Newer drug treatments for type 2 diabetes

Guo, Jingchuan; Smith, Steven M.

doi:10.1136/bmj.n1171

Cited by 5 publications

(1 citation statement)

References 14 publications

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“…Pharmacotherapy for managing T2DM may involve a combination of medications to achieve optimal glycaemic control. Over the years, increasing prevalence of patients with diabetes worldwide have encouraged the development of new pharmaceutical drugs and expanded the therapeutic treatment options 5 , 6 . Formulating an individualized treatment plan is increasingly challenging due to heterogeneity in patients’ clinical profiles along with a growing list of new medications to prescribe.…”

Section: Introductionmentioning

confidence: 99%

Diabetes medication recommendation system using patient similarity analytics

Tan

Gao

Oei

et al. 2022

Sci Rep

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Type-2 diabetes mellitus (T2DM) is a medical condition in which oral medications avail to patients to curb their hyperglycaemia after failed dietary therapy. However, individual responses to the prescribed pharmacotherapy may differ due to their clinical profiles, comorbidities, lifestyles and medical adherence. One approach is to identify similar patients within the same community to predict their likely response to the prescribed diabetes medications. This study aims to present an evidence-based diabetes medication recommendation system (DMRS) underpinned by patient similarity analytics. The DMRS was developed using 10-year electronic health records of 54,933 adult patients with T2DM from six primary care clinics in Singapore. Multiple clinical variables including patient demographics, comorbidities, laboratory test results, existing medications, and trajectory patterns of haemoglobin A1c (HbA1c) were used to identify similar patients. The DMRS was evaluated on four groups of patients with comorbidities such as hyperlipidaemia (HLD) and hypertension (HTN). Recommendations were assessed using hit ratio which represents the percentage of patients with at least one recommended sets of medication matches exactly the diabetes prescriptions in both the type and dosage. Recall, precision, and mean reciprocal ranking of the recommendation against the diabetes prescriptions in the EHR records were also computed. Evaluation against the EHR prescriptions revealed that the DMRS recommendations can achieve hit ratio of 81% for diabetes patients with no comorbidity, 84% for those with HLD, 78% for those with HTN, and 75% for those with both HLD and HTN. By considering patients’ clinical profiles and their trajectory patterns of HbA1c, the DMRS can provide an individualized recommendation that resembles the actual prescribed medication and dosage. Such a system is useful as a shared decision-making tool to assist clinicians in selecting the appropriate medications for patients with T2DM.

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Section: Introductionmentioning

confidence: 99%

Diabetes medication recommendation system using patient similarity analytics

Tan

Gao

Oei

et al. 2022

Sci Rep

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High resorption rates following glenoid augmentation procedures do not seem to lead to higher recurrence rates or worse clinical outcomes: a systematic review and meta-analysis

Rutgers

Verweij

Schuit

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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PurposeBone augmentation techniques show a relatively high complication rate, which might be due to graft non‐union and resorption. It is unclear which augmentation techniques demonstrate the highest amount of non‐union and resorption and whether this leads to worse clinical or functional outcomes. Therefore, the aim of this review was (i) to compare non‐union and resorption rates between surgical approaches, procedures, graft types, donor sites and fixation methods regarding clinical and functional outcomes and (ii) determine whether high non‐union or resorption rates lead to less favorable clinical or functional outcomes. MethodsThe Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statements were followed. PubMed, EMBASE (Ovid) and Cochrane Library were searched on December 15th 2021 for studies examining bone graft non‐union or resorption using radiograph or CT following glenoid augmentation to treat anterior shoulder dislocation. ResultsThe search resulted in 103 inclusions, comprising 5,128 glenoid augmentations. When comparing pooled proportions of bony union, graft fracture rate, hardware failure rate, recurrence rate, return to sports and Rowe score, most results were similar between approaches, procedures, graft types, donor sites and fixation methods. High resorption rates were seen for allograft augmentation (74.3; 95% CI: 39.8–92.7) compared to autograft augmentation (15.5; 95% CI 10.1–23.2), but this was not associated with higher recurrence rates or worse clinical outcomes. Meta‐analyses (8 studies; 494 patients) demonstrated no difference in incomplete and complete non‐union rates between arthroscopic and open procedures; however, both analyses showed substantial heterogeneity. Higher partial resorption rates were observed on CT (48.0; 95% CI 43.3–52.7) compared to radiograph (14.1; 95% CI 10.9–18.1). Three studies comprising 267 shoulders demonstrated a higher rate of non‐union and recurrence in smokers, whereas one study comprising 38 shoulders did not. ConclusionNon‐union and resorption rates were similar among procedures, grafts and fixation methods. Higher resorption rates were observed in allografts, but this was not associated with higher recurrence rates or worse clinical outcomes. Pooling data demonstrated substantial heterogeneity and definitions varied among studies, warranting more standardized measuring. Level of evidenceIV.

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Transport, Stability, and In Vivo Hypoglycemic Effect of a Broccoli-Derived DPP-IV Inhibitory Peptide VPLVM

Pei

Pan

et al. 2022

J. Agric. Food Chem.

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Diabetes is a major metabolic disease that requires long-term pharmacotherapy. Bioactive peptides have unique advantages such as higher potency, selectivity, and safety over small molecules and have achieved great success in the treatment of diabetes. We previously isolated a dipeptidyl peptidase-IV (DPP-IV) inhibitory peptide VPLVM with IC 50 = 99.68 μM from the protein hydrolysates of broccoli stems and leaves. Here, we evaluated the interaction with DPP-IV, transport, stability, and in vivo hypoglycemic effects of VPLVM. VPLVM interacted closely and steadily with DPP-IV at S1 and S2 pockets. VPLVM had a good gastrointestinal enzyme resistance and was transported through the Caco-2 cell monolayer via paracellular diffusion and by the PepT1 with a P app of 6.96 × 10 −7 cm/s. VPLVM has a t 1/2 of 12.56 ± 0.41 min in vitro plasma stability. In the oral glucose tolerance test, VPLVM showed an excellent hypoglycemic effect at 30 min after administration. VPLVM has potential as a candidate for the treatment of hyperglycemia.

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Newer drug treatments for type 2 diabetes

Cited by 5 publications

References 14 publications

Diabetes medication recommendation system using patient similarity analytics

Diabetes medication recommendation system using patient similarity analytics

High resorption rates following glenoid augmentation procedures do not seem to lead to higher recurrence rates or worse clinical outcomes: a systematic review and meta-analysis

Transport, Stability, and In Vivo Hypoglycemic Effect of a Broccoli-Derived DPP-IV Inhibitory Peptide VPLVM

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