1
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Gallwitz B. Diabetestherapie bei herzkranken Patienten. DIABETOL STOFFWECHS 2023. [DOI: 10.1055/a-1930-2899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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2
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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.
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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
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3
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Amin KF, Fakhre NA, Abdullah AM. Comparative Study of Different Derivative Spectrophotometric Techniques for the Analysis and Separation of Metformin, Empagliflozin, and Glimepiride. CURR PHARM ANAL 2020. [DOI: 10.2174/1573412915666190416122337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background:
In some cases, lifestyle changes are not enough to keep type 2 diabetes under
control, so there are several medications that may help. Metformin can lower your blood sugar levels,
Glimepiride makes more insulin, whereas Empagliflozin prevents the kidneys from reabsorbing sugar
into the blood and sending it out in the urine.
Methods:
Mean centering, double divisor, ratio spectra-zero crossing, and successive derivative were
applied for the estimation of metformin, empagliflozin, and glimepiride respectively, in their prepared
laboratory mixtures and in pharmaceutical tablets, without prior chemical separation. The absorption
spectra of the mentioned drugs were recorded in the range of 200-400nm.
Results:
These methods were linear over concentration ranges of 1.0-10, 2.5-30, and 1.0-10 μgmL-1 of
metformin, empagliflozin, and glimepiride respectively. Mean centering for metformin was measured at
234 and 248 nm, while empagliflozin and glimepiride had amplitude values at 276 and 262 nm, respectively.
The derivative of double divisor was measured at 234, 278, and 288 nm for metformin, empagliflozin
and glimepiride, respectively. The ratio of spectra-zero crossing was quantified at amplitude values
of the analytical signal at 234 and 274 nm for metformin and empagliflozin, respectively, whereas
glimepiride was determined at 242 and 286 nm. The successive ratio of metformin, empagliflozin, and
glimepiride was determined at 284, 242, and 266 nm, respectively.
Conclusion:
The methods are validated according to the ICH guidelines where accuracy, precision and
repeatability are found to be within the acceptable limit. The methods were studied and optimized. Upon
validation linearity, precision, accuracy, LOD, LOQ and selectivity were proved to be operative for
the analysis of specified drugs in pharmaceutical dosage configuration. Statistical illustration was done
between the suggested methods with the reported methods with consideration to accuracy and precision.
No significant difference was found by student’s t-test, F-test and one-way ANOVA.
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Affiliation(s)
- Khanda F.M. Amin
- Department of Chemistry, College of Science, University of Sulaimani, Sulaimani, Iraq
| | - Nabil A. Fakhre
- Department of Chemistry, College of Education, Salahaddin University, Erbil, Iraq
| | - Ahmed M. Abdullah
- Department of Chemistry, College of Science, University of Sulaimani, Sulaimani, Iraq
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4
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Shpakov AO, Derkach KV. Molecular Mechanisms of the Effects of Metformin on the Functional Activity of Brain Neurons. ACTA ACUST UNITED AC 2018. [DOI: 10.1007/s11055-018-0657-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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5
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Kalra S, Ghosh S, Aamir AH, Ahmed MT, Amin MF, Bajaj S, Baruah MP, Bulugahapitiya U, Das AK, Giri M, Gunatilake S, Mahar SA, Pathan MF, Qureshi NK, Raza SA, Sahay R, Shakya S, Shreshta D, Somasundaram N, Sumanatilleke M, Unnikrishnan AG, Wijesinghe AM. Safe and pragmatic use of sodium-glucose co-transporter 2 inhibitors in type 2 diabetes mellitus: South Asian Federation of Endocrine Societies consensus statement. Indian J Endocrinol Metab 2017; 21:210-230. [PMID: 28217523 PMCID: PMC5240067 DOI: 10.4103/2230-8210.196029] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Diabetes prevalence shows a continuous increasing trend in South Asia. Although well-established treatment modalities exist for type 2 diabetes mellitus (T2DM) management, they are limited by their side effect profile. Sodium-glucose co-transporter 2 inhibitors (SGLT2i) with their novel insulin-independent renal action provide improved glycemic control, supplemented by reduction in weight and blood pressure, and cardiovascular safety. Based on the clinical outcomes with SGLT2i in patients with T2DM, treatment strategies that make a "good clinical sense" are desirable. Considering the peculiar lifestyle, body types, dietary patterns (long duration religious fasts), and the hot climate of the South Asian population, a unanimous decision was taken to design specific, customized guidelines for T2DM treatment strategies in these regions. The panel met for a discussion three times so as to get a consensus for the guidelines, and only unanimous consensus was included. After careful consideration of the quality and strength of the available evidence, the executive summary of this consensus statement was developed based on the American Association of Clinical Endocrinologists/American College of Endocrinology protocol.
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Affiliation(s)
- Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India
| | - Sujoy Ghosh
- Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - A. H. Aamir
- Department of Endocrinology and Metabolic Diseases, Post Graduate Medical Institute, Hayatabad Medical Complex, Peshawar, Pakistan
| | - Md. Tofail Ahmed
- Department of Endocrinology, BIRDEM and Ibrahim Medical College, Dhaka, Bangladesh
| | - Mohammod Feroz Amin
- Department of Endocrinology, BIRDEM and Ibrahim Medical College, Dhaka, Bangladesh
| | - Sarita Bajaj
- Department of Medicine, MLN Medical College, Allahabad, Uttar Pradesh, India
| | - Manash P. Baruah
- Department of Endocrinology, Excel Centre Hospitals, Guwahati, Assam, India
| | | | - A. K. Das
- Department of Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Mimi Giri
- BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Sonali Gunatilake
- Department of Endocrinology, Colombo South Teaching Hospital, Colombo, Sri Lanka
| | - Saeed A. Mahar
- Department of Medicine, National Institute of Cardiovascular Diseases, Karachi, Pakistan
| | - Md. Faruque Pathan
- Department of Endocrinology, BIRDEM and Ibrahim Medical College, Dhaka, Bangladesh
| | | | - S. Abbas Raza
- Department of Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Rakesh Sahay
- Department of Endocrinology, Osmania Medical College, Hyderabad, Telangana, India
| | - Santosh Shakya
- Diabetes, Thyroid and Endocrinology Care Centre, Kopundole, Nepal
| | - Dina Shreshta
- Department of Endocrinology, Norvic Hospital, Kathmandu, Nepal
| | - Noel Somasundaram
- Department of Endocrinology, National Hospital of Sri Lanka, Colombo, Sri Lanka
| | | | - A. G. Unnikrishnan
- Department of Endocrinology, Chellaram Institute of Diabetes, Pune, Maharashtra, India
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6
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Gallwitz B. [Therapy with oral antidiabetic drugs]. MMW Fortschr Med 2016; 158:48-54. [PMID: 27822846 DOI: 10.1007/s15006-016-8233-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Baptist Gallwitz
- Medizinische Klinik IV, Universitätsklinikum Tübingen, Otfried-Müller-Str. 10, D-72076, Tübingen, Deutschland.
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Zhao Y, Zhang X, Chen J, Lin C, Shao R, Yan C, Chen C. Hexarelin Protects Rodent Pancreatic Β-Cells Function from Cytotoxic Effects of Streptozotocin Involving Mitochondrial Signalling Pathways In Vivo and In Vitro. PLoS One 2016; 11:e0149730. [PMID: 26918825 PMCID: PMC4769129 DOI: 10.1371/journal.pone.0149730] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 02/04/2016] [Indexed: 01/25/2023] Open
Abstract
Mitochondrial functions are crucial for pancreatic β-cell survival and glucose-induced insulin secretion. Hexarelin (Hex) is a synthetic small peptide ghrelin analogue, which has been shown to protect cardiomyocytes from the ischemia-reperfusion process. In this study, we used in vitro and in vivo models of streptozotocin (STZ)-induced β-cell damage to study the protective effect of Hex and the associated mechanisms. We found that STZ produced a cytotoxic effect in a dose- and time-dependent manner in MIN6 cells (a mouse β-cell line). Hex (1.0 μM) decreased the STZ-induced damage in β-cells. Rhodamine 123 assay and superoxide DHE production assay revealed that Hex ameliorated STZ-induced mitochondrial damage and excessive superoxide activity in β-cells. In addition, Hex significantly reduced STZ-induced expression of cleaved Caspases-3, Caspases-9 and the ratio of pro-apoptotic protein Bax to anti-apoptotic protein Bcl-2 in MIN6 cells. We further examined the in vivo effect of Hex in a rat model of type 1 diabetes induced by STZ injection. Hex ameliorated STZ-induced decrease in plasma insulin and protected the structure of islets from STZ-induced disruption. Hex also ameliorated STZ-induced expression of cleaved Caspase-9 and the Bax in β-cells. In conclusion, our data indicate that Hex is able to protects β-cell mass from STZ-caused cytotoxic effects involving mitochondrial pathways in vitro and in vivo. Hex may serve as a potential protective agent for the management of diabetes.
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Affiliation(s)
- Yan Zhao
- Institute of Basic Medicine Science, Xi'an Medical University, Xi'an, China
- Department of Forensic Science, School of Medicine, Xi’an Jiaotong University, Xi’an, China
- School of Biomedical Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Xinli Zhang
- School of Biomedical Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Jiezhong Chen
- School of Biomedical Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Chao Lin
- School of Biomedical Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Renfu Shao
- Gene Cology Research Centre, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Maroochydore, QLD, Australia
| | - Chunxia Yan
- Department of Forensic Science, School of Medicine, Xi’an Jiaotong University, Xi’an, China
| | - Chen Chen
- School of Biomedical Sciences, The University of Queensland, St Lucia, QLD, Australia
- * E-mail:
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8
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Weiss M, Tura A, Kautzky-Willer A, Pacini G, D'Argenio DZ. Human insulin dynamics in women: a physiologically based model. Am J Physiol Regul Integr Comp Physiol 2015; 310:R268-74. [PMID: 26608654 DOI: 10.1152/ajpregu.00113.2015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 11/20/2015] [Indexed: 11/22/2022]
Abstract
Currently available models of insulin dynamics are mostly based on the classical compartmental structure and, thus, their physiological utility is limited. In this work, we describe the development of a physiologically based model and its application to data from 154 patients who underwent an insulin-modified intravenous glucose tolerance test (IM-IVGTT). To determine the time profile of endogenous insulin delivery without using C-peptide data and to evaluate the transcapillary transport of insulin, the hepatosplanchnic, renal, and peripheral beds were incorporated into the circulatory model as separate subsystems. Physiologically reasonable population mean estimates were obtained for all estimated model parameters, including plasma volume, interstitial volume of the peripheral circulation (mainly skeletal muscle), uptake clearance into the interstitial space, hepatic and renal clearance, as well as total insulin delivery into plasma. The results indicate that, at a population level, the proposed physiologically based model provides a useful description of insulin disposition, which allows for the assessment of muscle insulin uptake.
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Affiliation(s)
- Michael Weiss
- Department of Pharmacology, Martin Luther University, Halle-Wittenberg, Halle, Germany;
| | - Andrea Tura
- Metabolic Unit, National Research Council Neuroscience Institute, Padova, Italy
| | | | - Giovanni Pacini
- Metabolic Unit, National Research Council Neuroscience Institute, Padova, Italy
| | - David Z D'Argenio
- Department of Biomedical Engineering, University of Southern California, Los Angeles, California
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9
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Zhou J, Zheng F, Guo X, Yang H, Zhang M, Tian H, Guo L, Li Q, Mo Y, Jia W. Glargine insulin/gliclazide MR combination therapy is more effective than premixed insulin monotherapy in Chinese patients with type 2 diabetes inadequately controlled on oral antidiabetic drugs. Diabetes Metab Res Rev 2015; 31:725-33. [PMID: 25952634 DOI: 10.1002/dmrr.2661] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Accepted: 04/28/2015] [Indexed: 02/05/2023]
Abstract
BACKGROUND The aim of this study is to compare the efficacy and safety of once-daily insulin glargine plus gliclazide modified release combination therapy versus twice-daily premixed insulin monotherapy in Chinese type 2 diabetic patients insufficiently controlled by oral antidiabetic agents. METHODS In a 12-week, multicenter, randomized, parallel-group clinical trial, patients with poor glycaemic control (fasting plasma glucose ≥ 7.0 mmol/L and 7.5% < haemoglobin A1c ≤ 10%) on oral antidiabetic drugs were randomized to the treatment groups for combination therapy (n = 52) or monotherapy (n = 53). Continuous glucose monitoring was carried out over two 72-h periods, at the beginning and the end of the study, and the data were used to calculate the 24-h mean blood glucose, mean amplitude of glycaemic excursions, standard deviation of blood glucose, and the mean of daily differences. RESULTS The mean haemoglobin A1c decrease from baseline to study end was significant for both treatment groups (combination therapy: -1.23 ± 0.92%; insulin monotherapy: -1.02 ± 1.04%); moreover, the combination therapy group showed a significantly more robust haemoglobin A1c decrease (p = 0.0308). Both therapies significantly reduced the 24-h mean blood glucose (both, p < 0.001), but neither produced a significant effect on glycaemic variability, calculated as mean amplitude of glycaemic excursions, standard deviation of blood glucose, and mean of daily differences. In addition, the effects on rates of hypoglycaemic episodes were similar between the two therapies. CONCLUSIONS Chinese patients with type 2 diabetes inadequately controlled with oral antidiabetic agents attained greater benefit from once-daily insulin glargine plus gliclazide modified release regimen than from a twice-daily premixed insulin regimen.
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Affiliation(s)
- Jian Zhou
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Fenping Zheng
- Department of Endocrinology and Metabolism, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xiaohui Guo
- Department of Endocrinology and Metabolism, Peking University First Hospital, Beijing, China
| | - Huazhang Yang
- Department of Endocrinology and Metabolism, Guangdong General Hospital, Guangzhou, Guangdong, China
| | - Muxun Zhang
- Department of Endocrinology and Metabolism, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Haoming Tian
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, China
| | - Lixin Guo
- Department of Endocrinology and Metabolism, Beijing Hospital of Ministry of Public Health, Beijing, China
| | - Qiang Li
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Yifei Mo
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Weiping Jia
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
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10
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Ugrankar R, Berglund E, Akdemir F, Tran C, Kim MS, Noh J, Schneider R, Ebert B, Graff JM. Drosophila glucome screening identifies Ck1alpha as a regulator of mammalian glucose metabolism. Nat Commun 2015; 6:7102. [PMID: 25994086 PMCID: PMC4455130 DOI: 10.1038/ncomms8102] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 04/07/2015] [Indexed: 01/18/2023] Open
Abstract
Circulating carbohydrates are an essential energy source, perturbations in which are pathognomonic of various diseases, diabetes being the most prevalent. Yet many of the genes underlying diabetes and its characteristic hyperglycaemia remain elusive. Here we use physiological and genetic interrogations in D. melanogaster to uncover the ‘glucome', the complete set of genes involved in glucose regulation in flies. Partial genomic screens of ∼1,000 genes yield ∼160 hyperglycaemia ‘flyabetes' candidates that we classify using fat body- and muscle-specific knockdown and biochemical assays. The results highlight the minor glucose fraction as a physiological indicator of metabolism in Drosophila. The hits uncovered in our screen may have conserved functions in mammalian glucose homeostasis, as heterozygous and homozygous mutants of Ck1alpha in the murine adipose lineage, develop diabetes. Our findings demonstrate that glucose has a role in fly biology and that genetic screenings carried out in flies may increase our understanding of mammalian pathophysiology. Diabetes is associated with aberrations in glucose metabolism. Here the authors perform a genomic screen in fruit flies to identify new regulators of fly glucose metabolism, and show that mice lacking the murine homologue of one of their hits, the protein kinase CK1alpha, in the adipose lineage develop diabetes.
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Affiliation(s)
- Rupali Ugrankar
- Department of Developmental Biology, University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA
| | - Eric Berglund
- 1] Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA [2] Department of Pharmacology, University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA
| | - Fatih Akdemir
- Department of Developmental Biology, University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA
| | - Christopher Tran
- 1] Department of Developmental Biology, University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA [2] University of Texas, Dallas, Texas 75080, USA
| | - Min Soo Kim
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA
| | - Jungsik Noh
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA
| | - Rebekka Schneider
- Division of Hematology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Benjamin Ebert
- Division of Hematology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Jonathan M Graff
- 1] Department of Developmental Biology, University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA [2] Department of Molecular Biology, University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA
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Naidoo P, Rambiritch V, Butkow N, Saman S. Optimal utilisation of sulphonylureas in resource-constrained settings. Cardiovasc J Afr 2015; 25:83-5. [PMID: 24844554 PMCID: PMC4026768 DOI: 10.5830/cvja-2014-007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 02/04/2014] [Indexed: 01/21/2023] Open
Abstract
Abstract Sulphonylureas (SUs) are oral anti-diabetic drugs (OADs) that were introduced more than 60 years ago. Clinicians are familiar with their use and they remain extensively used. However, the SU class is associated with adverse effects of weight gain and hypoglycaemia. In addition, their effects on cardiovascular events remain contentious. Newer classes of anti-diabetic agents have been developed and these agents are weight neutral (di-peptidyl peptidase IV inhibitors), while others reduce weight (glucagon-like peptide analogues and sodium glucose co-transporter inhibitors). Furthermore, the newer agents are less likely to cause hypoglycaemia and have a potentially better cardiovascular safety profile. However, the newer agents are more costly than SUs and their long-term safety is unknown. It is therefore likely that SUs will continue to be used, and more so in resource-limited settings. One may mitigate the adverse effects of weight gain and hypoglycaemia associated with the SU class by using members within this class that are less probable to cause these adverse effects. Furthermore, the specific SU must be used at the lowest effective therapeutic dose. In patients at high risk of SU-induced hypoglycaemic episodes (frail, clinically significant renal impairment), or patients in whom hypoglycaemic episodes may have devastating effects (bus drivers), newer anti-diabetic agents may be a justifiable alternative option.
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Affiliation(s)
| | | | - Neil Butkow
- Department of Pharmacy and Pharmacology, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Selvarajah Saman
- Port Shepstone Regional Hospital and University of Kwa-Zulu Natal, Durban, South Africa
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12
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Zhao Q, Hong D, Zheng D, Xiao Y, Wu B. Risk of diarrhea in patients with type 2 diabetes mellitus treated with sitagliptin: a meta-analysis of 30 randomized clinical trials. DRUG DESIGN DEVELOPMENT AND THERAPY 2014; 8:2283-94. [PMID: 25419118 PMCID: PMC4234286 DOI: 10.2147/dddt.s70945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Sitagliptin is an important drug used for diabetes treatment and is used as a monotherapy in diabetic patients. However, there are also reported cases of diarrhea with sitagliptin use. Unfortunately, data concerning the relationship of diarrhea with sitagliptin use in various conditions have yet to be identified. Therefore, the overall incidence and risk of diarrhea with sitagliptin use have not been well defined. METHODS We conducted searches on Embase, PubMed, and the Cochrane Library databases for relevant randomized controlled trials. Registered relevant trials at the clinical trials registration website were also searched. Statistical analyses were conducted to calculate the overall incidence, odds ratios, and 95% confidence intervals (CI) by using either random-effects or fixed-effect models according to the heterogeneity of the included studies. RESULTS A total of 8,891 subjects with diabetes from 30 randomized clinical trials were included in the meta-analysis. The overall incidence of sitagliptin-associated diarrhea was 4.48% (95% CI: 3.59%-5.58%). Compared with the controls, the use of sitagliptin was not associated with a significantly increased risk of diarrhea with an odds ratio of 1.10 (95% CI: 0.78%-1.55%; P=0.58). No evidence of publication bias was observed. CONCLUSION Our study has shown that there is no difference in diarrhea risk between sitagliptin and controlled therapies. Moreover, sitagliptin is not a medicine that potentially increases the risk of diabetic diarrhea. More studies are recommended to further investigate this association.
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Affiliation(s)
- Qingwei Zhao
- Department of Pharmacy, First Affiliated Hospital of College of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Dongsheng Hong
- Department of Pharmacy, First Affiliated Hospital of College of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Dongsheng Zheng
- Department of Pharmacy, First Affiliated Hospital of College of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Yao Xiao
- College of Pharmaceutical Science, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Baohua Wu
- Department of Pharmacy, First Affiliated Hospital of College of Medicine, Zhejiang University, Hangzhou, People's Republic of China
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13
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Duan Y, Zhang R, Zhang M, Sun L, Dong S, Wang G, Zhang J, Zhao Z. Metformin inhibits food intake and neuropeptide Y gene expression in the hypothalamus. Neural Regen Res 2014; 8:2379-88. [PMID: 25206548 PMCID: PMC4146045 DOI: 10.3969/j.issn.1673-5374.2013.25.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 08/06/2013] [Indexed: 12/25/2022] Open
Abstract
Metformin may reduce food intake and body weight, but the anorexigenic effects of metformin are still poorly understood. In this study, Sprague-Dawley rats were administered a single intracere-broventricular dose of metformin and compound C, in a broader attempt to investigate the regula-tory effects of metformin on food intake and to explore the possible mechanism. Results showed that central administration of metformin significantly reduced food intake and body weight gain, par-ticularly after 4 hours. A reduction of neuropeptide Y expression and induction of AMP-activated protein kinase phosphorylation in the hypothalamus were also observed 4 hours after metformin administration, which could be reversed by compound C, a commonly-used antagonist of AMP-activated protein kinase. Furthermore, metformin also improved lipid metabolism by reducing plasma low-density lipoprotein. Our findings suggest that under normal physiological conditions, central regulation of appetite by metformin is related to a decrease in neuropeptide Y gene expres-sion, and that the activation of AMP-activated protein kinase may simply be a response to the anorexigenic effect of metformin.
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Affiliation(s)
- Yale Duan
- Key Laboratory of Brain Functional Genomics, Ministry of Education, Shanghai Key Laboratory of Brain Functional Genomics, East China Normal University, Shanghai 200062, China
| | - Rui Zhang
- Key Laboratory of Brain Functional Genomics, Ministry of Education, Shanghai Key Laboratory of Brain Functional Genomics, East China Normal University, Shanghai 200062, China
| | - Min Zhang
- Department of Clinical Laboratory, Shanghai Public Health Clinical Center Affiliated to Fudan University, Shanghai 201508, China
| | - Lijuan Sun
- Key Laboratory of Brain Functional Genomics, Ministry of Education, Shanghai Key Laboratory of Brain Functional Genomics, East China Normal University, Shanghai 200062, China
| | - Suzhen Dong
- Key Laboratory of Brain Functional Genomics, Ministry of Education, Shanghai Key Laboratory of Brain Functional Genomics, East China Normal University, Shanghai 200062, China
| | - Gang Wang
- Department of Clinical Laboratory, Shanghai Public Health Clinical Center Affiliated to Fudan University, Shanghai 201508, China
| | - Jun Zhang
- Department of Clinical Laboratory, Shanghai Public Health Clinical Center Affiliated to Fudan University, Shanghai 201508, China
| | - Zheng Zhao
- Key Laboratory of Brain Functional Genomics, Ministry of Education, Shanghai Key Laboratory of Brain Functional Genomics, East China Normal University, Shanghai 200062, China
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14
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Kysenius K, Brunello CA, Huttunen HJ. Mitochondria and NMDA receptor-dependent toxicity of berberine sensitizes neurons to glutamate and rotenone injury. PLoS One 2014; 9:e107129. [PMID: 25192195 PMCID: PMC4156429 DOI: 10.1371/journal.pone.0107129] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 08/14/2014] [Indexed: 12/21/2022] Open
Abstract
The global incidence of metabolic and age-related diseases, including type 2 diabetes and Alzheimer's disease, is on the rise. In addition to traditional pharmacotherapy, drug candidates from complementary and alternative medicine are actively being pursued for further drug development. Berberine, a nutraceutical traditionally used as an antibiotic, has recently been proposed to act as a multi-target protective agent against type 2 diabetes, dyslipidemias, ischemic brain injury and neurodegenerative diseases, such as Parkinson's and Alzheimer's disease. However, the safety profile of berberine remains controversial, as isolated reports suggest risks with acute toxicity, bradycardia and exacerbation of neurodegeneration. We report that low micromolar berberine causes rapid mitochondria-dependent toxicity in primary neurons characterized by mitochondrial swelling, increased oxidative stress, decreased mitochondrial membrane potential and depletion of ATP content. Berberine does not induce caspase-3 activation and the resulting neurotoxicity remains unaffected by pan-caspase inhibitor treatment. Interestingly, inhibition of NMDA receptors by memantine and MK-801 completely blocked berberine-induced neurotoxicity. Additionally, subtoxic nanomolar concentrations of berberine were sufficient to sensitize neurons to glutamate excitotoxicity and rotenone injury. Our study highlights the need for further safety assessment of berberine, especially due to its tendency to accumulate in the CNS and the risk of potential neurotoxicity as a consequence of increasing bioavailability of berberine.
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Affiliation(s)
- Kai Kysenius
- Neuroscience Center, University of Helsinki, Helsinki, Finland
| | | | - Henri J. Huttunen
- Neuroscience Center, University of Helsinki, Helsinki, Finland
- * E-mail:
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15
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Alterations of pancreatic islet structure, metabolism and gene expression in diet-induced obese C57BL/6J mice. PLoS One 2014; 9:e86815. [PMID: 24505268 PMCID: PMC3914796 DOI: 10.1371/journal.pone.0086815] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 12/19/2013] [Indexed: 11/19/2022] Open
Abstract
The reduction of functional β cell mass is a key feature of type 2 diabetes. Here, we studied metabolic functions and islet gene expression profiles of C57BL/6J mice with naturally occurring nicotinamide nucleotide transhydrogenase (NNT) deletion mutation, a widely used model of diet-induced obesity and diabetes. On high fat diet (HF), the mice developed obesity and hyperinsulinemia, while blood glucose levels were only mildly elevated indicating a substantial capacity to compensate for insulin resistance. The basal serum insulin levels were elevated in HF mice, but insulin secretion in response to glucose load was significantly blunted. Hyperinsulinemia in HF fed mice was associated with an increase in islet mass and size along with higher BrdU incorporation to β cells. The temporal profiles of glucose-stimulated insulin secretion (GSIS) of isolated islets were comparable in HF and normal chow fed mice. Islets isolated from HF fed mice had elevated basal oxygen consumption per islet but failed to increase oxygen consumption further in response to glucose or carbonyl cyanide-4-trifluoromethoxyphenylhydrazone (FCCP). To obtain an unbiased assessment of metabolic pathways in islets, we performed microarray analysis comparing gene expression in islets from HF to normal chow-fed mice. A few genes, for example, those genes involved in the protection against oxidative stress (hypoxia upregulated protein 1) and Pgc1α were up-regulated in HF islets. In contrast, several genes in extracellular matrix and other pathways were suppressed in HF islets. These results indicate that islets from C57BL/6J mice with NNT deletion mutation develop structural, metabolic and gene expression features consistent with compensation and decompensation in response to HF diet.
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16
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Tiwari AK, Manasa K, Kumar DA, Zehra A. Raw horse gram seeds possess more in vitro antihyperglycaemic activities and antioxidant properties than their sprouts. ACTA ACUST UNITED AC 2013. [DOI: 10.1007/s13749-013-0012-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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