Efficacy of metformin in the treatment of NIDDM. Meta-analysis.

Johansen, K. B.

doi:10.2337/diacare.22.1.33

Cited by 169 publications

(99 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Gluconeogenesis is suppressed, and stimulation of peripheral glucose uptake is increased (45). Such characteristics are useful in the typical obese type 2 diabetic patient (46) but also in nonobese individuals with type 2 diabetes. Furthermore, one potential problem associated with the use of metformin is the development of lactic acidosis in a patient at high risk of becoming insulin-dependent.…”

Section: Metforminmentioning

confidence: 86%

Autoimmune Diabetes Not Requiring Insulin at Diagnosis (Latent Autoimmune Diabetes of the Adult)

2001

View full text Add to dashboard Cite

Type 1 diabetes is caused by the immune-mediated destruction of islet insulin-secreting β-cells. This chronic destructive process is associated with both cellular and humoral immune changes in the peripheral blood that can be detected months or even years before the onset of clinical diabetes. Throughout this prediabetic period, metabolic changes, including altered glucose tolerance and reduced insulin secretion, deteriorate at variable rates and eventually result in clinical diabetes. A fraction of individuals with humoral immunological changes have clinical diabetes that initially is not insulin-requiring. The onset of diabetes in these patients is usually in adult life, and because their diabetes is at least initially not insulin-requiring, they appear clinically to be affected by type 2 diabetes. Such patients probably have the same disease process as patients with type 1 diabetes in that they have similar HLA genetic susceptibility as well as autoantibodies to islet antigens, low insulin secretion, and a higher rate of progression to insulin dependency. These patients are defined as being affected by an autoimmune type of diabetes not requiring insulin at diagnosis, which is also named latent autoimmune diabetes of the adult (LADA). Special attention should be paid to diagnose such patients because therapy may influence the speed of progression toward insulin dependency, and in this respect, efforts should be made to protect residual C-peptide secretion. LADA can serve as a model for designing new strategies for prevention of type 1 diabetes but also as a target group for prevention in its own right.

show abstract

Section: Metforminmentioning

confidence: 86%

Autoimmune Diabetes Not Requiring Insulin at Diagnosis (Latent Autoimmune Diabetes of the Adult)

2001

View full text Add to dashboard Cite

show abstract

“…Effective medications for maintaining glycemic control in diabetic patients are available. One of the most frequently prescribed in obese diabetic subjects is metformin as, unlike insulin, sulfonylureas or thiazolidinediones, it does not promote weight gain, [15][16][17] and further pharmacological weight-loss options are clearly needed. 18 Topiramate, a sulfamate-substituted monosaccharide that is approved worldwide for the adjunctive treatment of specific seizure disorders and for migraine prophylaxis, has been investigated for the treatment of obesity and type 2 diabetes.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of topiramate in combination with metformin in the treatment of obese subjects with type 2 diabetes: a randomized, double-blind, placebo-controlled study

Toplak

Hamann

Moore³

et al. 2006

Int J Obes

View full text Add to dashboard Cite

Objective: To investigate the efficacy and safety of topiramate in obese subjects with type 2 diabetes treated with metformin. Design: This was a multicenter, double-blind, placebo-controlled trial. All subjects received a non-pharmacological program of diet, exercise and behavioral modification throughout the study; the assigned diet was 600 kcal/day less than the subject's individually calculated energy expenditure. After a 6-week single-blind placebo run-in, subjects were randomized to placebo, topiramate 96 mg/day or topiramate 192 mg/day. Following an 8-week titration period, subjects remained on their assigned dose for 52 weeks. However, the sponsor ended the study early in order to develop a new controlled-release formulation with the potential to enhance tolerability and simplify dosing in this patient population. A total of 646 obese men and women (age: 18-75 years, body mass index: 27-50 kg/m 2 ) with an established history of type 2 diabetes mellitus controlled by metformin monotherapy were randomized. Efficacy was assessed in a pre-determined modified intent-to-treat (MITT) population of 307 subjects whose randomization date would have allowed them to complete 24 weeks on study medication before the announcement of study termination. Measurements: Joint primary efficacy parameters were mean percent change in weight and change in glycosylated hemoglobin (HbA 1c ) from baseline to week 24. Results: Subjects in the placebo, topiramate 96 mg/day and topiramate 192 mg/day groups lost 1.7%, 4.5% (Po0.001) and 6.5% (Po0.001), respectively, of their baseline body weight and had absolute decreases in HbA 1c of 0.1%, 0.4% (Po0.001) and 0.6% (Po0.001) (MITT, last observation carried forward). Topiramate-treated subjects also experienced statistically significant decreases in systolic blood pressure. Most common adverse events were paresthesia and events related to the central nervous system. Conclusions: Topiramate was effective for weight reduction and improvement in glycemic control in obese subjects with type 2 diabetes treated with metformin monotherapy. Further study in obese diabetics is warranted.

show abstract

“…Em relação às biguanidas, temos disponíveis a metformina e a fenformina, sendo a primeira mais utilizada, pela menor freqüência de efeitos colaterais (8)(9)(10)(11)(12)(13)(14).…”

Section: Biguanidasunclassified

“…Foi demonstrado, também, que a eficácia do controle glicêmico pela metformina é similar à da sulfoniluréia, além de estar associada à redução ponderal, tão importante no DM2 (11). O estudo multicêntrico do UKPDS em diabéti-cos acompanhados por cerca de 11 anos mostrou que o controle intensivo da glicemia pelo uso de metformina diminuiu significativamente os riscos de doença cardiovascular e a mortalidade relacionada ao DM, associado com menor ganho de peso e sem a inconveniência das hipoglicemias induzidas pelo tratamento com insulina ou sulfoniluréias (13).…”

Section: Biguanidasunclassified

Tratamento do diabetes mellitus do tipo 2: novas opções

Araújo

Britto

Cruz

2000

Arq Bras Endocrinol Metab

View full text Add to dashboard Cite

RESUMOO diabetes mellitus do tipo 2 (DM2) resulta de defeitos na secreção e ação da insulina. Ele está freqüentemente associado à resistência à insulina, obesidade andróide, dislipidemia e hipertensão arterial, constituindo a síndrome metabólica. O tratamento atual visa diminuir a resistência à insulina e melhorar a função da célula beta pancreática com dieta, exercícios, hipoglicemiantes orais, anti-hiperglicemiantes e/ou drogas anti-obesidade. Novas drogas no tratamento do DM estão surgindo, tornando possíveis múltiplas opções terapêuticas. Este artigo apresenta uma revisão sobre o assunto. ABSTRACTType 2 diabetes mellitus results from defects in both insulin action and insulin secretion. It is frequently associated with hyperinsulinemia, central obesity, dyslipidemia and arterial hypertension, components of the so-called metabolic syndrome. The main targets of the treatment are to decrease insulin resistance and improve beta cell function with diet, exercise, oral hypoglycemic and anti-hyperglycemic agents and/or anti-obesity drugs. New drugs for the treatment of diabetes mellitus make possible multiples therapeutics options. This article reviews this subject. O DIABETES MELLITUS DO TIPO 2 (DM2) ou não insulino-dependente e a intolerância à glicose têm se tornado um dos distúrbios mais comuns em clínica médica e estão freqüentemente associados à síndrome metabólica, que se caracteriza por resistência à insulina, obesidade andróide ou central, dislipidemia e hipertensão arterial (1,2). A síndrome metabólica é responsável pela maior morbi-mortalidade por doenças cardiovasculares tanto em obesos quanto em diabéticos tipo 2.O tratamento atual do DM2 visa manter o controle glicêmico adequado, seja com dieta hipocalórica, aumento da prática de exercícios físi-cos ou uso de medicações. Existem no momento diversas opções terapêu-ticas, que podem ser utilizadas isoladamente ou em associações: sensibilizadores da ação de insulina (metformina, tiazolidinedionas), anti-hiperglicemiantes (acarbosc), secretagogos (sulfoniluréias, repaglinida, nateglinida), drogas anti-obesidade e/ou insulina. O Diabetes Control and Complications Trial (DCCT) (3), um estudo prospectivo multicêntrico sobre as diversas formas de tratamento com insulina no DM1 e, mais recentemente,

show abstract

Efficacy of metformin in the treatment of NIDDM. Meta-analysis.

Cited by 169 publications

References 0 publications

Autoimmune Diabetes Not Requiring Insulin at Diagnosis (Latent Autoimmune Diabetes of the Adult)

Autoimmune Diabetes Not Requiring Insulin at Diagnosis (Latent Autoimmune Diabetes of the Adult)

Efficacy and safety of topiramate in combination with metformin in the treatment of obese subjects with type 2 diabetes: a randomized, double-blind, placebo-controlled study

Tratamento do diabetes mellitus do tipo 2: novas opções

Contact Info

Product

Resources

About