Effects Of Sitagliptin Monotherapy On Insulin Resistance And Immune Functions In Type 2 Diabetic Patients
Endocrine Abstracts (2017) 49 EP601 | DOI: 10.1530/endoabs.49.EP601 Effects of sitagliptin monotherapy on insulin resistance and immune functions in type 2 diabetic patients Serdar Almacioglu1, Ozen Oz Gul2, Soner Cander2 & Canan Ersoy2 1Department of Internal Medicine, Diyarbakir Gazi Yasargil Education and Research Hospital, Bursa, Turkey; 2Department of Endocrinology and Metabolism, Uludag University Medical School, Bursa, Turkey. Background: Sitagliptin, unlike the some major antihyperglycemic drugs, is not associated with weight gain and has neutral effects on body weight. It is unclear whether sitagliptin treatment alters immune functions and insulin resistance in people with type 2 diabetes. The aim of the present study was to assess the effect of sitagliptin on insulin resistance and immune functions in patients with type 2 diabetes mellitus. Methods: Twenty type 2 diabetic subjects were randomly assigned to receive sitagliptin (100 mg/day; n=10) or medical nutrition therapy (MNT) (n=10) for 12 weeks. Changes in anthropometric variables, glycemic control, insulin resistance, lipid parameters and immune functions were evaluated at baseline and following 12 weeks of treatment. T lymphocyte subgroups like as CD3, CD4, CD8 and TGF-1, IL-12 were analyzed to evaluate immune functions. Results: Significant decreases in body weight and body mass index were observed over the entire study period in MNT treatment group but not in sitagliptin group. HbA1c and postprandial plasma glucose (PPG) levels were decreased in the sitagliptin group compared with baseline values but not statistically significant while they were unchanged in the MNT group. There was a significant decrease c-peptide and insulin resistance (HOMA-IR) in sitagliptin group compared with baseline values but Continue reading >>
Triple Combination Of Insulin Glargine, Sitagliptin And Metformin In Type 2 Diabetes: The Easie Post-hoc Analysis And Extension Trial
Abstract We examined the effects of adding glargine to metformin–sitagliptin (MS + G) or sitagliptin to metformin–glargine (MG + S) therapy in type 2 diabetic persons uncontrolled after 24-week MS or MG dual therapy. Subjects with A1c ≥ 7% on MS or MG treatment were respectively given glargine (0.2 U/kg starting dose) or sitagliptin (100 mg daily) for 12 weeks. The primary endpoint was number of subjects attaining A1c goal defined as < 7%. After receiving 24-week MS or MG dual therapy in the original EASIE Study, 42% (104/248) on MS and 68% (152/224) on MG attained A1c < 7% (p < 0.0001). The reduction in A1c was negatively associated with baseline fasting blood glucose (FBG) only in the MG group. Reduction in A1c was not related to baseline postprandial blood glucose (PPBG) in either the MG or MS group. Amongst 194 eligible patients, 57.7% (n = 111) entered the 12-week extension trial [MS + G:74/131, 57.3%; MG + S:37/63, 58.7%) with 55 (51.9%) subjects attaining goal [MS + G:59.2%; MG + S:37.1%] at week 12. The final insulin dosage was similar in both groups [MS + G: 0.46 U/kg; MG + S: 0.45 U/kg] with a higher rate of hypoglycemia in the MG + S (6.5 events/patient-year) than the MS + G group (3.2 events/patient-year), although neither group had severe hypoglycemia. In metformin-treated type 2 diabetes patients, high fasting BG predicted greater A1c reductions with the addition of glargine, but not with sitagliptin. In subjects uncontrolled with 6-month dual therapy of MS or MG, 50% attained A1c < 7% with triple therapy of MS + G or MG + S in 12 weeks. The increased rate of hypoglycemia with MG + S (but not with MS + G) underlines the need to take measures to avoid the hypoglycemia. Conflict of Interest: J.C.N. Chan, P. Aschner, D.R. Owens, M. Vincent, M-P. Dain, V Continue reading >>
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Adding Of Sitagliptin On Insulin Therapy Effectively And Safely Reduces A Hemoglobin A1c Level And Glucose Fluctuation In Japanese Patients With Type 2 Diabetes
Adding of Sitagliptin on Insulin Therapy Effectively and Safely Reduces a Hemoglobin A1c Level and Glucose Fluctuation in Japanese Patients with Type 2 Diabetes 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-Machi, Kurume 830-0011, Japan 2Municipal Yame General Hospital, Yame 834-0034, Japan 3Kouhoukai Takagi Hospital, Okawa 831-0016, Japan 5Shimada Hospital, Ogori 838-0141, Japan 6Tenjinkai Koga Hospital 21, Kurume 839-0801, Japan 7Saint Mary Hospital, Kurume 830-8543, Japan 8Tenjinkai Shin-Koga Hospital, Kurume 830-8577, Japan Received 10 March 2014; Accepted 5 June 2014; Published 3 August 2014 Copyright 2014 Yuji Tajiri et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Aims. Efficacy and safety of DPP-4 inhibitor, sitagliptin, add-on therapy to insulin were investigated in Japanese patients with type 2 diabetes. Subjects and Methods. Two hundred and sixteen patients (126 men, 65 12 years old, BMI 24.9 4.5, means S.D.) who had been treated by insulin alone or insulin combined with other oral hypoglycemic agents (OHAs) were recruited, and sitagliptin was added for 3 months. Results. HbA1c was significantly decreased after 3 months of add-on therapy as a whole (8.56 1.50% to 7.88 1.25%, ). Body weight did not change and insulin dosage was significantly ( ) decreased for 3 months. Furthermore, day-to-day glucose variability was significantly reduced (18.3 9.1 to 16.1 8.1%, ). In stepwise multiple regression analysis on HbA1c as an outcome variable, the higher baseline HbA1c value and a preserved CPR were selected as signific Continue reading >>
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Januvia
JANUVIA® (sitagliptin) Tablets DESCRIPTION JANUVIA Tablets contain sitagliptin phosphate, an orally-active inhibitor of the dipeptidyl peptidase4 (DPP-4) enzyme. Sitagliptin phosphate monohydrate is described chemically as 7-[(3R)-3-amino-1-oxo-4-(2,4,5trifluorophenyl)butyl]-5,6,7,8-tetrahydro-3-(trifluoromethyl)-1,2,4-triazolo[4,3-a]pyrazine phosphate (1:1) monohydrate. The empirical formula is C16H15F6N5O•H3PO4•H2O and the molecular weight is 523.32. The structural formula is: Sitagliptin phosphate monohydrate is a white to off-white, crystalline, non-hygroscopic powder. It is soluble in water and N,N-dimethyl formamide; slightly soluble in methanol; very slightly soluble in ethanol, acetone, and acetonitrile; and insoluble in isopropanol and isopropyl acetate. Each film-coated tablet of JANUVIA contains 32.13, 64.25, or 128.5 mg of sitagliptin phosphate monohydrate, which is equivalent to 25, 50, or 100 mg, respectively, of free base and the following inactive ingredients: microcrystalline cellulose, anhydrous dibasic calcium phosphate, croscarmellose sodium, magnesium stearate, and sodium stearyl fumarate. In addition, the film coating contains the following inactive ingredients: polyvinyl alcohol, polyethylene glycol, talc, titanium dioxide, red iron oxide, and yellow iron oxide. For Consumers What are the possible side effects of sitagliptin (Januvia)? Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop taking sitagliptin and call your doctor at once if you have a serious side effect such as: pancreatitis - severe pain in your upper stomach spreading to your back, nausea and vomiting, loss of appetite, fast heart rate; or urinating less than usual Continue reading >>
Sitagliptin Approved As Add-on To Insulin
Sitagliptin approved as add-on to insulin Sitagliptin approved as add-on to insulin Sitagliptin (known as Januvia) has been approved by the European Commission as an add-on to insulin (with or without metformin)for people with Type 2 diabetes who cannot control their condition effectively with a combination of diet, physical activity and insulin. Sitagliptin is a once-daily DPP-4 inhibitor thatworks by blocking the action ofDPP-4, an enzyme which destroys the hormone incretin. Incretins help the body produce more insulin only when it is needed and reduce the amount of glucose being produced by the liver when it is not needed. Further option for people with Type 2 diabetes We welcome any advances that help improve quality of life for people with diabetes," said Pav Kalsi, Care Advisor at Diabetes UK. "When it is not possible for people with Type 2 diabetes to achieve good blood glucose control through lifestyle and current medication, Diabetes UK recognises that a wide choice of treatment options, including Januvia (sitagliptin) in combination with insulin, can help. People with diabetes should have as wide a choice as possible of effective treatments for their condition. Good blood glucose control is essential for people with diabetes to improve wellbeing and protect against long-term damage to the eyes, kidneys, nerves, heart and major arteries. Continue reading >>
Sitagliptin For Diabetes Januvia
Take sitagliptin tablets once a day. Remember to follow any advice you have been given about your diet. The most common side-effects are feeling sick (nausea), headache, and nose or throat infections. About sitagliptin Type of medicine An antidiabetic medicine Used for Adults with type 2 diabetes mellitus Also called Januvia®; Janumet® (a combination tablet containing sitagliptin with metformin) Available as Tablets Insulin is a hormone which is made naturally in your body, in the pancreas. It helps to control the levels of sugar in your blood. If your body does not make enough insulin, or if it does not use the insulin it makes effectively, this results in the condition called sugar diabetes (diabetes mellitus). People with diabetes need treatment to control the amount of sugar (glucose) in their blood. This is because good control of blood glucose levels reduces the risk of complications later on. Some people can control the sugar in their blood by making changes to the food they eat but, for other people, medicines like sitagliptin are given alongside the changes in diet. Sitagliptin works in part by increasing the amount of insulin produced by your body. It also reduces the amount of a substance called glucagon being produced by your pancreas. Glucagon causes your liver to produce more sugar, so by reducing the amount of glucagon in your body, this also helps to reduce the levels of glucose in your blood. Before taking sitagliptin Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking sitagliptin it is important that your doctor knows: If you are pregnant, trying for a baby or breast-feeding. If you have any problems with the way your kidneys w Continue reading >>
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Sitagliptin Plus Basal Insulin Comparable To Basal-bolus Regimen In Type 2 Diabetes
Sitagliptin Plus Basal Insulin Comparable to Basal-Bolus Regimen in Type 2 Diabetes Sitagliptin Plus Basal Insulin Comparable to Basal-Bolus Regimen in Type 2 Diabetes Patients who used a combination therapy of sitagliptin plus basal insulin for type 2 diabetes management had similar hospital length of stay, daily blood glucose concentration levels, and rates of hypoglycemia compared with patients who used a more labor-intensive basal-bolus insulin regimen, according to results from a prospective, randomized clinical trial published in The Lancet Diabetes & Endocrinology. Francisco J Pasquel, MD, from Emory University in Atlanta, and colleagues randomly assigned 277 patients between August 2013 and July 2015 to receive treatment with once-daily sitagliptin plus basal glargine (n=138) or a once-daily basalt 2013 and July 2015 to receiv and rapid-acting insulin lispro or aspart (n=139) taken before meals. Patients, aged 18 to 80 years, were from 5 different hospitals; had type 2 diabetes; were taking diet or oral antidiabetic drugs; and had a total daily insulin dose of 0.6 units per kg and a random blood glucose concentration of 7.8 to 22.2 mmol/L. Guidelines from professional organizations for the management of non-critically ill patients with type 2 diabetes admitted to hospital recommend the use of basal-bolus insulin regimens, which are labor-intensive and associated with a risk of hypoglycemia, Dr Pasquel and colleagues wrote. The results of our clinical trial show that treatment with the DPP-4 inhibitor sitagliptin and basal insulin once daily is similarly efficacious and safe compared to multidose regimens with basal insulin once daily and rapid-acting insulin before meals in patients in hospital with uncontrolled glucose concentrations. The researchers found bot Continue reading >>
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What Is Januvia®?
JANUVIA (jah-NEW-vee-ah) is a once-daily prescription pill that, along with diet and exercise, helps lower blood sugar levels in adults with type 2 diabetes. JANUVIA should not be used in patients with type 1 diabetes or with diabetic ketoacidosis (increased ketones in the blood or urine). If you have had pancreatitis (inflammation of the pancreas), it is not known if you have a higher chance of getting it while taking JANUVIA. IMPORTANT SAFETY INFORMATION Serious side effects can happen in people who take JANUVIA, including pancreatitis, which may be severe and lead to death. Before you start taking JANUVIA, tell your doctor if you've ever had pancreatitis. Stop taking JANUVIA and call your doctor right away if you have pain in your stomach area (abdomen) that is severe and will not go away. The pain may be felt going from your abdomen through to your back. The pain may happen with or without vomiting. These may be symptoms of pancreatitis. Before you start taking JANUVIA, tell your doctor if you have ever had heart failure (your heart does not pump blood well enough) or have problems with your kidneys. Contact your doctor right away if you have increasing shortness of breath or trouble breathing (especially when you lie down); swelling or fluid retention (especially in the feet, ankles, or legs); an unusually fast increase in weight; or unusual tiredness. These may be symptoms of heart failure. Do not take JANUVIA if you are allergic to any of its ingredients, including sitagliptin. Symptoms of serious allergic reactions to JANUVIA, including rash, hives, and swelling of the face, lips, tongue, and throat that may cause difficulty breathing or swallowing, can occur. If you have any symptoms of a serious allergic reaction, stop taking JANUVIA and call your doctor right Continue reading >>
Use Januvia Concomitantly With Insulin: Strong A1c Reductions1
As an adjunct to diet and exercise for appropriate patients with type 2 diabetes FAS = full analysis set; LS = least squares. This is an electronic version of a figure published in Diabetes, Obesity and Metabolism Volume 12, Issue 2, pages 167-177, February 2010, published by Wiley. As an adjunct to diet and exercise for appropriate patients with type 2 diabetes PPG = postprandial glucose; FPG = fasting plasma glucose; FAS = full-analysis-set; LS = least squares. JANUVIA is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. JANUVIA should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis. JANUVIA has not been studied in patients with a history of pancreatitis. It is unknown whether patients with a history of pancreatitis are at increased risk of developing pancreatitis while taking JANUVIA. Selected Important Risk Information About JANUVIA® (sitagliptin) tablets JANUVIA is contraindicated in patients with a history of a serious hypersensitivity reaction to sitagliptin, such as anaphylaxis or angioedema. There have been postmarketing reports of acute pancreatitis, including fatal and nonfatal hemorrhagic or necrotizing pancreatitis, in patients taking JANUVIA. After initiating JANUVIA, observe patients carefully for signs and symptoms of pancreatitis. If pancreatitis is suspected, promptly discontinue JANUVIA and initiate appropriate management. It is unknown whether patients with a history of pancreatitis are at increased risk of developing pancreatitis while taking JANUVIA. An association between dipeptidyl peptidase-4 (DPP-4) inhibitor treatment and heart failure has been observed in cardiovascular outcomes trials for two other members of the DPP-4 inhibitor class. Continue reading >>
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Sitagliptin Insulin Evaluated In Hospitalized T2d Patients
Sitagliptin Insulin Evaluated in Hospitalized T2D Patients Combination proved non-inferior to standard basal-bolus insulin treatment by Jeff Minerd Jeff Minerd, Contributing Writer, MedPage Today Sitagliptin, a dipeptidyl peptidase-4 inhibitor, plus basal insulin was non-inferior to a basalbolus insulin regimen in hospitalized general medicine and surgery patients with type 2 diabetes, in an open-label study. Note that no difference in hospital complications, including acute kidney injury, was found between the groups. For hospitalized patients with type 2 diabetes, management with sitagliptin (Januvia) plus basal insulin worked as well as the standard basal-bolus insulin treatment regimen, according to an open-label, non-inferiority study. After the mean hospital stay for the participants of 4 days, the mean daily blood glucose concentration in the sitagliptin-basal group was 171.2 mg/dL versus 169.4 mg/dL in the basal-bolus group (P=0.79), Guillermo Umpierrez, MD , chief of diabetes and endocrinology at Grady Memorial Hospital of Emory University in Atlanta, and colleagues reported in The Lancet Diabetes & Endocrinology . Treatment failure occurred in 22 patients (16%) of the sitagliptin-basal group and 26 (19%) in the basal-bolus group (P=0.54). Hypoglycemia occurred in 13 patients (9%) in the sitagliptin-basal group and 17 (12%) in the basal-bolus group (P=0.45). No difference in hospital complications was found between the groups. Acute kidney injury occurred in seven patients (5%) in the sitagliptin-basal group and six (4%) in the basal-bolus group (P=0.79), the study found. Sitagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor, an incretin-based drug manufactured by Merck, which funded the study. "Guidelines from professional organizations for the management Continue reading >>
Efficacy And Safety Of Sitagliptin When Added To Insulin Therapy In Patients With Type 2 Diabetes
To evaluate the efficacy and tolerability of sitagliptin when added to insulin therapy alone or in combination with metformin in patients with type 2 diabetes.After a 2 week placebo run-in period, eligible patients inadequately controlled on long-acting, intermediate-acting or premixed insulin (HbA1c > or = 7.5% and < or = 11%), were randomised 1:1 to the addition of once-daily sitagliptin 100 mg or matching placebo over a 24-week study period. The study capped the proportion of randomised patients on insulin plus metformin at 75%. Further, the study capped the proportion of randomised patients on premixed insulin at 25%. The metformin dose and the insulin dose were to remain stable throughout the study. The primary endpoint was HbA1c change from baseline at week 24.Mean baseline characteristics were similar between the sitagliptin (n = 322) and placebo (n = 319) groups, including HbA1c (8.7 vs. 8.6%), diabetes duration (13 vs. 12 years), body mass index (31.4 vs. 31.4 kg/m(2)), and total daily insulin dose (51 vs. 52 IU), respectively. At 24 weeks, the addition of sitagliptin significantly (p < 0.001) reduced HbA1c by 0.6% compared with placebo (0.0%). A greater proportion of patients achieved an HbA1c level < 7% while randomised to sitagliptin as compared with placebo (13 vs. 5% respectively; p < 0.001). Similar HbA1c reductions were observed in the patient strata defined by insulin type (long-acting and intermediate-acting insulins or premixed insulins) and by baseline metformin treatment. The addition of sitagliptin significantly (p < 0.001) reduced fasting plasma glucose by 15.0 mg/dl (0.8 mmol/l) and 2-h postmeal glucose by 36.1 mg/dl (2.0 mmol/l) relative to placebo. A higher incidence of adverse experiences was reported with sitagliptin (52%) compared with plac Continue reading >>
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The Effectiveness Of Combination Treatment With Insulin And Sitagliptin In T2 Patients
Patients on therapy may see increased reduction in HbA1c, lower BP, lower lipid values…. Dipeptidyl peptidase-4 (DPP-4) inhibitors are used for the treatment of type 2 diabetes. Sitagliptin was the first medication approved for people with type 2 diabetes who are taking insulin. There are not a lot of studies that have investigated the use of DPP-4 and insulin therapy in patients with long-term diabetes diagnosis. Currently, there aren’t any studies that have evaluated the efficiency of DPP-4 inhibitors in activating insulin feedback in patients with minimal insulin secretion who are on insulin therapy. Researchers evaluated the effectiveness and safety of insulin-sitagliptin combination treatment to establish the benefit of this regimen in patients with type 2 diabetes. The study design was a multicenter retrospective study from November 2011 to March 2013. The study was conducted in 36 diabetes clinic in Kanagawa Prefecture, Japan. Patients who were eligible were on insulin 6 months prior and on sitagliptin if their HbA1c was 7.0% or higher with insulin therapy. The primary endpoint was the variation in HbA1c levels. The results from this study were reported as mean + standard deviation. Other endpoints in this study were weight, blood pressure values, total cholesterol, and triglycerides. The study included 1,169 patients. The results showed that most patients (n=809) received sitagliptin 50mg. In 1,004 patients, HbA1c was reduced by 0.74% and body weight was increased by 0.1kg after 6 months of combination treatment of insulin and sitagliptin. In this study, hypoglycemic events occurred in 7.4% of the patient population, however none of the events were severe. Also, a multiple regression analysis on 114 patients showed that C-peptide had no effect on the effecti Continue reading >>
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Sitagliptin; Januvia
are allergic to dapagliflozin or any of the ingredients in FARXIGA. Symptoms of a serious allergic reaction may include skin rash, raised red patches on your skin (hives), swelling of the face, lips, tongue, and throat that may cause difficulty in breathing or swallowing. If you have any of these symptoms, stop taking FARXIGA and contact your healthcare provider or go to the nearest hospital emergency room right away have severe kidney problems or are on dialysis. Your healthcare provider should do blood tests to check how well your kidneys are working before and during your treatment with FARXIGA Dehydration (the loss of body water and salt), which may cause you to feel dizzy, faint, lightheaded, or weak, especially when you stand up (orthostatic hypotension). You may be at a higher risk of dehydration if you have low blood pressure; take medicines to lower your blood pressure, including water pills (diuretics); are 65 years of age or older; are on a low salt diet, or have kidney problems Ketoacidosis occurred in people with type 1 and type 2 diabetes during treatment with FARXIGA. Ketoacidosis is a serious condition which may require hospitalization and may lead to death. Symptoms may include nausea, tiredness, vomiting, trouble breathing, and abdominal pain. If you get any of these symptoms, stop taking FARXIGA and call your healthcare provider right away. If possible, check for ketones in your urine or blood, even if your blood sugar is less than 250 mg/dL Kidney problems. Sudden kidney injury occurred in people taking FARXIGA. Talk to your doctor right away if you reduce the amount you eat or drink, or if you lose liquids; for example, from vomiting, diarrhea, or excessive heat exposure Serious urinary tract infections (UTI), some that lead to hospitalization, occu Continue reading >>
Efficacy And Safety Of Sitagliptin When Added To Insulin Therapy In Patients With Type 2 Diabetes.
Abstract OBJECTIVE: To evaluate the efficacy and tolerability of sitagliptin when added to insulin therapy alone or in combination with metformin in patients with type 2 diabetes. METHODS: After a 2 week placebo run-in period, eligible patients inadequately controlled on long-acting, intermediate-acting or premixed insulin (HbA1c > or = 7.5% and < or = 11%), were randomised 1:1 to the addition of once-daily sitagliptin 100 mg or matching placebo over a 24-week study period. The study capped the proportion of randomised patients on insulin plus metformin at 75%. Further, the study capped the proportion of randomised patients on premixed insulin at 25%. The metformin dose and the insulin dose were to remain stable throughout the study. The primary endpoint was HbA1c change from baseline at week 24. RESULTS: Mean baseline characteristics were similar between the sitagliptin (n = 322) and placebo (n = 319) groups, including HbA1c (8.7 vs. 8.6%), diabetes duration (13 vs. 12 years), body mass index (31.4 vs. 31.4 kg/m(2)), and total daily insulin dose (51 vs. 52 IU), respectively. At 24 weeks, the addition of sitagliptin significantly (p < 0.001) reduced HbA1c by 0.6% compared with placebo (0.0%). A greater proportion of patients achieved an HbA1c level < 7% while randomised to sitagliptin as compared with placebo (13 vs. 5% respectively; p < 0.001). Similar HbA1c reductions were observed in the patient strata defined by insulin type (long-acting and intermediate-acting insulins or premixed insulins) and by baseline metformin treatment. The addition of sitagliptin significantly (p < 0.001) reduced fasting plasma glucose by 15.0 mg/dl (0.8 mmol/l) and 2-h postmeal glucose by 36.1 mg/dl (2.0 mmol/l) relative to placebo. A higher incidence of adverse experiences was reported wi Continue reading >>
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Sitagliptin
Sitagliptin (INN; /sɪtəˈɡlɪptɪn/ ( listen), previously identified as MK-0431 and marketed as the phosphate salt under the trade name Januvia) is an oral antihyperglycemic (antidiabetic drug) of the dipeptidyl peptidase-4 (DPP-4) inhibitor class. It was developed, and is marketed, by Merck & Co. This enzyme-inhibiting drug is used either alone or in combination with other oral antihyperglycemic agents (such as metformin or a thiazolidinedione) for treatment of diabetes mellitus type 2.[2] Adverse effects[edit] Side effects are as common with sitagliptin (whether used alone or with metformin or pioglitazone) as they were with placebo, except for rare nausea and common cold-like symptoms, including photosensitivity.[3] No significant difference exists in the occurrence of hypoglycemia between placebo and sitagliptin.[3][4][5] In those taking sulphonylureas, the risk of low blood sugar is increased.[6] The existence of rare case reports of renal failure and hypersensitivity reactions is noted in the United States prescribing information, but a causative role for sitagliptin has not been established.[7] Several postmarketing reports of pancreatitis (some fatal) have been made in people treated with sitagliptin and other DPP-4 inhibitors,[8] and the U.S. package insert carries a warning to this effect,[9] although the causal link between sitagliptin and pancreatitis has not yet been fully substantiated.[2] One study with lab rats published in 2009 concluded that some of the possible risks of pancreatitis or pancreatic cancer may be reduced when it is used with metformin. However, while DPP-4 inhibitors showed an increase in such risk factors, as of 2009, no increase in pancreatic cancer has been reported in individuals taking DPP-4 inhibitors.[10] The updated (August 20 Continue reading >>
