Glycemic and lipid responses to glucomannan in Thais with type 2 diabetes mellitus. Effect of vildagliptin on hsCRP and arterial stiffness in patients with type 2 diabetes mellitus Sodium‐glucose cotransporter‐2 inhibitor luseogliflozin added to glucagon‐like peptide 1 receptor agonist liraglutide improves glycemic control with bodyweight and fat mass reductions in Japanese patients with type 2 diabetes: A 52‐week, open‐label, single‐arm study Comparison of effects of gliclazide, metformin and pioglitazone monotherapies on glycemic control and cardiovascular risk factors in patients with newly diagnosed uncontrolled type 2 diabetes mellitus. Effects of nateglinide and glibenclamide on prothrombotic factors in naïve type 2 diabetic patients treated with metformin: a 1-year, double-blind, randomized clinical trial. A comparison of preconstituted, fixed combinations of low-dose glyburide plus metformin versus high-dose glyburide alone in the treatment of type 2 diabetic patients Effects of sitagliptin or metformin added to pioglitazone monotherapy in poorly controlled type 2 diabetes mellitus patients. Vildagliptin compared to glimepiride on post-prandial lipemia and on insulin resistance in type 2 diabetic patients. Comparison of glycaemic control and cardiovascular risk profile in patients with type 2 diabetes during treatment with either repaglinide or metformin. Evaluation of mobile phone and Internet intervention on waist circumference and blood pressure in post-menopausal women with abdominal obesity Effects of exenatide and metformin in combination on some adipocytokine levels: a comparison with metformin monotherapy. Effect of plant sterols and glucomannan on lipids in individuals with and without type II diabetes Evaluation of a Pharmaceutical Care Model on Diabetes Management Insulin versus glipizide treatment in patients with non-insulin-dependent diabetes mellitus. Effects on blood pressure and glucose tolerance. Exenatide versus glibenclamide in patients with diabetes. The effect of glargine versus glimepiride on pancreatic β-cell function in patients with type 2 diabetes uncontrolled on metformin monotherapy: open-label, randomized, controlled study Effects of one year treatment of vildagliptin added to pioglitazone or glimepiride in poorly controlled type 2 diabetic patients.
OBJECTIVE To evaluate the benefits of glucomannan supplement on glycemic and lipid controls in type 2 diabetic patients . MATERIAL AND METHOD A single-blind , placebo-controlled , crossover trial with two treatments separated by a 2-week washout period was performed in 10 men and 10 women with type 2 diabetes mellitus . Two separated protocol s of experiments were sequentially followed . Initially , purified glucomannan ( 1 g ) or placebo was ingested 30 min before 75-g glucose load to evaluate their effects on glucose absorption and insulin secretion in oral glucose tolerance test ( OGTT ) . Later , the glycemic and lipid changes after 4-week intervention with 3 g/day glucomannan comparing to the placebo were determined . The st and ard OGTT was performed before and after ending of each intervention . RESULTS Glucomannan taken before performing the OGTT can lower the rise of blood glucose and insulin from 1 to 2 hour in comparison with the placebo , though a statistically significance of insulin was not achieved . Long-term glucomannan supplement significantly reduced the 120-min glucose area under the curve of OGTT . Glucomannan also decreased the rise of low-density lipoprotein cholesterol ( LDL-C ) . Reductions of HOMA-insulin resistance index and body mass index were detected in glucomannan-treated group though the former was shown only in females . No within- and between-group differences of insulin , fructosamine , and other lipids were observed in glucomannan- nor placebo- treated groups . CONCLUSION In type 2 diabetes , pre-pr and ial glucomannan ingestion attenuated a rise of blood glucose without significantly affecting insulin levels . Long-term supplement of glucomannan to the regular diabetic regimen lessened post challenge glucose AUC and impeded the rise of LDL-C. Supplement of glucomannan may be beneficial to the glycemic and lipid controls in type 2 diabetes mellitus OBJECTIVE : To evaluate the effect of dipeptidyl-peptidase-4 ( DPP-4 ) inhibitor vildagliptin on high sensitivity C-reactive protein ( hsCRP ) and arterial stiffness ( AS ) in patients with type 2 diabetes ( T2DM ) . DESIGN : Sixty-four drug-naive diabetic patients , with inadequate glycemic control , participated in this r and omized , open-label study . Half of the patients received metformin 1700 mg/d and the other half of them received metformin 1700 mg/d plus vildagliptin 100 mg/d . AS was measured by carotid-femoral Pulse Wave Velocity ( cfPWV ) . Body weight ( BW ) , body mass index ( BMI ) , blood pressure ( BP ) , hsCRP , glycosylated hemoglobin ( HbA1c ) , fasting plasma glucose ( FPG ) , lipid profile , albumin/creatinine ratio ( ACR ) , fasting insulin , C-peptide , homeostasis model assessment of insulin resistance ( HOMA-IR ) and homeostasis model assessment of β-cell function ( HOMA-β ) were also assessed at baseline and after 6 months . RESULTS : Vildagliptin in combination with metformin had a beneficial influence on hsCRP , HbA1c , C-peptide and HOMA-β index ( p < 0.05 ) but had no effect on cfPWV , BP , BW , BMI , lipid profile , ACR and HOMA-IR compared with metformin alone ( p = NS ) . CONCLUSIONS : We have found that the addition of vildagliptin to metformin for a period of six months decreased hsCRP , improved glycemic control and β-cell function but had no effect on AS in drug-naive patients with T2DM Abstract Aims / Introduction The aim of the present study was to evaluate the safety and efficacy of luseogliflozin added to liraglutide monotherapy in Japanese individuals with type 2 diabetes . Material s and Methods This 52‐week , multicenter , open‐label , single‐arm clinical study enrolled Japanese patients who had inadequate glycemic control with diet/exercise and liraglutide monotherapy .  Major efficacy end‐points included the changes from baseline in glycated hemoglobin , fasting plasma glucose and bodyweight . Body composition was also assessed in individuals who had access to bioelectrical impedance analysis . Safety assessment s included adverse events , clinical laboratory tests , vital signs and 12‐lead electrocardiograms . Results Of 76 patients who received luseogliflozin , 62 completed the study . The changes from baseline in glycated hemoglobin , fasting plasma glucose , and bodyweight ( mean ± SE ) were −0.68 ± 0.10 % , −32.1 ± 3.6 mg/dL and −2.71 ± 0.24 kg at week 52 , respectively ( all , P < 0.001 vs baseline ) . Luseogliflozin was associated with greater reductions in fat mass than lean mass at all measuring points ( n = 22 ) : fat vs lean mass changes ( mean ± SE ) at week 52 were −2.49 ± 0.45 kg ( P < 0.001 vs baseline ) and −0.44 ± 0.26 kg ( P = 0.107 vs baseline ) , respectively . Insulin secretion and Matsuda Index were also improved at weeks 12 and 52 compared with baseline . Adverse events and adverse drug reactions occurred in 65.8 and 27.6 % of patients , respectively . The overall safety profile , including frequency of hypoglycemia , was found to be consistent with those of previous studies and there were no new safety concerns . Conclusions Luseogliflozin added to liraglutide was well tolerated , and improved glycemic control with bodyweight and fat mass reductions in Japanese type 2 diabetes patients OBJECTIVE The objective of this study was to evaluate and compare the effects of gliclazide-modified release ( gliclazide-MR ) , metformine ( MET ) and pioglitazone ( PIO ) monotherapies on glycemic control and conventional/non-conventional cardiovascular risk factors in patients with newly diagnosed type 2 diabetes mellitus ( T2DM ) . MATERIAL AND METHODS A single center , r and omized , 52-wk comparator-controlled clinical study was carried out in patients with newly diagnosed uncontrolled T2DM . A total of 57 patients were r and omized into gliclazide-MR , metformin and pioglitazone groups . Drugs were administered for 12 months . Anthropometric measurements , fasting plasma glucose ( FPG ) , postpr and ial plasma glucose ( PPG ) , HbA1c , insulin , HOMA-IR , lipid parameters , the markers of coagulation/fibrinolysis , inflammation and endothelial dysfunction were measured at baseline and at months 3 , 6 , and 12 . RESULTS In the gliclazide-MR group , HC , FPG , HbA1c , insulin , HOMA-IR , TC , trigylcerides , Lp ( a ) , E-selectin and Hcy were significantly decreased after treatment compared to baseline . In the MET group , BMI , WC , FPG , PPG , HbA1c , ICAM-1 and Hcy significantly decreased after treatment compared to baseline . In PIO group , WC , HC , FPG , PPG , HbA1c , C-peptid , HOMA-IR , trigylcerides , vWF , IL-6 , ICAM-1 , E-selectin and Hcy significantly decreased after treatment compared to baseline , whereas , HDL-C increased . At the end of the month 12 , the decreases in insulin and HOMA-IR score were more pronounced with PIO compared to gliclazide . CONCLUSIONS Gliclazide-MR , MET and PIO monotherapies , were equally effective in proving glycemic control in patients with newly diagnosed , oral antidiabetic (OAD)-naive T2DM . But , improvements in conventional/non-conventional cardiovascular risk factors were more pronounced in patients on PIO therapy compared to gliclazide and MET therapies . Also , all of the 3 drugs represent effective and safe first-line pharmacological treatment options in these patients OBJECTIVE To evaluate the effect on coagulation and fibrinolysis parameters and on non-conventional cardiovascular risk factors of metformin plus nateglinide or glibenclamide in naïve type 2 diabetes patients . PATIENTS AND METHODS A total of 248 type 2 diabetic patients were enrolled and r and omly assigned to receive nateglinide or glibenclamide , and metformin for 12 months . We assessed body mass index ( BMI ) , glycated hemoglobin ( HbA1c ) , fasting plasma glucose ( FPG ) , postpr and ial plasma glucose ( PPG ) , fasting plasma insulin ( FPI ) , postpr and ial plasma insulin ( PPI ) , homeostasis model assessment index ( HOMA index ) , lipid profile with lipoprotein ( a ) [ Lp(a ) ] , fibrinogen ( Fg ) , plasminogen activator inhibitor-1 ( PAI-1 ) , tissue plasminogen activator ( t-PA ) , homocysteine ( Hcy ) , systolic blood pressure ( SBP ) , diastolic blood pressure ( DBP ) . RESULTS After 9 months of treatment , both tested drug combinations were similarly associated with a significant reduction in FPG  ( nateglinide , -17.2 % ; glibenclamide , -16.9 % , both p<0.05 ) compared to the baseline , while HbA1c ( -17.3 % , p<0.05 ) and PPG ( -15.2 % , p<0.05 ) significantly decreased only in the nateglinide group . After one year of treatment , compared to the baseline the nateglinide group showed a significant reduction in HbA1c ( -21 % , p<0.01 ) , FPG ( -20.7 % ) , p<0.01 , PPG ( -21.5 % , p<0.05 ) , HOMA index ( -25.4 % , p<0.05 ) ; the glibenclamide group , showed a significant reduction in HbA1c ( -11 % , p<0.05 ) , FPG ( -23.2 % , p<0.05 ) , PPG ( -11.2 % , p<0.05 ) , and HOMA index ( -23.9 % , p<0.05 ) but to a minor extent . Moreover , the HbA1c difference value from baseline observed in the nateglinide-treated group was significantly higher than that observed in the glibenclamide group . Therefore the nateglinide-treated patients showed a significant reduction in some prothrombotic parameters ( PAI-1=-19 % , Lp(a)=-31 % , and Hcy=-32.3 % , all p<0.05 ) , whereas the glibenclamide-treated patients did not . CONCLUSION Nateglinide appears to improve glycemic control as well as the levels of some prothrombotic parameters compared to glibenclamide when administered in combination with metformin Abstract In the present study we assessed and compared the effectiveness and safety of preconstituted , fixed , combinations of low-dose glyburide plus metformin with higher-dose glyburide monotherapy in patients with type 2 diabetes . This r and omized , double-blind , cross-over study comprised 40 patients . After a 30-day run-in period of dietary treatment , patients received combined glyburide ( 5 , 7.5 or 10 mg/day ) and metformin ( 800 , 1,200 or 1,600 mg/day ) as preconstitued , fixed combinations , or glyburide alone ( 5 , 10 or 15 mg/day ) . The dose was increased stepwise so as to have 1 ( T1 ) , 2 ( T2 ) and 3 ( T3 ) months of treatment for any given regimen ( 6 months in total ) . After 2 weeks of washout ( T4 ) , the groups were then crossed over ( T5 , T6 , T7 periods ) . Body weight , fasting plasma glucose , HbA1c , blood lactate , total cholesterol and HDL-cholesterol , and triglycerides were measured at the beginning and end of T1 and T5 , and end of T2 , T3 , T6 and T7 ; postpr and ial plasma glucose , fasting and postpr and ial plasma insulin and C-peptide were evaluated at the beginning of T1 and T5 , and end of T3 and T7 . At these latter time points additional assessment s included routine clinical chemistry measurements , ECG , and ophthalmoscopic examination . Statistical analysis was performed by the paired Student 's t-test and analysis of variance for cross-over studies . Thirty-three patients completed the study .  Fasting plasma glucose , postpr and ial plasma glucose and HbA1c levels improved significantly during combined treatment with glyburide at lower doses plus metformin . This effect was achieved without any major change of insulin and C-peptide concentrations . Circulating lactate concentrations increased during the regimen including metformin , but they remained well within the reference values for normal subjects . Plasma total cholesterol and triglycerides levels remained substantielly unchanged throughout the study , whereas HDL-cholesterol concentrations increased slightly , but significantly , with glyburide plus metformin therapy . Routine clinical chemistry measurements , ECG and ophthalmoscopic examinations did not change during the study . These results demonstrate that improved metabolic control can be achieved with preconstituted , fixed combinations of low-dose glyburide plus metformin in patients with type 2 diabetes , compared to higher doses of the sulphonylurea alone The aim of the study was to compare the effects of the addition of sitagliptin or metformin to pioglitazone monotherapy in poorly controlled type 2 diabetes mellitus patients on body weight , glycemic control , beta-cell function , insulin resistance , and inflammatory state parameters .  One hundred fifty-one patients with uncontrolled type 2 diabetes mellitus ( glycated hemoglobin [ HbA(1c ) ] > 7.5 % ) in therapy with pioglitazone 30 mg/d were enrolled in this study . We r and omized patients to take pioglitazone 30 mg plus sitagliptin 100 mg once a day , or pioglitazone 15 mg plus metformin 850 mg twice a day . We evaluated at baseline and after 3 , 6 , 9 , and 12 months these parameters : body weight , body mass index , HbA(1c ) , fasting plasma glucose ( FPG ) , postpr and ial plasma glucose ( PPG ) , fasting plasma insulin ( FPI ) , homeostasis model assessment insulin resistance index ( HOMA-IR ) , homeostasis model assessment beta-cell function index , fasting plasma proinsulin ( Pr ) , Pr/FPI ratio , adiponectin , resistin ( R ) , tumor necrosis factor-alpha ( TNF-alpha ) , and high-sensitivity C-reactive protein . A decrease of body weight and body mass index was observed with metformin , but not with sitagliptin , at the end of the study . We observed a comparable significant decrease of HbA(1c ) , FPG , and PPG and a significant increase of homeostasis model assessment beta-cell function index compared with baseline in both groups without any significant differences between the 2 groups . Fasting plasma insulin , fasting plasma Pr , Pr/FPI ratio , and HOMA-IR values were decreased in both groups even if the values obtained with metformin were significantly lower than the values obtained with sitagliptin . There were no significant variations of ADN , R , or TNF-alpha with sitagliptin , whereas a significant increase of ADN and a significant decrease of R and TNF-alpha values were recorded with metformin . A significant decrease of high-sensitivity C-reactive protein value was obtained in both groups without any significant differences between the 2 groups . There was a significant correlation between HOMA-IR decrease and ADN increase , and between HOMA-IR decrease and R and TNF-alpha decrease in pioglitazone plus metformin group after the treatment . The addition of both sitagliptin or metformin to pioglitazone gave an improvement of HbA(1c ) , FPG , and PPG ; but metformin led also to a decrease of body weight and to a faster and better improvement of insulin resistance and inflammatory state parameters , even if sitagliptin produced a better protection of beta-cell function OBJECTIVES To evaluate the effects of vildagliptin compared to glimepiride on glycemic control , insulin resistance and post-pr and ial lipemia . MATERIAL AND METHODS 167 type 2 diabetic patients , not adequately controlled by metformin  , were r and omized to vildagliptin 50 mg twice a day or glimepiride 2 mg three times a day for 6 months , in a double blind , r and omized clinical trial . We evaluated : body mass index ( BMI ) , glycemic control , fasting plasma insulin ( FPI ) , homeostasis model assessment insulin resistance index ( HOMA-IR ) , fasting plasma proinsulin ( FPPr ) , glucagon , lipid profile , resistin , retinol binding protein-4 ( RBP-4 ) , visfatin and vaspin . Furthermore , at the r and omization and at the end of the study all patients underwent an euglycemic hyperinsulinemic clamp to evaluate M value and an oral fat load . RESULTS Despite a similar decrease of glycated hemoglobin , there were an increase of body weight with glimepiride + metformin and a decrease with vildagliptin + metformin .  Fasting plasma insulin increased with glimepiride + metformin , while it did not change with vildagliptin + metformin . Vildagliptin + metformin improved lipid profile . Regarding insulin sensitivity , vildagliptin + metformin increased M value . Resistin , RBP-4 , vaspin and visfatin were decreased by vildagliptin + metformin , but in group to group comparison , only vaspin reduction result ed statistically significant . Vildagliptin + metformin reduced post-pr and ial lipemia and insulinemia compared to glimepiride + metformin . CONCLUSION Vildagliptin , in addition to metformin , was more effective than glimepiride + metformin in reducing insulin resistance and post-pr and ial lipemia OBJECTIVE To compare glycaemic control and cardiovascular risk profile in patients with type 2 diabetes following 12 months ' treatment with either repaglinide or metformin . STUDY DESIGN AND METHODS This was an open uncontrolled r and omised study in n=112 patients with inadequately controlled type 2 diabetes not previously treated with oral hypoglycaemic agents . Patients beginning treatment with either repaglinide or metformin entered an 8-week titration period ( to optimise dosage : repaglinide , 2 - 4 mg/day ; metformin , 1500 - 2500 mg/day ) followed by a 12-month treatment period . Glycaemic control and cardiovascular risk factors were determined at baseline and at the end of the treatment period . RESULTS Mean ( S.D. ) final drug doses were 3 ( + /-1 ) mg/day in the repaglinide group and 2000 ( + /-500 ) mg/day in the metformin group . Significant improvements in glycaemic control [ glycated haemoglobin , fasting and 2-h postpr and ial plasma glucose ( PPG ) ] were demonstrated in both treatment groups . The decrease in PPG was significantly greater in the repaglinide group ( P<0.05 ) . During the treatment period , fasting plasma insulin ( FPI ) decreased significantly in both groups , more so with metformin ( P<0.05 ) . Two-hour postpr and ial plasma insulin ( PPI ) levels decreased only in the metformin group ( P<0.05 ) . Significant improvements between baseline and final visit were demonstrated in one or both groups in the following cardiovascular risk factors : total cholesterol , low-density lipoprotein cholesterol ( LDL-C ) , triglycerides , plasminogen activator inhibitor , lipoprotein(a ) and homocysteine . No changes were observed in high-density lipoprotein cholesterol ( HDL-C ) , apolipoprotein A-I , apolipoprotein B , fibrinogen , body mass index ( BMI ) or blood pressure . CONCLUSIONS The use of repaglinide or metformin in drug therapy-nai;ve patients with type 2 diabetes over a 12-month period is associated with improvements in both glycaemic control and cardiovascular risk profile . The latter can not necessarily be attributed to the pharmacotherapy per se , but provides reassurance in the context of initiating oral hypoglycaemic drug therapy with these agents PURPOSE The present study evaluated whether an intervention using a short message service ( SMS ) by personal cellular phone and Internet would reduce cardiovascular risk factors in post-menopausal women with abdominal obesity over 12 weeks . METHODS This is a quasi-experimental design with pre and post tests . Participants were recruited from the gynecology outpatient and family medicine departments of a tertiary care hospital located in an urban city of South Korea . Only 67 subjects completed the entire study , 34 in the intervention group and 33 controls . The goal of intervention was to reduce waist circumference ( WC ) , body weight ( BW ) and blood pressure ( BP ) levels . Before the intervention , demographic variables , WC , BW , BP , fasting plasma glucose ( FPG ) and serum lipids were measured as pre-test data . The WC , BW , BP , FPG and serum lipids were measured again 12 weeks later . Patients in the intervention group were requested to record their WC , BW , BP , type and amount of diet and exercise  in a weekly web-based diary through the Internet or by cellular phone . The research ers sent weekly recommendations on diet and exercise as an intervention to each patient , by both cellular phone and Internet . The intervention was applied for 12 weeks . RESULTS WC and BW significantly decreased by 3.0 cm and 2.0 kg , respectively , at 12 weeks compared with the baseline in the intervention group . However , the mean changes in the control group significantly increased by 0.9 cm and 0.7 kg . Systolic BP ( SBP ) and diastolic BP ( DBP ) significantly decreased by 6.5 and 4.6 mmHg in the intervention group , respectively . The mean changes in the control group were not significant in either SBP or DBP . A significant mean decrease in total cholesterol ( TC ) was observed for the intervention group by 12.9 mg/dl , while the control group showed a significant mean increase by 1.5mg/dl . Low-density lipoprotein-cholesterol ( LDL-C ) for the intervention group showed a significant mean decrease 11.3mg/dl . The mean change in the control group was , however , not significant . CONCLUSION Web-based individual intervention using both SMS and Internet improved WC , BW , BP , TC , and LDL-C during 12 weeks in post-menopausal women with abdominal obesity The aim of this study was to evaluate the effects of exenatide on levels of serum adipocytokines and on β-cell function . The study was conducted between 2008 and 2012 . After a run-in period with metformin , 174 patients with type-2 diabetes were r and omly distributed to either a group receiving exenatide at 10 μg twice daily , or a group receiving the placebo , for 12 months . We evaluated body mass index ( BMI ) , blood pressure , glycemic control , lipid profile , fasting plasma insulin ( FPI ) , HOMA-IR , HOMA-β , fasting plasma proinsulin ( FPPr ) , proinsulin : fasting plasma insulin ratio ( Pr/FPI ratio ) , C-peptide , glucagon , retinol binding protein-4 ( RBP-4 ) , visfatin , omentin-1 , and microalbuminuria . We used ELISA methods to assess the various parameters . Patients also underwent a combined euglycemic-hyperinsulinemic and hyperglycemic clamp , with subsequent arginine stimulation . After 12 months , a combination of exenatide and metformin produced a better decrease in body mass , BMI , glycemic control , FPI , FPPr , FPPr/FPI ratio , HOMA-IR , and glucagon level . Treatment with exenatide + metformin was superior to the placebo + metformin  in increasing HOMA-β , C-peptide , and β-cell function . Significant negative correlations were found between M value , an index of insulin sensitivity , and measured adipocytokines . In conclusion , the combination of exenatide + metformin plays a role in improving some adipocytokine levels , and is better than metformin alone . The significant negative correlation between M value and measured adipocytokines is another confirmation of the positive effects linked to the improvement in insulin sensitivity Objective : The purpose of this study was to determine whether supplements of plant sterols and /or glucomannan improve lipid profile and cholesterol bio synthesis in mildly hypercholesterolemic type II diabetic and non-diabetic subjects and to compare the response of these two subject groups to the treatments . Design : A r and omized , crossover study consisting of four phases of 21 days , with each phase separated by a 28-day washout . Setting : The Mary Emily Clinical Nutrition Research Unit of McGill University . Subjects : Eighteen non-diabetic individuals and 16 type II diabetic individuals aged 38–74 years . Interventions : Subjects were supplemented with plant sterols ( 1.8 g/day ) , glucomannan ( 10 g/day ) , a combination of glucomannan and plant sterols , and a placebo , provided in the form of bars . Results : Overall plasma cholesterol concentrations were lowered ( P<0.05 ) after combination treatment ( 4.72±0.20 mmol/l ) compared to control ( 5.47±0.18 mmol/l ) . Plasma low-density lipoprotein ( LDL ) cholesterol concentrations were decreased ( P<0.05 ) after glucomannan ( 3.16±0.14 mmol/l ) and combination treatments ( 2.95±0.16 mmol/l ) compared to control ( 3.60±0.16 mmol/l ) . The results of lipid profiles did not differ between subject groups . Overall plasma lathosterol concentrations , an index of cholesterol bio synthesis , were lowered ( P<0.05 ) after the combination treatment compared to the plant sterol treatment . Conclusions : The results suggest that glucomannan and a combination of glucomannan and plant sterols substantially improves plasma LDL cholesterol concentrations . Sponsorship : Forbes Medi-Tech Inc. , Vancouver , British Columbia , Canada OBJECTIVE : To assess the effectiveness of a pharmaceutical care model on the management of non-insulin-dependent diabetes mellitus ( NIDDM ) in urban African-American patients . DESIGN : Eligible patients were r and omized to either a pharmacist intervention or control group and followed over a 4-month period . Patients in the intervention group received diabetes education , medication counseling , instructions on dietary regulation , exercise , and home blood glucose monitoring , and evaluation and adjustment of their hypoglycemic regimen . Patients in the control group continued to receive st and ard medical care provided by their physicians . SETTING : A university-affiliated internal medicine outpatient clinic . PARTICIPANTS : The study population consisted of urban African-American patients with NIDDM currently attending the clinic . MAIN OUTCOME MEASURES : Primary outcome measures included fasting plasma glucose and glycated hemoglobin concentrations . Secondary outcome endpoints included blood pressure , serum creatinine , creatinine clearance , microalbumin to creatinine ratio , total cholesterol , triglycerides , high-density lipoprotein , and low-density lipoprotein concentrations . Quality -of-life assessment s were performed in both groups at baseline and at the end of the study . RESULTS : Thirty-nine patients ( 17 intervention , 22 control ) completed the study . The intervention group consisted of 12 women and 5 men with a mean ± SD age of 59 ± 12 years , total body weight ( TBW ) of 93 ± 22 kg , body mass index ( BMI ) of 34 ± 7 kg/m2 , and duration of NIDDM 6.8 ± 6.5 years . The control group consisted of 15 women and 7 men with a mean age of 65 ± 12 years , TBW of 88 ± 19 kg , BMI of 33 ± 7 kg/m2 , and a duration of NIDDM of 6.2 ± 4.8 y. Significant improvement in glycated hemoglobin ( p = 0.003 ) and fasting plasma glucose ( p = 0.015 ) was achieved in the intervention group . No change in glycemia was observed in the control subjects . Statistically significant differences in the final glycated hemoglobin ( p = 0.003 ) and fasting plasma glucose ( p = 0.022 ) concentrations were noted between groups . No significant changes in blood pressure control , lipid profile , renal function parameters , weight , or quality -of-life measures were noted within or between groups . CONCLUSIONS : Our data demonstrate the effectiveness of pharmaceutical care in the reduction of hyperglycemia associated with NIDDM in a group of urban African-American patients Insulin resistance that exists in patients with essential hypertension and in those with non-insulin-dependent diabetes mellitus ( NIDDM ) may be the common denominator for the impaired glucose homeostasis and elevated blood pressure ( BP ) levels in patients with NIDDM . Therefore , treatment that improves insulin action may also improve BP levels . Consequently , a four-phase ( glipizide v insulin ) cross-over design study was conducted to determine a better effect of glipizide treatment on insulin sensitivity and the effect this has on BP in 19 NIDDM patients . Patients were subjected to 1 month of diet only ( phase I ) followed by 3 months of glipizide treatment ( phase II ) , then an additional 1 month of diet only ( phase III ) , and finally 3 months of insulin treatment ( phase IV ) . At the end of phases I , II , and IV oral glucose tolerance tests ( OGTT ) were performed and plasma glucose , insulin , and C-peptide levels were analyzed . Fasting plasma glucose , insulin , total cholesterol , high density lipoprotein cholesterol , low density lipoprotein cholesterol and triglycerides , glycated hemoglobin , fructosamine , and 2-h postpr and ial plasma glucose were also analyzed at each phase . Supine and sitting BP levels and body weights were determined biweekly during the study . With the exception of higher plasma insulin and C-peptide levels during the OGTT ( area under the curve ) in phase IV ( insulin ) v phase II ( glipizide ) ( both P < .05 ) , and higher fasting plasma insulin levels ( P < .06 ) , there were no consistently significant metabolic differences between phases IV and II . ( ABSTRACT TRUNCATED AT 250 WORDS BACKGROUND Incretin-based therapies have provided additional options for the treatment of type 2 diabetes mellitus . The aim of our study was to evaluate the effects of exenatide compared to glibenclamide on body weight , glycemic control , beta-cell function , insulin resistance , and inflammatory state in patients with diabetes . METHODS One hundred twenty-eight patients with uncontrolled type 2 diabetes mellitus receiving therapy with metformin  were r and omized to take exenatide 5 microg twice a day or glibenclamide 2.5 mg three times a day and titrated to exenatide 10 microg twice a day or glibenclamide 5 mg three times a day . We evaluated body weight , body mass index ( BMI ) , glycated hemoglobin ( HbA(1c ) ) , fasting plasma glucose ( FPG ) , postpr and ial plasma glucose ( PPG ) , fasting plasma insulin ( FPI ) , homeostasis model assessment insulin resistance ( HOMA-IR ) index , homeostasis model assessment beta-cell function ( HOMA-beta ) index , plasma proinsulin ( PPr ) , PPr/FPI ratio , resistin , retinol binding protein-4 ( RBP-4 ) , and high-sensitivity C-reactive protein ( Hs-CRP ) at baseline and after 3 , 6 , 9 , and 12 months . RESULTS Body weight and BMI decreased with exenatide and increased with glibenclamide . A similar improvement of HbA(1c ) , FPG , and PPG was obtained in both groups , whereas FPI decreased with exenatide and increased with glibenclamide . The HOMA-IR index decreased and the HOMA-beta index increased with exenatide but not with glibenclamide . A decrease of PPr was reported in both groups , but only glibenclamide decreased the PPr/FPI ratio . Resistin and RBP-4 decreased with exenatide and increased with glibenclamide . A decrease of Hs-CRP was obtained with exenatide , whereas no variations were observed with glibenclamide . CONCLUSIONS Both exenatide and glibenclamide gave a similar improvement of glycemic control , but only exenatide gave improvements of insulin resistance and beta-cell function , giving also a decrease of body weight and of inflammatory state The aim of present study is to assess whether if basal insulin , glargine , could improve insulin secretory function of β-cells compared with glimepiride when metformin alone was failed . This was an open-label and multi-center study for 52 weeks in Korean patients with uncontrolled type 2 diabetes by metformin monotherapy . Subjects were r and omized to glargine or glimepiride groups ( n = 38 vs. 36 , respectively ) . The primary endpoint was to compare changes in c-peptide via glucagon test after 48 weeks . Glycemic efficacy and safety endpoints ( glycated hemoglobin ( HbA1c ) , HOMA-B , fasting plasma glucose ( FPG ) , lipid profiles , and hypoglycemic events ) were also checked . The mean disease duration of all subjects was 88.2 months . Changes in C-peptide was no significant different between groups ( P = 0.73 ) , even though insulin secretion was not worsened in both groups at the endpoint . Glargine was not superior to glimepiride in other β-cell function indexes such as HOMA-B ( P = 0.28 ) . HbA1c and FPG reduced significantly in each groups but not different between two groups . Although , severe hypoglycemia did not occur , symptomatic hypoglycemia was more frequent in glimepiride group ( P = 0.01 ) . Insulin glargine was as effective as glimepiride in controlling hyperglycemia and maintaining β-cell function in Korean patients with type 2 diabetes during 48 weeks study period , after failure of metformin monotherapy . Hypoglycemic profile was favorable in the insulin glargine group and less weight gain was observed in the glimepiride group . Our results suggest that glargine and glimepiride can be considered after failure of metformin monotherapy The aim of the study was to compare the effects of vildagliptin added to pioglitazone or glimepiride on metabolic and insulin resistance related-indices in poorly controlled type 2 diabetic patients ( T2DM ) . 168 patients with T2DM were r and omized to take either pioglitazone 30 mg once a day plus vildagliptin 50 mg twice a day or glimepiride 2 mg 3 times a day plus vildagliptin 50 mg twice a day . We evaluated body weight , body mass index ( BMI ) , glycated hemoglobin ( HbA1c ) , fasting plasma glucose ( FPG ) , postpr and ial plasma glucose ( PPG ) , fasting plasma insulin ( FPI ) , homeostasis model assessment insulin resistance index ( HOMA-IR ) , homeostasis model assessment beta-cell function index ( HOMA-beta ) , fasting plasma proinsulin ( FPPr ) , proinsulin/fasting plasma insulin ratio ( Pr/FPI ratio ) , adiponectin ( ADN ) , resistin ( R ) , tumor necrosis factor-alpha ( TNF-alpha ) , and high sensitivity C-reactive protein ( Hs-CRP ) at their baseline values , and after 3 , 6 , 9 , and 12 months of treatment . We observed a similar improvement of HbA1c , FPG , PPG , and Hs-CRP compared to baseline in the 2 groups . Fasting plasma insulin , FPPr , Pr/FPI ratio , R , and TNF-alpha were significantly decreased and ADN was significantly increased with pioglitazone plus vildagliptin , but not with glimepiride plus vildagliptin .  HOMA-IR , and HOMA-beta values obtained with pioglitazone plus vildagliptin were significantly better than the values obtained with glimepiride plus vildagliptin . Pioglitazone plus vildagliptin were found to be more effective in preserving beta-cell function , and in reducing insulin resistance , and inflammatory state parameters
The use of glucomannan did not appear to significantly alter any other study endpoints .
Pediatric patients , patients receiving dietary modification , and patients with impaired glucose metabolism did not benefit from glucomannan to the same degree .
Glucomannan appears to beneficially affect total cholesterol , LDL cholesterol , triglycerides , body weight , and FBG , but not HDL cholesterol or BP
BACKGROUND Several clinical trials have investigated the impact of glucomannan on plasma lipids , body weight , fasting blood glucose ( FBG ) , and blood pressure ( BP ) , but have yielded conflicting results and had only modest sample sizes .
OBJECTIVE The objective was to perform a meta- analysis of r and omized controlled trials of glucomannan to better characterize its impact on plasma lipids , FBG , body weight , and BP .