anti-diabetic treatment

  • 文章类型: Journal Article
    2型糖尿病是一种常见的慢性疾病。鉴于其与年龄的强烈正相关,这是老年人群的重大公共卫生问题。此外,人口老龄化,高收入和中等收入国家的预期寿命增加导致糖尿病患病率上升。尽管相同的诊断标准适用于老年人和年轻人,老年2型糖尿病患者的护理有其独特之处。治疗目标和首选药物,以及非药物方法应在老年人中进行调整。例如,增加身体活动量可能会遇到困难,而引入适当的饮食可能更具挑战性。由于认知和身体限制,患者的治疗依从性需要特别注意。最重要的治疗目标是避免低血糖。虚弱,社会和经济问题,合并症和随之而来的多重用药经常引起药物-药物相互作用,以及由于肾功能衰竭而增加的药物毒性的危险只是使老年糖尿病患者的医疗保健极其困难的一些问题。充分的护理需要多学科的医疗保健专业人员团队的合作。急性糖尿病并发症在老年人中有较高的死亡率,因此,必须密切注意避免它们。家庭成员应参与老年糖尿病患者的护理,建议教育他们并发症的临床症状。对患者的定期护理,包括对生活质量的反馈和健康问题的早期迹象至关重要。
    Type 2 diabetes is a frequent chronic disease. Given its strong positive association with older age, it is a significant public health issue in elderly populations. Furthermore, the aging of the population, driven by increasing life expectancy in high and middle-income countries leads to an increasing prevalence of diabetes.Although the same diagnostic criteria apply to the elderly and to younger people, there are unique aspects to the care for elderly type 2 diabetes patients. Both treatment goals and preferred medications, as well as non-pharmacological approaches should be adjusted in the elderly. For example, increasing the amount of physical activity may encounter difficulties, while introducing an appropriate diet may be more challenging. The patients\' therapeutic adherence requires special attention due to cognitive and physical limitations. The most important treatment goal is to avoid hypoglycemia. Frailty, social and economic issues, comorbidities and the consequent polypharmacy frequently causing drug-drug interactions, as well as the increased danger of drug toxicity due to renal failure are only some of the problems that make the health care for old diabetes patients extremely difficult. Adequate care requires cooperation from a multidisciplinary team of health care professionals.Acute diabetes complications have a higher mortality in the elderly, thus close attention must be paid to avoid them. Family members should be involved in the care of elderly diabetes patients, and it is recommended to educate them on clinical signs of complications. Regular care for the patients including feedback on quality of life and early signs of health issues are essential.
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  • 文章类型: Journal Article
    背景:世界卫生组织指出,到2030年,糖尿病将成为第七大死亡原因。功能障碍的病理生理学与肥胖有关,胰岛素敏感细胞的体重增加和主要的胰岛素抵抗以及胰腺β细胞功能的持续恶化。Imegliin是一种正在研究的新型口服抗糖尿病药物。盐酸Imeglimin的生物学和分析分析。
    方法:为了增进理解,通过从WebofScience等电子资源中建立相关现有研究的数据库,进行了系统综述。科学直接和PubMed。该方法反映在PRISMA设计中。
    结果:该药物于2021年在日本被批准用于治疗目的。它是用于这种类型的抗糖尿病治疗的新型和第一个批准的药物。它是一种小分子药物,其分子量为191.6克/摩尔,用于口服给药。Imeglimin被认为有两种活动,因为葡萄糖的量取决于胰岛素的分泌影响和胰岛素敏感性增加。
    结论:治疗性,药理学,本文讨论了新药盐酸伊梅利明的分析考虑因素。
    BACKGROUND: WHO indicates that diabetes will become the 7th leading reason for death by 2030. The physiopathology of dysfunctioning is associated with obesity, weight gain and predominantly insulin resistance in insulin-sensitive cells and continuous deterioration of pancreatic beta cell function..Imeglimin is an investigational novel oral anti-diabetic drug.
    OBJECTIVE: The motive of the review is to comprehensively explore the chemistry, biological and analytical analysis of the Imeglimin hydrochloride.
    METHODS: To enhance the understanding, a systematic review was conducted by forming a database of relevant existing studies from electronic resources like Web of Science, ScienceDirect and PubMed. The methodology is reflected in the PRISMA design.
    RESULTS: The drug was approved in the year 2021 for therapeutic purposes in Japan. It is the novel and first approved drug for this type of Anti-diabetic treatment. It is a small molecular drug whose molecular weight is 191.6 grams per mole utilized for oral administration. Imeglimin is thought to have both activities, as the amount of glucose is dependent on insulin secretory impact and insulin sensitivity is increased.
    CONCLUSIONS: Therapeutic, pharmacological, and analytical considerations for the novel drug Imeglimin hydrochloride are discussed in this review.
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  • 文章类型: English Abstract
    糖尿病在75岁以上的人群中很常见。现在有广泛的治疗手段。这很重要,然而,选择正确的治疗方案,以适应患者的特定血糖目标。
    Diabetes is very common in people over 75. A broad arsenal of treatments is now available. It is important, however, to choose the right treatment regimen to suit the patient\'s specific glycemic targets.
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  • 文章类型: Journal Article
    在暴露于母体预先存在的1型(T1D)后,在临床队列中检查从出生到10岁的纵向BMI轨迹,类型2(T2D),有或没有抗糖尿病药物治疗的妊娠期糖尿病,怀孕期间没有糖尿病。
    数据包括2008-2015年出生的218名227名来自基于人口的综合医疗保健系统的单胎儿童;537名暴露于孕产妇T1D,7836到T2D,6982用于含药GDM,12576用于未含药GDM。通过调整协变量的非线性混合效应模型评估组间BMI随时间的差异。
    与无糖尿病组相比,所有糖尿病暴露组的儿童出生后6个月的BMI显著降低。从大约2.5岁开始,T1D的BMI明显较高,T2D和含药GDM组比非糖尿病组。在3岁时,T1D和T2D组中的增长模式开始与最高BMI分离,其次是药物GDM,未用药的GDM,和无糖尿病组。到7岁时,未用药GDM组的BMI明显高于无糖尿病组。调整后的BMI在所有年龄段的T1D和T2D组之间通常具有可比性。从5岁开始,T1D,T2D和药物治疗GDM组的BMI大于无糖尿病组的BMI的一个SD。
    在采用标准糖尿病管理方法的临床队列中,在调整了重要的协变量后,在怀孕期间暴露于不同类型糖尿病的后代中存在分层的BMI增长模式,从3岁开始。
    To examine longitudinal BMI trajectory from birth to age 10 years in a clinical cohort after exposure to maternal pre-existing type 1 (T1D), type 2 (T2D), gestational diabetes managed with or without anti-diabetes medication, and no diabetes during pregnancy.
    Data included 218 227 singleton children born in 2008-2015 from a population-based integrated healthcare system; 537 exposed to maternal T1D, 7836 to T2D, 6982 to medicated GDM and 12 576 to unmedicated GDM. Differences in BMI over time among groups were assessed by non-linear mixed-effects models adjusting for covariates.
    Children\'s BMI was significantly lower 6-months after birth for all diabetes exposed groups compared to no diabetes. Beginning at approximately age 2.5 years, BMI was significantly higher for T1D, T2D and medicated GDM groups compared to the no diabetes group. At age 3, the growth pattern started separating with highest BMI in T1D and T2D groups, followed by medicated GDM, unmedicated GDM, and the no diabetes groups. By age 7, BMI was significantly higher for the unmedicated GDM group compared to the no diabetes group. Adjusted BMI was generally comparable between T1D and T2D groups for all ages. Starting at age 5, T1D, T2D and medicated GDM groups had BMI greater than one SD over the BMI in the no diabetes group.
    In a clinical cohort with standard diabetes management approaches, a hierarchical BMI growth pattern exists in offspring exposed to different types of diabetes during pregnancy after adjusting for important covariates, starting as early as age 3 years.
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  • 文章类型: Journal Article
    我们目前正处于生物医学研究的重大转变:今天可能会获得前所未有且快速增长的数据量,从体外,体内和临床研究,在分子,生理和临床水平。为了利用这些大规模,多层次数据集,需要相应的多层次数学模型,即同时捕获多层生物的模型,生理和疾病水平的组织(也称为定量系统药理学-QSP模型)。然而,今天的多层次模型尚未嵌入到最终使用应用程序中,无论是在药物研发还是在临床上。鉴于历史上提出的期望和主张,这种看似缓慢的采用似乎令人惊讶。因此,我们在此考虑一个具体的例子-2型糖尿病-并批判性地回顾了目前的状况,并确定了这些模型在未来成为主流的关键剩余步骤。这个概述揭示了如何,今天,我们可以用模型来问科学问题,例如,胰岛素抵抗的细胞起源,以及这如何转化为全身水平和短期膳食反应。然而,在这些多层次模型变得真正有用之前,它们需要与其他重要现有模型的功能联系起来,以使它们“个性化”(例如特定于某些患者表型)并能够描述长期疾病进展。在药物开发中有用,同样重要的是,开发的模型及其基础数据和假设易于访问。对于临床最终用途,此外,需要与其他学科相结合的决策支持系统的模型链接,以创建用户友好且具有成本效益的软件包。
    We are currently in the middle of a major shift in biomedical research: unprecedented and rapidly growing amounts of data may be obtained today, from in vitro, in vivo and clinical studies, at molecular, physiological and clinical levels. To make use of these large-scale, multi-level datasets, corresponding multi-level mathematical models are needed, i.e. models that simultaneously capture multiple layers of the biological, physiological and disease-level organization (also referred to as quantitative systems pharmacology-QSP-models). However, today\'s multi-level models are not yet embedded in end-usage applications, neither in drug research and development nor in the clinic. Given the expectations and claims made historically, this seemingly slow adoption may seem surprising. Therefore, we herein consider a specific example-type 2 diabetes-and critically review the current status and identify key remaining steps for these models to become mainstream in the future. This overview reveals how, today, we may use models to ask scientific questions concerning, e.g., the cellular origin of insulin resistance, and how this translates to the whole-body level and short-term meal responses. However, before these multi-level models can become truly useful, they need to be linked with the capabilities of other important existing models, in order to make them \'personalized\' (e.g. specific to certain patient phenotypes) and capable of describing long-term disease progression. To be useful in drug development, it is also critical that the developed models and their underlying data and assumptions are easily accessible. For clinical end-usage, in addition, model links to decision-support systems combined with the engagement of other disciplines are needed to create user-friendly and cost-efficient software packages.
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