixed-dose combination of pioglitazone ...

AIMS: To compare glucose control over 18 months between rosiglitazone oral combination therapy and combination metformin and sulphonylurea in people with Type 2 diabetes. METHODS: RECORD, a multicentre, parallel-group study of cardiovascular outcomes, enrolled people with an HbA(1c) of 7.1-9.0% on maximum doses of metformin or sulphonylurea. If on metformin ...

OBJECTIVE: The beneficial effects of metformin in peripubertal adolescents and rosiglitazone in overweight type 1 diabetic subjects, though modest have been demonstrated. This study was designed to analyze the effect of pioglitazone as an adjunctive therapy in post-pubertal lean T1DM. PATIENTS AND METHODS: Sixty type 1 diabetic subjects with duration ...

BACKGROUND/AIMS: Non-Alcoholic Steatohepatitis (NASH) is a chronic liver disease frequently associated with insulin resistance and type 2 diabetes mellitus (T2DM). Pioglitazone reverses the metabolic and histological abnormalities of patients with impaired glucose tolerance or T2DM and NASH, but also leads to weight gain. To understand the nature of weight gain ...

OBJECTIVE: There is considerable interindividual variation in sulfonylurea response in type 2 diabetes. Transcription factor 7-like 2 (TCF7L2) variants have been identified to be strongly associated with type 2 diabetes risk, probably due to decreased beta-cell function. We hypothesized that variation in TCF7L2 would influence response to sulfonylureas but not ...

CONTEXT: Metformin, a widely used treatment for diabetes that improves insulin sensitivity, also has both antiinflammatory properties and a modulatory effect on ovarian steroid production, two actions that have been suggested to be efficacious in therapy for endometriosis. OBJECTIVE: To determine whether metformin may be effective for the treatment of ...

OBJECTIVES: To evaluate the effects of pioglitazone on insulin sensitivity and levels of biomarkers associated with thrombotic risk in overweight and obese, non-diabetic subjects with coronary artery disease. BACKGROUND: Little information is available regarding the effects of thiazolidinediones in the absence of diabetes. Further, although postprandial hyperlipemia is a risk ...

AIM: Metformin is the 'drug-of-first-choice' in obese patients with type 2 diabetes mellitus (T2DM) due to its antihyperglycaemic and cardiovascular protective potentials. In non-obese patients with T2DM, insulin secretagogues are empirically used as first choice. In this investigator-initiated trial, we evaluated the effect of metformin vs. an insulin secretagogue, repaglinide ...

Metformin is among the most widely prescribed drugs for the treatment of type 2 diabetes. Organic cation transporter 1 (OCT1) plays a role in the hepatic uptake of metformin, but its role in the therapeutic effects of the drug, which involve activation of AMP-activated protein kinase (AMPK), is unknown. Recent ...

OBJECTIVE: To investigate the potential causes of weight gain using insulin and combination therapy in type 2 diabetes. DESIGN AND METHODS: This was an open-label prospective study of 6-month duration. Randomization was performed to insulin monotherapy, insulin and pioglitazone 30 mg daily, or insulin and metformin up to 2000 mg ...

Type 2 diabetes mellitus affects 9.6% of the adults in the United States and more than 200 million people worldwide. Diabetes can be a devastating disease, but it can now be treated with nine classes of approved drugs (insulins, sulfonylureas, glinides, biguanides, alpha-glucosidase inhibitors, thiazolidinediones, glucagon-like peptide 1 mimetics, amylin ...

AIMS AND OBJECTIVE: To study the effects of pioglitazone and metformin combination in type 2 diabetics in achieving long-term optimal glycemic control. METHODS AND MATERIALS: Patients whose duration of type 2 diabetes was less than 24 months were selected for the study. 373 such patients meeting the selection criteria were ...

BACKGROUND: Weight loss is difficult to achieve in type 2 diabetes and many therapies are associated with weight gain, an effect attenuated by metformin. We studied the effects of metformin on energy expenditure, appetite and the regulation of PYY and ghrelin in type 2 diabetes. METHODS: Plasma peptide YY (PYY), ...

Hepatic steatosis occurs in up to 78% of patients with type 2 diabetes. Studies evaluating the effect of metformin on hepatic steatosis are conflicting. Insulin is believed to be detrimental due to its lipogenic effect. Since insulin-metformin combination is commonly used for the treatment of diabetes, it is important to ...

OBJECTIVE: The objective of this analysis was to evaluate the impact of several classes of oral antihyperglycemic therapy relative to sulfonylurea monotherapy on all-cause mortality among a cohort of patients with diabetes from the Veterans Health Administration (VHA). RESEARCH DESIGN AND METHODS: A retrospective cohort study using data obtained from ...

CONTEXT: Oral contraceptives may worsen the metabolic profile of patients with polycystic ovary syndrome (PCOS), favoring the use of insulin sensitizers in these patients. OBJECTIVE: The aim of the study was to compare the effects of a contraceptive pill on metabolic classic cardiovascular risk factors with those of the insulin ...

Thiazolidinediones (TZDs) represent insulin-sensitizing agents that have several pleiotropic properties, possibly related to their favorable effects on cardiovascular remodeling. We briefly describe 2 diabetic patients who experienced a remarkable improvement in their paroxysmal atrial fibrillation (AF) after treatment with rosiglitazone. Current evidence suggests that atrial remodeling represents a prominent mechanism ...

AIMS: To compare combination use of repaglinide, metformin and bedtime Neutral Protamine Hagedorn (NPH) insulin with conventional approaches of insulin initiation in patients with Type 2 diabetes (T2DM). METHODS: Eighty-two patients with T2DM with suboptimal glycaemic control on oral glucose-lowering agents were randomized to one of three treatment regimens for ...

AIMS: To compare the efficacy and safety of either continuing or discontinuing rosiglitazone + metformin fixed-dose combination when starting insulin therapy in people with Type 2 diabetes inadequately controlled on oral therapy. METHODS: In this 24-week double-blind study, 324 individuals with Type 2 diabetes inadequately controlled on maximum dose rosiglitazone ...

In the Diabetes Prevention Program, treatment of subjects with impaired glucose tolerance with metformin >3.2 years reduced the risk of developing type 2 diabetes by 30% compared with placebo. This study describes the mechanisms of this effect. In proportional hazards regression models with 2,155 subjects, changes in weight, the insulinogenic ...

(1) Type 2 diabetes is rare in children. Lifestyle measures are the cornerstone of treatment. When they fail to control hyperglycaemia and when drug therapy is envisaged, insulin has long been the only approved drug. (2) Metformin is now indicated to treat hyperglycaemia due to type 2 diabetes in children ...

PURPOSE OF REVIEW: To review recent clinical trials of oral dipeptidyl peptidase-4 inhibitors and examine their role in managing type 2 diabetes mellitus. RECENT FINDINGS: Oral dipeptidyl peptidase-4 inhibitors improve islet function by increasing alpha-cell and beta-cell responsiveness to glucose, resulting in improved glucose-dependent insulin secretion and reduced inappropriate glucagon ...

OBJECTIVE: To compare the efficacy and safety of glimepiride versus metformin in pediatric subjects with type 2 diabetes inadequately controlled with diet and exercise alone or oral monotherapy. RESEARCH DESIGN AND METHODS: This 26-week, single-blind, active-controlled, multinational study randomized 285 subjects to receive glimepiride (1-8 mg once daily) or metformin ...

Despite the increased prevalence of type 2 diabetes mellitus (T2DM) in the pediatric population, there is limited information about the relative effectiveness of treatment approaches. This article describes the rationale and design of a National Institutes of Health-sponsored multi-site, randomized, parallel group clinical trial designed to test the hypothesis that ...

BACKGROUND: Oral antidiabetic agents differ with regard to mechanisms of action, hemoglobin A(1c)-lowering efficacy, safety, and tolerability. Traditional agents consist of those that enhance insulin secretion (i.e., sulfonylureas and glinides), those that enhance insulin sensitivity (i.e., metformin and the thiazolidinediones), and those that inhibit intestinal carbohydrate absorption (i.e., the alpha-glucosidase ...

Sitagliptin is a once-daily, orally active, competitive and fully reversible inhibitor of dipeptidyl peptidase 4, the enzyme that is responsible for the rapid degradation of the incretin hormone glucagon-like peptide-1. It is the first in this new class of antihyperglycaemic agents to gain regulatory approval for the treatment of Type ...

BACKGROUND: Type 2 diabetes is characterized by increased acute phase serum proteins. They are also risk factors for cardiovascular disease. We wanted to study how improvement of glycemic control with pioglitazone or glibenclamide affects their serum concentrations. MATERIALS AND METHODS: A total of 59 patients with Type 2 diabetes (age ...

OBJECTIVE: To examine the effects of metformin and rosiglitazone, alone and in combination, on endometrial histology and ovarian steroid production. STUDY DESIGN: Randomized open-label study of metformin and rosiglitazone in 16 women with polycystic ovary syndrome (PCOS) performed at a single academic health center. The study consisted of a 6-week ...

AIM: In obese patients, the diet-induced weight loss markedly improves glucose tolerance with an increase in insulin sensitivity and a partial reduction of insulin secretion. The association with metformin treatment might potentiate the effect of diet alone. METHODS: From patients admitted to our Nutritional Division for diet programme, we selected ...

We previously reported that lipoprotein lipase mass levels in preheparin serum (preheparin LPL mass) was significantly lower in type 2 diabetes mellitus compared to healthy subjects and that low preheparin LPL mass may be a high-risk factor of coronary atherosclerosis. The aim of this study was to clarify the effects ...

OBJECTIVE: This is a randomized, placebo-controlled study of the weight-loss efficacy and safety of a controlled-release (CR) formulation of topiramate in overweight and obese patients with type 2 diabetes treated with diet and exercise alone or in combination with metformin. RESEARCH DESIGN AND METHODS: Patients with type 2 diabetes, BMI ...

AIMS: The reporting of estimated glomerular filtration rate (eGFR) will identify people with diabetes who have previously undiagnosed renal impairment. Our current guideline recommends discontinuation of metformin when serum creatinine > 150 micromol/l. We examined the implications of replacing this with a criterion based on eGFR. METHODS: The Lothian diabetes ...

BACKGROUND: Metformin and rosiglitazone both improve glycemic control in type 2 diabetes mellitus, however may possess different anti-inflammatory and anti-atherosclerotic properties. We investigated the effects of these medications on high-sensitivity C-reactive protein (hsCRP) and carotid artery intima-media thickness (CIMT) to determine their relative potential to reduce cardiovascular risk independent of ...

OBJECTIVES: Metformin is widely used in patients with type 2 diabetes but may decrease vitamin B(12) levels and increase levels of homocysteine (Hcy), a cardiovascular risk factor. Rosiglitazone, a peroxisome proliferator-activated receptor-gamma agonist, may reduce markers of inflammation. We investigated whether 6 weeks' treatment with metformin or rosiglitazone affects serum ...

In this study, the Authors assessed some insulin counter-regulatory factors, fibrinogen and C-reactive protein after olanzapine administration, and the effect of metformin on these variables, 37 patients with chronic schizophrenia were given olanzapine (10 mg/day for 14 weeks). Nineteen patients received metformin (850-2550 mg/day) and 18 received placebo in a ...

BACKGROUND: To achieve glycemic control in type 2 diabetes mellitus (T2DM), multiple oral agents are used in a stepwise approach, but long-term maintenance of normoglycemia is difficult to achieve, and, eventually, most patients require insulin. The aim of this study was to evaluate the feasibility, acceptability, and efficacy of insulin ...

Hyperglycemia commonly is observed as part of the hypermetabolic response to severe burn injury. In routine burn care, physicians use interventions to address and reduce the complications of this stress-induced hyperglycemia. Metformin (1,1-dimethylbiguanide), an orally administered hyperglycemic medication, has been used previously to modulate the stress-induced hyperglycemic response in nondiabetic ...

BACKGROUND: There is increasing evidence that insulin resistance (IR) has an important implication in the pathogenesis of polycystic ovary syndrome (PCOS), a common endocrinopathy in women. This study was performed to investigate the impact of different treatments for IR on five currently discussed markers for insulin resistance: intact proinsulin, adiponectin, ...

OBJECTIVE: Significant race and ethnic disparities exist in diabetes-related health care. Using a nationally representative database, we sought to determine if use of thiazolidinediones (TZDs) differs by race and ethnicity. As a secondary objective, we sought to determine if race and ethnicity is associated with use of older oral antidiabetic ...

OBJECTIVE: To compare the effect of N-acetyl cysteine and metformin on hormonal profile (insulin and T) and ovulation rate in women with clomiphene citrate-resistant polycystic ovary syndrome. DESIGN: Prospective randomized controlled study. SETTING: Department of obstetrics and gynecology in a university hospital in Egypt. PATIENT(S): Sixty-one infertile women with clomiphene ...

AIMS: To describe initial achievement of glycaemic targets and subsequent hyperglycaemia in patients with Type 2 diabetes managed with oral agent monotherapy in UK primary care from 1998 to 2004. METHODS: Electronic medical records of patients initiating metformin (n = 3362) or a sulphonylurea agent (n = 3070) in 290 ...

OBJECTIVE: The biguanide, metformin, is a commonly prescribed oral antihyperglycemic agent. However, there are several clinical conditions that are considered as contraindications to the use of metformin among patients with type 2 diabetes mellitus. The aim of this study was to investigate the presence and nature of contraindications to metformin ...