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ksl.ch
Type 2 diabetes mellitus is often associated with other risk factors for atherosclerotic disease, resulting in a marked increase in cardiovascular events and deaths. Combined treatment of hyperglycaemia, dyslipidaemia and hypertension significantly decreases the frequency and severity of diabetic microvascular and macrovascular complications. In a prospective cohort study including 356 type 2 diabetic patients (= 14% of all in-patients during a 6 months' period) the prevalence and treatment of cardiovascular risk factors were determined. Hypertension was diagnosed in 54% of the diabetic patients, albuminuria in 53% and dyslipidaemia in 47%; there were 40 smokers (17%). On admission the mean HbA1c was 7.7 +/- 2.0%, the mean fasting plasma glucose 10.0 +/- 4.2 mmol/l (and 8.9 +/- 3.9 mmol/l, p = 0.03, when discharged), the mean systolic blood pressure was 144 +/- 28 mm Hg (and 131 +/- 20, p < 0.0001, when discharged), and the triglycerides were 2.6 +/- 0.4 mmol/l. 34% of the hypertensive diabetic patients were treated with a combination of anti-hypertensive drugs, 44% of the dyslipidaemic diabetic patients were treated with statins, and 58% of all diabetic patients received aspirin or oral anticoagulation. 23% of the diabetic patients were treated by diet alone, 36% with insulin, 25% with sulfonylureas and 5% with metformin, while 11% were given a combination of antihyperglycaemic medication. In-hospital mortality was 11%. The diabetic patients were discharged on 2.9 +/- 1.7 different drugs. The prevalence of associated cardiovascular risk factors is high in type 2 diabetic patients, and thus a combination of drugs is often warranted. The rate of admissions and in-hospital mortality is high in type 2 diabetic patients.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11688065&dopt=Abstract
Horm Metab Res. 1989 Jun;21(6):317-9.
A comparison of metformin versus guar in combination with sulphonylureas in the treatment of non insulin dependent diabetes.
Wilson JA, Scott MM, Gray RS.
Bangour General Hospital, Broxburn, West Lothian, United Kingdom.
Twelve non-obese non insulin dependent diabetics whose mean +/- SE fasting blood glucose was 12.9 +/- 0.9 mmol/l despite maximal doses of sulphonylureas, received 8 weeks of guar (5 g tid before meals) and 8 weeks of metformin (0.5 g tid) following a six week washout period, in a cross-over design. Guar significantly lowered fasting cholesterol and triglyceride concentrations but did not alter glucose concentrations. Conversely, metformin significantly reduced fasting and post-prandial glucose concentrations but had no influence on plasma lipids.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2777189&dopt=Abstract
Acta Med Austriaca. 1978;5(3):85-8.
[Biguanides: reasons for withdrawal of drugs and remaining indications]
[Article in German]
Bolzano K.
The pharmacological properties and the mode of action of biguanides is presented. In Austria, the association of lactic acidosis with biguanide therapy has led to a cancellation of the registration of buformin and phenformin. Only, if all contraindications for biguanide therapy are strictly observed, metformin can be prescribed for the treatment of obese patients with type II diabetes.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=752219&dopt=Abstract
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