Pioglitazone prevents the increase in plasma ketone concentration associated with dapagliflozin in insulin‐treated T2DM patients: Results from the Qatar Study

Abdul‐Ghani, Muhammad; Migahid, Osama; Megahed, Ayman; Singh, Rajvir; Fawaz, Mohammad; DeFronzo, Ralph A.; Jayyousi, Amin

doi:10.1111/dom.13546

Cited by 5 publications

(11 citation statements)

References 18 publications

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“…A study conducted by Muhammad Abdul-Ghani et al shows dapagliflozin caused a four-fold increase in fasting plasma ketone concentration, while the combination of pioglitazone plus dapagliflozin was not associated with a significant increase (0.13 vs. 0.15 mM) in plasma ketone concentration or in risk of hypoglycemia. These results demonstrate that the addition of pioglitazone to dapagliflozin prevents the increase in plasma ketone concentration associated with SGLT2 therapy [35].…”

Section: Ketoacidosismentioning

confidence: 61%

“…The daily insulin dose is often reduced at the time of initiating sodium-glucose cotransporter-2 (SGLT2) therapy in insulin-treated patients to avoid hypoglycemia. However, reduction of insulin dose can increase the risk of ketoacidosis [35].…”

Section: Ketoacidosismentioning

confidence: 99%

“…Recent research has delved into the distinct mechanisms through which these drugs may confer beneficial effects in ketoacidosis scenarios. Pioglitazone, for example, has been investigated for its capacity to enhance insulin sensitivity and alleviate insulin resistance, thereby contributing to improved glucose utilization [35]. This effect is mediated through the activation of PPAR-γ, a pivotal transcription factor in glucose and lipid metabolism.…”

Section: Ketoacidosismentioning

confidence: 99%

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Lobeglitazone and Its Therapeutic Benefits: A Review

2023

Cureus

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Lobeglitazone is a newer oral hypoglycemic agent that has been tested in type 2 diabetes mellitus (T2DM). We aim to conduct a narrative review to find out the therapeutic benefits of lobeglitazone in patients with T2DM. We scientifically searched the electronic database of PubMed from inception until September 12, 2023, using Medical Subject Heading (MeSH) keywords. Additionally, we searched for pre-clinical trials related to lobeglitazone. We retrieved all available results of phase 1 to phase 3 studies of lobeglitazone in T2DM. Subsequently, we reviewed the results narratively. Three double-blind, randomized, placebocontrolled studies and a phase 3 trial of lobeglitazone showed that 0.5 mg daily dose exhibits effective therapeutic activity in glycemic, lipid, and hepatic control, and is also used as a secondary treatment in nonalcoholic fatty liver disease. Lobeglitazone exhibits as much antidiabetic activity as other thiazolidinediones such as pioglitazone and rosiglitazone. Side effects of lobeglitazone included peripheral edema, weight gain, and bone mineral density, which did not require hospitalization for these effects. This article highlights the pharmacological, pre-clinical, clinical, and safety pharmacology of novel thiazolidinedione lobeglitazone.

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Section: Ketoacidosismentioning

confidence: 61%

Section: Ketoacidosismentioning

confidence: 99%

Section: Ketoacidosismentioning

confidence: 99%

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Lobeglitazone and Its Therapeutic Benefits: A Review

2023

Cureus

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“…The design of the Qatar study has been published [10][11][12] and is described in detail in the supporting information. Briefly, poorly controlled (HbA1c > 7.5%), otherwise healthy subjects with T2D who were treated with maximal/near maximal doses of metformin plus sulphonylurea were sequentially recruited into the study.…”

Section: Methodsmentioning

confidence: 99%

Combination therapy with pioglitazone/exenatide improves beta‐cell function and produces superior glycaemic control compared with basal/bolus insulin in poorly controlled type 2 diabetes: A 3‐year follow‐up of the Qatar study

Abdul‐Ghani

Migahid

Megahed

et al. 2020

Diabetes Obesity Metabolism

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Aim: To examine the long-term efficacy of thiazolidinedione plus a glucagon-like peptide-1 receptor agonist versus basal-bolus insulin on glycaemic control and beta-cell function in patients with poorly controlled type 2 diabetes (T2D) on metformin plus sulphonylurea. Materials and Methods: Three hundred and thirty-one patients with poorly controlled T2D were recruited over 3 years and were followed for an additional year. Subjects received a 75 g oral glucose tolerance test (OGTT) at baseline and at study end. After completing the baseline OGTT, subjects were randomized to receive either pioglitazone plus weekly exenatide (combination therapy) or basal/bolus insulin (insulin therapy) to maintain an HbA1c of less than 7.0%. The primary outcome of the study was the difference in HbA1c at study end between the two treatment groups. Results: Both therapies caused a robust decrease in HbA1c. However, combination therapy caused a greater decrement (−1.1%, P < .0001) than insulin therapy, and more subjects in the combination therapy group (86%) achieved the American Diabetes Association goal of glycaemic control (HbA1c < 7.0%) than those in the insulin therapy group (44%) (P < .0001). Both therapies improved insulin secretion. However, the improvement in insulin secretion with combination therapy was 2.5-fold greater (P < .001) than with insulin therapy (50%). Insulin therapy caused more weight gain and hypoglycaemia. Conclusion: Both combination therapy and insulin therapy effectively reduced HbA1c in poorly controlled T2D on multiple oral agents. However, combination therapy produced a greater improvement in insulin secretion and decrease in HbA1c with a lower risk of hypoglycaemia.

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“…Pioglitazona podría ser de especial utilidad en pacientes con esteatosis hepática no alcohólica, con interesante asociación con iSGLT-2 ya que permite una fuerte disminución de la HbA1c (-1,4 %) con una importante reducción en la dosis diaria de insulina, sin incremento de cetonemia ni riesgo de hipoglucemias 19 .…”

Section: Tratamiento Combinado Con Otros Adnisunclassified

Intensificación del tratamiento con insulina. Transición de pautas

Loiola¹,

Carbonell²

2022

diabetpract

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Niveles de glucemia basal adecuados con hemoglobina glucosilada (HbA1c) por encima de los objetivos en personas con diabetes mellitus tipo 2 (DM2) tratadas con insulina basal, indican la necesidad de intensificar el tratamiento con insulina. Existen distintas alternativas para realizar la intensificación del tratamiento tras insulina basal: (1) La insulina basal con arGLP-1 u otros antidiabéticos no insulínicos (ADNIs), de manera que se podrían disminuir las dosis de insulina, mejorando el control glucémico y el riesgo cardiovascular (RCV). (2) Las insulinas premezcladas o en coformulación. (3) La pauta basal plus o basal bolo por medio de insulinas prandiales o de acción corta. Las características para considerar la intensificación del tratamiento tras la insulina basal incluyen las preferencias del paciente, la tolerabilidad, el coste, la seguridad, la eficacia glucémica, el riesgo de hipoglucemia, el potencial de pérdida de peso y la reducción del RCV.

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Pioglitazone prevents the increase in plasma ketone concentration associated with dapagliflozin in insulin‐treated T2DM patients: Results from the Qatar Study

Cited by 5 publications

References 18 publications

Lobeglitazone and Its Therapeutic Benefits: A Review

Lobeglitazone and Its Therapeutic Benefits: A Review

Combination therapy with pioglitazone/exenatide improves beta‐cell function and produces superior glycaemic control compared with basal/bolus insulin in poorly controlled type 2 diabetes: A 3‐year follow‐up of the Qatar study

Intensificación del tratamiento con insulina. Transición de pautas

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