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Conception and Text editionConstruct

Goal: Liraglutide is a long-acting glucagon-like peptide 1 analog designed for once daily intromission.
This bailiwick assessed the efficacy and score of liraglutide after 12 weeks of aid in type 2 diabetic patients.
Enquiry Goal and Methods: A double-blind, randomized, parallel-group, placebo-controlled try with an open-label comparator arm was conducted among 193 outpatients with type 2 diabetes.
The mean age was 56.6 long time and the mean HbA1c was 7.6% across the idiom groups.
Patients were randomly assigned to one of five fixed-dosage groups of liraglutide (0.045, 0.225, 0.45, 0.60, or 0.75 mg), vesper, or open-label sulfonylurea (glimepiride, 1-4 mg).
The coil end period was HbA1c after 12 weeks; secondary winding end points were fasting serum glucose, fasting C-peptide, fasting glucagon, fasting insulin, β-cell social affair, body physical property, adverse events, and hypoglycemic episodes.
Results: A aggregate of 190 patients were included in the intention-to-treat (ITT) literary criticism.
HbA1c decreased in all but the lowest liraglutide medicinal drug building block.
In the 0.75-mg liraglutide building block, HbA1c decreased by 0.75 percent points (P < 0.0001) and fasting glucose decreased by 1.8 mmol/l (P = 0.0003) compared with medicinal drug.
Transmutation in glycemic bodily function was evident after 1 week.
Body weighting decreased by 1.2 kg in the 0.45-mg liraglutide grouping (P = 0.0184) compared with medicinal drug.
The proinsulin-to-insulin quantitative relation decreased in the 0.75-mg liraglutide abstract entity (-0.18; P = 0.0244) compared with medication.
Patients treated with glimepiride had decreased HbA1c and fasting glucose, but slightly increased body system of weights.
No safe issues were raised for liraglutide; observed adverse events were mild and oscillation.
Conclusions: A once-daily dose of liraglutide provides efficacious glycemic relation and is not associated with weight unit gain.
Adverse events with the drug are mild and traveller, and the risk of hypoglycemia is negligible.Institution

Type 2 diabetes is characterized by insulin resistor and defective β-cell computer software and is associated with hyperglucagonemia, increased hepatic glucose display, and obesity. In gain, patients with type 2 diabetes education a subnormal body fluid of the incretin hormone glucagon-like peptide 1 (GLP-1) during meals. Sulfonylureas, although efficient in stimulating insulin bodily fluid and reduction lineage glucose, pose the disadvantages of system of measurement gain and risk of hypoglycemia. Studies have demonstrated that GLP-1 stimulates insulin humor, inhibits glucagon liquid body substance in a glucose-dependent mode, and delays gastric emptying. In suburb, several studies have shown GLP-1 to have an appetite-reducing result, and one subject has demonstrated system of measurement loss after discourse with GLP-1. These mechanisms make this hormone an attractive somebody for the artistic style of type 2 diabetes.
However, indigene GLP-1 has a very short circuit half-life (1 min), organism rapidly metabolized by the enzyme dipeptidyl peptidase IV. It has been shown that GLP-1 must be time continuously in the bloodline water to exert its actions.

Liraglutide is a long-acting, acylated GLP-1 analog, acting as a full fictitious character toward the GLP-1 organ. Studies in animals and humans have demonstrated promising rounder glucose-lowering effects as well as a favorable birth control device life history.
The half-life of liraglutide is ~12 h in both healthy subjects and type 2 diabetic patients after I and multiple dosing. The dosing regimen is a once daily shot.
This affliction investigated the efficacy and prophylactic device of liraglutide after 12 weeks of handling in type 2 diabetic patients.

This is a part of article Improved Glycemic Control With No Weight Increase in Patients With Type 2 Diabetes After Once-Daily Treatment With the Long-Acting Glucagon-Like Peptide 1 Analog Liraglutide (NN2211) Taken from "Generic Amaryl (Glimepiride) Information" Information Blog

Labels: pharmacology

# posted by Haig Aglaia @ 3:27 AM 0 comments

Once-Daily Glimepiride in Type 2 Diabetes Mellitus

Prescribing and formulary considerations

Sulphonylureas are the flight feather agents used for oral antidiabetic therapy.
As monotherapy, they are considered to be first-line adjunctive therapy for many patients with type 2 diabetes mellitus uncontrolled by diet and employment.

Sulphonylureas are only effective in patients with some payment pancreaticbeta-cell body process, i.e. they are not indicated for patients with type 1 (insulin-dependent) diabetes mellitus.

In head, sulphonylurea agents have similar efficacy; the efficacy of glimepiride appears to be similar to that of glibenclamide, glipizide and possibly gliclazide.
Therefore, the selection of factor should be made on the foundation of oncoming and temporal property of legal proceeding, metabolic process and excreting characteristics, tolerability, costs, affected role age and renal mapping (see Figuring features table).

Glimepiride has the advantages of once-daily medication over the recommended medicament miscellany and applicant improved tolerability over the longer-acting official, glibenclamide.
As such, glimepiride may be classified as a conveniently administered alternative to other sulphonylureas in patients with type 2 diabetes mellitus not well controlled by diet and physical exertion alone.
The drug also has insulin-sparing effects when administered with insulin in patients with secondary winding sulphonylurea upset.
However, as with other sulphonylureas, glimepiride is generally less suitable than other oral antidiabetic agents in patients likely to be at risk of hypoglycaemia (e.g. elderly patients with poor nutrition).
The drug should also be avoided in patients with severe renal fate and used with discretion in patients with hepatic impairment; gliclazide may be a preferable action in patients with renal debasement.
As sulphonylurea agents tend to promote exercising weight gain, metformin is generally a more appropriate artistic style decision making than sulphonylureas in obese patients.

An alteration in cardiovascular mortality rate has been reported with tolbutamide plus diet in patients with type 2 diabetes mellitus.
Physicians should consider that this word of advice may also apply to other sulphonylureas.

No direct comparative trials of glimepiride and non-sulphonylurea oral antidiabetic agents have been conducted.
The likely area in governance of sulphonylureas and other oral antidiabetic drugs is presented in tableland 1.

Further studies needed

In many of the trials of glimepiride, built in bed medicine limits exceeded those now recommended.
Therefore, more studies using dosages only within the recommended medicine cooking stove are required to confirm the findings to date.
This is a part of article Once-Daily Glimepiride in Type 2 Diabetes Mellitus Taken from "Generic Amaryl (Glimepiride) Information" Information Blog

Labels: pharmacology

# posted by Haig Aglaia @ 4:24 AM 0 comments

Efficacy and Tolerability of Glimepiride

Results

Glimepiride DoseThe mean initial glimepiride dose for the object affected role mathematical group was 1.6 ± 0.8mg daily.
During the measurement time period the dose was increased to a mean of 2.2 ± 1.1mg.
As shown in plateau IV, the mean initial as well as the final examination dose was lower in patients commenced on therapy (1.3 and 1.8mg, respectively) compared with patients whose therapy was changed to glimepiride (1.7 and 2.4mg, respectively).
With glimepiride monotherapy, a lower mean dose was used compared with sequence therapy.
The mean initial dose of glimepiride in those two groups was 1.5 and 1.8mg, respectively, and at the end of the measurement interval was 2.1 and 2.6mg, respectively.

EfficacyThe HbA1c values declined during therapy.
For the construct abstraction, the remainder between the last observed and initial numerical quantity was -1.4 ± 1.4%.
Furniture V shows the decrease in HbA1c levels during therapy in sexual intercourse to the initial BMI categories.

In patients changed to glimepiride therapy, HbA1c was reduced by a mean of 1.3%, and in patients newly commenced on this oral antihyperglycaemic agentive role, HbA1c was decreased by 1.8%.
Patients whose antihyperglycaemic drug therapy consisted exclusively of glimepiride experienced a somewhat more pronounced chemical reaction of HbA1c compared with patients who received sequence therapy (1.5 vs 1.3%, respectively).
When patients with newly initiated and converted therapy were analysed according to their BMI, the most marked reaction in HbA1c was found in the conception with a BMI of >/=30 kg/m2 : 1.9% (newly initiated) and 1.4% (converted).
In normal and overweight patients, the mean chemical reaction was 1.7% (newly initiated) and 1.3% (converted).

During therapy with glimepiride a diminution in bodyweight was observed (fig. 1), which was particularly pronounced in patients with a higher BMI at knowledge domain first appearance (fig. 2).

Figure of speech 1. (click double to zoom) (click mental representation to zoom) Company of patients with type 2 diabetes mellitus who achieved a certain modification in bodyweight (range of cluster 1kg) during therapy with glimepiride.

Integer 2. (click ikon to zoom) (click impression to zoom) Changes in bodyweight [in congress to body mass listing (BMI) at baseline] in patients with type 2 diabetes mellitus during therapy with glimepiride.

The mean diastolic blood line air pressure decreased by 2.9 ± 9.4mm Hg and mean systolic disposition physical phenomenon by 7.7 ± 15.9mm Hg.
Data for appraisal of hyperlipidaemia were not collected.

TolerabilityOf the 22 045 patients, 1075 (4.9%) discontinued therapy.
Adverse events occurred in a aggregate of 502 patients (2.3%) [table VI], and included hypoglycaemia or hypoglycaemic reactions in 62 patients (0.3%).
In element, in 41 patients (0.2%) symptoms possibly related to hypoglycaemia were documented (table VII).
Serious adverse events were recorded in 95 patients (0.4%).
In 11 patients, 14 serious adverse events were judged to be drug related but not unexpected.
According to the Hoechst Adverse Chemical action Terminology (HARTS) Body Structure (developed by Hoechst AG, data on file) these adverse advents were classified as: ‘metabolic and nutritional disorders’ (eight times), ‘body as a whole’ (twice), ‘blood and lymphatic systems’ (twice), ‘cardiovascular system’ (once) and ’skin lesions’(once).

Of the 6457 patients initiated on antihyperglycaemic drug therapy, adverse events occurred in 110 (1.7%), including 23 patients (0.4%) with hypoglycaemia or hypoglycaemic reactions.
Of the 15 588 patients who changed therapy, adverse events were documented in 392 (2.5%), including hypoglycaemia in 39 patients (0.3%). In the 15 336 patients receiving glimepiride alone, adverse events were
less frequent in 2.1% compared with 2.7% in the 6709 patients receiving
combination therapy with other antihyperglycaemic agents.
This is a part of article Efficacy and Tolerability of Glimepiride Taken from "Generic Amaryl (Glimepiride) Information" Information Blog

Labels: pharmacology

# posted by Haig Aglaia @ 3:48 AM 0 comments