1
|
Fatimawali, Tallei TE, Kepel BJ, Bodhi W, Manampiring AE, Nainu F. Molecular Insight into the Pharmacological Potential of Clerodendrum minahassae Leaf Extract for Type-2 Diabetes Management Using the Network Pharmacology Approach. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1899. [PMID: 38003949 PMCID: PMC10673377 DOI: 10.3390/medicina59111899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/18/2023] [Accepted: 10/23/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: The increasing occurrence and prevalence of type-2 diabetes mellitus (T2DM) have led to a growing interest in researching available treatment alternatives. Clerodendrum minahassae, a native plant species of North Sulawesi, has been a focus of ethnopharmacological studies due to its significance contributions to drug development, particularly its potential antidiabetic properties. This study investigated the pharmacological potential of Clerodendrum minahassae (CM) leaf extract for managing type-2 diabetes (T2DM) using a network pharmacology approach. Materials and Methods: Active compounds were extracted from CM leaves, and their interactions with target proteins in T2DM were explored through various in silico analyses. Results: SAR analysis using Way2Drug Pass Online identified 29 bioactive CM leaf extract compounds with promise as T2DM treatments. Additionally, 26 of these met Ro5 criteria for favorable drug-likeness. Most compounds exhibited positive pharmacodynamic and pharmacokinetic profiles, with 22 considered safe, while 7 posed potential toxicity risks when ingested individually. CM leaf extract targeted 60 T2DM-related proteins, potentially affecting T2DM via cytokine regulation, particularly in proteins linked to metabolic processes, cellular response to angiotensin, and the sphingosine-1-phosphate signaling pathway. The network pharmacology analysis identified five genes targeted by CM leaf extract, namely, STAT3, MAPK1, ESR1, PIK3R1, and NFKB1. Among these genes, PIK3R1's interaction with the insulin receptor (INSR) positions it as a crucial candidate gene due to its pivotal role in insulin signal transduction during T2DM development. Conclusions: This research sheds light on the therapeutic potential of CM leaf extract for treating T2DM. This potential is attributed to the diverse array of bioactive compounds present in the extract, which have the capacity to interact with and inhibit proteins participating in the insulin signal transduction pathway crucial for the progression of T2DM. The findings of this study may open up possibilities for future applications of CM leaf extract in the development of novel T2DM treatments.
Collapse
Affiliation(s)
- Fatimawali
- Department of Pharmacy, Faculty of Mathematics and Natural Sciences, Sam Ratulangi University, Manado 95115, North Sulawesi, Indonesia
| | - Trina Ekawati Tallei
- Department of Biology, Faculty of Mathematics and Natural Sciences, Sam Ratulangi University, Manado 95115, North Sulawesi, Indonesia
- Department of Biology, Faculty of Medicine, Sam Ratulangi University, Manado 95115, North Sulawesi, Indonesia
| | - Billy Johnson Kepel
- Department of Chemistry, Faculty of Medicine, Sam Ratulangi University, Manado 95115, North Sulawesi, Indonesia; (B.J.K.); (W.B.); (A.E.M.)
| | - Widdhi Bodhi
- Department of Chemistry, Faculty of Medicine, Sam Ratulangi University, Manado 95115, North Sulawesi, Indonesia; (B.J.K.); (W.B.); (A.E.M.)
| | - Aaltje Ellen Manampiring
- Department of Chemistry, Faculty of Medicine, Sam Ratulangi University, Manado 95115, North Sulawesi, Indonesia; (B.J.K.); (W.B.); (A.E.M.)
| | - Firzan Nainu
- Department of Pharmacy, Faculty of Pharmacy, Hasanuddin University, Makassar 90245, South Sulawesi, Indonesia;
| |
Collapse
|
2
|
Jifar WW, BaHammam AS, Bayane YB, Moges BT, Bekana T. In Vivo Hypolipidemic, Hypoglycemic, Antihyperglycemic, and In Vitro Antioxidant Effects of Podocarpus gracilis Leaf Extract and Fractions in Diabetic Mice. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2023; 2023:9187837. [PMID: 37842332 PMCID: PMC10575746 DOI: 10.1155/2023/9187837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/23/2023] [Accepted: 09/27/2023] [Indexed: 10/17/2023]
Abstract
Background Podocarpus gracilis is an evergreen, dioecious tree found in Ethiopia and other African nations. It can reach a height of 60 meters. Without any scientific validation, ethnobotanical studies conducted in Ethiopia revealed that the Podocarpus gracilis plant's leaf is consumed orally to treat diabetes mellitus. Hence, this study aims to evaluate the in vivo blood glucose level lowering, lipid-lowering, and in vitro-free radical scavenging responses of Podocarpus gracilis leaf extract and fractions on experimental mice induced with diabetes. Methods The in vitro antioxidant activity of PGC (Podocarpus gracilis) leaf extract was assessed by using a diphenyl-2-picrylhydrazyl (DPPH) assay. The oral glucose-loaded, normoglycemic, and streptozotocin- (STZ-) induced diabetic mouse models were employed. In the STZ-induced mice model, the leaf extract and solvent fractions activity on serum lipid and weight were also measured. The extract and fractions were tested at 100, 200, and 400 mg/kg dosages. One-way ANOVA was used to determine the statistical significance of BGL (blood glucose level) changes within and between groups, and Tukey's post hoc multiple comparisons were then performed. Results In the acute toxicity study of Podocarpus gracilis leaf extract and fractions, there was no evidence of animal mortality at the maximum dose of 2 g/kg during the observation period. The extract-treated group with normoglycemia revealed a significant lowering in BGL at the 4-hour mark of 27.4% (p < 0.001) and 25.2% (p < 0.01) at doses of 200 mg/kg and 400 mg/kg, respectively, compared to that in negative control. In the oral glucose tolerance test (OGTT) model, only 400 mg/kg treated groups at 120 min after exposure showed a BGL reduction of 31.17% which was statistically significant (p < 0.05) in comparison to the negative control. In the single-dose STZ-induced model, eighth-hour BGL measurements from CE 100, CE 200, CE 400, and GLC5 showed drops in BGL of 43.1%, 44.1%, 45%, and 47.3% from baseline fasting BGL values. In the repeated streptozotocin (STZ)-induced model, at all doses of leaf extract and fractions, the fasting BGL was significantly (p < 0.001) reduced. Moreover, the leaf extract and solvent fractions have shown a significant (p < 0.001) reduction of serum lipids such as LDL, TC, and VLDL, and at the same time, it increases HDL at 14 days with body weight gained. In the test for antioxidant activity, the half-maximal inhibitory concentrations (IC50) for leaf extract and the standard medication (ascorbic acid) were 8.2 μg/ml and 3.3 μg/ml, respectively. The IC50 value denotes the concentration of the sample required to scavenge 50% DPPH radicals. Conclusion The 80% hydromethanolic leaf extract and fractions of Podocarpus gracilis exhibited blood glucose lowering, lipid-lowering activity in normoglycemic, oral glucose tolerance test (OGTT) mode, and STZ-induced diabetic mice with weight gains. There is scientific support for the alleged traditional use as an antidiabetic, lipid-lowering, and antioxidant activity. The results need to be confirmed by future studies.
Collapse
Affiliation(s)
- Wakuma Wakene Jifar
- Department of Pharmacy, College of Health Sciences, Mattu University, Mettu, Ethiopia
| | - Ahmed S. BaHammam
- University Sleep Disorders Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Strategic Technologies Program of the National Plan for Science and Technology and Innovation in the Kingdom of Saudi Arabia, Riyadh, Saudi Arabia
| | - Yadeta Babu Bayane
- Department of Pharmacy, College of Health Sciences, Mattu University, Mettu, Ethiopia
| | - Biruk Tafese Moges
- Department of Pharmacy, College of Health Sciences, Mattu University, Mettu, Ethiopia
| | - Teshome Bekana
- Department of Medical Laboratory Sciences, College Health Sciences, Mattu University, Mettu, Ethiopia
| |
Collapse
|
3
|
Zhu Y, Li M, Wang H, Yang F, Pang X, Du R, Zhang J, Huang X. Genetically proxied antidiabetic drugs targets and stroke risk. J Transl Med 2023; 21:681. [PMID: 37777789 PMCID: PMC10544120 DOI: 10.1186/s12967-023-04565-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/22/2023] [Indexed: 10/02/2023] Open
Abstract
BACKGROUND Previous studies have assessed the association between antidiabetic drugs and stroke risk, but the results are inconsistent. Mendelian randomization (MR) was used to assess effects of antidiabetic drugs on stroke risk. METHODS We selected blood glucose-lowering variants in genes encoding antidiabetic drugs targets from genome-wide association studies (GWAS). A two-sample MR and Colocalization analyses were applied to examine associations between antidiabetic drugs and the risk of stroke. For antidiabetic agents that had effect on stroke risk, an independent blood glucose GWAS summary data was used for further verification. RESULTS Genetic proxies for sulfonylureas targets were associated with reduced risk of any stroke (OR=0.062, 95% CI 0.013-0.295, P=4.65×10-4) and any ischemic stroke (OR=0.055, 95% CI 0.010-0.289, P=6.25×10-4), but not with intracranial hemorrhage. Colocalization supported shared casual variants for blood glucose with any stroke and any ischemic stroke within the encoding genes for sulfonylureas targets (KCNJ11 and ABCC8) (posterior probability>0.7). Furthermore, genetic variants in the targets of insulin/insulin analogues, glucagon-like peptide-1 analogues, thiazolidinediones, and metformin were not associated with the risk of any stroke, any ischemic stroke and intracranial hemorrhage. The association was consistent in the analysis of sulfonylureas with stroke risk using an independent blood glucose GWAS summary data. CONCLUSIONS Our findings showed that genetic proxies for sulfonylureas targets by lowering blood glucose were associated with a lower risk of any stroke and any ischemic stroke. The study might be of great significance to guide the selection of glucose-lowering drugs in individuals at high risk of stroke.
Collapse
Affiliation(s)
- Yahui Zhu
- Medical School of Chinese PLA, Beijing, China
- Department of Neurology, The First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Mao Li
- Department of Neurology, The First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Hongfen Wang
- Department of Neurology, The First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Fei Yang
- Department of Neurology, The First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Xinyuan Pang
- Department of Neurology, The First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China
- College of Medicine, Nankai University, Tianjin, China
| | - Rongrong Du
- Department of Neurology, The First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China
- College of Medicine, Nankai University, Tianjin, China
| | - Jinghong Zhang
- Medical School of Chinese PLA, Beijing, China
- Department of Neurology, The First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Xusheng Huang
- Medical School of Chinese PLA, Beijing, China.
- Department of Neurology, The First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China.
| |
Collapse
|
4
|
Guarnotta V, Emanuele F, Salzillo R, Bonsangue M, Amato C, Mineo MI, Giordano C. Practical therapeutic approach in the management of diabetes mellitus secondary to Cushing's syndrome, acromegaly and neuroendocrine tumours. Front Endocrinol (Lausanne) 2023; 14:1248985. [PMID: 37842314 PMCID: PMC10569460 DOI: 10.3389/fendo.2023.1248985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 08/28/2023] [Indexed: 10/17/2023] Open
Abstract
Cushing's syndrome, acromegaly and neuroendocrine disorders are characterized by an excess of counterregulatory hormones, able to induce insulin resistance and glucose metabolism disorders at variable degrees and requiring immediate treatment, until patients are ready to undergo surgery. This review focuses on the management of diabetes mellitus in endocrine disorders related to an excess of counterregulatory hormones. Currently, the landscape of approved agents for treatment of diabetes is dynamic and is mainly patient-centred and not glycaemia-centred. In addition, personalized medicine is more and more required to provide a precise approach to the patient's disease. For this reason, we aimed to define a practical therapeutic algorithm for management of diabetes mellitus in patients with glucagonoma, pheochromocytoma, Cushing's syndrome and acromegaly, based on our practical experience and on the physiopathology of the specific endocrine disease taken into account. This document is addressed to all specialists who approach patients with diabetes mellitus secondary to endocrine disorders characterized by an excess of counterregulatory hormones, in order to take better care of these patients. Care and control of diabetes mellitus should be one of the primary goals in patients with an excess of counterregulatory hormones requiring immediate and aggressive treatment.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Carla Giordano
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Section of Endocrinology, University of Palermo, Piazza delle Cliniche 2, Palermo, Italy
| |
Collapse
|
5
|
Van Cauwenberghe J, De Block C, Vanderschueren D, Antonio L. Effects of treatment for diabetes mellitus on testosterone concentrations: A systematic review. Andrology 2023; 11:225-233. [PMID: 36251281 DOI: 10.1111/andr.13318] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 10/03/2022] [Accepted: 10/06/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Low testosterone levels are frequently present in men with obesity and insulin resistance. Currently available treatment options (testosterone replacement therapy or lifestyle changes) hold possible risks or are insufficient. Since low testosterone levels are closely related to obesity and type 2 diabetes, treatment modalities for these conditions could result into improvement of testosterone levels. OBJECTIVES To summarize the available evidence on the effects of traditional and recent treatment modalities for diabetes mellitus on testosterone levels and androgen-deficiency-related signs and symptoms. MATERIALS AND METHODS PubMed was searched from the year 2000 till present using MESH terms: "hypogonadism," "testosterone," "testosterone deficiency," "functional hypogonadism," and the different classes of medications. Studies with observational and experimental designs on humans that evaluated the effect of antidiabetic medications on gonadotropins and testosterone were eligible for inclusion. RESULTS Current available data show no or only limited improvement on testosterone levels with the classic antidiabetic drugs. Studies with GLP1-receptor analogues show beneficial effects on both body weight and testosterone levels in men with low testosterone levels and obesity with or without type 2 diabetes. However, data are limited to small and heterogeneous study groups and only few studies report data about impact on androgen-deficiency-related signs and symptoms. DISCUSSION AND CONCLUSION With the recent advances in the knowledge of the pathophysiological pathways in obesity, there is an enormous progress in the development of medications for obesity and type 2 diabetes. Newer incretin-based agents have a great potential for the treatment of functional hypogonadism due to obesity since they show promising weight reducing results. However, before the use of GLP1-receptor analogues can be suggested to treat functional hypogonadism, further studies are needed.
Collapse
Affiliation(s)
- Jolijn Van Cauwenberghe
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, University of Antwerp, Edegem, Belgium.,University of Antwerp, Faculty of Medicine and Health Sciences, Laboratory of Experimental Medicine and Paediatrics (LEMP), Wilrijk, Belgium
| | - Christophe De Block
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, University of Antwerp, Edegem, Belgium.,University of Antwerp, Faculty of Medicine and Health Sciences, Laboratory of Experimental Medicine and Paediatrics (LEMP), Wilrijk, Belgium
| | - Dirk Vanderschueren
- Department of Endocrinology, University Hospital Leuven, Leuven, Belgium.,Department of Chronic Diseases and Metabolism, KU Leuven, Laboratory of Clinical and Experimental Endocrinology, Leuven, Belgium
| | - Leen Antonio
- Department of Endocrinology, University Hospital Leuven, Leuven, Belgium.,Department of Chronic Diseases and Metabolism, KU Leuven, Laboratory of Clinical and Experimental Endocrinology, Leuven, Belgium
| |
Collapse
|
6
|
Cai H, Chen Q, Duan Y, Zhao Y, Zhang X. Short-term effect of polyethylene glycol loxenatide on weight loss in overweight or obese patients with type 2 diabetes: An open-label, parallel-arm, randomized, metformin-controlled trial. Front Endocrinol (Lausanne) 2023; 14:1106868. [PMID: 36777344 PMCID: PMC9909427 DOI: 10.3389/fendo.2023.1106868] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 01/11/2023] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE Polyethylene glycol loxenatide (PEG-Loxe) is a novel, once-weekly glucagon-like peptide 1 receptor agonist that is approved in doses of 0.1 mg and 0.2 mg for the treatment of type 2 diabetes mellitus (T2DM). However, no clinical trials have been designed to determine the effect of 0.3 mg PEG-Loxe on weight loss in overweight or obese patients with T2DM. This trial aimed to evaluate the short-term effect of 0.3 mg PEG-Loxe, injected subcutaneously once weekly, for weight management in overweight or obese patients with T2DM. METHODS This 16-week, open-label, parallel-arm, randomized, metformin-controlled trial was conducted at Shandong Provincial Hospital in Shandong, China. Patients with T2DM, who were overweight or obese (body mass index ≥ 25.0 kg/m2) and had been treated with lifestyle interventions or a combination with oral antidiabetic drug monotherapy were randomized (2:1) to receive 0.3 mg PEG-Loxe or 1500 mg metformin. The primary endpoint was a change in body weight from baseline to week 16. RESULTS Overall, 156 patients were randomized and exposed to treatment. Weight loss was 7.52 kg (8.37%) with PEG-Loxe and 2.96 kg (3.00%) with metformin, with a between-group difference of 4.55 kg (95% CI, 3.43 to 5.67) (P < 0.001). A significantly higher proportion of patients lost ≥5% (61.5% vs. 25.0%) or 10% (26.9% vs. 5.8%) body weight in the PEG-Loxe group than in the metformin group (P < 0.01). Additionally, PEG-Loxe resulted in marked improvements in several cardiovascular risk factors compared to metformin, including body mass index, waist circumference, visceral fat area, blood pressure, and lipid profile. PEG-Loxe and metformin displayed almost equal potency for glycemic control. The incidence of adverse events was 46.2% (48/104) and 44.2% (23/52) in the PEG-Loxe and metformin groups, respectively. CONCLUSION In overweight or obese patients with T2DM, a once-weekly subcutaneous administration of PEG-Loxe for 16 weeks, in addition to lifestyle interventions or oral antidiabetic drug therapy, resulted in significantly greater weight loss compared to metformin. Additional trials are necessary to establish whether these effects can be maintained in the long term. CLINICAL TRIAL REGISTRATION www.chictr.org.cn, identifier ChiCTR2200057800.
Collapse
Affiliation(s)
- Hongyu Cai
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Qianqian Chen
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Yale Duan
- Department of Medical Affairs, Jiangsu Hansoh Pharmaceutical Group Co., Ltd., Shanghai, China
| | - Yue Zhao
- Department of Medical Affairs, Jiangsu Hansoh Pharmaceutical Group Co., Ltd., Shanghai, China
| | - Xiujuan Zhang
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- *Correspondence: Xiujuan Zhang,
| |
Collapse
|
7
|
Fiorini G, Pellegrini G, Franchi M, Pincelli AI, Rigamonti AE, Corrao G, Sartorio A, Cella SG. Pharmacological Treatment of Type-2-Diabetes and Cardiovascular Comorbidities: Differences between Undocumented Migrants and Natives in Italy. Healthcare (Basel) 2022; 11:healthcare11010004. [PMID: 36611464 PMCID: PMC9818502 DOI: 10.3390/healthcare11010004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/12/2022] [Accepted: 12/17/2022] [Indexed: 12/24/2022] Open
Abstract
Diabetes prevalence is growing worldwide, especially in some populations. Though migrations seem to contribute to the presence in host countries of a significant number of patients with diabetes and its comorbidities, very little is known about the health conditions of undocumented migrants. We retrospectively studied 838 patients with type 2 diabetes mellitus (T2DM), 425 Italians followed by the diabetes clinic of a university hospital, and 413 undocumented migrants receiving assistance from a non-governmental organization. We analyzed their demographic and clinical data together with the medications they were on. The prevalence of the use of specific classes of drugs was compared between undocumented migrants and Italians by fitting a Poisson regression model, and the results were reported as prevalence rate ratios (PRRs) with a 95% confidence interval. Undocumented migrants with T2DM received fewer medications for cardiovascular (CV) conditions (PRR: 0.68, 0.60 to 0.76) than Italians, after correcting for confounding factors. Only sulfonylureas were more frequently used in undocumented migrants. The causes of these differences are not completely clear, but social, cultural, and economic factors can have an important role. More efforts are needed to provide appropriate treatment of diabetes and its CV comorbidities to undocumented migrants.
Collapse
Affiliation(s)
| | - Giacomo Pellegrini
- National Centre for Healthcare Research and Pharmacoepidemiology, 20126 Milan, Italy
| | - Matteo Franchi
- National Centre for Healthcare Research and Pharmacoepidemiology, 20126 Milan, Italy
- Laboratory of Healthcare Research and Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano Bicocca, 20126 Milan, Italy
| | | | - Antonello Emilio Rigamonti
- Laboratory of Clinical Pharmacology and Pharmacoepidemiology, Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Giovanni Corrao
- National Centre for Healthcare Research and Pharmacoepidemiology, 20126 Milan, Italy
- Laboratory of Healthcare Research and Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano Bicocca, 20126 Milan, Italy
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, 28824 Piancavallo-Verbania, Italy
| | - Silvano Gabriele Cella
- National Centre for Healthcare Research and Pharmacoepidemiology, 20126 Milan, Italy
- Laboratory of Clinical Pharmacology and Pharmacoepidemiology, Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Correspondence:
| |
Collapse
|
8
|
Aloysius M, Felekkis KN, Petrou C, Papandreou D, Andreou E. Chitosan Nanogel with Mixed Food Plants and Its Relation to Blood Glucose in Type 2 Diabetes: A Systematic and Meta-Analysis Review of Observational Studies. Nutrients 2022; 14:nu14224710. [PMID: 36432398 PMCID: PMC9694128 DOI: 10.3390/nu14224710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/25/2022] [Accepted: 10/25/2022] [Indexed: 11/09/2022] Open
Abstract
This systematic review with metanalysis evaluated and analyzed the beneficial effects of certain plants food in type 2 diabetes (T2D) when consumed alone or in combination with chitosan. The main objective of the paper was to examine the relation of chitosan nanogel and mixed food plant (MFP) to control T2D. The databases included Medline, Scopus, PubMed, as well as Cochrane available between the month of January 1990 to January 2021. The eligibility criteria for selecting studies were case-controlled studies that included unripe plantain, bitter yam, okra, and chitosan either used-alone or in combination with non-specified food plants (NSFP). Two-fold autonomous critics retrieved the information required and evaluated the risk of bias of involved studies. Random-effect meta-analyses on blood glucose controls, were performed. Results of 18 studies included: seven that examined unripe plantains, one bitter yam, two okras, and eight chitosan, found regarding the decrease in blood glucose level. Meta-analysis of the results found a large proportion of I2 values for all studies (98%), meaning heterogeneity. As a consequence, the combined effect sizes were not useful. Instead, prediction interval (PI) was used (mean difference 4.4 mg/dL, 95% PI -6.65 to 15.50 and mean difference 3.4 mg/dL, 95% PI -23.65 to 30.50) rather than the estimate of its confidence interval (CI). These studies were at 50% high risk of bias and 50% low risk of bias and there was judged to be an unclear risk of bias due to the insufficient information from the included study protocol (moderately low). The intervention lasted between three and 84 days, indicating potency and effectiveness of the intervention at both short and long durations. Due to the moderately low quality of the studies, the findings were cautiously interpreted. In conclusion, the current evidence available from the study does support the relation of chitosan with mixed unripe plantain, bitter yam and okra for the management of T2D. Further high-quality case-controlled animal studies are required to substantiate if indeed chitosan nanogel should be cross-linked with the specified food plant (SFP) for the management T2D.
Collapse
Affiliation(s)
- Morris Aloysius
- Department of Life and Health Sciences, University of Nicosia, 46 Makedonitissas Ave., CY-2417, P.O. Box 24005, Nicosia CY-1700, Cyprus
| | - Kyriacos N. Felekkis
- Department of Life and Health Sciences, University of Nicosia, 46 Makedonitissas Ave., CY-2417, P.O. Box 24005, Nicosia CY-1700, Cyprus
| | - Christos Petrou
- Department of Life and Health Sciences, University of Nicosia, 46 Makedonitissas Ave., CY-2417, P.O. Box 24005, Nicosia CY-1700, Cyprus
| | - Dimitrios Papandreou
- Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Khalifa B City, Abu Dhabi 144534, United Arab Emirates
| | - Eleni Andreou
- Department of Life and Health Sciences, University of Nicosia, 46 Makedonitissas Ave., CY-2417, P.O. Box 24005, Nicosia CY-1700, Cyprus
- Correspondence: ; Tel.: +357-9946-4040 or +357-2284-1740
| |
Collapse
|
9
|
Tomlinson B, Li YH, Chan P. Evaluating gliclazide for the treatment of type 2 diabetes mellitus. Expert Opin Pharmacother 2022; 23:1869-1877. [DOI: 10.1080/14656566.2022.2141108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Brian Tomlinson
- Faculty of Medicine, Macau University of Science and Technology, Macau 999078, China
| | - Yan-hong Li
- The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Paul Chan
- Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei City, Taiwan
| |
Collapse
|
10
|
Blonde L, Umpierrez GE, Reddy SS, McGill JB, Berga SL, Bush M, Chandrasekaran S, DeFronzo RA, Einhorn D, Galindo RJ, Gardner TW, Garg R, Garvey WT, Hirsch IB, Hurley DL, Izuora K, Kosiborod M, Olson D, Patel SB, Pop-Busui R, Sadhu AR, Samson SL, Stec C, Tamborlane WV, Tuttle KR, Twining C, Vella A, Vellanki P, Weber SL. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. Endocr Pract 2022; 28:923-1049. [PMID: 35963508 PMCID: PMC10200071 DOI: 10.1016/j.eprac.2022.08.002] [Citation(s) in RCA: 136] [Impact Index Per Article: 68.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The objective of this clinical practice guideline is to provide updated and new evidence-based recommendations for the comprehensive care of persons with diabetes mellitus to clinicians, diabetes-care teams, other health care professionals and stakeholders, and individuals with diabetes and their caregivers. METHODS The American Association of Clinical Endocrinology selected a task force of medical experts and staff who updated and assessed clinical questions and recommendations from the prior 2015 version of this guideline and conducted literature searches for relevant scientific papers published from January 1, 2015, through May 15, 2022. Selected studies from results of literature searches composed the evidence base to update 2015 recommendations as well as to develop new recommendations based on review of clinical evidence, current practice, expertise, and consensus, according to established American Association of Clinical Endocrinology protocol for guideline development. RESULTS This guideline includes 170 updated and new evidence-based clinical practice recommendations for the comprehensive care of persons with diabetes. Recommendations are divided into four sections: (1) screening, diagnosis, glycemic targets, and glycemic monitoring; (2) comorbidities and complications, including obesity and management with lifestyle, nutrition, and bariatric surgery, hypertension, dyslipidemia, retinopathy, neuropathy, diabetic kidney disease, and cardiovascular disease; (3) management of prediabetes, type 2 diabetes with antihyperglycemic pharmacotherapy and glycemic targets, type 1 diabetes with insulin therapy, hypoglycemia, hospitalized persons, and women with diabetes in pregnancy; (4) education and new topics regarding diabetes and infertility, nutritional supplements, secondary diabetes, social determinants of health, and virtual care, as well as updated recommendations on cancer risk, nonpharmacologic components of pediatric care plans, depression, education and team approach, occupational risk, role of sleep medicine, and vaccinations in persons with diabetes. CONCLUSIONS This updated clinical practice guideline provides evidence-based recommendations to assist with person-centered, team-based clinical decision-making to improve the care of persons with diabetes mellitus.
Collapse
Affiliation(s)
| | | | - S Sethu Reddy
- Central Michigan University, Mount Pleasant, Michigan
| | | | | | | | | | | | - Daniel Einhorn
- Scripps Whittier Diabetes Institute, La Jolla, California
| | | | | | - Rajesh Garg
- Lundquist Institute/Harbor-UCLA Medical Center, Torrance, California
| | | | | | | | | | | | - Darin Olson
- Colorado Mountain Medical, LLC, Avon, Colorado
| | | | | | - Archana R Sadhu
- Houston Methodist; Weill Cornell Medicine; Texas A&M College of Medicine; Houston, Texas
| | | | - Carla Stec
- American Association of Clinical Endocrinology, Jacksonville, Florida
| | | | - Katherine R Tuttle
- University of Washington and Providence Health Care, Seattle and Spokane, Washington
| | | | | | | | - Sandra L Weber
- University of South Carolina School of Medicine-Greenville, Prisma Health System, Greenville, South Carolina
| |
Collapse
|
11
|
Enhancing the Biological Activities of Food Protein-Derived Peptides Using Non-Thermal Technologies: A Review. Foods 2022; 11:foods11131823. [PMID: 35804638 PMCID: PMC9265340 DOI: 10.3390/foods11131823] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/14/2022] [Accepted: 06/20/2022] [Indexed: 02/05/2023] Open
Abstract
Bioactive peptides (BPs) derived from animal and plant proteins are important food functional ingredients with many promising health-promoting properties. In the food industry, enzymatic hydrolysis is the most common technique employed for the liberation of BPs from proteins in which conventional heat treatment is used as pre-treatment to enhance hydrolytic action. In recent years, application of non-thermal food processing technologies such as ultrasound (US), high-pressure processing (HPP), and pulsed electric field (PEF) as pre-treatment methods has gained considerable research attention owing to the enhancement in yield and bioactivity of resulting peptides. This review provides an overview of bioactivities of peptides obtained from animal and plant proteins and an insight into the impact of US, HPP, and PEF as non-thermal treatment prior to enzymolysis on the generation of food-derived BPs and resulting bioactivities. US, HPP, and PEF were reported to improve antioxidant, angiotensin-converting enzyme (ACE)-inhibitory, antimicrobial, and antidiabetic properties of the food-derived BPs. The primary modes of action are due to conformational changes of food proteins caused by US, HPP, and PEF, improving the susceptibility of proteins to protease cleavage and subsequent proteolysis. However, the use of other non-thermal techniques such as cold plasma, radiofrequency electric field, dense phase carbon dioxide, and oscillating magnetic fields has not been examined in the generation of BPs from food proteins.
Collapse
|
12
|
Rathor S, Bhatt DC. Formulation, Characterization, and Pharmacokinetic Evaluation of Novel Glipizide-Phospholipid Nano-complexes with Improved Solubility and Bioavailability. Pharm Nanotechnol 2022; 10:125-136. [PMID: 35346004 DOI: 10.2174/2211738510666220328151512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/01/2022] [Accepted: 02/09/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND The proposed study was aimed to formulate and evaluate the Glipizide-Phospholipid Nano-complex. Since Glipizide is a poorly soluble drug, its complexation with phospholipids is an ideal approach to improving solubility. METHOD To improve the oral potency of Glipizide, its phospholipid complex was prepared by employing the solvent evaporation method. The formulations were characterized using DSC, FT-IR, PXRD, SEM, TEM, and hot stage microscopy (HSM). Solubility tests of the Glipizide-Phospholipid Nano-complex revealed a significant increase in aqueous solubility compared to Glipizide's physical combination. The oral bioavailability of the Glipizide-Phospholipid Nano-complex was measured by using HPLC in Wistar rats' plasma. FTIR and PXRD results revealed no significant interaction between the drug and the phospholipid in the formulation. SEM and TEM studies confirmed the morphology of the formulation assuring the conversion of crystalline form into an amorphous structure. RESULTS The Glipizide-Phospholipid Nano-complex had a greater peak plasma concentration (5.2 vs 3.8 g/mL), a larger AUC (26.31 vs 19.55 μgh/L), and a longer T1/2 (2.1 vs 4.1 h) than free Glipizide, indicating that it improved drug dissolution rate. CONCLUSION The outcomes suggested that a phospholipid complexation is a potential approach to increasing water-insoluble drugs' oral bioavailability.n.
Collapse
Affiliation(s)
- Sandeep Rathor
- Department of Pharmaceutical Sciences, Guru Jambheswar University of Sciences & Technology, Hisar, Haryana-125001, India
- Department of Pharmaceutics, ISF College of Pharmacy, Moga, Punjab-142001, India
| | - D C Bhatt
- Department of Pharmaceutical Sciences, Guru Jambheswar University of Sciences & Technology, Hisar, Haryana-125001, India
| |
Collapse
|
13
|
Lee DSU, Lee H. Adherence and persistence rates of major antidiabetic medications: a review. Diabetol Metab Syndr 2022; 14:12. [PMID: 35033161 PMCID: PMC8761325 DOI: 10.1186/s13098-022-00785-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 01/05/2022] [Indexed: 12/15/2022] Open
Abstract
The objective of this paper was to review the adherence and persistence rates of major antidiabetic medication classes (i.e., metformin, sulfonylureas, sodium glucose cotransporter-2 inhibitors, dipeptidyl peptidase-4 inhibitors, insulin, glucagon-like peptide-1 receptor agonists, and thiazolidinediones) by summarizing the major findings of the studies published since 2017. In addition, we reported the potential causes for low adherence and persistence of antidiabetic medications. Based on the literature, the highest rate of adherence and persistence was consistently observed in metformin users. Second to metformin were sodium glucose cotransporter-2 inhibitors. Injectable therapies such as insulin and glucagon-like peptide-1 receptor agonists trailed low on the adherence and persistence rates. To the best of our knowledge, no studies published since the year 2017 analyzed the adherence and persistence of thiazolidinediones independently. The most frequently cited cause for low adherence and persistence was the severity of adverse events. Baseline characteristics (e.g., baseline HbA1c level), demographic information (e.g., age, gender, or ethnicity), and comorbidity profiles also had significant impacts on adherence and persistence in patients with type 2 diabetes mellitus.
Collapse
Affiliation(s)
- David Seung U Lee
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, 08826, South Korea
- Center for Convergence Approaches in Drug Development, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, 08826, South Korea
| | - Howard Lee
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, 08826, South Korea.
- Department of Applied Biomedical Engineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, 08826, South Korea.
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, 103 Daehak-ro, Jongno-gu, Seoul, 110-799, Republic of Korea.
- Center for Convergence Approaches in Drug Development, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, 08826, South Korea.
- Advanced Institute of Convergence Technology, Suwon, 16229, South Korea.
| |
Collapse
|
14
|
Shakerian S, Rashidi H, Birgani MT, Saberi A. KCNQ1 rs2237895 polymorphism is associated with the therapeutic response to sulfonylureas in Iranian type 2 diabetes mellitus patients. J Diabetes Metab Disord 2022; 21:33-41. [PMID: 35673481 PMCID: PMC9167421 DOI: 10.1007/s40200-021-00931-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 11/01/2021] [Indexed: 01/13/2023]
Abstract
Background and Aims Sulfonylureas are the most secondary prescribed oral anti-diabetic drug. Understanding its genetic role in pharmacodynamics can elucidate a considerable knowledge about personalized treatment in type 2 diabetes patients. This study aimed to assess the impact of KCNQ1 variants on sulfonylureas response among type 2 diabetes Iranian patients. Methods and Results 100 patients were recruited who were under sulfonylureas therapy for six months. 50 responder and 50 non-responder patients were selected. KCNQ1 variants were determined by the RFLP method, and their role in treatment response was assessed retrospectively. Patients with rs2237895 CC and AC genotypes demonstrated a significant decrement in FBS and HbA1c after treatment over patients with AA genotypes (All P < 0.001). Compared to the A allele, the odds ratio for treatment success between carriers with rs2237895 C allele was 4.22-fold (P < 0.001). Patients with rs2237892 CT heterozygous genotype exhibit a higher reduction rate in HbA1c and FBS than CC homozygotes (P=0.064 and P=0.079, respectively). The rs2237892 T allele carriers showed an odds ratio equals to 2.83-fold over C allele carriers in the responder group compared to the non-responder group (p=0.081). Conclusion Findings suggest that the KCNQ1 rs2237895 polymorphism is associated with the sulfonylureas response on Iranian type 2 diabetes patients.
Collapse
Affiliation(s)
- Siavash Shakerian
- Department of Medical Genetics, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Homeira Rashidi
- Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Imam Khomeini Hospital, Department of diabetes, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Tahmasebi Birgani
- Department of Medical Genetics, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Alihossein Saberi
- Department of Medical Genetics, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| |
Collapse
|
15
|
Chai J, Sun Z, Xu J. A Contemporary Insight of Metabolomics Approach for Type 1 Diabetes: Potential for Novel Diagnostic Targets. Diabetes Metab Syndr Obes 2022; 15:1605-1625. [PMID: 35642181 PMCID: PMC9148614 DOI: 10.2147/dmso.s357007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 04/08/2022] [Indexed: 11/23/2022] Open
Abstract
High-throughput omics has been widely applied in metabolic disease, type 1 diabetes (T1D) was one of the most typical diseases. Effective prevention and early diagnosis are very important because of infancy and persistent characteristics of T1D. The occurrence and development of T1D is a chronic and continuous process, in which the production of autoantibodies (ie serum transformation) occupies the central position. Metabolomics can evaluate the metabolic characteristics of serum before seroconversion, the changes with age and T1D complications. And the addition of natural drug metabolomics is more conducive to the systematic and comprehensive diagnosis and treatment of T1D. This paper reviewed the metabolic changes and main pathogenesis from pre-diagnosis to treatment in T1D. The metabolic spectrum of significant abnormal energy and glucose-related metabolic pathway, down-regulation of lipid metabolism and up-regulation of some antioxidant pathways has appeared before seroconversion, indicating that the body has been in the dual state of disease progression and disease resistance before T1D onset. Some metabolites (such as methionine) are closely related to age, and the types of autoantibodies produced are age-specific. Some metabolites may jointly predict DN with eGFR, and metabolomics can further contribute to the pathogenesis based on the correlation between DN and DR. Many natural drug components have been proved to act on abnormal metabolic pathways of T1D and have a positive impact on some metabolic levels, which is very important for further finding therapeutic targets and developing new drugs with small side effects. Metabolomics can provide auxiliary value for the diagnosis of T1D and provide a new direction to reveal the pathogenesis of T1D and find new therapeutic targets. The development of T1D metabolomics shows that high-throughput research methods are expected to be introduced into clinical practice.
Collapse
Affiliation(s)
- Jiatong Chai
- Department of Laboratory Medicine, The First Hospital of Jilin University, Changchun, People’s Republic of China
| | - Zeyu Sun
- Department of Laboratory Medicine, The First Hospital of Jilin University, Changchun, People’s Republic of China
| | - Jiancheng Xu
- Department of Laboratory Medicine, The First Hospital of Jilin University, Changchun, People’s Republic of China
- Correspondence: Jiancheng Xu, Department of Laboratory Medicine, The First Bethune Hospital of Jilin University, 71 Xinmin Street, Changchun, 130021, People’s Republic of China, Tel +86-431-8878-2595, Fax +86-431-8878-6169, Email
| |
Collapse
|
16
|
Frías JP, Maaske J, Suchower L, Johansson L, Hockings PD, Iqbal N, Wilding JPH. Long-term effects of dapagliflozin plus saxagliptin versus glimepiride on a background of metformin in patients with type 2 diabetes: Results of a 104-week extension to a 52-week randomized, phase 3 study and liver fat MRI substudy. Diabetes Obes Metab 2022; 24:61-71. [PMID: 34514692 PMCID: PMC9293136 DOI: 10.1111/dom.14548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/24/2021] [Accepted: 09/03/2021] [Indexed: 11/30/2022]
Abstract
AIM To report the results of a 104-week extension to a 52-week study in which dapagliflozin plus saxagliptin (DAPA+SAXA) improved glycaemic control, liver fat and metabolic variables compared with glimepiride (GLIM) in participants with type 2 diabetes (T2D) receiving background metformin. MATERIALS AND METHODS This extension to a 52-week global, multicentre, parallel-group, active-controlled, double-blind study (NCT02419612) continued randomized participants (1:1) on DAPA+SAXA (10/5 mg) plus placebo, or GLIM (1-6 mg) plus placebo, once daily. Eligible participants were aged ≥18 years, had T2D (glycated haemoglobin [HbA1c] 58.5-91.3 mmol/mol [7.5%-10.5%]), and a body mass index of 20.0 to 45.0 kg/m2 , and were receiving metformin (MET; ≥1500 mg/d). Key outcomes were: requirement for treatment intensification, based on HbA1c ≥53 mmol/mol (7%); achieving therapeutic glycaemic response; and changes in adipose tissue and liver fat on magnetic resonance imaging in a substudy. RESULTS Overall, 382 participants entered and 338 completed the 104-week extension period (MRI substudy, n = 82). The need for treatment intensification during the 156-week period was lower for DAPA+SAXA+MET (37.0%) than GLIM+MET (55.6%; hazard ratio 0.52, 95% confidence interval [CI] 0.39-0.68; P < 0.001). At week 156, 21.4% of DAPA+SAXA+MET versus 11.7% of GLIM+MET participants achieved therapeutic glycaemic response (HbA1c <53 mmol/mol; odds ratio 2.1, 95% CI 1.23-3.42; P = 0.006). DAPA+SAXA+MET led to greater adjusted mean reductions from baseline in liver fat and visceral and subcutaneous adipose tissue volumes versus GLIM+MET at week 122 (least-squares mean difference from GLIM+MET -4.89%, -0.41 L and -0.44 L, respectively; nominal P values ≤ 0.008). Safety was consistent with that of the monocomponents. CONCLUSIONS Overall, glycaemic control, metabolic benefits and efficacy were better maintained with DAPA+SAXA+MET than with GLIM+MET in T2D.
Collapse
Affiliation(s)
| | | | | | | | - Paul D. Hockings
- Antaros Medical AB, BioVenture HubMölndalSweden
- MedTech WestChalmers University of TechnologyGothenburgSweden
| | | | - John P. H. Wilding
- Obesity and Endocrinology Research Group, Department of Cardiovascular and Metabolic MedicineInstitute of Life Course and Medical Sciences, University of LiverpoolLiverpoolUK
| |
Collapse
|
17
|
Hougen I, Whitlock RH, Komenda P, Rigatto C, Clemens KK, Tangri N. Safety of add-on sulfonylurea therapy in patients with type 2 diabetes using metformin: a population-based real-world study. BMJ Open Diabetes Res Care 2021; 9:9/2/e002352. [PMID: 34969692 PMCID: PMC8718392 DOI: 10.1136/bmjdrc-2021-002352] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 11/26/2021] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Metformin is the initial oral antihyperglycemic agent (OHA) of choice for most patients with type 2 diabetes (T2D). However, more than one agent is often required for optimal glucose control. As the choice of preferred second OHAs is less well defined, we sought to compare the real-world safety of sulfonylureas to other OHAs as add-on therapy to metformin in patients with T2D. RESEARCH DESIGN AND METHODS This retrospective cohort study included adults in Manitoba, Canada with T2D from 2006 to 2017. Using a new-user design, we divided patients who started on metformin into two groups: add-on therapy with a sulfonylurea and add-on therapy with a different OHA. Outcomes included all-cause mortality, cardiovascular events, and major hypoglycemic episodes. We calculated propensity scores and applied inverse probability of treatment weights to each individual. We compared groups using Cox proportional hazards regression and explored differences in HRs between pre-2008 (acarbose, meglitinides, and thiazolidinediones) and post-2008 (dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists, and sodium-glucose linked transporter-2 inhibitors) OHAs. RESULTS Our cohort included 32 576 individuals (28 077 metformin plus sulfonylurea and 4499 metformin plus 'other'). Patients newly prescribed a sulfonylurea in the setting of metformin had a higher risk of all-cause mortality (HR 1.44, 95% CI 1.12 to 1.84, p=0.005) and major hypoglycemic episodes (HR 2.78, 95% CI 1.66 to 4.66, p<0.001) than those prescribed an 'other' OHA. No differences in cardiovascular events were observed (HR 0.99, 95% CI 0.81 to 1.22, p=0.92). In subgroup analyses, mortality and cardiovascular event risk was higher in patients prescribed sulfonylureas versus post-2008 OHAs. CONCLUSIONS Sulfonylureas as add-on therapy to metformin are associated with increased risk of all-cause mortality and major hypoglycemic episodes compared with 'other' OHAs. Post hoc analysis suggests newer OHAs may be preferred to sulfonylureas as second-line therapy for glycemic control.
Collapse
Affiliation(s)
- Ingrid Hougen
- Department of Internal Medicine, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada
| | - Reid H Whitlock
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Manitoba, Canada
| | - Paul Komenda
- Department of Internal Medicine, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Manitoba, Canada
| | - Claudio Rigatto
- Department of Internal Medicine, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Manitoba, Canada
| | - Kristin K Clemens
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - Navdeep Tangri
- Department of Internal Medicine, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Manitoba, Canada
| |
Collapse
|
18
|
Tomlinson B, Patil NG, Fok M, Chan P, Lam CWK. The role of sulfonylureas in the treatment of type 2 diabetes. Expert Opin Pharmacother 2021; 23:387-403. [PMID: 34758676 DOI: 10.1080/14656566.2021.1999413] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Type 2 diabetes (T2D) is increasingly prevalent and associated with increased risk for cardiovascular and renal disease. After lifestyle modification, metformin is usually the first-line pharmacotherapy and sulfonylureas are traditionally added after metformin failure. However, with newer glucose lowering drugs that may have less risk of hypoglycemia or that may reduce cardiovascular and renal events, the position of sulfonylureas is being reevaluated. AREAS COVERED In this article, the authors review relevant publications related to the use of sulfonylureas. EXPERT OPINION Sulfonylureas are potent glucose lowering drugs. The risk of hypoglycemia varies with different drugs within the class and can be minimized by using the safer drugs, possibly in lower doses. Cardiovascular events do not appear to be increased with some of the newer generation drugs. The durability of glycemic control also appears comparable to other newer agents. Sulfonylureas are the preferred treatment for some types of monogenic diabetes and selection of T2D patients who may have greater benefit from sulfonylureas based on certain phenotypes and genotypes is likely to be refined further by precision medicine. Sulfonylureas are inexpensive and readily available everywhere and they are still the most frequently used second-line treatment for T2D in many parts of the world.
Collapse
Affiliation(s)
- Brian Tomlinson
- Faculty of Medicine, Macau University of Science and Technology, Macau, China
| | | | - Manson Fok
- Faculty of Medicine, Macau University of Science and Technology, Macau, China
| | - Paul Chan
- Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei City, Taiwan
| | | |
Collapse
|
19
|
Abe T, Matsubayashi Y, Muragishi S, Yoshida A, Suganami H, Furusawa K, Fujihara K, Tanaka S, Kaku K, Sone H. Dipeptidyl peptidase-4 inhibitor, anagliptin, alters hepatic insulin clearance in relation to the glycemic status in Japanese individuals with type 2 diabetes. J Diabetes Investig 2021; 12:1805-1815. [PMID: 33751849 PMCID: PMC8504901 DOI: 10.1111/jdi.13543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 02/24/2021] [Accepted: 03/04/2021] [Indexed: 12/12/2022] Open
Abstract
AIMS/INTRODUCTION This study investigated the impact of the dipeptidyl peptidase-4 inhibitor, anagliptin, on hepatic insulin clearance (HIC) in Japanese type 2 diabetes patients and explored its relationship to glycemic status. MATERIALS AND METHODS Data on 765 participants in anagliptin phase 2 and 3 studies were analyzed. Adjusted changes in variables during 12 weeks of anagliptin therapy were compared with a placebo. HIC was calculated as the ratio, C-peptide area under the curve 0-120 min to insulin area under the curve 0-120 min, after a meal tolerance test. To explore the effects of baseline HIC levels on variables, participants receiving anagliptin were divided according to quartiles of baseline HIC. Furthermore, multivariate analysis investigated the association between baseline HIC levels and glycemic status. RESULTS Anagliptin significantly reduced glycosylated hemoglobin levels (P < 0.001 vs placebo) and HIC levels (P < 0.01). Longer duration of diabetes, lower body mass index, higher glycosylated hemoglobin and lower insulin secretion capacity were observed with increases in baseline HIC levels. Improvements in glycosylated hemoglobin, glycoalbumin and 1,5-anhydroglucitol levels were greater in the relatively higher HIC group (baseline HIC levels ≥median) than in the lower HIC group ( CONCLUSIONS Anagliptin affected HIC levels according to HIC baseline levels. Higher baseline HIC values might result in improved hyperglycemia through reduced HIC.
Collapse
Affiliation(s)
- Takahiro Abe
- Department of Hematology, Endocrinology and MetabolismNiigata University Faculty of MedicineNiigataJapan
| | - Yasuhiro Matsubayashi
- Department of Hematology, Endocrinology and MetabolismNiigata University Faculty of MedicineNiigataJapan
| | | | - Akihiro Yoshida
- Department of Hematology, Endocrinology and MetabolismNiigata University Faculty of MedicineNiigataJapan
- Kowa Co., Ltd.TokyoJapan
| | | | | | - Kazuya Fujihara
- Department of Hematology, Endocrinology and MetabolismNiigata University Faculty of MedicineNiigataJapan
| | - Shiro Tanaka
- Department of Clinical BiostatisticsGraduate School of Medicine Kyoto UniversityKyotoJapan
| | | | - Hirohito Sone
- Department of Hematology, Endocrinology and MetabolismNiigata University Faculty of MedicineNiigataJapan
| |
Collapse
|
20
|
Al-Saleh Y, Sabico S, Al-Furqani A, Jayyousi A, Alromaihi D, Ba-Essa E, Alawadi F, Alkaabi J, Hassanein M, Al-Sifri S, Saleh S, Alessa T, Al-Daghri NM. Sulfonylureas in the Current Practice of Type 2 Diabetes Management: Are They All the Same? Consensus from the Gulf Cooperation Council (GCC) Countries Advisory Board on Sulfonylureas. Diabetes Ther 2021; 12:2115-2132. [PMID: 33983614 PMCID: PMC8342668 DOI: 10.1007/s13300-021-01059-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/09/2021] [Indexed: 12/22/2022] Open
Abstract
Since their inception in the commercial market in the mid-twentieth century, sulfonylureas (SUs) have remained a therapeutic option in the management of type 2 diabetes (T2D). Despite their established glucose-lowering effects, there is no consensus among global experts and modern guidelines regarding the priority of SUs in relation to other therapeutic options, given the lack of evidence that SUs are associated with a low risk of macrovascular events and excess mortality. However, findings from recent trials and real-time observations have resolved this contentious issue somewhat, albeit to varying degrees. The present consensus discusses the role of SUs in contemporary diabetes management in the Gulf Cooperation Council (GCC) countries. Regional experts from these countries gathered virtually to formulate a consensus following presentations of topics relevant to SU therapy with an emphasis on gliclazide, including long-term efficacy, cost, end-organ benefits, and side effects, based on up-to-date evidence. The present narrative review reflects the conclusions of this assembly and provides a platform upon which future guidelines for the use of SUs in the GCC can be tailored.
Collapse
Affiliation(s)
- Yousef Al-Saleh
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, 22490, Saudi Arabia.
- King Abdullah International Medical Research Center, Riyadh, 11481, Saudi Arabia.
- Department of Medicine, King Abdulaziz Medical City, Riyadh, Ministry of National Guard-Health Affairs, Riyadh, 14611, Saudi Arabia.
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia.
| | - Shaun Sabico
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
| | | | - Amin Jayyousi
- Endocrine and Diabetes Section, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medical College, Doha, Qatar
| | - Dalal Alromaihi
- King Hamad University Hospital, Busaiteen, Bahrain
- Medical University of Bahrain, Busaiteen, Bahrain
- Bahrain Diabetes Society, Manama, Bahrain
| | | | - Fatheya Alawadi
- Endocrine Department, Dubai Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | - Juma Alkaabi
- Department of Internal Medicine, College of Medicine, and Health Sciences, UAE University, Al Ain, United Arab Emirates
| | - Mohamed Hassanein
- Endocrine Department, Dubai Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | | | - Seham Saleh
- Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
| | - Thamer Alessa
- Division of Endocrinology, Diabetes and Metabolism, Jaber Al-Ahmad Hospital, Kuwait City, Kuwait
- Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Nasser M Al-Daghri
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
| |
Collapse
|
21
|
Pergakis M, Badjatia N, Simard JM. An update on the pharmacological management and prevention of cerebral edema: current therapeutic strategies. Expert Opin Pharmacother 2021; 22:1025-1037. [PMID: 33467932 DOI: 10.1080/14656566.2021.1876663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Introduction: Cerebral edema is a common complication of multiple neurological diseases and is a strong predictor of outcome, especially in traumatic brain injury and large hemispheric infarction.Areas Covered: Traditional and current treatments of cerebral edema include treatment with osmotherapy or decompressive craniectomy at the time of clinical deterioration. The authors discuss preclinical and clinical models of a variety of neurological disease states that have identified receptors, ion transporters, and channels involved in the development of cerebral edema as well as modulation of these receptors with promising agents.Expert opinion: Further study is needed on the safety and efficacy of the agents discussed. IV glibenclamide has shown promise in preclinical and clinical trials of cerebral edema in large hemispheric infarct and traumatic brain injury. Consideration of underlying pathophysiology and pharmacodynamics is vital, as the synergistic use of agents has the potential to drastically mitigate cerebral edema and secondary brain injury thusly transforming our treatment paradigms.
Collapse
Affiliation(s)
- Melissa Pergakis
- Program in Trauma Department of Neurology University of Maryland School of Medicine,Baltimore MD USA
| | - Neeraj Badjatia
- Program in Trauma Department of Neurology University of Maryland School of Medicine,Baltimore MD USA
| | - J Marc Simard
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, USA
| |
Collapse
|
22
|
Simos YV, Spyrou K, Patila M, Karouta N, Stamatis H, Gournis D, Dounousi E, Peschos D. Trends of nanotechnology in type 2 diabetes mellitus treatment. Asian J Pharm Sci 2021; 16:62-76. [PMID: 33613730 PMCID: PMC7878460 DOI: 10.1016/j.ajps.2020.05.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 03/25/2020] [Accepted: 05/10/2020] [Indexed: 12/16/2022] Open
Abstract
There are several therapeutic approaches in type 2 diabetes mellitus (T2DM). When diet and exercise fail to control hyperglycemia, patients are forced to start therapy with antidiabetic agents. However, these drugs present several drawbacks that can affect the course of treatment. The major disadvantages of current oral modalities for the treatment of T2DM are mainly depicted in the low bioavailability and the immediate release of the drug, generating the need for an increase in frequency of dosing. In conjugation with the manifestation of adverse side effects, patient compliance to therapy is reduced. Over the past few years nanotechnology has found fertile ground in the development of novel delivery modalities that can potentially enhance anti-diabetic regimes efficacy. All efforts have been targeted towards two main vital steps: (a) to protect the drug by encapsulating it into a nano-carrier system and (b) efficiently release the drug in a gradual as well as controllable manner. However, only a limited number of studies published in the literature used in vivo techniques in order to support findings. Here we discuss the current disadvantages of modern T2DM marketed drugs, and the nanotechnology advances supported by in vivo in mouse/rat models of glucose homeostasis. The generation of drug nanocarriers may increase bioavailability, prolong release and therefore reduce dosing and thus, improve patient compliance. This novel approach might substantially improve quality of life for diabetics. Application of metal nanoformulations as indirect hypoglycemic agents is also discussed.
Collapse
Affiliation(s)
- Yannis V. Simos
- Department of Physiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina 45110, Greece
- Nanomedicine and Nanobiotechnology Research Group, University of Ioannina, Ioannina 45110, Greece
| | - Konstantinos Spyrou
- Department of Materials Science and Engineering, University of Ioannina, Ioannina 45110, Greece
- Nanomedicine and Nanobiotechnology Research Group, University of Ioannina, Ioannina 45110, Greece
| | - Michaela Patila
- Biotechnology Laboratory, Department of Biological Applications and Technologies, University of Ioannina, Ioannina 45110, Greece
- Nanomedicine and Nanobiotechnology Research Group, University of Ioannina, Ioannina 45110, Greece
| | - Niki Karouta
- Department of Materials Science and Engineering, University of Ioannina, Ioannina 45110, Greece
- Nanomedicine and Nanobiotechnology Research Group, University of Ioannina, Ioannina 45110, Greece
| | - Haralambos Stamatis
- Biotechnology Laboratory, Department of Biological Applications and Technologies, University of Ioannina, Ioannina 45110, Greece
- Nanomedicine and Nanobiotechnology Research Group, University of Ioannina, Ioannina 45110, Greece
| | - Dimitrios Gournis
- Department of Materials Science and Engineering, University of Ioannina, Ioannina 45110, Greece
- Nanomedicine and Nanobiotechnology Research Group, University of Ioannina, Ioannina 45110, Greece
| | - Evangelia Dounousi
- Department of Nephrology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina 45110, Greece
- Nanomedicine and Nanobiotechnology Research Group, University of Ioannina, Ioannina 45110, Greece
| | - Dimitrios Peschos
- Department of Physiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina 45110, Greece
- Nanomedicine and Nanobiotechnology Research Group, University of Ioannina, Ioannina 45110, Greece
| |
Collapse
|
23
|
Zhao Y, Xie L, Ou N, Wu J, Zhang H, Zhou S, Liu Y, Chen J, Wang L, Wang L, Wang J, Shao F. Tolerability, safety, pharmacokinetics and pharmacodynamics of SHR0534, a potent G protein-coupled receptor 40 (GPR40) agonist, at single- and multiple-ascending oral doses in healthy Chinese subjects. Xenobiotica 2020; 51:297-306. [PMID: 33331206 DOI: 10.1080/00498254.2020.1864510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
SHR0534 is being developed for type-2 diabetes mellitus. Herein the tolerability, safety, pharmacokinetics and pharmacodynamics of SHR0534 in healthy Chinese subjects were assessed in a phase-I, randomized, double-blind, placebo-controlled, single- and multiple-ascending dose study. Forty subjects were randomized 4:1 to receive SHR0534 at the dose of 10, 25, 50 or 100 mg, or placebo, and another eleven subjects were allocated to either the 5 mg group or the placebo group at an 8:3 ratio. All subjects received a single dose on day 1, followed by a 9-day washout and once-daily administrations for 14 consecutive days. Serial samples were collected, and vital signs, electrocardiograms, laboratory tests, urinalysis and adverse events (AEs) were recorded. All doses of SHR0534 were safe and well tolerated with infrequent, generally mild-to-moderate AEs and no serious AEs in the study. SHR0534 was absorbed with a T max of approximately 4 hours, and systemic exposure increased with dose. Accumulation was minimal (2- to 3-fold) and steady state was reached after seven days of dosing. For pharmacodynamics, no significant hypoglycaemic effects were seen in healthy adults. Good pharmacokinetics and safety were demonstrated but no obvious effect was found.
Collapse
Affiliation(s)
- Yuqing Zhao
- Phase I Clinical Trial Unit, Jiangsu Province Hospital and the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Lijun Xie
- Phase I Clinical Trial Unit, Jiangsu Province Hospital and the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Ning Ou
- Phase I Clinical Trial Unit, Jiangsu Province Hospital and the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Jie Wu
- Jiangsu Hengrui Medicine Co., Ltd., Lianyungang, China
| | - Hongwen Zhang
- Phase I Clinical Trial Unit, Jiangsu Province Hospital and the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Sufeng Zhou
- Phase I Clinical Trial Unit, Jiangsu Province Hospital and the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Yun Liu
- Phase I Clinical Trial Unit, Jiangsu Province Hospital and the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Juan Chen
- Phase I Clinical Trial Unit, Jiangsu Province Hospital and the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Lu Wang
- Phase I Clinical Trial Unit, Jiangsu Province Hospital and the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Libin Wang
- Phase I Clinical Trial Unit, Jiangsu Province Hospital and the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Jingjing Wang
- Jiangsu Hengrui Medicine Co., Ltd., Lianyungang, China
| | - Feng Shao
- Phase I Clinical Trial Unit, Jiangsu Province Hospital and the First Affiliated Hospital with Nanjing Medical University, Nanjing, China.,Pharmacy College, Nanjing Medical University, Nanjing, China
| |
Collapse
|
24
|
Consoli A, Czupryniak L, Duarte R, Jermendy G, Kautzky-Willer A, Mathieu C, Melo M, Mosenzon O, Nobels F, Papanas N, Roman G, Schnell O, Sotiropoulos A, Stehouwer CDA, Tack CJ, Woo V, Fadini GP, Raz I. Positioning sulphonylureas in a modern treatment algorithm for patients with type 2 diabetes: Expert opinion from a European consensus panel. Diabetes Obes Metab 2020; 22:1705-1713. [PMID: 32476244 DOI: 10.1111/dom.14102] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 05/15/2020] [Accepted: 05/27/2020] [Indexed: 12/21/2022]
Abstract
The large number of pharmacological agents available to treat type 2 diabetes (T2D) makes choosing the optimal drug for any given patient a complex task. Because newer agents offer several advantages, whether and when sulphonylureas (SUs) should still be used to treat T2D is controversial. Published treatment guidelines and recommendations should govern the general approach to diabetes management. However, expert opinions can aid in better understanding local practices and in formulating individual choices. The current consensus paper aims to provide additional guidance on the use of SUs in T2D. We summarize current local treatment guidelines in European countries, showing that SUs are still widely proposed as second-line treatment after metformin and are often ranked at the same level as newer glucose-lowering medications. Strong evidence now shows that sodium-glucose co-transporter-2 inhibitors (SGLT-2is) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) are associated with low hypoglycaemia risk, promote weight loss, and exert a positive impact on vascular, cardiac and renal endpoints. Thus, using SUs in place of SGLT-2is and GLP-1RAs may deprive patients of key advantages and potentially important cardiorenal benefits. In subjects with ascertained cardiovascular disease or at very high cardiovascular risk, SGLT-2is and/or GLP-1RAs should be used as part of diabetes management, in the absence of contraindications. Routine utilization of SUs as second-line agents continues to be acceptable in resource-constrained settings.
Collapse
Affiliation(s)
| | - Leszek Czupryniak
- Department of Diabetology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Rui Duarte
- Associação Protectora dos Diabéticos de Portugal (APDP), Lisbon, Portugal
| | | | - Alexandra Kautzky-Willer
- Department of Internal Medicine III, Clinical Division of Endocrinology and Metabolism, Unit of Gender Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Miguel Melo
- Department of Endocrinology, Diabetes and Metabolism, University and Hospital Center of Coimbra, Coimbra, Portugal
- Medical Faculty, University of Coimbra, Coimbra, Portugal
| | - Ofri Mosenzon
- Diabetes Unit, Department of Endocrinology and Metabolism, Hadassah Hebrew University Hospital, The Faculty of Medicine, Jerusalem, Israel
| | | | - Nikolaos Papanas
- Diabetes Centre, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Gabriela Roman
- "Iuliu Hatieganu" University of Medicine & Pharmacy, Clinical Centre of Diabetes, Nutrition, Metabolic Diseases, Cluj-Napoca, Romania
| | - Oliver Schnell
- Forschergruppe Diabetes e.V., Helmholtz Centre, Munich, Germany
| | | | - Coen D A Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute (CARIM), Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Cees J Tack
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Vincent Woo
- Section of Endocrinology and Metabolism, Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Itamar Raz
- Diabetes Unit, Department of Endocrinology and Metabolism, Hadassah Hebrew University Hospital, The Faculty of Medicine, Jerusalem, Israel
| |
Collapse
|
25
|
Mouithys-Mickalad A, Ceusters J, Charif M, El Moualij B, Schoumacher M, Plyte S, Franck T, Bettendorff L, Pirotte B, Serteyn D, de Tullio P. Modulation of mitochondrial respiration rate and calcium-induced swelling by new cromakalim analogues. Chem Biol Interact 2020; 331:109272. [PMID: 33010220 DOI: 10.1016/j.cbi.2020.109272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/07/2020] [Accepted: 09/28/2020] [Indexed: 10/23/2022]
Abstract
A cellular model of cardiomyocytes (H9c2 cell line) and mitochondria isolated from mouse liver were used to understand the drug action of BPDZ490 and BPDZ711, two benzopyran analogues of the reference potassium channel opener cromakalim, on mitochondrial respiratory parameters and swelling, by comparing their effects with those of the parent compound cromakalim. For these three compounds, the oxygen consumption rate (OCR) was determined by high-resolution respirometry (HRR) and their impact on adenosine triphosphate (ATP) production and calcium-induced mitochondrial swelling was investigated. Cromakalim did not modify neither the OCR of H9c2 cells and the ATP production nor the Ca-induced swelling. By contrast, the cromakalim analogue BPDZ490 (1) induced a strong increase of OCR, while the other benzopyran analogue BPDZ711 (2) caused a marked slowdown. For both compounds, 1 displayed a biphasic behavior while 2 still showed an inhibitory effect. Both compounds 1 and 2 were also found to decrease the ATP synthesis, with pronounced effect for 2, while cromakalim remained without effect. Overall, these results indicate that cromakalim, as parent molecule, does not induce per se any direct effect on mitochondrial respiratory function neither on whole cells nor on isolated mitochondria whereas both benzopyran analogues 1 and 2 display totally opposite behavior profiles, suggesting that compound 1, by increasing the maximal respiration capacity, might behave as a mild uncoupling agent and compound 2 is taken as an inhibitor of the mitochondrial electron-transfer chain.
Collapse
Affiliation(s)
- Ange Mouithys-Mickalad
- Center for Oxygen, Research & Development (CORD) & Center for Interdisciplinary Research on Medicines (CIRM), Institute of Chemistry, B6a, ULiège, Allée du six Août, 11, B-4000, Liège, Belgium.
| | - Justine Ceusters
- Center for Oxygen, Research & Development (CORD) & Center for Interdisciplinary Research on Medicines (CIRM), Institute of Chemistry, B6a, ULiège, Allée du six Août, 11, B-4000, Liège, Belgium
| | - Mounia Charif
- Centre de Recherche sur les Protéines Prions (CRPP), ULiège, Quartier Hôpital, 15, Avenue Hippocrate, B-4000, Liège, Belgium
| | - Benaïssa El Moualij
- Centre de Recherche sur les Protéines Prions (CRPP), ULiège, Quartier Hôpital, 15, Avenue Hippocrate, B-4000, Liège, Belgium
| | - Mathieu Schoumacher
- Department of Medicinal Chemistry, Center for Interdisciplinary Research on Medicines (CIRM), ULiège, Quartier Hôpital, 15, Avenue de l'Hospital, B-4000, Liège, Belgium
| | - Simon Plyte
- Merus, Closing in on Cancer, Immuno-Oncology, Yalelaan 62, 3584 CM, Utrecht, the Netherlands
| | - Thierry Franck
- Center for Oxygen, Research & Development (CORD) & Center for Interdisciplinary Research on Medicines (CIRM), Institute of Chemistry, B6a, ULiège, Allée du six Août, 11, B-4000, Liège, Belgium; Department of Clinical Sciences, Faculty of Veterinary Medicine, Quartier Vallée 2, 5A-5D, Avenue de Cureghem, ULiège, B-4000, Liège, Belgium
| | - Lucien Bettendorff
- Laboratory of Neurophysiology, GIGA-neurosciences, ULiège, Quartier Hôpital, 15, Avenue Hippocrate, B-4000, Liège, Belgium
| | - Bernard Pirotte
- Center for Oxygen, Research & Development (CORD) & Center for Interdisciplinary Research on Medicines (CIRM), Institute of Chemistry, B6a, ULiège, Allée du six Août, 11, B-4000, Liège, Belgium; Department of Medicinal Chemistry, Center for Interdisciplinary Research on Medicines (CIRM), ULiège, Quartier Hôpital, 15, Avenue de l'Hospital, B-4000, Liège, Belgium
| | - Didier Serteyn
- Center for Oxygen, Research & Development (CORD) & Center for Interdisciplinary Research on Medicines (CIRM), Institute of Chemistry, B6a, ULiège, Allée du six Août, 11, B-4000, Liège, Belgium
| | - Pascal de Tullio
- Center for Oxygen, Research & Development (CORD) & Center for Interdisciplinary Research on Medicines (CIRM), Institute of Chemistry, B6a, ULiège, Allée du six Août, 11, B-4000, Liège, Belgium; Department of Medicinal Chemistry, Center for Interdisciplinary Research on Medicines (CIRM), ULiège, Quartier Hôpital, 15, Avenue de l'Hospital, B-4000, Liège, Belgium
| |
Collapse
|
26
|
Hasanpour M, Iranshahy M, Iranshahi M. The application of metabolomics in investigating anti-diabetic activity of medicinal plants. Biomed Pharmacother 2020; 128:110263. [DOI: 10.1016/j.biopha.2020.110263] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/08/2020] [Accepted: 05/10/2020] [Indexed: 12/21/2022] Open
|
27
|
Johansson L, Hockings PD, Johnsson E, Dronamraju N, Maaske J, Garcia‐Sanchez R, Wilding JPH. Dapagliflozin plus saxagliptin add-on to metformin reduces liver fat and adipose tissue volume in patients with type 2 diabetes. Diabetes Obes Metab 2020; 22:1094-1101. [PMID: 32072735 PMCID: PMC7318158 DOI: 10.1111/dom.14004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 01/13/2020] [Accepted: 01/21/2020] [Indexed: 12/14/2022]
Abstract
AIM To assess the effects of dapagliflozin plus saxagliptin plus metformin versus glimepiride plus metformin on liver fat (proton density fat fraction) and visceral and subcutaneous adipose tissue volumes over 52 weeks of treatment. MATERIALS AND METHODS This was a magnetic resonance imaging substudy of a 52-week, multicentre, randomized, double-blind, parallel-group trial that evaluated the efficacy and safety of dapagliflozin 10 mg/day plus saxagliptin 5 mg/day versus titrated glimepiride 1-6 mg (1, 2, 3, 4 or 6 mg) in 82 patients with type 2 diabetes (HbA1c 7.5%-10.5%) on metformin ≥1500 mg/day background. Analyses were exploratory and not controlled for multiplicity; P-values are nominal. RESULTS Magnetic resonance imaging was performed on 59 patients; liver fat and adipose tissue volumes were analysed for 59 and 57 patients, respectively. There was a significant >30% reduction from baseline in liver fat (P = 0.007) and >10% reduction in adipose tissue volumes (P < 0.01) with dapagliflozin plus saxagliptin plus metformin at week 52 versus glimepiride plus metformin. In the full-study population, dapagliflozin plus saxagliptin plus metformin decreased body weight and serum alanine aminotransferase and aspartate aminotransferase levels over 52 weeks. CONCLUSIONS Dapagliflozin plus saxagliptin significantly decreased liver fat and adipose tissue volume versus glimepiride, and reduced serum liver enzyme levels, indicating a favourable metabolic profile of dapagliflozin plus saxagliptin in patients with type 2 diabetes on metformin therapy.
Collapse
Affiliation(s)
| | | | - Eva Johnsson
- Global Medicines Development, AstraZenecaGothenburgSweden
| | - Nalina Dronamraju
- Global Medicines Development, AstraZenecaGaithersburgMarylandUnited States
| | - Jill Maaske
- Global Medicines Development, AstraZenecaGaithersburgMarylandUnited States
| | | | - John P. H. Wilding
- Obesity and Endocrinology Research Group, Institute of Ageing and Chronic DiseaseUniversity of LiverpoolLiverpoolUnited Kingdom
| |
Collapse
|
28
|
Vasconcelos I, da Silva PHR, Dias DRD, de Freitas Marques MB, da Nova Mussel W, Pedrosa TA, Ribeiro E Silva MES, de Souza Freitas RF, de Sousa RG, Fernandes C. Synthesis and characterization of a molecularly imprinted polymer (MIP) for solid-phase extraction of the antidiabetic gliclazide from human plasma. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 116:111191. [PMID: 32806298 DOI: 10.1016/j.msec.2020.111191] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/28/2020] [Accepted: 06/11/2020] [Indexed: 02/07/2023]
Abstract
Gliclazide is a sulfonylurea frequently prescribed for the management of type 2 diabetes mellitus in elderly patients and for patients with chronic renal or hepatic diseases. Even though it is considered a safer alternative, the drug can provoke side effects in some patients, especially hypoglycemia, due to the high interindividual variability. Therefore, the quantification of gliclazide in biological samples is usually recommended in order to assure efficacy and safety of the pharmacotherapy. However, due to the complexity of biological matrices, therapeutic monitoring can be very challenging, especially in the sample preparation step. For that reason, the synthesis and characterization of a novel and selective molecularly imprinted polymer (MIP) was proposed to be employed as sorbent for the extraction of gliclazide from human plasma samples by a molecularly imprinted solid-phase extraction (MISPE) procedure. Synthesis conditions were optimized (monomer, crosslinker and porogen) and the polymer was characterized for its morphological, physicochemical and stability properties. The influence of drug concentration, solvent composition and pH on the coefficient of distribution (Kd) and imprinting factor (IF) were studied, as well as repeatability between batches and selectivity. A bioanalytical method was developed applying the developed MIP as sorbent in solid phase extraction and liquid chromatography using a Poroshell 120 C18 (100 × 4.6 mm, 4 μm) column, acetonitrile and 10 mM potassium phosphate buffer pH 3.0 (50:50) at a flow-rate of 1.2 mL/min as mobile phase, temperature of 30 °C, injection volume of 40 μL and detection at 230 nm. The best reaction yield, extraction capacity, and selectivity was obtained using 2-hydroxyethyl methacrylate (2-HEMA), ethyleneglycol dimethacrylate (EGDMA) and acetonitrile. The optimized MIP showed coefficient of distribution (Kd) of 59.85 μg/g, imprinting factor (IF) of 1.60, and selectivity for gliclazide and other sulfonylureas compared to possible concurrent drugs. The developed method by MISPE-HPLC-UV showed to be appropriate to determine gliclazide in human plasma samples.
Collapse
Affiliation(s)
- Ingrid Vasconcelos
- Laboratório de Controle de Qualidade de Medicamentos e Cosméticos, Departamento de Produtos Farmacêuticos, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG 31270-901, Brazil
| | - Pedro Henrique Reis da Silva
- Laboratório de Controle de Qualidade de Medicamentos e Cosméticos, Departamento de Produtos Farmacêuticos, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG 31270-901, Brazil
| | - Derick Rodrigues Davila Dias
- Laboratório de Controle de Qualidade de Medicamentos e Cosméticos, Departamento de Produtos Farmacêuticos, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG 31270-901, Brazil
| | - Maria Betânia de Freitas Marques
- Departamento de Química, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG 31270-901, Brazil
| | - Wagner da Nova Mussel
- Departamento de Química, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG 31270-901, Brazil
| | - Tércio Assunção Pedrosa
- Laboratório de Microscopia Eletrônica, Centro de Desenvolvimento da Tecnologia Nuclear - CDTN, Av. Antônio Carlos 6627, Belo Horizonte, Minas Gerais, Brazil
| | - Maria Elisa Scarpelli Ribeiro E Silva
- Laboratório de Ciência e Tecnologia de Polímeros, Departamento de Engenharia Química, Escola de Engenharia, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG 31270-901, Brazil
| | - Roberto Fernando de Souza Freitas
- Laboratório de Ciência e Tecnologia de Polímeros, Departamento de Engenharia Química, Escola de Engenharia, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG 31270-901, Brazil
| | - Ricardo Geraldo de Sousa
- Laboratório de Ciência e Tecnologia de Polímeros, Departamento de Engenharia Química, Escola de Engenharia, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG 31270-901, Brazil
| | - Christian Fernandes
- Laboratório de Controle de Qualidade de Medicamentos e Cosméticos, Departamento de Produtos Farmacêuticos, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG 31270-901, Brazil.
| |
Collapse
|
29
|
Poupon-Bejuit L, Rocha-Ferreira E, Thornton C, Hagberg H, Rahim AA. Neuroprotective Effects of Diabetes Drugs for the Treatment of Neonatal Hypoxia-Ischemia Encephalopathy. Front Cell Neurosci 2020; 14:112. [PMID: 32435185 PMCID: PMC7218053 DOI: 10.3389/fncel.2020.00112] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 04/08/2020] [Indexed: 12/15/2022] Open
Abstract
The perinatal period represents a time of great vulnerability for the developing brain. A variety of injuries can result in death or devastating injury causing profound neurocognitive deficits. Hypoxic-ischemic neonatal encephalopathy (HIE) remains the leading cause of brain injury in term infants during the perinatal period with limited options available to aid in recovery. It can result in long-term devastating consequences with neurologic complications varying from mild behavioral deficits to severe seizure, intellectual disability, and/or cerebral palsy in the newborn. Despite medical advances, the only viable option is therapeutic hypothermia which is classified as the gold standard but is not used, or may not be as effective in preterm cases, infection-associated cases or low resource settings. Therefore, alternatives or adjunct therapies are urgently needed. Ongoing research continues to advance our understanding of the mechanisms contributing to perinatal brain injury and identify new targets and treatments. Drugs used for the treatment of patients with type 2 diabetes mellitus (T2DM) have demonstrated neuroprotective properties and therapeutic efficacy from neurological sequelae following HIE insults in preclinical models, both alone, or in combination with induced hypothermia. In this short review, we have focused on recent findings on the use of diabetes drugs that provide a neuroprotective effect using in vitro and in vivo models of HIE that could be considered for clinical translation as a promising treatment.
Collapse
Affiliation(s)
| | - Eridan Rocha-Ferreira
- Centre for Perinatal Medicine and Health, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Claire Thornton
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London, United Kingdom
| | - Henrik Hagberg
- Centre for Perinatal Medicine and Health, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ahad A. Rahim
- UCL School of Pharmacy, University College London, London, United Kingdom
| |
Collapse
|
30
|
Gedawy A, Al-Salami H, Dass CR. Advanced and multifaceted stability profiling of the first-line antidiabetic drugs metformin, gliclazide and glipizide under various controlled stress conditions. Saudi Pharm J 2020; 28:362-368. [PMID: 32194338 PMCID: PMC7078535 DOI: 10.1016/j.jsps.2020.01.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Accepted: 01/29/2020] [Indexed: 11/24/2022] Open
Abstract
The antidiabetic drugs metformin, gliclazide and glipizide have been widely used and studied in terms of pharmacological and antidiabetic effects, and their individual stability has been studied in the literature. However, the drugs’ combined stability profiling remains poorly understood, and hence the aim of this study was to investigate the collective stability profiling of different combinations at various controlled conditions. Degradation assessments were carried out on metformin, glipizide and gliclazide by applying a stability-indicating HPLC method that was developed and validated in accordance with ICH guidelines. Glipizide, gliclazide, metformin and the binary mixtures (metformin/glipizide and metformin/gliclazide) were subjected to different forced degradation conditions and were detected at 227 nm by an isocratic separation on an Alltima CN column (250 mm × 4.6 mm × 5µ) utilizing a mobile phase that consists of 20 mM ammonium formate buffer (pH 3.5) and acetonitrile at a ratio of (45:55, v/v). The method is linear (R2 = 0.9999) at the concentration range 2.5–150 µg/ml for metformin and 1.25–150 µg/ml for sulfonylureas respectively and offers a specific and sensitive tool for their determination in <10 min chromatographic run. All drug peaks were sharp and well separated. Stress degradation revealed that metformin has a remarkable sensitivity to alkaline stress, glipizide was more sensitive to thermal degradation while gliclazide exhibited almost full degradation in acidic, alkaline and oxidative stress conditions.
Collapse
Affiliation(s)
- Ahmed Gedawy
- School of Pharmacy, Curtin University, Bentley 6102, Australia
| | - Hani Al-Salami
- School of Pharmacy, Curtin University, Bentley 6102, Australia.,Curtin Health Innovation Research Institute, Bentley 6102, Australia
| | - Crispin R Dass
- School of Pharmacy, Curtin University, Bentley 6102, Australia.,Curtin Health Innovation Research Institute, Bentley 6102, Australia
| |
Collapse
|
31
|
Lv W, Wang X, Xu Q, Lu W. Mechanisms and Characteristics of Sulfonylureas and Glinides. Curr Top Med Chem 2020; 20:37-56. [PMID: 31884929 DOI: 10.2174/1568026620666191224141617] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/30/2019] [Accepted: 09/22/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Type 2 diabetes mellitus is a complex progressive endocrine disease characterized by hyperglycemia and life-threatening complications. It is the most common disorder of pancreatic cell function that causes insulin deficiency. Sulfonylurea is a class of oral hypoglycemic drugs. Over the past half century, these drugs, together with the subsequent non-sulfonylureas (glinides), have been the main oral drugs for insulin secretion. OBJECTIVE Through in-depth study, the medical profession considers it as an important drug for improving blood sugar control. METHODS The mechanism, characteristics, efficacy and side effects of sulfonylureas and glinides were reviewed in detail. RESULTS Sulfonylureas and glinides not only stimulated the release of insulin from pancreatic cells, but also had many extrapanular hypoglycemic effect, such as reducing the clearance rate of insulin in liver, reducing the secretion of glucagon, and enhancing the sensitivity of peripheral tissues to insulin in type 2 diabetes mellitus. CONCLUSION Sulfonylureas and glinides are effective first-line drugs for the treatment of diabetes mellitus. Although they have the risk of hypoglycemia, weight gain and cardiovascular disease, their clinical practicability and safety can be guaranteed as long as they are reasonably used.
Collapse
Affiliation(s)
- Wei Lv
- School of Materials Science and Engineering, Shanghai University, Shanghai, China.,Shanghai Huayi Resins Co., Ltd., Shanghai, China
| | - Xianqing Wang
- Charles Institute of Dermatology, University College Dublin, Dublin D04 V1W8, Ireland
| | - Qian Xu
- Charles Institute of Dermatology, University College Dublin, Dublin D04 V1W8, Ireland
| | - Wencong Lu
- School of Materials Science and Engineering, Shanghai University, Shanghai, China
| |
Collapse
|
32
|
Second-Generation Antidiabetic Sulfonylureas Inhibit Candida albicans and Candidalysin-Mediated Activation of the NLRP3 Inflammasome. Antimicrob Agents Chemother 2020; 64:AAC.01777-19. [PMID: 31712208 DOI: 10.1128/aac.01777-19] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 11/04/2019] [Indexed: 12/16/2022] Open
Abstract
Repurposing of currently approved medications is an attractive option for the development of novel treatment strategies against physiological and infectious diseases. The antidiabetic sulfonylurea glyburide has demonstrated off-target capacity to inhibit activation of the NLRP3 inflammasome in a variety of disease models, including vaginal candidiasis, caused primarily by the fungal pathogen Candida albicans Therefore, we sought to determine which of the currently approved sulfonylurea drugs prevent the release of interleukin 1β (IL-1β), a major inflammasome effector, during C. albicans challenge of the human macrophage-like THP1 cell line. Findings revealed that the second-generation antidiabetics (glyburide, glisoxepide, gliquidone, and glimepiride), which exhibit greater antidiabetic efficacy than prior iterations, demonstrated anti-inflammatory effects with various degrees of potency as determined by calculation of 50% inhibitory concentrations (IC50s). These same compounds were also effective in reducing IL-1β release during noninfectious inflammasome activation (e.g., induced by lipopolysaccharide [LPS] plus ATP), suggesting that their anti-inflammatory activity is not specific to C. albicans challenge. Moreover, treatment with sulfonylurea drugs did not impact C. albicans growth and filamentation or THP1 viability. Finally, the use of ECE1 and Candidalysin deletion mutants, along with isogenic NLRP3-/- cells, demonstrated that both Candidalysin and NLRP3 are required for IL-1β secretion, further confirming that sulfonylureas suppress inflammasome signaling. Moreover, challenge of THP1 cells with synthetic Candidalysin peptide demonstrated that this toxin is sufficient to activate the inflammasome. Treatment with the experimental inflammasome inhibitor MCC950 led to similar blockade of IL-1β release, suggesting that Candidalysin-mediated inflammasome activation can be inhibited independently of potassium efflux. Together, these results demonstrate that the second-generation antidiabetic sulfonylureas retain anti-inflammatory activity and may be considered for repurposing against immunopathological diseases, including vaginal candidiasis.
Collapse
|
33
|
Modulated Protein Binding Ability of Anti-Diabetic Drugs in Presence of Monodispersed Gold Nanoparticles and its Inhibitory Potential towards Advanced Glycated End (AGE) Product Formation. J Fluoresc 2020; 30:193-204. [DOI: 10.1007/s10895-019-02485-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 12/26/2019] [Indexed: 12/31/2022]
|
34
|
Akhter MS, Uppal P. Toxicity of Metformin and Hypoglycemic Therapies. Adv Chronic Kidney Dis 2020; 27:18-30. [PMID: 32146997 DOI: 10.1053/j.ackd.2019.08.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 08/01/2019] [Indexed: 12/15/2022]
Abstract
Metformin along with other antidiabetic medications provide benefit to patients in the treatment of type 2 diabetes mellitus, but caution is advised in certain scenarios to avoid toxicity in kidney disease. Renal dosing, monitoring of kidney function, and evaluating the risk of developing serious side effects are warranted with some agents. The available literature with regard to incidence of adverse events and toxicity of hypoglycemic therapies is reviewed.
Collapse
|
35
|
Gökçay Canpolat A, Şahin M. Glucose Lowering Treatment Modalities of Type 2 Diabetes Mellitus. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1307:7-27. [PMID: 32200500 DOI: 10.1007/5584_2020_516] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This chapter gives an overview of present knowledge and clinical aspects of antidiabetic drugs according to the recently available research evidence and clinical expertise.Many agents are acting on eight groups of pathophysiological mechanisms, which is commonly called as "Ominous Octet" by DeFronzo. The muscle, liver and β-cell, the fat cell, gastrointestinal tract, α-cell, kidney, and brain play essential roles in the development of glucose intolerance in type 2 diabetic individuals (Defronzo, Diabetes 58:773-795, 2009).A treatment paradigm shift is seen in the initiation of anti-hyperglycemic agents from old friends (meglitinides or sulphonylürea) to newer agents effecting on GLP-1 RA or SGLT-2 inhibitors. It is mostly about the other protective positive effects of these agents for kidney, heart, etc. Although there are concerns for the long term safety profiles; they are used widely around the World. The delivery of patient-centered care, facilitating medication adherence, the importance of weight loss in obese patients, the importance of co-morbid conditions are the mainstays of selecting the optimal agent.
Collapse
Affiliation(s)
- Asena Gökçay Canpolat
- Department of Endocrinology and Metabolism, Ankara University School of Medicine, Ankara, Turkey
| | - Mustafa Şahin
- Department of Endocrinology and Metabolism, Ankara University School of Medicine, Ankara, Turkey.
| |
Collapse
|
36
|
Liu W, Kin T, Ho S, Dorrell C, Campbell SR, Luo P, Chen X. Abnormal regulation of glucagon secretion by human islet alpha cells in the absence of beta cells. EBioMedicine 2019; 50:306-316. [PMID: 31780397 PMCID: PMC6921359 DOI: 10.1016/j.ebiom.2019.11.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 11/11/2019] [Accepted: 11/11/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The understanding of the regulation of glucagon secretion by pancreatic islet α-cells remains elusive. We aimed to develop an in vitro model for investigating the function of human α-cells under direct influence of glucose and other potential regulators. METHODS Highly purified human α-cells from islets of deceased donors were re-aggregated in the presence or absence of β-cells in culture, evaluated for glucagon secretion under various treatment conditions, and compared to that of intact human islets and non-sorted islet cell aggregates. FINDINGS The pure human α-cell aggregates maintained proper glucagon secretion capability at low concentrations of glucose, but failed to respond to changes in ambient glucose concentration. Addition of purified β-cells, but not the secreted factors from β-cells at low or high concentrations of glucose, partly restored the responsiveness of α-cells to glucose with regulated glucagon secretion. The EphA stimulator ephrinA5-fc failed to mimic the inhibitory effect of β-cells on glucagon secretion. Glibenclamide inhibited glucagon secretion from islets and the α- and β-mixed cell-aggregates, but not from the α-cell-only aggregates, at 2.0 mM glucose. INTERPRETATION This study validated the use of isolated and then re-aggregated human islet cells for investigating α-cell function and paracrine regulation, and demonstrated the importance of cell-to-cell contact between α- and β-cells on glucagon secretion. Loss of proper β- and α-cell physical interaction in islets likely contributes to the dysregulated glucagon secretion in diabetic patients. Re-aggregated select combinations of human islet cells provide unique platforms for studying islet cell function and regulation.
Collapse
Affiliation(s)
- Wei Liu
- Department of Nephropathy, The Second Hospital of Jilin University, 218 Ziquiang Street, Nanguan District, Changchun, Jilin 130041, China; Columbia Center for Translational Immunology, Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | - Tatsuya Kin
- Clinical Islet Laboratory, University of Alberta, Edmonton, Alberta, Canada
| | - Siuhong Ho
- Columbia Center for Translational Immunology, Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | - Craig Dorrell
- Oregon Stem Cell Center, Oregon Health & Science University, Portland, OR, USA
| | - Sean R Campbell
- Columbia Center for Translational Immunology, Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | - Ping Luo
- Department of Nephropathy, The Second Hospital of Jilin University, 218 Ziquiang Street, Nanguan District, Changchun, Jilin 130041, China.
| | - Xiaojuan Chen
- Columbia Center for Translational Immunology, Department of Surgery, Columbia University Medical Center, 650 West 168th Street, BB1701, New York, NY 10032, USA.
| |
Collapse
|
37
|
Webb DR, Davies MJ, Jarvis J, Seidu S, Khunti K. The right place for Sulphonylureas today. Diabetes Res Clin Pract 2019; 157:107836. [PMID: 31479704 DOI: 10.1016/j.diabres.2019.107836] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 08/22/2019] [Indexed: 12/28/2022]
Abstract
The place of Sulphonylurea based insulin secretagogues in the management of Type 2 diabetes appears as controversial today as it was fifty years ago. Newer therapies are associated with less hypoglycaemia and weight gain than Sulphonylureas but currently cost more and lack assurances which come with long-term exposure. Emergence of recent CVOT data for SGLT-2 inhibitors and GLP-1 receptor agonists is likely to influence therapeutic choices and guidance is now supportive of their earlier use in cases at high risk of cardiovascular disease. Meta-analyses of Sulphonylurea trials have failed to indicate a consistent effect (positive or negative) on cardiovascular disease or mortality, although are limited by the relative scarcity of studies directly reporting these outcomes. The CAROLINA trial is reassuring in demonstrating cardiovascular safety for the Sulphonylurea Glimepiride when compared directly with the DPP-4 inhibitor Linagliptin, suggesting either of these agents would be relatively safe second line options after Metformin in the majority of patients. This review provides a balanced assessment of available Sulphonylurea treatments in the context of current cardiovascular outcome trial data (CVOT) data and hopefully assists informed decision making about the place of these drugs in contemporary glucose lowering practice.
Collapse
Affiliation(s)
- David R Webb
- University of Leicester, Diabetes Research Centre, Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, UK.
| | - Melanie J Davies
- University of Leicester, Diabetes Research Centre, Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, UK.
| | - Janet Jarvis
- University Hospitals of Leicester NHS Trust, Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, UK.
| | - Sam Seidu
- University of Leicester, Diabetes Research Centre, Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, UK.
| | - Kamlesh Khunti
- University of Leicester, Diabetes Research Centre, Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, UK.
| |
Collapse
|
38
|
Suzuki R, Brown GA, Christopher JA, Scully CCG, Congreve M. Recent Developments in Therapeutic Peptides for the Glucagon-like Peptide 1 and 2 Receptors. J Med Chem 2019; 63:905-927. [PMID: 31577440 DOI: 10.1021/acs.jmedchem.9b00835] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Glucagon-like peptide 1 (GLP-1) and glucagon-like peptide 2 (GLP-2) are proglucagon derived peptides that are released from gut endocrine cells in response to nutrient intake. These molecules are rapidly inactivated by the action of dipeptidyl peptidase IV (DPP-4) which limits their use as therapeutic agents. The recent emergence of three-dimensional structures of GPCRs such as GLP-1R and glucagon receptor has helped to drive the rational design of innovative peptide molecules that hold promise as novel peptide therapeutics. One emerging area is the discovery of multifunctional molecules that act at two or more pharmacological systems to enhance therapeutic efficacy. In addition, drug discovery efforts are also focusing on strategies to improve patient convenience through alternative routes of peptide delivery. These novel strategies highlight the broad utility of peptide-based therapeutics in human disease settings where unmet needs still exist.
Collapse
Affiliation(s)
- Rie Suzuki
- Sosei Heptares , Steinmetz Building, Granta Park , Cambridge CB21 6DG , U.K
| | - Giles A Brown
- Sosei Heptares , Steinmetz Building, Granta Park , Cambridge CB21 6DG , U.K
| | - John A Christopher
- Sosei Heptares , Steinmetz Building, Granta Park , Cambridge CB21 6DG , U.K
| | - Conor C G Scully
- Sosei Heptares , Steinmetz Building, Granta Park , Cambridge CB21 6DG , U.K
| | - Miles Congreve
- Sosei Heptares , Steinmetz Building, Granta Park , Cambridge CB21 6DG , U.K
| |
Collapse
|
39
|
Allen K, McFarland M. How Are Income and Education Related to the Prevention and Management of Diabetes? J Aging Health 2019; 32:1063-1074. [PMID: 31609162 DOI: 10.1177/0898264319879608] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Objective: To understand whether income and education have unique contributions in the prevention and management of diabetes, as measured by Hba1c levels among diagnosed and undiagnosed individuals. Method: Data were obtained from the Nashville Stress and Health Study (N = 1,189). Ordinary least squares regression analyses were used to examine the associations among education, annual household income, diabetes onset, and diabetes management (Hba1c). Results: Education, but not income, was inversely associated with Hba1c in undiagnosed participants. Income, but not education, was inversely associated with Hba1c among diagnosed participants. Discussion: These results support the idea that education and income provide non-fungible social and economic resources that vary in their consequences for Hba1c level depending on whether someone has been diagnosed with diabetes. The social resources provided by education may be more important in delaying the onset of disease, whereas resources provided by income may be more important for disease management.
Collapse
|
40
|
Costantini S, Conte C. Bone health in diabetes and prediabetes. World J Diabetes 2019; 10:421-445. [PMID: 31523379 PMCID: PMC6715571 DOI: 10.4239/wjd.v10.i8.421] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 06/03/2019] [Accepted: 07/20/2019] [Indexed: 02/05/2023] Open
Abstract
Bone fragility has been recognized as a complication of diabetes, both type 1 diabetes (T1D) and type 2 diabetes (T2D), whereas the relationship between prediabetes and fracture risk is less clear. Fractures can deeply impact a diabetic patient’s quality of life. However, the mechanisms underlying bone fragility in diabetes are complex and have not been fully elucidated. Patients with T1D generally exhibit low bone mineral density (BMD), although the relatively small reduction in BMD does not entirely explain the increase in fracture risk. On the contrary, patients with T2D or prediabetes have normal or even higher BMD as compared with healthy subjects. These observations suggest that factors other than bone mass may influence fracture risk. Some of these factors have been identified, including disease duration, poor glycemic control, presence of diabetes complications, and certain antidiabetic drugs. Nevertheless, currently available tools for the prediction of risk inadequately capture diabetic patients at increased risk of fracture. Aim of this review is to provide a comprehensive overview of bone health and the mechanisms responsible for increased susceptibility to fracture across the spectrum of glycemic status, spanning from insulin resistance to overt forms of diabetes. The management of bone fragility in diabetic patient is also discussed.
Collapse
Affiliation(s)
- Silvia Costantini
- Department of Immunology, Transplantation and Infectious Diseases, Vita-Salute San Raffaele University, Milan 20123, Italy
- Epatocentro Ticino, Lugano 6900, Switzerland
| | - Caterina Conte
- Department of Immunology, Transplantation and Infectious Diseases, Vita-Salute San Raffaele University, Milan 20123, Italy
- IRCCS Ospedale San Raffaele, Internal Medicine and Transplantation, Milan 20123, Italy
| |
Collapse
|
41
|
Mada SB, Ugwu CP, Abarshi MM. Health Promoting Effects of Food-Derived Bioactive Peptides: A Review. Int J Pept Res Ther 2019. [DOI: 10.1007/s10989-019-09890-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
|
42
|
Garla V, Kanduri S, Yanes-Cardozo L, Lién LF. Management of diabetes mellitus in chronic kidney disease. MINERVA ENDOCRINOL 2019; 44:273-287. [DOI: 10.23736/s0391-1977.19.03015-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
43
|
Guo T, Liu T, Sun Y, Liu X, Xiong R, Li H, Li Z, Zhang Z, Tian Z, Tian Y. Sonodynamic therapy inhibits palmitate-induced beta cell dysfunction via PINK1/Parkin-dependent mitophagy. Cell Death Dis 2019; 10:457. [PMID: 31186419 PMCID: PMC6560035 DOI: 10.1038/s41419-019-1695-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 05/27/2019] [Accepted: 05/28/2019] [Indexed: 12/20/2022]
Abstract
In type 2 diabetes mellitus (T2DM), the overload of glucose and lipids can promote oxidative stress and inflammatory responses and contribute to the failure of beta cells. However, therapies that can modulate the function of beta cells and thus prevent their failure have not been well explored. In this study, beta cell injury model was established with palmitic acid (PA) to simulate the lipotoxicity (high-fat diet) found in T2DM. Sonodynamic therapy (SDT), a novel physicochemical treatment, was applied to treat injured beta cells. We found that SDT had specific effects on mitochondria and induced transient large amount of mitochondrial reactive oxygen species (ROS) production in beta cells. SDT also improved the morphology and function of abnormal mitochondria, inhibited inflammatory response and reduced beta cell dysfunction. The improvement of mitochondria was mediated by PINK1/Parkin-dependent mitophagy. Additionally, SDT rescued the transcription of PINK1 mRNA which was blocked by PA treatment, thus providing abundant PINK1 for mitophagy. Moreover, SDT also increased insulin secretion from beta cells. The protective effects of SDT were abrogated when mitophagy was inhibited by cyclosporin A (CsA). In summary, SDT potently inhibits lipotoxicity-induced beta cell failure via PINK1/Parkin-dependent mitophagy, providing theoretical guidance for T2DM treatment in aspects of islet protection.
Collapse
Affiliation(s)
- Tian Guo
- Department of Pathophysiology, Harbin Medical University, Harbin, 150081, China
| | - Tianyang Liu
- Department of Pathophysiology, Harbin Medical University, Harbin, 150081, China
| | - Yun Sun
- Department of Pathophysiology, Harbin Medical University, Harbin, 150081, China
| | - Xianna Liu
- Department of Pathophysiology, Harbin Medical University, Harbin, 150081, China
| | - Rongguo Xiong
- Department of Pathophysiology, Harbin Medical University, Harbin, 150081, China
| | - He Li
- Department of Pathophysiology, Harbin Medical University, Harbin, 150081, China
| | - Zhitao Li
- Department of Pathophysiology, Harbin Medical University, Harbin, 150081, China
| | - Zhiguo Zhang
- Laboratory of Photo- and Sono-theranostic Technologies and Condensed Matter Science and Technology Institute, Harbin Institute of Technology, Harbin, 150001, China
| | - Zhen Tian
- Department of Pathophysiology, Harbin Medical University, Harbin, 150081, China. .,Key Laboratory of Acoustic Photoelectric Magnetic Diagnosis and Treatment of Cardiovascular Diseases in Heilongjiang Province, Harbin, 150081, China.
| | - Ye Tian
- Department of Pathophysiology, Harbin Medical University, Harbin, 150081, China. .,Key Laboratory of Acoustic Photoelectric Magnetic Diagnosis and Treatment of Cardiovascular Diseases in Heilongjiang Province, Harbin, 150081, China. .,Department of Cardiology, The First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, 150001, China.
| |
Collapse
|
44
|
Santamarina M, Carlson CJ. Review of the cardiovascular safety of dipeptidyl peptidase-4 inhibitors and the clinical relevance of the CAROLINA trial. BMC Cardiovasc Disord 2019; 19:60. [PMID: 30876392 PMCID: PMC6419798 DOI: 10.1186/s12872-019-1036-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 02/27/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cardiovascular (CV) disease (CVD) is a well-recognized complication of type 2 diabetes mellitus (T2DM) and there is a clinical need for glucose-lowering therapies that do not further increase CV risk in this population. Although sulfonylureas (SUs) may be used as second-line therapy for patients requiring additional therapy after first-line metformin to improve glycemic control, their long-term effects on CV outcomes remain uncertain, and a wide range of alternative agents exist including dipeptidyl peptidase-4 (DPP-4) inhibitors. METHODS Literature searches in PubMed (2013-2018) were conducted with terms for DPP-4 inhibitors combined with CV terms, with preference given to cardiovascular outcomes trials (CVOTs). Reference lists from retrieved articles and diabetes guidelines were also considered. RESULTS This narrative review discusses current evidence for the CV safety of these agents, describes the long-term CV effects of DPP-4 inhibitors, including effects on CV events, mortality, the risk for heart failure hospitalization, and highlights the need for further research into the CV effects of SU therapy. Although SUs remain a treatment option for T2DM, the long-term effects of these agents on CV outcomes are unclear, and further long-term studies are required. For DPP-4 inhibitors, uncertainties have been raised about their long-term effect on hospitalization for heart failure in light of the results of SAVOR-TIMI 53, although the findings of other DPP-4 inhibitor CVOTs in T2DM and data analyses have suggested these agents do not increase the occurrence of adverse CV outcomes. CONCLUSIONS Based on recent CVOTs and guideline updates, the choice of add-on to metformin therapy for patients with T2DM and established CV disease should be a sodium-glucose co-transporter-2 inhibitor or a glucagon-like peptide-1 agonist with proven CV benefit. Additional treatment options for those individuals who require therapy intensification, as well as in patients with T2DM and without established CVD include DPP-4 inhibitors and SUs. Since few head-to-head trials have compared the effects of different oral glucose-lowering agents on CV outcomes in T2DM, with most CVOTs using placebo as a comparator, the CAROLINA trial will provide important information on the comparative CV safety of a commonly prescribed SU and a DPP-4 inhibitor.
Collapse
Affiliation(s)
- Marile Santamarina
- Gregory School of Pharmacy, Palm Beach Atlantic University, 901 South Flagler Drive, West Palm Beach, FL, 33416, USA.
| | - Curt J Carlson
- Gregory School of Pharmacy, Palm Beach Atlantic University, 901 South Flagler Drive, West Palm Beach, FL, 33416, USA
| |
Collapse
|
45
|
Mannino GC, Andreozzi F, Sesti G. Pharmacogenetics of type 2 diabetes mellitus, the route toward tailored medicine. Diabetes Metab Res Rev 2019; 35:e3109. [PMID: 30515958 PMCID: PMC6590177 DOI: 10.1002/dmrr.3109] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 11/27/2018] [Accepted: 11/30/2018] [Indexed: 12/11/2022]
Abstract
Type 2 diabetes mellitus (T2DM) is a chronic disease that has reached the levels of a global epidemic. In order to achieve optimal glucose control, it is often necessary to rely on combination therapy of multiple drugs or insulin because uncontrolled glucose levels result in T2DM progression and enhanced risk of complications and mortality. Several antihyperglycemic agents have been developed over time, and T2DM pharmacotherapy should be prescribed based on suitability for the individual patient's characteristics. Pharmacogenetics is the branch of genetics that investigates how our genome influences individual responses to drugs, therapeutic outcomes, and incidence of adverse effects. In this review, we evaluated the pharmacogenetic evidences currently available in the literature, and we identified the top informative genetic variants associated with response to the most common anti-diabetic drugs: metformin, DPP-4 inhibitors/GLP1R agonists, thiazolidinediones, and sulfonylureas/meglitinides. Overall, we found 40 polymorphisms for each drug class in a total of 71 loci, and we examined the possibility of encouraging genetic screening of these variants/loci in order to critically implement decision-making about the therapeutic approach through precision medicine strategies. It is possible then to anticipate that when the clinical practice will take advantage of the genetic information of the diabetic patients, this will provide a useful resource for the prevention of T2DM progression, enabling the identification of the precise drug that is most likely to be effective and safe for each patient and the reduction of the economic impact on a global scale.
Collapse
Affiliation(s)
- Gaia Chiara Mannino
- Department of Medical and Surgical SciencesUniversity Magna Graecia of CatanzaroCatanzaroItaly
| | - Francesco Andreozzi
- Department of Medical and Surgical SciencesUniversity Magna Graecia of CatanzaroCatanzaroItaly
| | - Giorgio Sesti
- Department of Medical and Surgical SciencesUniversity Magna Graecia of CatanzaroCatanzaroItaly
| |
Collapse
|
46
|
Li YY, Stewart DA, Ye XM, Yin LH, Pathmasiri WW, McRitchie SL, Fennell TR, Cheung HY, Sumner SJ. A Metabolomics Approach to Investigate Kukoamine B-A Potent Natural Product With Anti-diabetic Properties. Front Pharmacol 2019; 9:1575. [PMID: 30723413 PMCID: PMC6350459 DOI: 10.3389/fphar.2018.01575] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 12/31/2018] [Indexed: 12/11/2022] Open
Abstract
Due to the surge in type 2 diabetes mellitus (T2DM), treatments for chronic metabolic dysregulations with fewer side-effects are sought. Lycii Cortex (LyC), a traditional Chinese Medicine (TCM) herb has a long history of being widely prescribed to treat T2DM as alternative medicine; however, the bioactive molecules and working mechanism remained unknown. Previous studies revealed kukoamine B (KB) as a major and featured compound for LyC with bioactivities for anti-oxidation and acute inflammation, which may be related to anti-diabetes properties. This study aims to understand the efficacy and the mode of action of KB in the diabetic (db/db) mouse model using a metabolomics approach. Parallel comparison was conducted using the first-line anti-diabetic drugs, metformin and rosligtazone, as positive controls. The db/db mice were treated with KB (50 mg kg-1 day-1) for 9 weeks. Bodyweight and fasting blood glucose were monitored every 5 and 7 days, respectively. Metabolomics and high-throughput molecular approaches, including lipidomics, targeted metabolomics (Biocrates p180), and cytokine profiling were applied to measure the alteration of serum metabolites and inflammatory biomarkers between different treatments vs. control (db/db mice treated with vehicle). After 9 weeks of treatment, KB lowered blood glucose, without the adverse effects of bodyweight gain and hepatomegaly shown after rosiglitazone treatment. Lipidomics analysis revealed that KB reduced levels of circulating triglycerides, cholesterol, phosphatidylethanolamine, and increased levels of phosphatidylcholines. KB also increased acylcarnitines, and reduced systemic inflammation (cytokine array). Pathway analysis suggested that KB may regulate nuclear transcription factors (e.g., NF-κB and/or PPAR) to reduce inflammation and facilitate a shift toward metabolic and inflammatory homeostasis. Comparison of KB with first-line drugs suggests that rosiglitazone may over-regulate lipid metabolism and anti-inflammatory responses, which may be associated with adverse side effects, while metformin had less impact on lipid and anti-inflammation profiles. Our research from holistic and systemic views supports the conclusion that KB is the bioactive compound of LyC for managing T2DM, and suggests KB as a nutraceutical or a pharmaceutical candidate for T2D treatment. In addition, our research provides insights related to metformin and rosiglitazone action, beyond lowering blood glucose.
Collapse
Affiliation(s)
- Yuan-Yuan Li
- NIH Eastern Regional Comprehensive Metabolomics Resource Core, Nutrition Research Institute, Department of Nutrition, University of North Carolina at Chapel Hill, Kannapolis, NC, United States
| | - Delisha A Stewart
- NIH Eastern Regional Comprehensive Metabolomics Resource Core, Nutrition Research Institute, Department of Nutrition, University of North Carolina at Chapel Hill, Kannapolis, NC, United States
| | - Xiao-Min Ye
- Department of Pharmacology, Wuhan Institute for Drug and Medical Device Control, Wuhan, China
| | - Li-Hua Yin
- Department of Pharmacology, Wuhan Institute for Drug and Medical Device Control, Wuhan, China
| | - Wimal W Pathmasiri
- NIH Eastern Regional Comprehensive Metabolomics Resource Core, Nutrition Research Institute, Department of Nutrition, University of North Carolina at Chapel Hill, Kannapolis, NC, United States
| | - Susan L McRitchie
- NIH Eastern Regional Comprehensive Metabolomics Resource Core, Nutrition Research Institute, Department of Nutrition, University of North Carolina at Chapel Hill, Kannapolis, NC, United States
| | - Timothy R Fennell
- Analytical Chemistry and Pharmaceutics, RTI International, Research Triangle Park, Durham, NC, United States
| | - Hon-Yeung Cheung
- Department of Biomedical Science, City University of Hong Kong, Kowloon, Hong Kong
| | - Susan J Sumner
- NIH Eastern Regional Comprehensive Metabolomics Resource Core, Nutrition Research Institute, Department of Nutrition, University of North Carolina at Chapel Hill, Kannapolis, NC, United States
| |
Collapse
|
47
|
Singh IR, Mitra S. Interaction of chlorpropamide with serum albumin: Effect on advanced glycated end (AGE) product fluorescence. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2019; 206:569-577. [PMID: 30189383 DOI: 10.1016/j.saa.2018.08.055] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 08/17/2018] [Accepted: 08/27/2018] [Indexed: 06/08/2023]
Abstract
Carrier proteins like bovine or human serum albumin (BSA and HSA, respectively) are prone to glycation as compared to the other available proteins. In this study, reducing sugars such as l-arabinose (ara), d-(-) galactose (gal) and d-(-) fructose (fru) were used to create model glycated serum albumins and binding ability of these with well-known antidiabetic drug chlorpropamide (CPM) was monitored. Fluorescence quenching experiment revealed that interaction of CPM with native as well as glycated albumins undergoes through a ground state complex formation. CPM binds strongly to glycated HSA with arabinose (gHSAara) as compared to other glycated systems and to the native proteins. CPM interacts through Van der Waals and hydrogen bonding interaction to glycated BSA by d-(-) fructose (gBSAfru) and also with native HSA; whereas, it's interaction with BSA and others glycated systems like gBSAara, gBSAgal and gHSAara occurs primarily through hydrophobic interaction. CPM showed an enhancement in the production of the advanced glycated end products (AGE) in all the glycated proteins. The difference in the binding capability of CPM to differently glycated albumins could be a major model to understand the drug carrying capacity of the glycated serum albumins.
Collapse
Affiliation(s)
- Imocha Rajkumar Singh
- Centre for Advanced Studies in Chemistry, North-Eastern Hill University, Shillong 793 022, India
| | - Sivaprasad Mitra
- Centre for Advanced Studies in Chemistry, North-Eastern Hill University, Shillong 793 022, India.
| |
Collapse
|
48
|
Zhou X, Zhang R, Zou Z, Shen X, Xie T, Xu C, Dong J, Liao L. Hypoglycaemic effects of glimepiride in sulfonylurea receptor 1 deficient rat. Br J Pharmacol 2018; 176:478-490. [PMID: 30471094 DOI: 10.1111/bph.14553] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 10/30/2018] [Accepted: 11/02/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AND PURPOSE Sulfonylureas (SUs) have been suggested to have an insulin-independent blood glucose-decreasing activity due to an extrapancreatic effect. However, a lack of adequate in vivo evidence makes this statement controversial. Here, we aimed to evaluate whether glimepiride has extrapancreatic blood glucose-lowering activity in vivo. EXPERIMENTAL APPROACH Sulfonylurea receptor 1 deficient (SUR1-/- ) rats were created by means of transcription activator-like effector nucleases (TALEN)-mediated gene targeting technology. Type 2 diabetic models were established by feeding a high-fat diet and administering a low-dose of streptozotocin. These rats were then randomly divided into four groups: glimepiride, gliclazide, metformin and saline. All rats were treated for 2 weeks. KEY RESULTS Glimepiride decreased blood glucose levels and increased insulin sensitivity without elevating insulin levels. Gliclazide showed similar effects as glimepiride. Both agents were weaker than metformin. Further mechanistic investigations revealed that glimepiride increased hepatic glycogen synthesis and decreased gluconeogenesis, which were accompanied by the activation of Akt in the liver. Moreover, glimepiride increased both total and membrane glucose transporter 4 (GLUT4) levels in muscle and fat, which might be attributed to insulin receptor-independent IRS1/Akt activation. CONCLUSION AND IMPLICATIONS Glimepiride possesses an extrapancreatic blood glucose-lowering effect in vivo, which might be attributed to its direct effect on insulin-sensitive tissues. Therefore, the combination of glimepiride with multiple insulin injections should not be excluded per se.
Collapse
Affiliation(s)
- Xiaojun Zhou
- Department of Endocrinology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China
| | - Rui Zhang
- Department of Endocrinology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China
| | - Zhiwei Zou
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, China
| | - Xue Shen
- Department of Endocrinology, Shandong Provincial Qianfoshan Hospital, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Tianyue Xie
- Department of Endocrinology, Shandong Provincial Qianfoshan Hospital, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Chunmei Xu
- Department of Endocrinology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China
| | - Jianjun Dong
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, China
| | - Lin Liao
- Department of Endocrinology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China
| |
Collapse
|
49
|
Prevalence of hypoglycemia among a sample of sulfonylurea-treated patients with Type 2 diabetes mellitus in Argentina: The real-life effectiveness and care patterns of diabetes management (RECAP-DM) study. ENDOCRINOL DIAB NUTR 2018; 65:592-602. [DOI: 10.1016/j.endinu.2018.05.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 05/17/2018] [Accepted: 05/22/2018] [Indexed: 02/06/2023]
|
50
|
Sulis PM, Dambrós BF, Mascarello A, dos Santos ARS, Yunes RA, Nunes RJ, Frederico MJS, Barreto Silva FRM. Sulfonyl(thio)urea derivative induction of insulin secretion is mediated by potassium, calcium, and sodium channel signal transduction. J Cell Physiol 2018; 234:10138-10147. [DOI: 10.1002/jcp.27680] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 10/08/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Paola Miranda Sulis
- Departamento de Bioquímica, Centro de Ciências Biológicas Universidade Federal de Santa Catarina, Campus Universitário Florianópolis Brazil
| | - Betina Fernanda Dambrós
- Departamento de Bioquímica, Centro de Ciências Biológicas Universidade Federal de Santa Catarina, Campus Universitário Florianópolis Brazil
| | - Alessandra Mascarello
- Departamento de Química, Centro de Ciências Físicas e Matemáticas Universidade Federal de Santa Catarina, Campus Universitário Florianópolis Brazil
| | - Adair Roberto Soares dos Santos
- Departamento de Ciências Fisiológicas, Centro de Ciências Biológicas Universidade Federal de Santa Catarina, Campus Universitário Florianópolis Brazil
| | - Rosendo Augusto Yunes
- Departamento de Química, Centro de Ciências Físicas e Matemáticas Universidade Federal de Santa Catarina, Campus Universitário Florianópolis Brazil
| | - Ricardo José Nunes
- Departamento de Química, Centro de Ciências Físicas e Matemáticas Universidade Federal de Santa Catarina, Campus Universitário Florianópolis Brazil
| | - Marisa Jádna Silva Frederico
- Departamento de Bioquímica, Centro de Ciências Biológicas Universidade Federal de Santa Catarina, Campus Universitário Florianópolis Brazil
| | - Fátima Regina Mena Barreto Silva
- Departamento de Bioquímica, Centro de Ciências Biológicas Universidade Federal de Santa Catarina, Campus Universitário Florianópolis Brazil
| |
Collapse
|