{"title":"Sojourn of Gemigliptin: A Hidden Gem?","authors":"A. Singh","doi":"10.5603/dk.a2022.0027","DOIUrl":"https://doi.org/10.5603/dk.a2022.0027","url":null,"abstract":"Gemigliptin (LC15-0444) is a competitive, reversible (fast association and slow dissociation), selective (> 3000-fold against DPP-8/9), and long-acting (halflife 30.8 hours) dipeptidyl peptidase-4 (DPP-4) inhibitor, first approved for clinical use by the Korean Food and Drug Administration (FDA) in 2012. It has been approved to be taken orally, with or without food, at a dose of 50 mg once daily, either as monotherapy or in combination with other drugs, and no dose adjustment is required in patients with renal or hepatic impairment. While DPP-4 inhibition with gemigliptin in experimental animal studies was found to be 80%, the fast association and slow dissociation kinetics of DPP-4 inhibition with gemigliptin were found to be albeit different compared with sitagliptin (fast on and fast off rate) and vildagliptin (slow on and slow off rate). Although the originator LG Life Sciences initially signed a licensing agreement with developers such as Sanofi (France) and Stendhal (Mexico) for 104 countries, gemigliptin has been currently approved in 11 countries including India, Columbia, Costa Rica, Panama, Ecuador, Russia, Mexico, and Thailand beside South Korea. In this issue of Clinical Diabetology, a real-world, 12-week, small study (n = 60), of gemigliptin by Sarkar et al. [1] from the Eastern part of India conducted during 2016–2017, reported a robust –1.25% (95% confidence interval, –1.59 to –0.92) HbA1c reduction with gemigliptin in people with type 2 diabetes (median age 52.2 years with a mean HbA1c of 9.5% and duration of diabetes of 8.6 years) on a background antidiabetic (mono, dual, triple combination) therapy but majorly (65%) on background metformin monotherapy. Moreover, 57% of patients achieved a target HbA1c of < 7% with the addition of gemigliptin. The larger HbA1c lowering effect of gemigliptin in this real-world study could be due to a higher baseline mean HbA1c of 9.5% but this appears to be > 2-fold higher than the HbA1c lowering effect observed in the randomized controlled trials (RCTs) conducted in Indian patients. In the subgroup analysis of a double-blind RCT [2], the HbA1c lowering effect of gemigliptin was lower in 108 Indian patients compared with 74 Korean patients (–0.55% vs. –0.94%, respectively) against placebo, despite a higher mean baseline HbA1c (including a higher percentage of patients with baseline HbA1c of > 8.5%) in Indians compared to the Koreans. This suggests real-world studies could often overestimate the effect size related to its inherent bias. Interestingly, the sojourn of gemigliptin did not last long (launched in India in April 2016) and it was withdrawn from India in July 2018 by the Sanofi for unknown or perhaps commercial reasons related to its cost. Notably, the cost of gemigliptin (not approved by the USA FDA and with no cardiovascular (CV) outcome trial (CVOT) conducted) was nearly similar to another DPP-4 inhibitor sitagliptin (US FDA-approved) with clean cardiovascular (CV) safety data shown in ","PeriodicalId":10386,"journal":{"name":"Clinical Diabetology","volume":"101 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82490332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fateme Abshenas, Gholamhosein Yaghoobi, A. Moradi, Hassan Mehrad‐Majd, M. Yaghoubi, A. Sahebkar
{"title":"Association between Red Blood Cell Distribution Width and Retinopathy in Patients with Type 2 Diabetes: A Cross-Sectional Study","authors":"Fateme Abshenas, Gholamhosein Yaghoobi, A. Moradi, Hassan Mehrad‐Majd, M. Yaghoubi, A. Sahebkar","doi":"10.5603/dk.a2022.0023","DOIUrl":"https://doi.org/10.5603/dk.a2022.0023","url":null,"abstract":"","PeriodicalId":10386,"journal":{"name":"Clinical Diabetology","volume":"27 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77557888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Tripathi, S. Jindal, M. Chawla, Arvind Gupta, S. Jha, U. Phadke, T. Lathia
{"title":"The Implication of Time-in-Range for the Management of Diabetes in India: A Narrative Review","authors":"S. Tripathi, S. Jindal, M. Chawla, Arvind Gupta, S. Jha, U. Phadke, T. Lathia","doi":"10.5603/dk.a2022.0018","DOIUrl":"https://doi.org/10.5603/dk.a2022.0018","url":null,"abstract":"Introduction: In recent times, traditional self-monitor-ing of blood glucose (SMBG) using fingerstick capillary samples is moving to continuous glucose monitoring (CGM) due to inherent limitations of the traditional methods. CGM displays current glucose level, trends, rate of change, time-in-range (TIR), and glucose variability (GV) over a period of several days. It detects episodes of hyperglycemia and hypoglycemia, which allows immediate response to prevent these episodes. It also allows physicians to provide a personalized glycemic response to the patients. Materials and methods: Though CGM systems have been available for more than 20 years, their use is quite low. It is challenging for clinicians to invest time in learning and understanding the diverse reports of the various CGM devices. Moreover, there is a lack of consensus on the frequency of TIR measurement. Hence. a review of the literature was performed and existing guidelines from India and abroad were reviewed for a need for CGM and its frequency of measurements in DM patients. Results: TIR is inversely correlated to the risk of mi crovascular and macrovascular complications. CGM is recommended by expert clinician consensus and national and international medical organizations. For the patients use of CGMs involves cost. Besides, there is the discomfort and inconvenience of wearing the device. Hence, defining the implications of using CGM in practice is important. According to the 2020 recommendations by the Research Society for the Study of Diabetes in India (RSSDI) — Endocrine Society of India (ESI) and the 2019 recommendations by an expert group of endocrinologists and diabetologists, in the Indian context, CGM could be suggested for patients with Type 2 Diabetes who encounter severe hyper glycemia or hypoglycemia, repeated hypoglycemia, asymptomatic hypoglycemia, nocturnal hypoglyce -mia, refractory hyperglycemia, or large blood glucose excursions. Conclusions: The role of CGM to achieve better glyce mic control and prevention of complications in T1D and T2D is well established. Significant education and awareness on CGM needs to be provided to physicians as well as patients with high GV and those on insulin therapy. (Clin Diabetol 2022, 11; 3: 192–199) diabetes in clinical practice, particularly patients not adherent to medications and lifestyle modifications","PeriodicalId":10386,"journal":{"name":"Clinical Diabetology","volume":"111 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75629459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Mohammadi, Banafsheh Tehranineshat, M. Farjam, Soheila Rahnavard, M. Bijani
{"title":"The Correlation between Resilience, Self-efficacy and Illness Perception in Patients with Type 2 Diabetes: A Cross-Sectional Study","authors":"F. Mohammadi, Banafsheh Tehranineshat, M. Farjam, Soheila Rahnavard, M. Bijani","doi":"10.5603/dk.a2022.0024","DOIUrl":"https://doi.org/10.5603/dk.a2022.0024","url":null,"abstract":"Background: The present study aims to investigate the correlation between resilience, self-efficacy, and illness perception in patients with type 2 diabetes mellitus in the south of Iran. Materials and methods: The present study is a cross-sectional work conducted on 405 patients with type 2 diabetes mellitus who were selected via convenience sampling from clinics in the south of Iran, from De - cember 2019 to July 2020. Data were collected using a questionnaire consisting of four sections: a demo - graphics survey, the Connor-Davidson Resilience Scale (CD-RISC), Lev’s Self-efficacy Scale, and Broadbent’s Brief Illness Perception Questionnaire (BIPQ). Data analy - sis was performed in SPSS 22 software using descriptive statistics, Pearson correlation, ANOVA, and multiple regression analysis at a p < 0.05 significance level. Results: The results of the study showed that there were significant positive correlations between the participants’ resilience and self-efficacy (r = 0.78, p < 0.001), resilience and illness perception (r = 0.57, p < 0.001), and self-efficacy and illness perception (r = 0.76, p < 0.001). Conclusions: The findings of the present study show that there is a positive correlation between resilience and self-efficacy and illness perception in patients with type 2 diabetes mellitus. patients with diabetes who can successfully cope with the traumatic conditions caused by their illness and have confidence in their ability to perform self-care activities have a more positive view of the manageability of their condition. Therefore, healthcare policymakers and nurses can use interven - tions designed to enhance resilience and self-efficacy in order to improve diabetic patients’ illness perception and management. (Clin Diabetol 2022, 11; 3: 175–182)","PeriodicalId":10386,"journal":{"name":"Clinical Diabetology","volume":"1 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82020858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Features of the Course of Chronic Kidney Disease in Patients with Type 1 and Type 2 Diabetes, Depending on the Level of Amylinemia","authors":"I. Tsaryk, N. Pashkovska","doi":"10.5603/dk.a2022.0022","DOIUrl":"https://doi.org/10.5603/dk.a2022.0022","url":null,"abstract":"","PeriodicalId":10386,"journal":{"name":"Clinical Diabetology","volume":"20 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75026640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Vázquez-Velázquez, José J. Pizarro, Sofia Sánchez Román, Valeria Soto Fuentes, D. Arcila-Martinez, Héctor Velázquez-Jurado
{"title":"Psychological Impact of COVID-19 Lockdown on Well-being: Comparisons between People with Obesity, with Diabetes and without Diseases","authors":"V. Vázquez-Velázquez, José J. Pizarro, Sofia Sánchez Román, Valeria Soto Fuentes, D. Arcila-Martinez, Héctor Velázquez-Jurado","doi":"10.5603/dk.a2022.0020","DOIUrl":"https://doi.org/10.5603/dk.a2022.0020","url":null,"abstract":"Introduction: Obesity and type 2 diabetes mellitus are two chronic diseases most associated with hospitalizations and deaths from COVID-19. Background: This study compared psychological impact of COVID-19 lockdown in people with obesity, people with type 2 diabetes (T2D) and people without diseases, and determined the factors associated with well-being. Materials and methods: An online survey on negative affect, attitudes, social support and sharing, coping, well-being, and eating behavior was conducted in 157 people with obesity, 92 with type 2 diabetes and 288 without diseases. Results: People with obesity were the most worried of getting infected (70%) or dying (64%) and had the highest levels of emotional eating. People with T2D showed better coping strategies and higher well-being. Negative affect, worries about COVID-19 consequences and uncontrolled eating had negative impact, but social support, social sharing, and coping contributed positively (p < 0.001) to well-being. A 48.7% of people with obesity experienced more difficulties to adhere to treatment compared to only 11.1% of people with T2D. Conclusions: People with obesity had less well-being and more COVID-19 worries and emotional eating than people with T2D and without diseases. Well-being depends on negative affect, worries and eating behavior. Future research about the impact in long-term on weight and health status in patients with chronic diseases is needed.","PeriodicalId":10386,"journal":{"name":"Clinical Diabetology","volume":"26 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74783393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Omid Khosravizadeh, B. Ahadinezhad, Aisa Maleki, A. Hashtroodi, A. Moqadam, Hamideh Kamali
{"title":"Understanding Medication-Related Belief in Patients with Type 2 Diabetes: a Meta-Analytic Review","authors":"Omid Khosravizadeh, B. Ahadinezhad, Aisa Maleki, A. Hashtroodi, A. Moqadam, Hamideh Kamali","doi":"10.5603/dk.a2022.0025","DOIUrl":"https://doi.org/10.5603/dk.a2022.0025","url":null,"abstract":"","PeriodicalId":10386,"journal":{"name":"Clinical Diabetology","volume":"47 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87419985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Patil, S. Bhosale, A. Kshirsagar, H. Patil, Sanjay S. Patil
{"title":"Outcome Prediction and Severity of Corona Virus Disease (COVID-19) on the Basis of Clinical and Laboratory Parameters","authors":"V. Patil, S. Bhosale, A. Kshirsagar, H. Patil, Sanjay S. Patil","doi":"10.5603/dk.a2022.0017","DOIUrl":"https://doi.org/10.5603/dk.a2022.0017","url":null,"abstract":"Background: Laboratory parameters play a key role in triaging, predicting disease course, severity and may determine prognosis COVID-19 patients. Material and methods: Aim and Objectives: To study the relation of clinical and laboratory parameters (total WBC count, neutrophil: lymphocyte ratio, serum ferritin, serum D-dimer, serum LDH, CRP, ESR) with severity and outcome of Corona Virus Disease (COVID-19) confirmed by real-time RT-PCR. Sample size: It was a time-bound study conducted over 3 months (1st April to 30th June, 2020). A total of 206 patients will be included in this study satisfying the inclusion criteria. Study design: This was a prospective, observational and non-interventional study conducted on patients with laboratory-confirmed COVID-19 admitted in a tertiary care teaching hospital. Statistical Analysis: Data will be analyzed for mean, percentage, standard deviation, and chi-square test for quantitative data by using appropriate statistical tests using INSTAT software version 8.0 (trial version) and p-value < 0.05 will be considered statistically significant. Results: Total of 206 patients of both genders were included in the present study. Total 141 (68.44%) patients were males and 65 (31.55%) patients were females (Chi Sq. 56.07;DF:1;p < 0.001). Among all the groups according to the severity of illness, 'D' group was the most common group (n = 99;45.06%). Age > 60 years (17.48%), obesity (13.11%), hypertension (10.19%), COPD (5.83%), and diabetes mellitus (5.83%) were the most frequent risk factors or comorbidities associated with COVID-19 disease. Many patients had multiple risk factors in the present study. The majority (3/4th) of the patients were in C and D group (moderate) with co-morbidities and about 1/4th were in the severe group. Total 5 (2.43%) patients with COVID-19 patients succumbed to death with an overall case fatality rate of 2.43%. The case fatality rate was significantly higher among the patients with risk factors or comorbidities (p = 0.0124). Late presentation, associated comorbidity, advancing age, High level of ferritin, D-dimer, CRP, PaO2/FiO(2) ratio less than 100 at the time of admission were associated with mortality. The terminal event in patients who have succumbed was bradycardia followed by cardiorespiratory arrest. The cause of death was ARDS with bilateral extensive pneumonia. Conclusions: Late presentation, associated comorbidity like diabetes mellitus, advancing age, High level of ferritin, D-dimer, CRP, PaO2/FiO(2) ratio less than 100 at the time of admission were associated with mortality. The terminal event in patients who have succumbed was bradycardia followed by cardiorespiratory arrest. The cause of death was ARDS with bilateral extensive pneumonia.","PeriodicalId":10386,"journal":{"name":"Clinical Diabetology","volume":"1 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74951279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Heydari, M. Yaghoubi, G. Yaghoobi, B. Bijari, Shadieh Poorabbas Feizabadi, A. Sahebkar
{"title":"Evaluation of the Relationship between Serum Copeptin Level and Diabetic Retinopathy in Patients with Type 2 Diabetes","authors":"S. Heydari, M. Yaghoubi, G. Yaghoobi, B. Bijari, Shadieh Poorabbas Feizabadi, A. Sahebkar","doi":"10.5603/dk.a2022.0016","DOIUrl":"https://doi.org/10.5603/dk.a2022.0016","url":null,"abstract":"","PeriodicalId":10386,"journal":{"name":"Clinical Diabetology","volume":"7 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82084127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}