Drugs online research references
chu-bordeaux.fr
OBJECTIVE: In the present study, we measured fibrinolytic parameters, including PAI-1 antigen and activity in a group of type 2 diabetic patients in secondary oral anti-diabetic failure treated with insulin alone or with insulin plus metformin. RESEARCH DESIGN AND METHODS: 12 type 2 diabetic patients in secondary oral anti-diabetic failure were randomly allocated into two groups receiving insulin alone or insulin plus metformin 1000 mg twice a day; six weeks later, the treatments were swapped over. At the end of each treatment period, blood samples were withdrawn for metabolic and fibrinolytic analysis. RESULTS: There were no significant differences in fasting blood glucose, fructosamine or fibrinogen; LDL cholesterol, PAI-1 antigen and activity, insulin needs were reduced by the inulin plus metformin regimen (LDL cholesterol: 1.59 +/- 0.62 versus 1.28 +/- 0.5 mmol/l, PAI-1 antigen: 28.3 +/- 17.4 versus 23.9 +/- 18 ng/ml, PAI-1 activity: 23.8 +/- 9.6 versus 21.9 +/- 10 IU/ml, insulin needs: 64 +/- 18 versus 52 +/- 15 U/day (p<0.05). CONCLUSION: In type 2 diabetic patients with secondary oral treatment failure, insulin alone controlled blood glucose but had no effect on the levels of PAI-1; addition of metformin improved the fibrinolytic parameters.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14631327&dopt=Abstract [PubMed - in process]
chru.strasbg.fr
Type 2 diabetes (T2D), a major public health problem in all parts of the world, is preceded by an identifiable phase of impaired glucose tolerance (IGT) during which a therapeutic intervention aimed at preventing the glycaemic decompensation can be considered. The efficacy of a diet resulting in a weight loss and even more of an exercise program has been clearly established, but the long term continuation of these measures is difficult in real life conditions. So, pharmacological interventions on insulin resistance and B cell dysfunction, the major pathophysiologic components of the disease have been tested. A relative risk reduction of conversion from IG to T2D has been obtained with metformin in the Diabetes Prevention Program, but this effect seems to be directly linked to the antihyperglycaemic effect of the drug. Likewise, the relative risk reduction of 25% with acarbose in the Stop-NIDDM trial results more from a short term therapeutic effect than from an action in depth on the mechanisms leading to the glycaemic decompensation. This might does not be the case with troglitazone in the TRIPOD trial, since the protection conferred by this drug largely exceeds the treatment period and the B cell function appears to be preserved. However, these results should be confirmed in larger and more common populations of IGT. Finally, the practical carrying out of a prevention program at the scale of a whole population raises several unsolved problems.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14631333&dopt=Abstract [PubMed - in process]
nymc.edu
Long-term weight reduction remains the ultimate objective and challenge of obesity management. Few long-term dietary or pharmacointervention studies have been conducted and there is a critical need for long-range treatment strategies that are effective, safe, and acceptable. The authors conducted a retrospective cohort analysis of 21 euglycemic, hyperinsulinemic women with progressive, refractory, midlife weight gain (Syndrome W) who had previously lost weight (> or =10% reduction from baseline) with a comprehensive 1-year treatment program that included metformin and a hypocaloric, carbohydrate-modified (low-glycemic index) diet, as well as, other lifestyle modifications. The goal of the analysis was to determine long-term efficacy of the composite intervention using NHLBI criteria for weight stabilization, weight regain < or =3 kg (6.6 lb) in 2 years. Of a total of 26 consecutive women with Syndrome W who achieved goal weight during a 3-year period (1998-2001), 21 women (mean [standard error] age, 55.2 [2.4] years; mean body mass index, 34.2 [1.3] kg/m(2)) continued metformin and returned for annual follow-up visits. Weight maintenance was observed at the final (2-4 year) follow-up visit in 19/21 (90.5%) of women. Mean final follow-up weight (77.5 [2.8] kg) correlated highly with mean weight at 1-year protocol completion (77.2 [2.7] kg), (correlation coefficients r(xy) and sigma(xy) = 0.96, P = 0.000), demonstrating long-term weight reduction in the surveillance phase. Significant and robust decrements in fasting insulin (-28.4% [8.1%] to -43.4% [3.7%]) were observed at all follow-up visits (P < or = 0.002). This preliminary case series suggests that metformin may be an effective long-term adjunct to dietary and other interventions in the treatment of obesity in hyperinsulinemic patients. A randomized clinical trial of the dual regimen should be considered in nondiabetic women with midlife weight gain and hyperinsulinemia (Syndrome W) and, quite possibly, in additional euglycemic overweight and obese subjects with documented hyperinsulinemia and other portentous features of the Metabolic Syndrome.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14633321&dopt=Abstract
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