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Hong KF, Liu PY, Zhang W, Gui DK, Xu YH. The Efficacy and Safety of Astragalus as an Adjuvant Treatment for Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:11-24. [PMID: 37433206 DOI: 10.1089/jicm.2022.0767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
Objective: This meta-analysis evaluated the beneficial and potential adverse effects of Astragalus in the treatment of patients with type 2 diabetes mellitus (T2DM). Methods: The authors searched for randomized controlled trials of Astragalus treatment for patients with T2DM in the following databases: PubMed, Embase, Cochrane Library, China Knowledge Resource Integrated Database (CNKI), Wanfang Data, China Science and Technology Journal Database (CQVIP), and SinoMed. Two reviewers conducted independent selection of studies, data extraction, and coding, as well as the assessment of risk of bias in the studies included. Standard meta-analysis and, if appropriate, meta-regression were performed using the STATA, v.15.1, software. Results: This meta-analysis encompasses 20 studies and a total of 953 participants. Compared to the control group (CG), the observation group (OG) decreased fasting plasma glucose (FPG) (WMD = -0.67, 95% CI: -1.13∼-0.20, P = 0.005), 2 hours postprandial plasma glucose (2hPG) (WMD = -0.67 (95% CI: -1.13∼-0.20, P=0.005), glycated hemoglobin A1C (HbA1c) (WMD = -0.93, 95% CI: -1.22∼-0.64, P = 0.000), homeostatic model assessment for insulin resistance (HOMA-IR) (WMD = -0.45, 95% CI: -0.99∼0.99, P = 0.104), insulin sensitive index (WMD = 0.42, 95% CI: 0.13-0.72, P = 0.004). The total effective ratio of the OG is more effective than CG (RR = 1.33, 95% CI: 1.26-1.40, P = 0.000), the significant effective ratio (RR = 1.69, 95% CI: 1.48-1.93, P = 0.000). Conclusions: Astragalus may provide specific benefits for T2DM patients as an adjuvant treatment. Nonetheless, the certainty of the evidence and risk of bias fell short of optimal performance, indicating the need for additional clinical research to ascertain potential effects. PROSPERO REGISTRATION NUMBER CRD42022338491.
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Affiliation(s)
- Kin-Fong Hong
- Faculty of Medicine, Macau University of Science and Technology, Taipa, China
| | - Pei-Yu Liu
- Faculty of Medicine, Macau University of Science and Technology, Taipa, China
| | - Wei Zhang
- Faculty of Medicine, Macau University of Science and Technology, Taipa, China
- Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Ding-Kun Gui
- Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - You-Hua Xu
- Faculty of Medicine, Macau University of Science and Technology, Taipa, China
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Sebastian-Valles F, Arranz Martín JA, Girón RM, Knott-Torcal C, Sampedro-Nuñez MA, Martin-Adan JC, Jiménez-Díaz J, Marazuela M. Continuous Glucose Monitoring as an Additional Tool in Early Cystic Fibrosis-Related Diabetes Monitoring and in Evaluation of Short-Term Sitagliptin Response. Biomedicines 2023; 11:1754. [PMID: 37371849 DOI: 10.3390/biomedicines11061754] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/14/2023] [Accepted: 06/17/2023] [Indexed: 06/29/2023] Open
Abstract
Cystic fibrosis-related diabetes (CFRD) is a complication associated with a negative prognosis in patients with cystic fibrosis (CF). Although the oral glucose tolerance test (OGTT) is the widely recommended screening test for CFRD diagnosis, continuous glucose monitoring (CGM) is increasingly considered a useful and easy-to-perform test for diagnosis and follow-up in clinical practice. Regarding CFRD treatment, although insulin is the classic approved pharmacological option, incretins could also be a helpful alternative in early stages. CGM could be also a useful tool to measure the early response to this therapy. METHODS We studied 25 CF patients with abnormal OGTT results and compared glucose and insulin levels during the OGTTs with CGM results as a tool for early CFRD diagnosis. In addition, we evaluated glycaemic control with CGM before and after treatment with sitagliptin. RESULTS A correlation was found between lower plasma insulin levels during the OGTTs and higher average sensor glucose (p = 0.009) and hyperglycaemic excursions (p = 0.017). The CGM data on sitagliptin treatment (n = 25) showed an average glycaemic improvement from 124.2 to 117.2 mg/dL (p = 0.002) with a 5.6-point standard deviation of glucose decrease (p < 0.001). Hyperglycaemic excursions ≥200 mg/dL diminished 57.1% (p = 0.021). Both time in range and time above 180 mg/dL improved during treatment (p = 0.036 and p = 0.006, respectively). CONCLUSION CGM is a useful tool that offers valuable information for both the diagnosis and the management of CFRD. Lower plasma insulin levels during OGTTs are associated with a poor ambulatory glucose profile in CGM. Sitagliptin could play an important role in the treatment of the early stages of CFRD.
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Affiliation(s)
- Fernando Sebastian-Valles
- Department of Endocrinology and Nutrition, Hospital Universitario de la Princesa, IIS-Princesa, Universidad Autónoma de Madrid (UAM), 28006 Madrid, Spain
| | - José Alfonso Arranz Martín
- Department of Endocrinology and Nutrition, Hospital Universitario de la Princesa, IIS-Princesa, Universidad Autónoma de Madrid (UAM), 28006 Madrid, Spain
| | - Rosa María Girón
- Department of Pneumology, Hospital Universitario la Princesa, IIS-Princesa, Universidad Autónoma de Madrid (UAM), 28006 Madrid, Spain
| | - Carolina Knott-Torcal
- Department of Endocrinology and Nutrition, Hospital Universitario de la Princesa, IIS-Princesa, Universidad Autónoma de Madrid (UAM), 28006 Madrid, Spain
| | - Miguel Antonio Sampedro-Nuñez
- Department of Endocrinology and Nutrition, Hospital Universitario de la Princesa, IIS-Princesa, Universidad Autónoma de Madrid (UAM), 28006 Madrid, Spain
| | - Jose Carlos Martin-Adan
- Department of Endocrinology and Nutrition, Hospital Universitario de la Princesa, IIS-Princesa, Universidad Autónoma de Madrid (UAM), 28006 Madrid, Spain
| | - Jessica Jiménez-Díaz
- Department of Endocrinology and Nutrition, Hospital Universitario de la Princesa, IIS-Princesa, Universidad Autónoma de Madrid (UAM), 28006 Madrid, Spain
| | - Mónica Marazuela
- Department of Endocrinology and Nutrition, Hospital Universitario de la Princesa, IIS-Princesa, Universidad Autónoma de Madrid (UAM), 28006 Madrid, Spain
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HEMATYAR J, RASHIDI H, ZAKERKISH M, PAYAMI SP, GHADERIAN SB. Effect of Sitagliptin Versus Glibenclamide on Glycemic Markers, Lipid Profile Inflammatory and Oxidative Stress Factors in Type 2 Diabetes Patients: a Double-Blinded Randomized Controlled Trial. MAEDICA 2022; 17:762-770. [PMID: 36818268 PMCID: PMC9923081 DOI: 10.26574/maedica.2022.17.4.762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Objectives:Diabetes mellitus is leading to chronic complications, including cardiovascular diseases. The aim of this study was to compare the effect of Sitagliptin and Glibenclamide on glycemic markers, lipid profile inflammatory, and oxidative stress factors in type 2 diabetes patients. Methods: This double-blinded randomized controlled trial was performed on patients with type 2 diabetes mellitus (n=54). The treatment group (27 patients) received 100 mg of Sitagliptin once daily + 500 mg Metformin twice daily, orally, for 12 weeks, and the control group (27 patients) was given 5 mg of Glibenclamide once daily + 500 mg Metformin twice daily, also orally, for 12 weeks. Serum levels of tumor necrosis factor alpha (TNF-α), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), lipid profile [cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglyceride (TG)], fasting blood sugar (FBS) and hemoglobin A1C (HbA1c), body weight, and body mass index (BMI) were measured before and after the study. Results:In both groups, the FBS level was significantly reduced from baseline (P=0.03 in the Sitagliptin group and P=0.02 in the Glibenclamide one). The percent of HbA1c was also significantly reduced from baseline in both the Sitagliptin group (P=0.01) and the Glibenclamide one (P=0.008). However, comparing the groups, these changes were not different. In the Sitagliptin group, IL-6 was significantly reduced from baseline (P=0.01) as well as in comparison with the Glibenclamide group (P=0.001). The TG level was significantly lower than the baseline in the Sitagliptin group (P=0.03), so changes between groups were significant (P=0.04). Weight and BMI were significantly increased from baseline in the Glibenclamide group (P=0.02 and P=0.03, respectively), and their changes between the two groups were also significant (P=0.001). Conclusion:These finding support the favorable effects of Sitagliptin on cardiovascular risks beyond its advantages on insulin-glucose hemostasis in patients with type 2 diabetes.
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Affiliation(s)
- Javad HEMATYAR
- Diabetic Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Homeira RASHIDI
- Diabetic Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mehrnoosh ZAKERKISH
- Diabetic Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Peyman PAYAMI
- Diabetic Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Bahman GHADERIAN
- Diabetic Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Hendawy AS, El-Lakkany NM, Mantawy EM, Hammam OA, Botros SS, El-Demerdash E. Vildagliptin alleviates liver fibrosis in NASH diabetic rats via modulation of insulin resistance, oxidative stress, and inflammatory cascades. Life Sci 2022; 304:120695. [PMID: 35671811 DOI: 10.1016/j.lfs.2022.120695] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 05/30/2022] [Accepted: 06/03/2022] [Indexed: 02/06/2023]
Abstract
AIMS This study investigates the therapeutic potential of Vilda in a NASH model with liver fibrosis and elucidates the underlying molecular mechanisms. MAIN METHODS To induce NASH, male Sprague-Dawley rats were fed a high-fat diet for 24 weeks with a single dose of STZ (40 mg/kg, IP). Vilda was orally administered at two doses (10 and 20 mg/kg) for 20 weeks. KEY FINDINGS The induction of NASH was validated by abnormalities in hepatotoxicity indices, lipid profile, oxidative stress markers, and pathologically by marked fat deposition in hepatic tissues together with severe inflammatory cell infiltration. Moreover, NASH-affected rats demonstrated reduced insulin sensitivity manifested as elevated fasting blood glucose levels and disrupted homeostasis model assessment for insulin resistance. Vilda, at both doses, effectively abrogated all these pathological features of NASH. Mechanistically, these hepatoprotective properties of Vilda can be attributed to its antioxidant effects, anti-inflammatory effects (by inhibiting the TNF-α, NF-κB, JNK, and JAK/STAT pathways), and insulin-sensitizing effect (by upregulating the IRS-1/PI3K/Akt pathway). Besides, Vilda successfully counteracted NASH-associated liver fibrosis by downregulating the TGF-β1 pathway. SIGNIFICANCE The hepatoprotective and antifibrotic effects of Vilda were mostly dose-dependent. Collectively, this study offered a promising therapeutic avenue for Vilda as a novel strategy for counteracting the pathological progression of NASH and associated liver fibrosis.
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Affiliation(s)
- Ahmed S Hendawy
- Department of Pharmacology, Theodor Bilharz Research Institute, Kornaish El Nile, Warrak El-Hadar, Imbaba, 30, Giza 12411, Egypt
| | - Naglaa M El-Lakkany
- Department of Pharmacology, Theodor Bilharz Research Institute, Kornaish El Nile, Warrak El-Hadar, Imbaba, 30, Giza 12411, Egypt
| | - Eman M Mantawy
- Department of Pharmacology & Toxicology, Faculty of Pharmacy, Ain Shams University, Organization of African Unity Street, Abbasia, Cairo 11566, Egypt
| | - Olfat A Hammam
- Department of Pathology, Theodor Bilharz Research Institute, Kornaish El Nile, Warrak El-Hadar, Imbaba, 30, Giza 12411, Egypt
| | - Sanaa S Botros
- Department of Pharmacology, Theodor Bilharz Research Institute, Kornaish El Nile, Warrak El-Hadar, Imbaba, 30, Giza 12411, Egypt
| | - Ebtehal El-Demerdash
- Department of Pharmacology & Toxicology, Faculty of Pharmacy, Ain Shams University, Organization of African Unity Street, Abbasia, Cairo 11566, Egypt.
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Elhini SH, Hussien AK, Omran AAE, Elsayed AA, Saeed H. Efficacy and safety profile of sitagliptin, vildagliptin, and metformin in newly diagnosed type 2 diabetic subjects. Clin Exp Pharmacol Physiol 2021; 48:1589-1602. [PMID: 34333803 DOI: 10.1111/1440-1681.13561] [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: 04/12/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 11/27/2022]
Abstract
Type 2 diabetes mellitus (T2DM) is a chronic and progressive disease that requires long-term management. Thus, dipeptidyl peptidase-4 inhibitors (DPP-4) need more investigations about their efficacy and safety profile as there is still no evidence of whether DPP-4 inhibitors can be used as a first line option for T2DM drug-naïve patients. In this randomized case-controlled study, 60 drug-naïve T2DM subjects were randomized into three groups, each group comprising 20 subjects. Group 1 was given sitagliptin 100 mg once daily, Group 2 was given vildagliptin 50 mg twice daily, and Group 3 served as the control group and was given metformin 1 g twice daily. Efficacy endpoints included changes in glycosylated haemoglobin (HbA1c), fasting plasma glucose (FPG), and 2-hr postprandial plasma glucose (PPG), and the secondary endpoints were related to safety profile were the assessment of liver and kidney function tests and complete blood count (CBC). All treatment regimens had comparable efficacy and safety profiles with the non-significant relative superiority of vildagliptin in lowering HbA1c more than sitagliptin but significant (p = 0.011) regarding FPG reduction, vildagliptin significantly decreased HbA1c by -1.02% (p < 0.001), sitagliptin significantly decreased HbA1c by -0.96% (p < 0.001), and control significantly decreased HbA1c by -0.90% (p < 0.001) compared with baseline. The studied drugs showed moderate efficacy in lowering HbA1c levels with the non-significant relative higher efficacy of DPP-4 inhibitors. DPP-4 inhibitors and metformin showed favourable effects on improving metabolic syndrome by decreasing blood pressure, serum triglycerides (TG), low-density lipoprotein (LDL), total cholesterol, and increasing high-density lipoprotein (HDL), plus their positive impacts on weight. As a final conclusion, the three medications are highly comparable.
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Affiliation(s)
- Sahar Hossam Elhini
- Diabetes and Endocrinology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Amal K Hussien
- Department of Pharmaceutics, Faculty of Pharmacy, Minia University, Minia, Egypt
| | | | - Asmaa A Elsayed
- Department of Clinical Pharmacy, Faculty of Pharmacy, Minia University, Minia, Egypt
| | - Haitham Saeed
- Department of Clinical Pharmacy, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
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Citrus Flavanone Narirutin, In Vitro and In Silico Mechanistic Antidiabetic Potential. Pharmaceutics 2021; 13:pharmaceutics13111818. [PMID: 34834233 PMCID: PMC8619962 DOI: 10.3390/pharmaceutics13111818] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/16/2021] [Accepted: 10/21/2021] [Indexed: 12/15/2022] Open
Abstract
Citrus fruits and juices have been studied extensively for their potential involvement in the prevention of various diseases. Flavanones, the characteristic polyphenols of citrus species, are the primarily compounds responsible for these studied health benefits. Using in silico and in vitro methods, we are exploring the possible antidiabetic action of narirutin, a flavanone family member. The goal of the in silico research was to anticipate how narirutin would interact with eight distinct receptors implicated in diabetes control and complications, namely, dipeptidyl-peptidase 4 (DPP4), protein tyrosine phosphatase 1B (PTP1B), free fatty acid receptor 1 (FFAR1), aldose reductase (AldR), glycogen phosphorylase (GP), alpha-amylase (AAM), peroxisome proliferator-activated receptor gamma (PPAR-γ), alpha-glucosidase (AGL), while the in vitro study looked into narirutin’s possible inhibitory impact on alpha-amylase and alpha-glucosidase. The results indicate that the studied citrus flavanone interacted remarkably with most of the receptors and had an excellent inhibitory activity during the in vitro tests suggesting its potent role among the different constituent of the citrus compounds in the management of diabetes and also its complications.
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Yong‐Lin W, Yan Z, Yan T, Yuan‐Fang K, Yu‐Long H, Jie‐Ming L, Shao‐Pei W, Chun‐Hong D, Xiao‐Fei L. Exploring the Hypoglycaemic Mechanism of Chinese Medicine Xiao‐Ke‐An Based on Target Dipeptidyl Peptidase 4 Using Molecular Docking and Dynamics Simulation. ChemistrySelect 2021. [DOI: 10.1002/slct.202101661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Wang Yong‐Lin
- School of Pharmacy Henan University of Chinese Medicine 156 Jinshui East Road Zhengzhou Henan China
| | - Zhuang Yan
- School of Pharmacy Henan University of Chinese Medicine 156 Jinshui East Road Zhengzhou Henan China
| | - Tong Yan
- School of Pharmacy Henan University of Chinese Medicine 156 Jinshui East Road Zhengzhou Henan China
| | - Kong Yuan‐Fang
- School of Pharmacy Henan University of Chinese Medicine 156 Jinshui East Road Zhengzhou Henan China
| | - Hu Yu‐Long
- School of Pharmacy Henan University of Chinese Medicine 156 Jinshui East Road Zhengzhou Henan China
| | - Li Jie‐Ming
- School of Pharmacy Henan University of Chinese Medicine 156 Jinshui East Road Zhengzhou Henan China
| | - Wang Shao‐Pei
- School of Pharmacy Henan University of Chinese Medicine 156 Jinshui East Road Zhengzhou Henan China
| | - Dong Chun‐Hong
- School of Pharmacy Henan University of Chinese Medicine 156 Jinshui East Road Zhengzhou Henan China
| | - Li Xiao‐Fei
- School of Pharmacy Henan University of Chinese Medicine 156 Jinshui East Road Zhengzhou Henan China
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Shaheer A, Kumar A, Menon P, Jallo M, Basha S. Effect of Add-On Therapy of Sodium-Glucose Cotransporter 2 Inhibitors and Dipeptidyl Peptidase 4 Inhibitors on Adipokines in Type 2 Diabetes Mellitus. J Clin Med Res 2021; 13:355-362. [PMID: 34267843 PMCID: PMC8256907 DOI: 10.14740/jocmr4510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 05/07/2021] [Indexed: 02/07/2023] Open
Abstract
Background Excess adiposity is associated with an increased risk of cardiovascular disease due to metabolic changes in the body. Visceral obesity increases the risk of diabetes mellitus through adipocytokines and hence the effective targeting therapies are essential to control obesity in high-risk individuals. The study's main objective was to evaluate the effect of add-on therapy of sodium-glucose cotransporter 2 (SGLT2) inhibitors and dipeptidyl peptidase 4 (DPP4) inhibitors on visceral fat-associated serum adipokines. Methods The study included 90 subjects diagnosed with type 2 diabetes mellitus. The blood samples were taken before starting first-line therapy with metformin, 12 weeks after starting metformin therapy and 12 weeks after starting add-on therapy. Serum adipokines were analyzed with enzyme-linked immunosorbent assay (ELISA). Hemoglobin A1c (HbA1c) level was estimated with high-performance liquid chromatography (HPLC). The biochemical variables were measured using Cobas® 6000 analyzer. Results The mean adiponectin level was significantly elevated with add-on therapy using SGLT2 inhibitors and DPP4 inhibitors (P < 0.001). The mean retinol binding protein 4 (RBP4), fatty acid binding protein 4 (FABP4) and visfatin levels were reduced considerably (P < 0.001). The SGLT2 inhibitors are more effective on serum FABP4 in patients with type 2 diabetes (P = 0.038). The mean fasting plasma glucose (FPG), postprandial blood glucose (PPBG) and HbA1c levels were reduced significantly with add-on therapy (P < 0.001). Lipid profile was also altered significantly with this add-on therapy (P < 0.001). Conclusions The results indicate that add-on therapy exerts a beneficial effect in type 2 diabetic patients insufficiently controlled with metformin only by altering the visceral fat-associated adipokine levels and controlling the metabolic activities.
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Affiliation(s)
- Abid Shaheer
- Department of Biomedical Sciences, Gulf Medical University, Ajman, United Arab Emirates
| | - Ashok Kumar
- Department of Biochemistry, Rajah Muthiah Medical College, Annamalai University, Chidambaram, India
| | - Palat Menon
- Clinical Department, Pathology Laboratory, Fakeeh University Hospital, Dubai, United Arab Emirates
| | - Mahir Jallo
- Department of Internal Medicine, Gulf Medical University, Ajman, United Arab Emirates
| | - Shaikh Basha
- Department of Internal Medicine, Gulf Medical University, Ajman, United Arab Emirates
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Type II diabetes mellitus: a review on recent drug based therapeutics. Biomed Pharmacother 2020; 131:110708. [DOI: 10.1016/j.biopha.2020.110708] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/23/2020] [Accepted: 08/28/2020] [Indexed: 12/15/2022] Open
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Cardiovascular risk of sitagliptin in treating patients with type 2 diabetes mellitus. Biosci Rep 2019; 39:BSR20190980. [PMID: 31262972 PMCID: PMC6629947 DOI: 10.1042/bsr20190980] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 05/29/2019] [Accepted: 06/18/2019] [Indexed: 12/16/2022] Open
Abstract
Patients with type 2 diabetes mellitus (T2DM) have a very high risk of cardiovascular related events, and reducing complications is an important evaluation criterion of efficacy and safety of hypoglycemic drugs. Previous studies have shown that the dipeptidyl peptidase-4 (DPP-4) inhibitors (DPP4i), such as sitagliptin, might reduce the incidence of major cardiovascular events (MACEs). However, the safety and efficacy of sitagliptin remains controversial, especially the safety for cardiovascular related events. Here, a systematic review was conducted to assess the cardiovascular safety of sitagliptin in T2DM patients. The literature research dating up to October 2018 was performed in the electronic database. The clinical trials about sitagliptin for T2DM patients were included. Two reviewers independently screened literature according to the inclusion and exclusion criteria. The primary outcome was the MACE, and the secondary outcome was all-cause mortality. Finally, 32 clinical trials composed of 16082 T2DM patients were included in this meta-analysis. The results showed that: there was no significant difference between sitagliptin group and the control group on MACE (odds ratio (OR) = 0.85, 95% confidence intervals (CIs) = 0.63–1.15), myocardial infarction (MI) (OR = 0.66, 95% CI = 0.38–1.16), stroke (OR = 0.83, 95% CI = 0.44–1.54) and mortality (OR = 0.52, 95% CI = 0.26–1.07). These results demonstrated that sitagliptin did not increase the risk of cardiovascular events in patients with T2DM.
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