共查询到20条相似文献,搜索用时 15 毫秒
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Y. Nagai E. Hashimoto R. Oikawa S. Asai Y. Terashima Y. Nakamura Y. Sasaki H. Tsukiyama H. Fukuda T. Ohshige H. Kato A. Ohta Y. Tanaka 《Diabetes, obesity & metabolism》2014,16(6):573-576
This study was performed to clarify the influence of liraglutide on gastric emptying in Japanese patients with type 2 diabetes. In 16 patients, the [13C]‐acetate breath test was performed to compare gastric emptying before and after liraglutide treatment. We found two patterns of response, with gastric emptying being delayed by liraglutide in seven patients (delayers) and not delayed in nine patients (non‐delayers). The mean increase of the maximum gastric emptying time was 31 ± 4 min (p < 0.01 vs. baseline) in the delayers, while it was only 2 ± 3 min (p = 0.60 vs. baseline) in the non‐delayers. The delayers showed a greater early decrease of AUC‐PG from 0 to 60 min, despite no increase of the plasma insulin level compared with non‐delayers. In conclusion, the effect of liraglutide treatment on gastric emptying shows heterogeneity, and patients can be classified as delayers or non‐delayers. 相似文献
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Lukashevich V Schweizer A Shao Q Groop PH Kothny W 《Diabetes, obesity & metabolism》2011,13(10):947-954
Aim: Assess safety/tolerability and efficacy of the DPP‐4 inhibitor vildagliptin in 515 patients with type 2 diabetes mellitus (T2DM) and moderate or severe renal impairment (RI). Methods: Double‐blind, randomized, parallel‐group, placebo‐controlled, 24‐week clinical trial assessing safety and efficacy of vildagliptin (50 mg qd) added to current antidiabetic therapy, in patients with T2DM and moderate or severe RI (GFR ≥ 30 to <50 or <30 ml/min/1.73 m2). Results: The study population comprised of 165 and 129 patients with moderate RI and 124 and 97 patients with severe RI randomized to vildagliptin and placebo, respectively, with most patients receiving background insulin therapy (68 and 81% for moderate and severe RI, respectively). After 24 weeks, the between‐treatment difference in the adjusted mean change in A1C was ?0.5 ± 0.1% (p < 0.0001) in moderate RI (baseline A1C = 7.9%) and ?0.6 ± 0.1% (p < 0.0001) in severe RI (baseline A1C = 7.7%). In patients with moderate RI, similar proportions of those receiving vildagliptin or placebo experienced any AE (68 vs. 73%), any SAE (9 vs. 9%), any AE leading to discontinuation (3 vs. 5%) or death (1 vs. 1%). This was also true for patients with severe RI: AEs (73 vs. 74%), SAEs (19 vs. 21%), AEs leading to discontinuation (9 vs. 6%) and death (2 vs. 4%). Conclusions: In this 24‐week study of 515 patients with T2DM and moderate or severe RI, vildagliptin added to ongoing antidiabetic therapy had a safety profile similar to placebo. Further, relative to placebo, vildagliptin elicited a statistically and clinically significant decrease in A1C in patients with moderate or severe RI. 相似文献
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Kamlesh Khunti MD Bernard Charbonnel MD Hungta Chen PhD David Z. Cherney MD Andrew Cooper PhD Peter Fenici MD Marilia B. Gomes MD Niklas Hammar PhD Hiddo J. L. Heerspink PhD Linong Ji MD Jesús Medina PhD Antonio Nicolucci MD Larisa Ramirez MD Wolfgang Rathmann MD Marina V. Shestakova MD Iichiro Shimomura MD Fengming Tang MS Hirotaka Watada MD Mikhail Kosiborod MD the DISCOVER Investigators 《Diabetes, obesity & metabolism》2021,23(8):1956-1960
We report the prevalence and change in severity of chronic kidney disease (CKD) in DISCOVER, a global, 3-year, prospective, observational study of patients with type 2 diabetes (T2D) initiating second-line glucose-lowering therapy. CKD stages were defined according to estimated glomerular filtration rate (eGFR). Overall, 7843 patients from 35 countries had a baseline serum creatinine measurement. Of these (56.7% male; mean age: 58.1 years; mean eGFR: 87.5 mL/min/1.73 m2), baseline prevalence estimates for stage 0-1, 2, 3 and 4-5 CKD were 51.4%, 37.7%, 9.4% and 1.4%, respectively. A total of 5819 patients (74.2%) also had at least one follow-up serum creatinine measurement (median time between measurements: 2.9 years, interquartile range: 1.9-3.0 years). Mean eGFR decreased slightly to 85.7 mL/min/1.73 m2 over follow-up. CKD progression (increase of ≥1 stage) occurred in 15.7% of patients, and regression (decrease of ≥1 stage) in 12.0%. In summary, a substantial proportion of patients with T2D developed CKD or had CKD progression after the initiation of second-line therapy. Renal function should be regularly monitored in these patients, to ensure early CKD diagnosis and treatment. 相似文献
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Tina Vilsbøll MD Thomas C. Blevins MD Esteban Jodar PhD Neil Poulter FMed Sci Nikolaos Tentolouris MD Bue F. Ross Agner PhD Lucine Lehmann MD Lawrence A. Leiter MD 《Diabetes, obesity & metabolism》2019,21(6):1506-1512
In this post hoc analysis we investigated the effects of insulin degludec/liraglutide fixed-ratio combination (IDegLira) versus comparators on cardiovascular (CV) risk markers in participants in the DUAL II (vs. insulin degludec), DUAL V (vs. insulin glargine 100 units/mL) and DUAL VII (vs. basal–bolus therapy) trials, grouped by sex, age (<65 years, ≥65 years) and diabetes duration (<10 years, ≥10 years). Treatment contrasts were in favour of IDegLira in many subgroups for changes from baseline in glycated haemoblogin (DUAL II, DUAL V), body weight (all three trials), systolic blood pressure (BP; all three trials), HDL cholesterol (DUAL VII) and LDL cholesterol (DUAL II, DUAL V). Higher heart rates were seen with IDegLira versus comparators (all three trials) plus significantly higher diastolic BP in men (DUAL V). Differences in treatment effect were seen between sexes in waist circumference (DUAL II), systolic BP (DUAL II, DUAL V) and triglycerides (DUAL VII), and between diabetes durations in LDL cholesterol (DUAL V). In conclusion, IDegLira is associated with a general improvement in CV risk markers compared with basal insulin or basal–bolus therapy after 26 weeks of treatment. 相似文献
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Comparative efficacy and safety of gemigliptin versus linagliptin in type 2 diabetes patients with renal impairment: A 40‐week extension of the GUARD randomized study 下载免费PDF全文
Sang Youb Han MD PhD Sun Ae Yoon MD PhD Byoung Geun Han MD PhD Sung Gyun Kim MD PhD Young‐Il Jo MD PhD Kyung Hwan Jeong MD PhD Kook‐Hwan Oh MD PhD Hyeong Cheon Park MD PhD Sun‐Hee Park MD PhD Shin‐Wook Kang MD PhD Ki‐Ryang Na MD PhD Sun Woo Kang MD PhD Nam‐Ho Kim MD PhD Younghwan Jang BS Bogyeong Kim MS Seonghye Shin MS Dae Ryong Cha MD PhD 《Diabetes, obesity & metabolism》2018,20(2):292-300
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Background:Recently, many clinical experiments have evaluated the influences of liraglutide in the treatment of type 2 diabetes. However, the outcomes of these studies are inconsistent, and the number of high-quality prospective trials that conducted to assess the cardiovascular safety is limited. Hence, for this research, it was implemented for the assessment of the cardiovascular effectiveness and safety of liraglutide in type 2 diabetes patients.Methods:This research was a 26-week active controlled and randomized trial. Our research protocol follows the guidelines of Good Clinical Practice issued via the Helsinki Declaration and International Conference on Coordination. All the patients will receive the written informed consent in order to involve in our clinical experiment. The participants with type 2 diabetes aged from 18 years to 80 years, patients with 45.0 kg/m2 body-mass index or less, and with glycosylated hemoglobin of 7.5 to 10.0 percent, and received metformin (daily 1500 mg or more) for 3 months or longer were eligible. All the patients were randomized to 1 of 2 interventions (in the ratio of 1:1): liraglutide placebo once daily (blinded) and liraglutide once daily (blinded), respectively, both combined with the glimepiride and metformin (open-labeled). For the efficacy variable, the major endpoint was the baseline glycated hemoglobin change after treating for 26 weeks. The secondary end points involved: the percentage of participants who achieved the goals of postprandial blood glucose, fasting blood glucose, and glycosylated hemoglobin; the changes of mean postprandial blood glucose, fasting blood glucose, and the body weight, pancreatic B-cell function index, and changes in blood pressure and insulin resistance assessed by homeostasis model.Conclusions:For this research, the limitations involve the short trial period and the limitation of glimepiride in some countries, thus excluding the maximum doses of glimepiride.Trial registration:This study protocol was registered in Research Registry (researchregistry6306). 相似文献
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The public health burden of type 2 diabetes mellitus has been dramatically increasing world-wide. The chronic complications of type 2 diabetes play an important role in decreasing life expectancy and adversely affecting quality of life. Diabetic nephropathy, which is originally microvascular in nature, is widely considered an important complication of diabetes. In prospective clinical investigations, increased urinary albumin excretion proved to be associated not only with subsequent renal outcomes but also with cardiovascular morbidity/mortality independently of other risk factors. Therefore, microalbuminuria as an early sign of increased urinary albumin excretion should be considered important for both treatment and even for prevention. Preventing microalbuminuria might diminish progression to overt nephropathy and, hopefully, might limit cardiovascular events. Regarding primary prevention of diabetic nephropathy, therapeutic intervention should optimally be initiated at the stage of normoalbuminuria. Although additional factors such as smoking cessation, reduction of protein intake, and treatment of lipid abnormalities are important, providing optimal diabetic control as well as targeting optimal blood pressure are the key elements of a prevention strategy in diabetic patients. Recently, the Bergamo Nephrologic Diabetes Complications Trial (BENEDICT) documented that a significant decrease of the development of persistent microalbuminuria could be achieved by using an ACE-inhibitor, trandolapril alone or in combination with verapamil SR, a non-dihydropyridine calcium-channel blocker in hypertensive type 2 diabetic patients with normoalbuminuria. The results of this primary-prevention strategy should be corroborated by further investigations to determine whether these beneficial changes could later result in improvement of renal clinical outcomes, macrovascular complications, or both. 相似文献
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Efficacy,safety and albuminuria‐reducing effect of gemigliptin in Korean type 2 diabetes patients with moderate to severe renal impairment: A 12‐week,double‐blind randomized study (the GUARD Study) 下载免费PDF全文
Sun A. Yoon MD PhD Byoung G. Han MD PhD Sung G. Kim MD PhD Sang Y. Han MD PhD Young I. Jo MD PhD Kyung H. Jeong MD PhD Kook H. Oh MD PhD Hyeong C. Park MD PhD Sun H. Park MD PhD Shin W. Kang MD PhD Ki R. Na MD PhD Sun W. Kang MD PhD Nam H. Kim MD PhD Young H. Jang BS Seong H. Shin MS Dae R. Cha MD PhD 《Diabetes, obesity & metabolism》2017,19(4):590-598
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Tong PC Ko GT Chan WB Ma RC So WY Lo MK Lee KF Ozaki R Chow CC Cockram CS Chan JC 《Diabetes, obesity & metabolism》2006,8(3):342-347
BACKGROUND: The renoprotective effect of angiotensin II antagonists has been demonstrated in type 2 diabetic patients with nephropathy but similar data on angiotensin-converting enzyme (ACE) inhibitors are limited. We examined the efficacy and tolerability of fosinopril, an ACE inhibitor with dual hepatic and renal clearance, in 38 type 2 diabetic patients with moderate renal impairment (plasma creatinine 130-300 micromol/l) over a 2-year period. METHODS: This was a single-centre, randomized, double-blinded, placebo-controlled trial comparing fosinopril 20 mg daily vs. placebo in addition to conventional antihypertensive treatment over a 2-year period. The primary endpoints were the rate of change and the percentage change in both 24-h urinary albumin excretion (UAE) and creatinine clearance (CrCl). RESULTS: The mean age of the patients was 65 +/- 6 years (range 47-76 years, median 66 years) and plasma creatinine 190 +/- 49 micromol/l. For similar blood pressure control, the percentage change of UAE in patients with microalbuminuria was greater in the fosinopril than the placebo group (-24.2 +/- 28.8 vs. 11.6 +/- 42.1%, p = 0.003 after adjustment for baseline covariates). In the fosinopril group, the rate of change of endogenous CrCl was slower than the placebo group (-0.07 +/- 0.19 vs. -0.24 +/- 0.35 ml/min/week, p = 0.026). The incidence of adverse events was similar between the two groups. CONCLUSIONS: Fosinopril treatment reduced albuminuria and rate of decline in renal function in type 2 diabetic patients with moderate renal insufficiency and did not increase the incidence of adverse events. 相似文献
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Chin Meng Khoo MD Chaicharn Deerochanawong MD Siew Pheng Chan MD Bien Matawaran MD Wayne Huey-Herng Sheu MD Juliana Chan MD Ambrish Mithal MD Andrea Luk MD Ketut Suastika MD Kun-Ho Yoon MD Linong Ji MD Nguyen Huu Man MD Carol Pollock MD 《Diabetes, obesity & metabolism》2021,23(2):299-317
Early onset of type 2 diabetes and a high prevalence of co-morbidities predispose the Asian population to a high risk for, and rapid progression of, diabetic kidney disease (DKD). Apart from renin-angiotensin system inhibitors, sodium-glucose co-transporter-2 (SGLT-2) inhibitors have been shown to delay renal disease progression in patients with DKD. In this review article, we consolidate the existing literature on SGLT-2 inhibitor use in Asian patients with DKD to establish contemporary guidance for clinicians. We extensively reviewed recommendations from international and regional guidelines, data from studies on Asian patients with DKD, global trials (DAPA-CKD, CREDENCE and DELIGHT) and cardiovascular outcomes trials. In patients with DKD, SGLT-2 inhibitor therapy significantly reduced albuminuria and the risk of hard renal outcomes (defined as the onset of end-stage kidney disease, substantial decline in renal function from baseline and renal death), cardiovascular outcomes and hospitalization for heart failure. In all the cardiovascular and renal outcomes trials, there was an initial decline in the estimated glomerular filtration rate (eGFR), which was followed by a slowing in the decline of renal function compared with that seen with placebo. Despite an attenuation in glucose-lowering efficacy in patients with low eGFR, there were sustained reductions in body weight and blood pressure, and an increase in haematocrit. Based on the available evidence, we conclude that SGLT-2 inhibitors represent an evidence-based therapeutic option for delaying the progression of renal disease in Asian patients with DKD and preserving renal function in patients at high risk of kidney disease. 相似文献
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Efficacy and safety of liraglutide versus sitagliptin,both in combination with metformin,in Chinese patients with type 2 diabetes: a 26‐week,open‐label,randomized, active comparator clinical trial 下载免费PDF全文
L. Zang Y. Liu J. Geng Y. Luo F. Bian X. Lv J. Yang J. Liu Y. Peng Y. Li Y. Sun H. Bosch‐Traberg Y. Mu 《Diabetes, obesity & metabolism》2016,18(8):803-811
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