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Hypoglycemic Agents (hypoglycemic + agent)
Kinds of Hypoglycemic Agents Selected AbstractsChemInform Abstract: N-Arylsulfonyl-benzimidazolones as Potential Hypoglycemic Agents.CHEMINFORM, Issue 33 2002Iftikhar Ahmad Abstract ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 100 leading journals. To access a ChemInform Abstract of an article which was published elsewhere, please select a "Full Text" option. The original article is trackable via the "References" option. [source] Thiazolidinediones and the risk of incident strokes in patients with type 2 diabetes: a nested case-control study,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 4 2010Laurent Azoulay PhD Abstract Purpose To determine whether the use of thiazolidinediones (TZDs) decreases the risk of incident strokes in patients with type 2 diabetes. Methods We conducted a nested case-control study within a population-based cohort from the UK General Practice Research Database (GPRD). The cohort comprised patients over the age of 40 who were prescribed a first oral hypoglycemic agent between 1 January 1988 and 30 June 2008. Cases included all subjects who experienced a first stroke during follow-up. Up to 10 controls were matched to each case on age (±2 years), sex, date of cohort entry (±1 year), and duration of follow-up. Rate ratios (RRs) of stroke associated with TZD use, including rosiglitazone and pioglitazone, relative to combinations of other oral hypoglycemic agents, were estimated using conditional logistic regression. Results The cohort comprised 75,717 users of oral hypoglycemic agents, of whom 2417 had a stroke during follow-up. The rate of stroke in users of TZDs given as monotherapy (RR: 1.20, 95%CI: 0.77, 1.86) or in combination with other oral hypoglycemic agents (RR: 0.78, 95%CI: 0.58, 1.04) was not lower than combinations of other oral hypoglycemic agents. The RRs were similar for rosiglitazone and pioglitazone. Conclusions The results of this study indicate that TZDs do not appear to decrease the incidence of first strokes. Copyright © 2009 John Wiley & Sons, Ltd. [source] Hypoglycemic effect and chlorogenic acid content in two Cecropia speciesPHYTOTHERAPY RESEARCH, Issue 8 2005Pilar Nicasio Abstract The hypoglycemic effect of methanol leaf extracts from Cecropia obtusifolia and C. peltata was evaluated in healthy mice. A significant decrease (p < 0.05) in plasma glucose levels was recorded 2 and 4 h after a single oral administration of methanol extracts (1 g/kg). This effect was correlated with the chlorogenic acid contents in both species; C. peltata, containing 19.84 ± 1.64 mg of chlorogenic acid/g of dried leaves produced the highest decrease (D, 2,60 = 20.18, p < 0.05) of plasma glucose levels (52.8%). The extracts of C. obtusifolia from Tabasco and Veracruz, showed similar hypoglycemic effects (33.3% and 35.7%, respectively) and chlorogenic acid contents (Tukey0.05 = 1.8859) (13.3 ± 3.2 mg/g and 13.1 ± 1.6 mg/g, respectively). The hypoglycemic effect produced by different doses (0.1, 0.25, 0.50, 0.75 and 1 g/kg body wt, p.o.) of C. peltata showed a lineal relationship with chlorogenic acid content, reaching an ED50 = 0.540 g/kg body wt for extract, and an ED50 = 10.8 mg/kg body wt for chlorogenic acid. These results suggest that C. peltata is a better hypoglycemic agent than C. obtusifolia, and it could be considered for developing a phytomedicinal product to carry out clinical trials. Copyright © 2005 John Wiley & Sons, Ltd. [source] Incidence of and Risk Factors for Posttransplant Diabetes Mellitus after Pancreas TransplantationAMERICAN JOURNAL OF TRANSPLANTATION, Issue 2 2010N. Neidlinger Posttransplant diabetes mellitus (PTDM) after pancreas transplantation (PTX) has not been extensively examined. This single center, retrospective analysis of 674 recipients from 1994 to 2005 examines the incidence of and risk factors for PTDM after PTX. PTDM was defined by fasting plasma glucose level ,126 mg/dL, confirmed on a subsequent measurement or treatment with insulin or oral hypoglycemic agent for ,30 days. The incidence of PTDM was 14%, 17% and 25% at 3, 5 and 10 years after PTX, respectively and was higher (p = 0.01) in solitary pancreas (PAN) versus simultaneous kidney pancreas (SPK) recipients (mean follow-up 6.5 years). In multivariate analysis, factors associated with PTDM were: older donor age (hazard ratio [HR] 1.04, 95% confidence interval [CI] 1.03,1.06, p < 0.001), higher recipient body mass index (HR 1.07,CI 1.01,1.13, p = 0.01), donor positive/recipient negative CMV status (HR 1.65,CI 1.03,2.6, p = 0.04), posttransplant weight gain (HR 4.7,CI 1.95,11.1, p < 0.001), pancreas rejection (HR 1.94.CI 1.3,2.9, p < 0.001) and 6 month fasting glucose (HR 1.01,CI 1.01,1.02, p < 0.001), hemoglobin A1c, (HR 1.12,CI 1.05,1.22, p = 0.002) and triglyceride to high-density lipoprotein (TG/HDL) ratio (HR 0.94,CI 0.91,0.96, p < 0.001). This study delineates the incidence and identifies risk factors for PTDM after PTX. [source] Diabetes trends in EuropeDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue S3 2002Philippe Passa Abstract Estimates and projections suggest an epidemic expansion of diabetes incidence and prevalence in Europe. To evaluate trends in type 1 and type 2 diabetes in seven European countries (Finland, Denmark, the UK, Germany, France, Spain, and Italy), a variety of information is available, including population-based studies on small or large cohorts of subjects representative of the general population in a particular country, European co-operative studies, and sales figures for insulin and oral hypoglycemic agents that allow extrapolation of the number of pharmacologically treated diabetic patients. The incidence of type 1 diabetes in young people is increasing in most European countries, as is its prevalence in all age groups. Type 2 diabetes is the major contributor to the epidemic rise in diabetes. From 1995 to 1999, the prevalence of type 2 diabetes increased considerably, particularly in the UK, Germany, and France. Costs of ambulatory and in-hospital diabetic care (including antidiabetic, antihypertensive, and hypolipidemic agents) have increased even more rapidly than has the number of affected patients. Diabetes trends in Europe are alarming; health care professionals involved in diabetes care must be made aware of these detrimental trends, and health care delivery to patients with diabetes must be improved. Copyright © 2002 John Wiley & Sons, Ltd. [source] Buccal delivery of insulin: the time is nowDRUG DEVELOPMENT RESEARCH, Issue 7 2006*Article first published online: 16 NOV 200, Gerald Bernstein Abstract The burgeoning numbers of individuals with diabetes mellitus and prediabetes, in particular Type 2 including large numbers of children, open up not only the classic risks for microvascular disease but the earlier and incapacitating risk for macrovascular disease. Oral hypoglycemic agents and insulin sensitizers have not been adequate to control postprandial glucose. Prandial insulin is most desirable but resistance to injections limits its use. This has led to a battery of needle-free insulin delivery systems. Buccal delivery stands out as being safe, simple, fast, flexible, and familiar to patient and physician alike. Drug Dev. Res. 67:597,599, 2006. © 2006 Wiley-Liss, Inc. [source] Thiazolidinedione derivatives in diabetes and cardiovascular disease: an updateFUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 3 2008Pantelis A. Sarafidis Abstract As the incidence and the public health impact of type 2 diabetes are constantly rising, treatment of hyperglycemia, prevention of diabetes-related complications are currently top medical priorities. Within the last decade several new classes of oral hypoglycemic agents were added to our armamentarium against diabetes. Among these new classes, the group of thiazolidinediones, which act through reduction of insulin resistance is perhaps the most widely used. For about 20 years, numerous background and clinical studies have evaluated the beneficial and adverse effects of these compounds. Current knowledge suggests that thiazolidinediones are as effective as metformin or sulfonylurea derivatives in improving glycemic control and exert several other beneficial metabolic and vascular effects, such as improvement in lipid profile, blood pressure lowering, redistribution of body fat away from the central compartment, microalbuminuria regression, reduction in subclinical vascular inflammation and others. On the other hand, currently used thiazolidinediones have well-established side effects, most important of which are fluid retention leading to weight gain and heart failure deterioration. Further, in the expectance of proper outcome studies to clarify the effects of these agents in cardiovascular morbidity and mortality, data from recent meta-analyses suggest that rosiglitazone may increase the risk for some cardiovascular outcomes. This article will discuss all the above issues attempting to provide an updated overview of this expanding field. [source] Meeting American Diabetes Association Guidelines In Endocrinologist PracticeJOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 2 2000C.D. Miller OBJECTIVE,To determine whether American Diabetes Association (ADA) guidelines can be met in the context of routine endocrinology practice. RESEARCH DESIGN AND METHODS,Charts were reviewed for a group of patients who were examined in 1998, followed for greater than or equal to 1 year, and had two or more visits during that year. Process measures and metabolic outcomes were studied for patients with type 2 diabetes, and glycemic control was assessed for patients with type 1 diabetes. RESULTS,A total of 1.21 patients with type 2 diabetes had a mean age of 63 years, a mean BMI of 31 kg/m(2), and a mean duration of diabetes of 12 years. Many had comorbidities or complications: 80% had hypertension, 64% had hyperlipidemia, 78% had neuropathy, 22% had retinopathy, and 21% had albuminuria. Management of type 2 diabetic patients was complex: 38% used oral hypoglycemic agents alone (54% of these were using two or more agents), 31% used oral hypoglycemic agents and insulin, and 26% used insulin alone, 42% of patients taking insulin therapy injected insulin three or more times per day. Within 12 months, 74% of patients had dilated eye examinations, 70% had lipid profiles, and 55% had urine albumin screening. Of the patients, 87% had a foot examination at their last visit. Blood pressure levels averaged 133/72 mmHg, cholesterol levels averaged 4.63 mmol/l, triglyceride levels averaged 1.99 mmol/l. HDL cholesterol levels averaged 1.24 mmol/l, and LDL cholesterol levels averaged 2.61. mmol/l. Random blood glucose levels averaged 8.0 mmol/l, and HbA(1c) levels averaged 6.9 +/, 0.1%. A total of 87% of patients had HbA(1c) levels less than or equal to 8.0%. A total of 30 patients with type 1 diabetes had mean age of 44 years, a mean BMI of 26 kg/m(2), and a mean duration of diabetes of 20 years. All type 1 diabetic patients used insulin and averaged 3.4 injections a day, their average HbA(1c) level was 7.1 +/, 0.2%, and 80% had HbA(1c) levels less than or equal to 8.0%. CONCLUSIONS,Although endocrinologists must manage patients with multifaceted problems, complex treatment regimens yield glycemic control levels comparable with the Diabetes Control and Complications Trial and allow ADA guidelines to be met in a routine practice setting. [source] Rapid steroid discontinuation for pediatric renal transplantation: A single center experiencePEDIATRIC TRANSPLANTATION, Issue 5 2007Keith K. Lau Abstract:, To determine the outcomes of pediatric renal transplant recipients who received immunosuppression consisting of early withdrawal of corticosteroids at a single Northern California center. Protocols using minimal steroid exposure have been recently reported in adult transplant recipients with successful results. We examined the outcomes of pediatric renal transplant recipients who were managed at our center using a protocol with very early discontinuation of steroids after renal transplantation. We retrospectively studied the medical records of all renal transplant recipients followed at the Children's Hospital at the University of California, Davis Medical Center from 01/2004 to 12/2005. All patients were less than 18 yr of age at the time of transplantation. The immunosuppressive protocol included three tapering daily doses of methylprednisolone, together with five doses of thymoglobulin followed by maintenance therapy with tacrolimus and MMF. Eight patients with equal numbers of males and females were transplanted during this time period. There were equal numbers of Caucasians, African-Americans, Hispanics, and Asians. A total of 37.5% (3/8) of the subjects received preemptive transplantation, 25% (2/8) received peritoneal, and 37.5% (3/8) received hemodialysis before transplantation. The median (range) age at transplantation was 12.3 (3.1,16.0) year with a follow-up of 1.7 (0.9,2.8) year. At one yr post-transplantation, 57% (4/7) of patients still required anti-hypertensives. Three children required erythropoietin supplementation after transplantation. The mean delta height standard deviation score at 12 months was 0.20 ± 0.56. There were no episodes of clinical acute rejection. One patient switched from tacrolimus to sirolimus due to biopsy-proven CAN. No patient became diabetic or required hypoglycemic agents. Surveillance biopsies showed no subclinical acute rejection in any patient. Steroid-free immunosuppression is safe in children after renal transplantation. Larger number of patients and longer follow-up are required to further confirm the effectiveness and safety of immunosuppression with rapid steroid discontinuation. [source] Thiazolidinediones and the risk of incident strokes in patients with type 2 diabetes: a nested case-control study,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 4 2010Laurent Azoulay PhD Abstract Purpose To determine whether the use of thiazolidinediones (TZDs) decreases the risk of incident strokes in patients with type 2 diabetes. Methods We conducted a nested case-control study within a population-based cohort from the UK General Practice Research Database (GPRD). The cohort comprised patients over the age of 40 who were prescribed a first oral hypoglycemic agent between 1 January 1988 and 30 June 2008. Cases included all subjects who experienced a first stroke during follow-up. Up to 10 controls were matched to each case on age (±2 years), sex, date of cohort entry (±1 year), and duration of follow-up. Rate ratios (RRs) of stroke associated with TZD use, including rosiglitazone and pioglitazone, relative to combinations of other oral hypoglycemic agents, were estimated using conditional logistic regression. Results The cohort comprised 75,717 users of oral hypoglycemic agents, of whom 2417 had a stroke during follow-up. The rate of stroke in users of TZDs given as monotherapy (RR: 1.20, 95%CI: 0.77, 1.86) or in combination with other oral hypoglycemic agents (RR: 0.78, 95%CI: 0.58, 1.04) was not lower than combinations of other oral hypoglycemic agents. The RRs were similar for rosiglitazone and pioglitazone. Conclusions The results of this study indicate that TZDs do not appear to decrease the incidence of first strokes. Copyright © 2009 John Wiley & Sons, Ltd. [source] Reassessing the Cardiovascular Risks and Benefits of ThiazolidinedionesCLINICAL CARDIOLOGY, Issue 9 2008Andrew Zinn MD Abstract This article is designed for the general cardiologist, endocrinologist, and internist caring for patients with diabetes and coronary artery disease. Despite the burden of coronary disease in diabetics, little is known about the impact of commonly used oral hypoglycemic agents on cardiovascular outcomes. As the untoward effects of insulin resistance (IR) are increasingly recognized, there is interest in targeting this defect. Insulin resistance contributes to dyslipidemia, hypertension, inflammation, hypercoagulability, and endothelial dysfunction. The aggregate impact of this process is progression of systemic atherosclerosis and an increased risk of adverse cardiovascular outcomes. As such, much attention has been paid to the peroxisome-proliferator-activated receptor gamma (PPARg) agonists rosiglitazone and pioglitazone (thiazolidinediones [TZDs]). Many studies have demonstrated a beneficial effect on the atherosclerotic process; specifically, these agents have been shown to reduce markers of inflammation, retard progression of carotid intimal thickness, prevent restenosis after coronary stenting, and prevent cardiovascular death and myocardial infarction in 1 large trial. Such benefits come at the risk of fluid retention and heart failure (HF) exacerbation, and the net effect on plasma lipids is still poorly understood. Thus, the aggregate risk-benefit ratio is poorly defined. A recent meta-analysis has raised significant concerns regarding the overall cardiovascular safety of 1 particular PPARg agonist (rosiglitazone), prompting international debate and regulatory changes. This review scrutinizes the clinical evidence regarding the cardiovascular risks and benefits of PPARg agonists. Future studies of PPARg agonists, and other emerging drugs that treat IR and diabetes, must be designed to look at cardiovascular outcomes. 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