Hypoglycemic Agents

降血糖药
  • 文章类型: News
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  • 文章类型: Journal Article
    糖尿病(DM)是一种长期疾病,其特征是由胰岛素抵抗引起的高血糖水平,这将导致其他疾病的并发症,例如血脂异常,这也会影响肝脏和肾脏的健康。蝴蝶豌豆花(ClitoreaternateaL.)具有酚类和类黄酮化合物,具有作为抗糖尿病药的草药的潜力。
    这项研究的目的是检查蝴蝶豌豆花提取物(BPE)作为抗糖尿病药的潜力,抗血脂异常,和保护肾脏。
    对链脲佐菌素-烟酰胺和高脂饮食-丙硫氧嘧啶诱导的SpragueDawley大鼠(RattusnorvegicusL.)进行体内试验,作为DM和血脂异常的模型,和BPE口服给药(200、400和800mg/kgBW)28天。谷胱甘肽过氧化物酶(GSH-Px),谷胱甘肽S-转移酶(GST),肿瘤坏死因子-α(TNF-α),核因子-κβ(NF-kB),碱性磷酸酶(ALP),肝白蛋白水平,血清尿素氮(BUN),血清肌酐,和血清尿酸(UA),用ELISA法和比色法进行测定。
    BPE800mg/kgBW的治疗增加了GSH-Px的水平,GST,白蛋白,和血清蛋白。BPE降低TNF-α,NF-kB,ALP。BPE也降低了BUN,血清CR,和血清UA。
    BPE具有用作治疗DM和血脂异常的药物替代品以及肝保护剂和肾脏保护剂的潜力。
    UNASSIGNED: Diabetes mellitus (DM) is a long-term condition marked by high blood glucose levels caused by insulin resistance which will lead to complications of other diseases such as dyslipidemia, which also affects the health of the liver and kidneys. Butterfly pea flower (Clitorea ternatea L.) has phenolic and flavonoid compounds which have the potential as herbal medicines for antidiabetics.
    UNASSIGNED: The purpose of this study is to examine the potential of butterfly pea flower extract (BPE) as an antidiabetic, anti-dyslipidemia, and renoprotection.
    UNASSIGNED: In vivo test was performed on Sprague Dawley rats (Rattus norvegicus L.) induced by Streptozotocin-Nicotinamide and High Fat Diet-Propylthiouracil as models of DM and dyslipidemia, and BPE was administered orally (200, 400, and 800 mg/kg BW) for 28 days. glutathione peroxidase (GSH-Px), glutathione S-transferase (GST), tumor necrosis factor-α (TNF-α), nuclear factor-kappa beta (NF-kB), alkaline phosphatase (ALP), liver albumin levels, serum blood urea nitrogen (BUN), serum creatinine, and serum uric acid (UA), were measured by ELISA and colorimetry methods.
    UNASSIGNED: Treatment of BPE 800 mg/kg BW increased levels of GSH-Px, GST, albumin, and serum protein. BPE decreased TNF-α, NF-kB, and ALP. BPE also decreased BUN, serum CR, and serum UA.
    UNASSIGNED: BPE has the potential to be used as a drug alternative for the treatment of DM and dyslipidemia as well as a hepatoprotective and renoprotective agent.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    背景:2型糖尿病(T2DM)与肠道微生物群(MB)的菌群失调有关。个别地,每种药物似乎都部分纠正了这一点。然而,没有关于MB对A1c变化的反应的研究。因此,我们调查了MB对强化血糖控制的反应.
    方法:我们研究了两组未控制的T2DM患者,一组A1c<9%(18名患者-G1),另一组A1c>9%(13名患者-G2),目标是A1c至少减少1%。我们在基线时收集A1c和粪便样本,6和12个月。G1实现了平均A1c下降1.1%,而G2减少了3.13%。
    结果:G1的微生物群在丹毒科_UCG_003和Mollicutes顺序中减少(均与代谢综合征和相关合并症有关)。G2,尽管A1c有更显著的下降,经历了增加的促炎细菌Megasphaera和酸性球菌,只有一个有益的属,相颈杆菌,增加,丁酸的生产者。
    结论:尽管A1c结果显著,G2无法恢复其MB。这似乎是对改变的抵制,导致G2中发现的持续炎症成分,可能是T2DM“代谢记忆”的一部分。
    BACKGROUND: Type 2 diabetes mellitus (T2DM) is associated with dysbiosis in the gut microbiota (MB). Individually, each medication appears to partially correct this. However, there are no studies on the response of the MB to changes in A1c. Therefore, we investigated the MB\'s response to intensive glycemic control.
    METHODS: We studied two groups of patients with uncontrolled T2DM, one group with an A1c <9% (18 patients-G1) and another group with an A1c >9% (13 patients-G2), aiming for at least a 1% reduction in A1c. We collected A1c and fecal samples at baseline, 6, and 12 months. G1 achieved an average A1c reduction of 1.1%, while G2 a reduction of 3.13%.
    RESULTS: G1\'s microbiota saw a decrease in Erysipelotrichaceae_UCG_003 and in Mollicutes order (both linked to metabolic syndrome and associated comorbidities). G2, despite having a more significant reduction in A1c, experienced an increase in the proinflammatory bacteria Megasphaera and Acidaminococcus, and only one beneficial genus, Phascolarctobacterium, increased, producer of butyrate.
    CONCLUSIONS: Despite a notable A1c outcome, G2 could not restore its MB. This seeming resistance to change, leading to a persistent inflammation component found in G2, might be part of the \"metabolic memory\" in T2DM.
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  • 文章类型: Published Erratum
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  • 文章类型: Journal Article
    结论:良好的血糖控制是控制2型糖尿病(T2DM)的目标,这对于预防T2DM患者的长期并发症至关重要。这项研究的目的是确定在果阿农村医疗机构(HCF)随访的T2DM患者中与良好血糖控制相关的因素。对120名T2DM患者进行了横断面研究,他们定期在果阿的农村HCF进行随访。参与者是使用简单随机抽样选择的。发现属于60-89岁年龄组的参与者和接受单/双口服治疗的参与者更有可能具有良好的血糖控制。参与者的糖化血红蛋白A1c每增加一年减少0.083%,腹围每增加一厘米增加0.044%。
    CONCLUSIONS: Good glycemic control is the aim of managing type 2 diabetes mellitus (T2DM) which is crucial for the prevention of long-term complications in individuals with T2DM. The aim of this study was to identify the factors associated with good glycemic control in individuals with T2DM following up at a rural health-care facility (HCF) in Goa. A cross-sectional study was conducted among 120 individuals with T2DM who regularly followed up at a rural HCF in Goa. Participants were selected using simple random sampling. It was found that the participants belonging to the 60-89 years of age group and those on mono/dual oral therapy were more likely to have good glycemic control. Participants\' glycated hemoglobin A1c decreased by 0.083% for every year of increase in age and increased by 0.044% for every centimeter increase in abdominal girth.
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  • 文章类型: Systematic Review
    我们评估了从一种速效胰岛素类似物到另一种速效胰岛素类似物的潜在转变,或者他们的生物仿制药,帮助更好更快的糖尿病管理决策。
    根据PRISMA报告指南进行了系统文献综述。搜索MEDLINE/EMBASE/COCHRANE数据库,以比较Aspart/lispro在1型(T1D)和2型(T2D)糖尿病中的随机对照试验(RCT)。纳入研究的方法学质量采用CochraneCollaboration的偏倚风险评估标准进行评估。
    在检索到的754条记录中,6个选定的疗效/安全性RCT和另外3个手工搜索的药代动力学/药效学RCT在连续变量的表示中显示出一定的异质性;然而,集体,结果显示,在T1D和T2D成年患者中,lispro和aspart具有相当的疗效和安全性.两种治疗都产生了类似的HbA1c下降,并有类似的剂量和体重变化,与类似的TEAE和SAE报告,在T1D和T2D人群中相似的低血糖发作,高血糖症没有临床显著差异,闭塞或其他输注部位/设置并发症。
    Aspart和lispro在T1D/T2D患者中具有相对的安全性和有效性。由于两者被认为同样适合控制餐时血糖波动,并且两者都具有相似的安全属性,它们在临床实践中可以互换使用.
    CRD42023376793。
    UNASSIGNED: We evaluated a potential move from one rapid-acting insulin analog to another, or their biosimilars, to aid better and faster decisions for diabetes management.
    UNASSIGNED: A systematic literature review was performed according to PRISMA reporting guidelines. The MEDLINE/EMBASE/COCHRANE databases were searched for randomized control trials (RCTs) comparing aspart/lispro in type-1 (T1D) and type-2 (T2D) diabetes. The methodological quality of the included studies was assessed using the Cochrane Collaboration\'s risk of bias assessment criteria.
    UNASSIGNED: Of the 753 records retrieved, the six selected efficacy/safety RCTs and the additional three hand-searched pharmacokinetics/pharmacodynamics RCTs showed some heterogeneity in the presentation of the continuous variables; however, collectively, the outcomes demonstrated that lispro and aspart had comparable efficacy and safety in adult patients with T1D and T2D. Both treatments yielded a similar decrease in glycated hemoglobin (HbA1c) and had similar dosing and weight changes, with similar treatment-emergent adverse events (TEAE) and serious adverse event (SAE) reporting, similar hypoglycemic episodes in both T1D and T2D populations, and no clinically significant differences for hyperglycemia, occlusions or other infusion site/set complications.
    UNASSIGNED: Aspart and lispro demonstrate comparative safety and efficacy in patients with T1D/T2D. Since both are deemed equally suitable for controlling prandial glycemic excursions and both have similar safety attributes, they may be used interchangeably in clinical practice.
    UNASSIGNED: CRD42023376793.
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  • 文章类型: Journal Article
    我们对2型糖尿病(T2D)的理解已经发生了巨大变化。进展已经颠覆了与T2D的发病和进展有关的根深蒂固的教条,从糖尿病研究的早期时代就盛行的信念-并继续填充我们的医学教科书和继续医学教育材料。本文重点介绍了关键见解,这些见解为T2D的黄金标准管理提供了新的治理原则。从旧信仰产生的历史背景到新发现,这篇文章概述了β细胞功能的证据和观点,葡萄糖调节的潜在缺陷,T2D的可修复性,and,支持转向以并发症为中心的处方的基本原理。实用的方法将这种对T2D的正确理解转化为策略,以填补当前糖尿病前期至晚期2型糖尿病的管理实践中的空白。
    Our understanding of type 2 diabetes (T2D) has evolved dramatically. Advances have upended entrenched dogmas pertaining to the onset and progression of T2D, beliefs that have prevailed from the early era of diabetes research-and continue to populate our medical textbooks and continuing medical education materials. This review article highlights key insights that lend new governing principles for gold standard management of T2D. From the historical context upon which old beliefs arose to new findings, this article outlines evidence and perspectives on beta cell function, the underlying defects in glucoregulation, the remediable nature of T2D, and, the rationale supporting the shift to complication-centric prescribing. Practical approaches translate this rectified understanding of T2D into strategies that fill gaps in current management practices of prediabetes through late type 2 diabetes.
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  • 文章类型: Journal Article
    水合在调节代谢疾病风险中的作用是一个相对较新的概念。由于渗透性利尿,糖尿病患者脱水的风险增加。未诊断或治疗不足的高血糖可能导致电解质失衡和肾脏葡萄糖排泄负担升高。这可能会改变肾脏的液体重吸收。此外,存在一个或多个促成因素,如液体摄入不足,剧烈运动,高温,酒精消费,腹泻,急性疾病,发烧,恶心,呕吐,可能会增加糖尿病患者脱水和电解质失衡的风险。糖尿病患者使用的某些抗糖尿病药物可能会在少数患者中引起液体潴留/缺陷和/或电解质异常。因此,饮用足量的水和具有适当电解质成分的液体对于防止脱水是重要的。糖尿病患者脱水的成功管理是一个未满足的需求,最好通过保持足够的水合状态来实现。
    The effect of hydration in modulating metabolic disease risk is a comparatively recent concept. Diabetic patients are at increased risk of dehydration due to osmotic diuresis. Undiagnosed or undertreated hyperglycemia may lead to electrolyte imbalance and elevated renal burden of glucose excretion, which may alter fluid reabsorption in the kidney. Also, the presence of one or more contributory factors, such as inadequate fluid intake, strenuous exercise, high temperatures, alcohol consumption, diarrhea, acute illnesses, fever, nausea, and vomiting, may put diabetic patients at increased risk of dehydration and electrolyte imbalance. Certain antidiabetic agents used by diabetic patients may cause fluid retention/deficits and/or electrolyte abnormalities in a few patients. Thus, drinking ample amounts of water and fluids with appropriate electrolyte composition is important to prevent dehydration. Successful management of dehydration in patients with diabetes is an unmet need and can best be accomplished by maintaining adequate hydration status.
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  • 文章类型: Journal Article
    目的:本研究的目的是评估司马鲁肽2.4mg的疗效和安全性,胰高血糖素样肽-1受体激动剂,按种族和种族划分,在三个阶段3试验中。
    方法:塞马鲁肽治疗肥胖者的效果(STEP)临床试验评估了每周一次皮下塞马鲁肽2.4mg的疗效和安全性。这里,将步骤1和3的数据合并用于分析;分别检查步骤2的数据。所有分析均使用来自种族和族裔亚组的数据进行。主要结果是估计的semaglutide2.4mg与安慰剂的体重变化百分比的治疗差异。
    结果:参与者报告种族为白色(步骤1和3,75.3%;步骤2,59.4%),黑色(8.8%;8.9%),亚洲(10.6%;27.3%),或其他种族组(5.3%;4.4%);和种族为西班牙裔或拉丁裔(13.9%;11.9%)或非西班牙裔或拉丁裔(83.9%;88.1%)。治疗效果与种族(步骤1和3:p≥0.07;步骤2:p≥0.15)或种族(p≥0.40;p≥0.85)之间没有显着相互作用。司马鲁肽2.4mg的安全性在各个亚组中是一致的。
    结论:在步骤1和3以及步骤2中,司马鲁肽的治疗效果与安慰剂相比具有统计学意义,并且在所有种族和民族亚组中具有临床相关性。两个样品的所有亚组都表现出良好的耐受性。
    OBJECTIVE: The objective of this study was to evaluate the efficacy and safety of semaglutide 2.4 mg, a glucagon-like peptide-1 receptor agonist, by race and ethnicity, across three phase 3 trials.
    METHODS: The Semaglutide Treatment Effect in People with Obesity (STEP) clinical trials evaluated the efficacy and safety of once-weekly subcutaneous semaglutide 2.4 mg. Here, STEP 1 and 3 data were pooled for analysis; STEP 2 data were examined separately. All analyses were conducted using data from racial and ethnic subgroups. The primary outcome was the estimated treatment difference in percent body weight change for semaglutide 2.4 mg versus placebo.
    RESULTS: Participants reported race as White (STEP 1 and 3, 75.3%; STEP 2, 59.4%), Black (8.8%; 8.9%), Asian (10.6%; 27.3%), or other racial group (5.3%; 4.4%); and ethnicity as Hispanic or Latino (13.9%; 11.9%) or not Hispanic or Latino (83.9%; 88.1%). There were no significant interactions between treatment effect and race (STEP 1 and 3: p ≥ 0.07; STEP 2: p ≥ 0.15) or ethnicity (p ≥ 0.40; p ≥ 0.85). The safety of semaglutide 2.4 mg was consistent across subgroups.
    CONCLUSIONS: The treatment effect of semaglutide was statistically significant versus placebo and clinically relevant across all racial and ethnic subgroups in STEP 1 and 3 and STEP 2. All subgroups across both samples demonstrated good tolerability.
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