Efficacy and safety of saxagliptin compared with acarbose in <scp>C</scp>hinese patients with type 2 diabetes mellitus uncontrolled on metformin monotherapy: <scp>R</scp>esults of a <scp>P</scp>hase <scp>IV</scp> open‐label randomized controlled study (the <scp>SMART</scp> study)

Du, Jin; Li, Liang; Fang, Hui; Xu, Feng; Li, Wei; Li-ya, Shen; Wang, Xueying; Xu, Chun; Bian, Fang; Mu, Yiming

doi:10.1111/dom.12942

Cited by 23 publications

(35 citation statements)

References 31 publications

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“…Drugs such as Acarbose act by inhibiting α-amylase and α-glucosidases and are used in the management of T2DM. Unfortunately, this drug is expensive which is a limitation to the therapeutic treatment of T2DM in low- and middle-income countries and there is evidence showing that long-term intervention with Acarbose results in gastrointestinal side effects (flatulence occurring in ≥1/10 patients, and diarrhoea and GI and abdominal pain in ≥1/100 to <1/10 patients) [ 22 , 23 ]. For these reasons, there is still a need for new therapeutic interventions.…”

Section: Resultsmentioning

confidence: 99%

Bioactive Peptides from Germinated Soybean with Anti-Diabetic Potential by Inhibition of Dipeptidyl Peptidase-IV, α-Amylase, and α-Glucosidase Enzymes

González-Montoya

Hernández-Ledesma

Mora‐Escobedo

et al. 2018

IJMS

140

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Functional foods containing peptides offer the possibility to modulate the absorption of sugars and insulin levels to prevent diabetes. This study investigates the potential of germinated soybean peptides to modulate postprandial glycaemic response through inhibition of dipeptidyl peptidase IV (DPP-IV), salivary α-amylase, and intestinal α-glucosidases. A protein isolate from soybean sprouts was digested by pepsin and pancreatin. Protein digest and peptide fractions obtained by ultrafiltration (<5, 5–10 and >10 kDa) and subsequent semipreparative reverse phase liquid chromatography (F1, F2, F3, and F4) were screened for in vitro inhibition of DPP-IV, α-amylase, maltase, and sucrase activities. Protein digest inhibited DPP-IV (IC50 = 1.49 mg/mL), α-amylase (IC50 = 1.70 mg/mL), maltase, and sucrase activities of α-glucosidases (IC50 = 3.73 and 2.90 mg/mL, respectively). Peptides of 5–10 and >10 kDa were more effective at inhibiting DPP-IV (IC50 = 0.91 and 1.18 mg/mL, respectively), while peptides of 5–10 and <5 kDa showed a higher potency to inhibit α-amylase and α-glucosidases. Peptides in F1, F2, and F3 were mainly fragments from β-conglycinin, glycinin, and P34 thiol protease. The analysis of structural features of peptides in F1–F3 allowed the tentative identification of potential antidiabetic peptides. Germinated soybean protein showed a promising potential to be used as a nutraceutical or functional ingredient for diabetes prevention.

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Section: Resultsmentioning

confidence: 99%

Bioactive Peptides from Germinated Soybean with Anti-Diabetic Potential by Inhibition of Dipeptidyl Peptidase-IV, α-Amylase, and α-Glucosidase Enzymes

González-Montoya

Hernández-Ledesma

Mora‐Escobedo

et al. 2018

IJMS

140

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“…Previous studies have demonstrated that saxagliptin therapy in Asian patients is well tolerated in treatment‐naive patients, in combination with metformin, and in combination with other oral glucose‐lowering agents . A potential benefit of using a DPP‐4 inhibitor as add‐on therapy over other antidiabetes agents is that the activity of this class of drugs on insulin secretion is glucose‐dependent, and DPP‐4 inhibitors are therefore associated with a low risk of hypoglycaemia .…”

Section: Discussionmentioning

confidence: 99%

“…Asian patients is well tolerated in treatment-naive patients, 6 in combination with metformin, 7,13,14 and in combination with other oral glucose-lowering agents. 15,16 A potential benefit of using a DPP-4…”

Section: Previous Studies Have Demonstrated That Saxagliptin Therapy Inmentioning

confidence: 99%

Saxagliptin add‐on therapy in Chinese patients with type 2 diabetes inadequately controlled by insulin with or without metformin: Results from the SUPER study, a randomized, double‐blind, placebo‐controlled trial

Chen

Liu

Li³

et al. 2017

Diabetes Obesity Metabolism

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This prospective, multicentre, phase III study (NCT02104804) evaluated the efficacy and safety of saxagliptin add-on therapy in Chinese patients with type 2 diabetes inadequately controlled by insulin ± metformin. Patients with glycated haemoglobin (HbA1c) 7.5% to 10.5% and fasting plasma glucose (FPG) <15 mmol/L (270 mg/dL) on stable insulin therapy (20-150 U/d) were randomized (1:1) to saxagliptin 5 mg once daily (N = 232) or placebo (N = 230) for 24 weeks, stratified by metformin use. The primary efficacy measure was change in HbA1c. Saxagliptin treatment resulted in a greater adjusted mean change in HbA1c from baseline to week 24 than placebo (-0.58%; P < .001), irrespective of metformin use, and a greater mean change in FPG (0.9 mmol/L [-15.9 mg/dL]; P < .001). More patients achieved HbA1c <7% with saxagliptin (11.4%) than with placebo (3.5%, P = .002). Adverse events and incidence of hypoglycaemia were similar in both groups. Overall, add-on saxagliptin 5 mg once daily significantly improved glycaemic control without increasing hypoglycaemia risk and was well tolerated in Chinese patients with type 2 diabetes inadequately controlled by insulin (± metformin).

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“…Alogliptin is the most weight neutral DDP-4 inhibitor and associated with a weight change of −0.9 to +0.7 kg. 97 – 100 Conversely, sitagliptin, saxagliptin and linagliptin are associated with modest weight losses ranging from 0.1 to −2.6, 100 – 103 2.1 to 0.5 100 , 103 – 105 and 2.1 to 0.6 kg, 90 , 100 , 106 , 107 respectively. Acarbose, an α-glucosidase inhibitor, is limited in its use due to gastrointestinal side effects, but is associated with modest weight loss of 0.4–2.8 kg.…”

Section: Antidepressantsmentioning

confidence: 99%

“…Acarbose, an α-glucosidase inhibitor, is limited in its use due to gastrointestinal side effects, but is associated with modest weight loss of 0.4–2.8 kg. 5 , 77 , 87 , 105 …”

Section: Antidepressantsmentioning

confidence: 99%

Medications that cause weight gain and alternatives in Canada: a narrative review

Wharton¹,

Raiber²,

Serodio³

et al. 2018

DMSO

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BackgroundThe cause of the obesity epidemic is multifactorial, but may, in part, be related to medication-induced weight gain. While clinicians may strive to do their best to select pharmacotherapy(ies) that has the least negative impact on weight, the literature regarding the weight effects of medication is often limited and devoid of alternative therapies.ResultsAntipsychotics, antidepressants, antihyperglycemics, antihypertensives and corticosteroids all contain medications that were associated with significant weight gain. However, there are several medication alternatives within the majority of these classes associated with weight neutral or even weight loss effects. Further, while not all of the classes of medication examined in this review have weight-favorable alternatives, there exist many other tools to mitigate weight gain associated with medication use, such as changes in dosing, medication delivery or the use of adjunctive therapies.ConclusionMedication-induced weight gain can be frustrating for both the patient and the clinician. As the use of pharmaceuticals continues to increase, it is pertinent for clinicians to consider the weight effects of medications prior to prescribing or in the course of treatment. In the case where it is not feasible to make changes to medication, adjunctive therapies should be considered.

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Efficacy and safety of saxagliptin compared with acarbose in Chinese patients with type 2 diabetes mellitus uncontrolled on metformin monotherapy: Results of a Phase IV open‐label randomized controlled study (the SMART study)

Abstract: NCT02243176, clinicaltrials.gov.

Cited by 23 publications

References 31 publications

Bioactive Peptides from Germinated Soybean with Anti-Diabetic Potential by Inhibition of Dipeptidyl Peptidase-IV, α-Amylase, and α-Glucosidase Enzymes

Bioactive Peptides from Germinated Soybean with Anti-Diabetic Potential by Inhibition of Dipeptidyl Peptidase-IV, α-Amylase, and α-Glucosidase Enzymes

Saxagliptin add‐on therapy in Chinese patients with type 2 diabetes inadequately controlled by insulin with or without metformin: Results from the SUPER study, a randomized, double‐blind, placebo‐controlled trial

Medications that cause weight gain and alternatives in Canada: a narrative review

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