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2018 ESC/ESH Guidelines for the Management of Arterial Hypertension
Published in Giuseppe Mancia, Guido Grassi, Konstantinos P. Tsioufis, Anna F. Dominiczak, Enrico Agabiti Rosei, Manual of Hypertension of the European Society of Hypertension, 2019
Bryan Williams, Giuseppe Mancia, Wilko Spiering, Enrico Agabiti Rosei, Michel Azizi, Michel Burnier, Denis L. Clement, Antonio Coca, Giovanni de Simone, Anna F. Dominiczak, Thomas Kahan, Felix Mahfoud, Josep Redon, Luis M. Ruilope, Alberto Zanchetti, Mary Kerins, Sverre E. Kjeldsen, Reinhold Kreutz, Stéphane Laurent, Gregory Y.H. Lip, Richard McManus, Krzysztof Narkiewicz, Frank Ruschitzka, Roland E. Schmieder, Evgeny Shlyakhto, Konstantinos P. Tsioufis, Victor Aboyans, Ileana Desormais
The impact of new glucose-lowering drugs on BP and the reduction in cardiovascular and renal risk, beyond their effect of glucose control, have received attention after the publication of the US Food and Drug Administration recommendations for evaluating cardiovascular risk in new therapies to treat type 2 diabetes. New generations of antidiabetes drugs, that is dipeptidyl peptidase 4 inhibitors and glucagon-like peptide 1 agonists, slightly reduce BP, and also body weight with glucagon-like peptide 1 agonists. Two glucagon-like peptide 1 agonists (liraglutide and semaglutide) reduced cardiovascular and total mortality, but not heart failure, in patients with type 2 diabetes [608,609]. More data are required with respect to the capacity of glucagon-like peptide 1 agonists and dipeptidyl peptidase 4 inhibitors to prevent heart failure.
Comparative efficacy and safety of two insulin aspart formulations (Rapilin and NovoRapid) when combined with metformin, for patients with diabetes mellitus: a multicenter, randomized, open-label, controlled clinical trial
Published in Current Medical Research and Opinion, 2022
Jun Yao, Xiaohui Guo, Li Sun, Ping Han, Xiaofeng Lv, Xiuzhen Zhang, Zhaohui Mo, Wenying Yang, Lihui Zhang, Zhanjian Wang, Lvyun Zhu, Quanmin Li, Tao Yang, Wenbo Wang, Yaoming Xue, Yongquan Shi, Juming Lu, Yongde Peng, Fan Zhang, Dewen Yan, Damei Wang, Xuefeng Yu
Patients with type 2 diabetes mellitus aged 18–75 years who had glycated hemoglobin (HbA1c) levels of >7.5% to ≤13% (centralized laboratory confirmed), had previously undergone treatment with metformin (≥1000 and ≤2000 mg) or ≤3 oral antidiabetes drugs (OADs, sulfonylureas, nonsulfonylurea insulin secretagogues, and glucosidase inhibitors) for more than 3 months prior to screening, and had a body mass index (BMI) of <40 kg/m2 were eligible for the study. Although not specifically excluded by the study protocol, patients had not received prior sodium-glucose co-transporter 2 (SGLT2) inhibitors as they were not available in China during the period the study was active16,17. Exclusion criteria included insulin treatment in the 6 months prior to screening; thiazolidinedione, human glucagon-like peptide-1 receptor agonist, or dipeptidyl peptidase 4 inhibitor treatment in the 3 months prior to screening, and a history of severe hypo/hyperglycemia. Patients with a known hypersensitivity to study drugs; glucocorticoid use in the 2 months prior to screening; alcohol/substance abuse in the 5 years prior to screening; or those who were pregnant, breastfeeding, or at risk of pregnancy were also excluded.
TGR5 agonists for diabetes treatment: a patent review and clinical advancements (2012-present)
Published in Expert Opinion on Therapeutic Patents, 2022
Rachana S. Bhimanwar, Amit Mittal
Kanazawa University conducted a Phase 4 clinical trial on Ursodeoxycholic Acid (UDCA) (21) addressing Glucagon-like peptide-1 (GLP-1) levels (Figure 19). Researchers studied the efficacy and safety of UDCA in people with Type 2 diabetes and chronic liver diseases. Participants (around 16) were administered 900 mg of UDCA for 12 weeks followed by 50 mg of sitagliptin as additive therapy for dipeptidyl peptidase-4 (DPP4) inhibitors. Results showed a decrease in body weight from 72.5 ± 8.4 to 70.6 ± 8.6 kg) and the HbA1c level (7.0%±0.3% to 6.4%±0.5%) in the patients treated with UDCA. The HbA1c level decreased further (6.4% ± 0.5% to 6.0% ± 0.4%) in patients treated with sitagliptin as add-on therapy. A combination of UDCA and the dipeptidyl peptidase-4 inhibitor can therefore be considered a novel treatment of Type 2 diabetes [49,50].
Assessment of suspected adverse drug reactions in elderly patients with diabetes mellitus based on a Portuguese spontaneous reporting database: analysis of reporting from 2008 to 2018
Published in Expert Opinion on Drug Safety, 2021
Cristina Monteiro, Samuel Silvestre, Ana Paula Duarte, Gilberto Alves
Evidence indicates that dipeptidyl peptidase-4 inhibitors are highly effective and safe in the elderly and that in the presence of mild, moderate and severe renal failure they improved glycemic control with low risk of hypoglycemia [41]. However, their use was associated to an increased risk of urinary tract infection in older patients [42]. This fact is in agreement with our results, since sitagliptin was connected to an Escherichia urinary tract infection, a bacterial pyelonephritis, a pneumonia aspiration, a bacteremia, and an infected skin ulcer. However, it is important to take into account that infectious diseases are more frequent and/or serious in patients with diabetes mellitus, because the hyperglycemic environment favors immune dysfunction (e.g. lead to damage of neutrophil function, reduction of antioxidant defenses and humoral immunity) [43]. Diabetes is also responsible for micro- and macroangiopathies, neuropathy, for decreasing the antibacterial activity of urine, gastrointestinal and urinary dysmotility and lead to a higher number of medical interventions in these patients [43]. Older adults with diabetes also have the highest rates of myocardial infarction, visual impairment, and end-stage renal disease of any age-group [40].