Exenatide once weekly plus dapagliflozin once daily versus exenatide or dapagliflozin alone in patients with type 2 diabetes inadequately controlled with metformin monotherapy (DURATION-8): a 28 week, multicentre, double-blind, phase 3, randomised controlled trial

Frías, Juan P.; Guja, Cristian; Hardy, Elise; Ahmed, Azazuddin; Dong, Fang; Öhman, Peter; Jabbour, Serge

doi:10.1016/s2213-8587(16)30267-4

Cited by 334 publications

(366 citation statements)

References 30 publications

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“…Exenatide has been shown to improve glycemic control in patients with T2DM who failed to achieve glycemic control with maximally effective MET doses (29). This implied that the shortcomings of MET may be avoided if exenatide is used in the combined therapy model (30). Consistent with the results of clinical trials with exenatide (19), a significant decrease in body weight was observed in the present study in patients receiving exenatide + MET combination therapy; this decrease was significantly greater than that observed in the patients receiving BIA30 + MET combination therapy.…”

Section: Discussionmentioning

confidence: 99%

A crossover study of the combination therapy of metformin and exenatide or biphasic insulin aspart 30 in overweight or obese patients newly diagnosed with type 2 diabetes mellitus

Quan¹,

Zhang²,

Wei³

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. The aim of the present study was to explore the effects of various combinations of exenatide, metformin (MET) and biphasic insulin aspart 30 (BIA30) on type 2 diabetes mellitus (T2DM). Two hundred overweight or obese patients newly diagnosed with T2DM were evenly randomized into two groups: A (twice daily for all: Phase I, 5 µg exenatide + 0.5 g MET for 4 weeks, then 10 µg exenatide + 0.5 g MET for 8 weeks; Phase II, 0.5 g MET for 12 weeks; Phase III, 0.3-0.4 U/kg/day BIA30 + 0.5 g MET for 12 weeks) and B (Phases I, II, III matched the phases III, II and I in group A). In groups A and B a significant decrease and increase, respectively, in glycated hemoglobin (HbAlc) and body mass index (BMI) was noted during Phase I. A 3.2±0.4-kg decrease in body weight in group A and a 2.6±0.3-kg increase in group B was observed. In Phase II, HbAlc was significantly increased in both groups (P<0.05). In Phase III, the BMI was increased in group A and reduced in group B (P<0.05). There was a 3.8±0.4-kg weight decrease in group B and 4.2±0.5-kg increase in group A (P<0.05). The combination of exenatide and MET promoted weight loss, glycemic control, β-cell function index, C peptide and adiponectin levels. These results suggested that the combination of exenatide and MET is better than the combination of BIA and MET for the therapy of overweight or obese patients newly diagnosed with T2DM.

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Section: Discussionmentioning

confidence: 99%

A crossover study of the combination therapy of metformin and exenatide or biphasic insulin aspart 30 in overweight or obese patients newly diagnosed with type 2 diabetes mellitus

Quan¹,

Zhang²,

Wei³

et al. 2017

Experimental and Therapeutic Medicine

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“…En el año 2007 un metaanálisis que valoró los efectos cardiovasculares de la rosiglitazona 9 concluyó que este medicamento incrementa el riesgo de infarto de miocardio (OR 1.43 IC 95% 1.03-1.98; [36][37][38][39][40][41][42][43][44][45][46] pacientes con una tasa de filtración glomerular (TFG) <30 mL/min/1.73 m 2 .…”

Section: Diabetes Mellitus Tipo 2 Y Riesgo Cardiovascularunclassified

“…Los efectos adversos de este medicamento son principalmente gastrointestinales como diarrea e intolerancia gástrica; además, se asocia a deficiencia de vitamina B 12 y se han descrito casos de acidosis láctica pero con una muy baja incidencia (<1/100 000). Se encuentra contraindicada en [36][37][38][39][40][41][42][43][44][45][46] la demanda energética por la célula muscular cardiaca e incrementa el tejido isquémico; sin embargo, hay un metaanálisis que no encontró asociación entre el uso de sulfonilureas y la incidencia de infarto de miocardio 25 y hay otro estudio 22 que incluso reporta una menor mortalidad (3.9%) con el uso de sulfonilureas luego de un infarto de miocardio, pero hay que hacer la salvedad que la mayoría de estos pacientes se encontraban en tratamiento con glicazide y glimepiride las cuales son más selectivas para el receptor SUR-1 (pancreático). La sulfonilurea de mayor acceso en Colombia es la glibenclamida la cual no es SUR-1 selectiva 22 .…”

Section: Biguanida -Metforminaunclassified

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Enfoque terapéutico de la diabetes mellitus tipo 2 en adultos. Más allá de una meta glucémica

Betancur

2018

MedUPB

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Enfoque terapéutico de la diabetes mellitus tipo 2 en adultos. Más allá de una meta glucémicaTherapeutic approach to type 2 diabetes mellitus in adults: Beyond a glycemic goal / Enfoque terapêutico da diabetes mellitus tipo 2 em adultos. Além de uma meta glicêmica Santiago Saldarriaga Betancur 1 RESUMEN La diabetes mellitus tipo 2 es una enfermedad que cada día incrementa su incidencia y prevalencia. Se estima que más de 400 millones de personas tienen esta enfermedad y muchos desconocen su diagnóstico. La diabetes mellitus produce desenlaces microvasculares y macrovasculares desfavorables. A lo largo de los años se ha encontrado que el control intensivo de la glucemia tiene beneficios sobre los desenlaces microvaculares; sin embargo, no se había logrado demostrar desenlaces macrovasculares satisfactorios hasta los últimos años cuando gracias a nuevas moléculas se demostró dicho beneficio. Es por esto que el enfoque terapéutico de la diabetes mellitus tipo 2 ha cambiado, ahora no solo es lograr una meta en hemoglobina glicada (HbA1c), sino también lograr disminuir el riesgo cardiovascular con el objetivo de disminuir eventos micro y especialmente macrovasculares. En los últimos años se han identificado nuevas dianas terapéuticas para el tratamiento de esta entidad, con el desarrollo de moléculas que además de haber demostrado un control glucémico aceptable, también representan seguridad cardiovascular, incluso algunas han confirmado disminuir el riesgo cardiovascular. A lo largo del artículo se discute la importancia del riesgo cardiovascular en la población con diabetes mellitus tipo 2 y los esquemas terapéuticos disponibles para impactar sobre este riesgo. Palabras clave: diabetes mellitus; enfermedades cardiovasculares; terapéutica. ABSTRACTThe incidence and prevalence of type 2 diabetes mellitus increase daily. It is estimated that more than 400 million people have this disease and many are unaware of it. Diabetes mellitus produces unfavorable microvascular and macrovascular outcomes. Over the years it has been found that intensive glycemic control has benefits over microvascular outcomes; however, it had not been possible to demonstrate satisfactory macrovascular outcomes until recent years when, thanks to new molecules, this benefit has been demonstrated. This is why the therapeutic approach of type 2 diabetes mellitus has changed, and no longer consists in simply achieving a goal in glycated hemoglobin (HbA1c), but also in reducing cardiovascular risk with the aim of decreasing micro and especially macrovascular events. In recent years, new therapeutic targets have been identified for the treatment of this entity, with the development of molecules that have demonstrated an acceptable glycemic control as well as cardiovascular safety; some have even been shown to decrease cardiovascular risk. This article discusses the importance of cardiovascular risk in people with type 2 diabetes mellitus and therapeutic options that have an impact on this risk.

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“…Были достигнуты первичные и вторичные конечные точки: значительное снижение уровня гликемии, массы тела и систолического артери-ального давления в сравнении с монотерапией. Дополнительные исследования по оценке соче-танного применения препаратов групп аГПП-1 и иНГЛТ-2 дадут более полную информацию, в том числе и о сердечно-сосудистой безопаснос-ти данной комбинации [35].…”

Section: обзорыunclassified

Modern aspects of the treatment and prevention of diabetes type 2 in patients with metabolic syndrome

et al. 2017

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Literature review is devoted to the most important medical-social problems of the XXI century - metabolic syndrome and diabetes mellitus type 2. Dirung the last decades prevalence of this pathology is steadily growing worldwide. Metabolic syndrome is associated with high risk of developing diabetes type 2, which is associated with early disability and high mortality from vascular complications. The wide spread of undiagnosed diabetes among persons of working age results in the need for early active detection of the disease in this group. Prophylaxis plays a huge role in the prevention of negative effects of diabetes. Since the major modifiable risk factors of its development are visceral obesity and a complex of its associated states (metabolic syndrome components), normalization of body weight preserves its significance as a measure of primary, secondary and tertiary prevention. In patients with diabetes not only carbohydrate metabolism requires correction, but also body mass, lipid profile, blood pressure, and hemostasis system, that should be considered when choosing a glucose-lowering drug. The article presents the results of nationwide epidemiological studies devoted to the evaluation of prevalence of metabolic syndrome and diabetes type 2 among the adult population. Current understanding of pathogenesis of metabolic syndrome and diabetes is discussed. Attention is paid to 2017 guidelines of the American diabetes Association for obesity management in terms of diabetes prevention, as well as medications that can be used for weight loss in metabolic syndrome. The new criteria for screening for diabetes type 2 are described, the main results of recent studies on cardiovascular safety of glucose-lowering drugs are presented.

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Exenatide once weekly plus dapagliflozin once daily versus exenatide or dapagliflozin alone in patients with type 2 diabetes inadequately controlled with metformin monotherapy (DURATION-8): a 28 week, multicentre, double-blind, phase 3, randomised controlled trial

Cited by 334 publications

References 30 publications

A crossover study of the combination therapy of metformin and exenatide or biphasic insulin aspart 30 in overweight or obese patients newly diagnosed with type 2 diabetes mellitus

A crossover study of the combination therapy of metformin and exenatide or biphasic insulin aspart 30 in overweight or obese patients newly diagnosed with type 2 diabetes mellitus

Enfoque terapéutico de la diabetes mellitus tipo 2 en adultos. Más allá de una meta glucémica

Modern aspects of the treatment and prevention of diabetes type 2 in patients with metabolic syndrome

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