Diabetes, Obesity & Metabolism最新文献

筛选
英文 中文
Anti-diabetic effects of GLP-1 receptor agonists on obese and overweight patients across diabetes status, administration routes, treatment duration and baseline characteristics: A systematic review. GLP-1受体激动剂对肥胖和超重患者的抗糖尿病作用,包括糖尿病状态、给药途径、治疗时间和基线特征:一项系统综述
IF 5.4 2区 医学
Diabetes, Obesity & Metabolism Pub Date : 2024-12-26 DOI: 10.1111/dom.16136
Hon Jen Wong, Norman H Y Lin, Yao Hao Teo, Brian S Y Yeo, Keith Zhi Xian Toh, Yao Neng Teo, Mark Y Chan, Leonard L L Yeo, Kian Keong Poh, William K F Kong, Pei Chia Eng, Benjamin Y Q Tan, Mayank Dalakoti, Ching-Hui Sia
{"title":"Anti-diabetic effects of GLP-1 receptor agonists on obese and overweight patients across diabetes status, administration routes, treatment duration and baseline characteristics: A systematic review.","authors":"Hon Jen Wong, Norman H Y Lin, Yao Hao Teo, Brian S Y Yeo, Keith Zhi Xian Toh, Yao Neng Teo, Mark Y Chan, Leonard L L Yeo, Kian Keong Poh, William K F Kong, Pei Chia Eng, Benjamin Y Q Tan, Mayank Dalakoti, Ching-Hui Sia","doi":"10.1111/dom.16136","DOIUrl":"https://doi.org/10.1111/dom.16136","url":null,"abstract":"<p><p>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used for anti-obesity indications. However, little is known of the comparative effect of GLP-1 RAs and their glycemic impact across the different routes of administration, diabetic statuses and durations of prescription. PubMed, EMBASE and CENTRAL were searched from inception to 13 February 2024. Only randomised controlled trials were included in this systematic review and meta-analysis. Adults aged above 18 years old, who were in the overweight/obesity range, with or without type 2 diabetes mellitus (T2DM) were included. Baseline characteristics and changes in glycated haemoglobin (HbA1c) and fasting plasma glucose (FPG) were obtained. GLP1-RAs demonstrated an overall reduction in HbA1c of -0.72% (95% confidence interval [CI] -0.79 to -0.65, p < 0.01) and in FPG of -1.00 mmol/L (95% CI -1.16 to -0.84, p < 0.01). HbA1c reduction in pre-DM patients was -0.44% (95% CI -0.54 to -0.18, p < 0.01). Patients who were followed up for more than a year experienced a smaller reduction of HbA1c. Meta-regression showed that the GLP-1 RAs are more efficacious at higher HbA1c and lower body mass index. Overall, GLP-1 RAs consistently led to a significant reduction in HbA1c at -0.72% and FPG at -1.00 mmol/L. These effects may be equally efficacious in pre-DM patients with obesity and those at lower BMI. With pre-DM and obesity being risk factors for metabolic syndrome, these findings may provide newer perspectives in expanding indications for GLP-1 RA initiation.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142890883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessing the benefit-risk profile of newer glucose-lowering drugs: A systematic review and network meta-analysis of randomized outcome trials. 评估新型降糖药物的获益-风险概况:随机结果试验的系统回顾和网络荟萃分析。
IF 5.4 2区 医学
Diabetes, Obesity & Metabolism Pub Date : 2024-12-26 DOI: 10.1111/dom.16147
Huilin Tang, Bingyu Zhang, Yiwen Lu, William T Donahoo, Naykky Singh Ospina, Pareeta Kotecha, Ying Lu, Jiayi Tong, Steven M Smith, Eric I Rosenberg, Stephen E Kimmel, Jiang Bian, Jingchuan Guo, Yong Chen
{"title":"Assessing the benefit-risk profile of newer glucose-lowering drugs: A systematic review and network meta-analysis of randomized outcome trials.","authors":"Huilin Tang, Bingyu Zhang, Yiwen Lu, William T Donahoo, Naykky Singh Ospina, Pareeta Kotecha, Ying Lu, Jiayi Tong, Steven M Smith, Eric I Rosenberg, Stephen E Kimmel, Jiang Bian, Jingchuan Guo, Yong Chen","doi":"10.1111/dom.16147","DOIUrl":"https://doi.org/10.1111/dom.16147","url":null,"abstract":"<p><strong>Aim: </strong>To comprehensively evaluate the benefits and risks of glucagon-like peptide-1 receptor agonists (GLP-1RA), dipeptidyl peptidase 4 inhibitors (DPP4i), and sodium-glucose cotransporter 2 inhibitors (SGLT2i).</p><p><strong>Materials and methods: </strong>A systematic search of PubMed, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) from inception to November 2023 to identify randomized cardiovascular and kidney outcome trials that enrolled adults with type 2 diabetes, heart failure, or chronic kidney disease and compared DPP4i, GLP-1RAs, or SGLT2i to placebo. Twenty-one outcomes (e.g., major adverse cardiovascular events [MACE], stroke, and hospitalization for heart failure [HHF]) were assessed. Data were pooled using population-averaged odds ratios (ORs) with 95% CIs.</p><p><strong>Results: </strong>Twenty-six trials enrolling 198 177 participants were included. GLP-1RAs were most effective in lowering the risks of MACE (OR, 0.85, [95% CI, 0.79 to 0.92]) and stroke (0.84 [0.77, 0.91]), but increased the risk of thyroid cancer (1.58 [1.36, 2.50]). SGLT2i showed the greatest benefits in reducing the risk of HHF (0.68 [0.64, 0.73]) and improving composite renal outcomes (0.67 [0.58, 0.77]), but increased the risk of genital infections (3.11 [2.15, 4.50]). DPP4i were associated with a lower risk of certain psychiatric disorders, Parkinson's disease (0.54 [0.32, 0.92]), and amputation (0.70 [0.86, 0.93]), but an increased risk of neuropathy (1.10 [1.02, 1.18]) and pancreatitis (1.63 [1.40, 1.91]). The weighted origami plot suggested that GLP-1RAs were more suitable for reducing macrovascular and microvascular outcomes, while DPP4i might be better for neurodegenerative diseases and cancer concerns.</p><p><strong>Conclusions: </strong>Given the distinct benefit-risk profiles, the selection of glucose-lowering drugs should be individualized based on patient characteristics and risk factors.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142890889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reply to the Letters by Louie and Pereira et al. 对Louie和Pereira等人的信的答复。
IF 5.4 2区 医学
Diabetes, Obesity & Metabolism Pub Date : 2024-12-26 DOI: 10.1111/dom.16138
Shoko Hamano, Mika Sawada, Naoto Kubota
{"title":"Reply to the Letters by Louie and Pereira et al.","authors":"Shoko Hamano, Mika Sawada, Naoto Kubota","doi":"10.1111/dom.16138","DOIUrl":"https://doi.org/10.1111/dom.16138","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142890638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy of imeglimin in patients with type 2 diabetes mellitus complicated by metabolic dysfunction-associated steatotic liver disease: A multicentre study. 伊米霉素治疗2型糖尿病合并代谢功能障碍相关脂肪变性肝病的疗效:一项多中心研究
IF 5.4 2区 医学
Diabetes, Obesity & Metabolism Pub Date : 2024-12-26 DOI: 10.1111/dom.16157
Kensaku Fukunaga, Asahiro Morishita, Hitomi Imachi, Kyoko Oura, Seisuke Sato, Toshihiro Kobayashi, Takanobu Saheki, Takafumi Yoshimura, Kurumi Komori, Mai Nakahara, Tomoko Tadokoro, Koji Fujita, Joji Tani, Hideki Kobara, Koji Murao
{"title":"Efficacy of imeglimin in patients with type 2 diabetes mellitus complicated by metabolic dysfunction-associated steatotic liver disease: A multicentre study.","authors":"Kensaku Fukunaga, Asahiro Morishita, Hitomi Imachi, Kyoko Oura, Seisuke Sato, Toshihiro Kobayashi, Takanobu Saheki, Takafumi Yoshimura, Kurumi Komori, Mai Nakahara, Tomoko Tadokoro, Koji Fujita, Joji Tani, Hideki Kobara, Koji Murao","doi":"10.1111/dom.16157","DOIUrl":"https://doi.org/10.1111/dom.16157","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to evaluate the effectiveness of imeglimin in improving liver function and fibrosis in patients with type 2 diabetes (T2D) complicated by metabolic dysfunction-associated steatotic liver disease (MASLD).</p><p><strong>Materials and methods: </strong>We conducted a multicentre study involving 80 patients with T2D and MASLD who were treated with or without imeglimin for 24 weeks. We assessed the changes in diabetes-related parameters, including HbA1c, fasting blood glucose, glycoalbumin and C-peptide index. Liver function was monitored using AST, ALT, γ-GTP and liver fibrosis indicators such as Fib-4 index and FibroScan-AST (FAST) score. Liver fat content and stiffness were measured using controlled attenuation parameter and vibration-controlled transient elastography, which were measured using FibroScan.</p><p><strong>Results: </strong>Compared with the control group, imeglimin treatment led to a significant reduction in HbA1c levels, fasting blood glucose and liver-related parameters, including AST, ALT and γ-GTP. Additionally, the Fib-4 index and FAST score, which reflect liver fibrosis and inflammation, were significantly lower in the imeglimin group. Liver fat content and stiffness remained unchanged during the study period.</p><p><strong>Conclusions: </strong>Imeglimin efficaciously improved liver inflammation and fibrosis in patients with T2D and MASLD, with no significant changes in liver fat content or stiffness. These findings suggest that imeglimin is a promising therapeutic drug for the management of MASLD in the context of T2D, warranting further research on its long-term efficacy and mechanisms of action.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142890890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The impact of novel probiotics isolated from the human gut on the gut microbiota and health. 从人体肠道中分离的新型益生菌对肠道菌群和健康的影响。
IF 5.4 2区 医学
Diabetes, Obesity & Metabolism Pub Date : 2024-12-26 DOI: 10.1111/dom.16129
Robert Caesar
{"title":"The impact of novel probiotics isolated from the human gut on the gut microbiota and health.","authors":"Robert Caesar","doi":"10.1111/dom.16129","DOIUrl":"https://doi.org/10.1111/dom.16129","url":null,"abstract":"<p><p>The gut microbiota plays a pivotal role in influencing the metabolism and immune responses of the body. A balanced microbial composition promotes metabolic health through various mechanisms, including the production of beneficial metabolites, which help regulate inflammation and support immune functions. In contrast, imbalance in the gut microbiota, known as dysbiosis, can disrupt metabolic processes and increase the risk of developing diseases, such as obesity, type 2 diabetes, and inflammatory disorders. The composition of the gut microbiota is dynamic and can be influenced by environmental factors such as diet, medication, and the consumption of live bacteria. Since the early 1900s, bacteria isolated from food and have been used as probiotics. However, the human gut also offers an enormous reservoir of bacterial strains, and recent advances in microbiota research have led to the discovery of strains with probiotic potentials. These strains, derived from a broad spectrum of microbial taxa, differ in their ecological properties and how they interact with their hosts. For most probiotics bacterial structural components and metabolites, such as short-chain fatty acids, contribute to the maintenance of metabolic and immunological homeostasis by regulating inflammation and reinforcing gut barrier integrity. Metabolites produced by probiotic strains can also be used for bacterial cross-feeding to promote a balanced microbiota. Despite the challenges related to safety, stability, and strain-specific properties, several newly identified strains offer great potential for personalized probiotic interventions, allowing for targeted health strategies.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142890703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ceramide-based risk score CERT-1 improves risk prediction for overall mortality and adverse cardiovascular outcomes in patients with and without cardiovascular disease: A prospective cohort study. 神经酰胺风险评分CERT-1提高了有或无心血管疾病患者总死亡率和不良心血管结局的风险预测:一项前瞻性队列研究
IF 5.4 2区 医学
Diabetes, Obesity & Metabolism Pub Date : 2024-12-26 DOI: 10.1111/dom.16156
Alessandro Mantovani, Gianluigi Lunardi, Stefano Bonapace, Agustin E Molinero, Riccardo Morandin, Veronica Fiorio, Giulio Molon, Christopher D Byrne, Giovanni Targher
{"title":"Ceramide-based risk score CERT-1 improves risk prediction for overall mortality and adverse cardiovascular outcomes in patients with and without cardiovascular disease: A prospective cohort study.","authors":"Alessandro Mantovani, Gianluigi Lunardi, Stefano Bonapace, Agustin E Molinero, Riccardo Morandin, Veronica Fiorio, Giulio Molon, Christopher D Byrne, Giovanni Targher","doi":"10.1111/dom.16156","DOIUrl":"https://doi.org/10.1111/dom.16156","url":null,"abstract":"<p><strong>Aims: </strong>Whether the plasma-based ceramide-based risk score CERT1 improves risk prediction for cardiovascular disease (CVD) is uncertain.</p><p><strong>Materials and methods: </strong>Baseline and follow-up data were combined from two cohorts, 334 patients with established/suspected CVD and 196 patients with type 2 diabetes followed for a median of 74 months (interquartile range 54-79 months). For the calculation of CERT1 risk score, we measured four specific plasma ceramides [Cer(d18:1/16:0), Cer(d18:1/18:0) and Cer(d18:1/24:1)] and their ratios to Cer(d18:1/24:0). Based on the CERT1 risk score, patients were split into four risk categories (low, moderate, increased or high risk). The primary outcome was a composite of overall mortality and incident nonfatal CVD outcomes (including myocardial infarction, ischaemic stroke or permanent atrial fibrillation).</p><p><strong>Results: </strong>One hundred and thirty-nine patients developed the primary composite outcome (72 nonfatal CVD outcomes and 67 total deaths) during follow-up. Baseline CERT1 risk categories were significantly associated with the risk of developing the primary composite outcome (adjusted HR for high vs. low-risk category 2.43, 95% CI 1.39-4.22, p = 0.002, and adjusted HR for increased vs. low-risk category 2.16, 95% CI 1.28-3.63, p = 0.004). Receiver operator characteristic curve analysis showed that adding CERT1 risk score to traditional CVD risk factors and pre-existing CVD, improved the discriminatory capability of the regression model for predicting the primary composite outcome (AUROC 0.691 [95% CI 0.674-0.769] vs. 0.722 [95% CI 0.642-0.742], p = 0.0275).</p><p><strong>Conclusions: </strong>The ceramide-based risk score CERT1 risk score improves risk prediction for long-term risk of overall mortality and adverse cardiovascular outcomes in patients with and without CVD.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142890915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Minimum expectations for market authorization of continuous glucose monitoring devices in Europe-'eCGM' compliance status. 欧洲连续血糖监测设备市场授权的最低期望-“eCGM”合规状态。
IF 5.4 2区 医学
Diabetes, Obesity & Metabolism Pub Date : 2024-12-26 DOI: 10.1111/dom.16153
Chantal Mathieu, Concetta Irace, Emma G Wilmot, Bassil Akra, Stefano Del Prato, Martin Cuesta, Peter Adolfsson, Tomasz Klupa, Eric Renard, Tadej Battelino
{"title":"Minimum expectations for market authorization of continuous glucose monitoring devices in Europe-'eCGM' compliance status.","authors":"Chantal Mathieu, Concetta Irace, Emma G Wilmot, Bassil Akra, Stefano Del Prato, Martin Cuesta, Peter Adolfsson, Tomasz Klupa, Eric Renard, Tadej Battelino","doi":"10.1111/dom.16153","DOIUrl":"https://doi.org/10.1111/dom.16153","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142890636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exclusion of older persons from randomized controlled trials in type 2 diabetes: A cross-sectional study. 将老年人排除在2型糖尿病随机对照试验之外:一项横断面研究。
IF 5.4 2区 医学
Diabetes, Obesity & Metabolism Pub Date : 2024-12-26 DOI: 10.1111/dom.16137
Jan Borysowski, Danuta Kłosowska, Leszek Pączek, Michał Ordak, Edward Franek
{"title":"Exclusion of older persons from randomized controlled trials in type 2 diabetes: A cross-sectional study.","authors":"Jan Borysowski, Danuta Kłosowska, Leszek Pączek, Michał Ordak, Edward Franek","doi":"10.1111/dom.16137","DOIUrl":"https://doi.org/10.1111/dom.16137","url":null,"abstract":"<p><strong>Background: </strong>Prevalence of type 2 diabetes increases with age. Both the Food and Drug Administration (FDA) and the European Medicines Agency (EMA) promote the enrollment of older patients to randomized controlled trials (RCTs) in diabetes. The objective of this study was to assess the eligibility criteria limiting the inclusion of older adults to RCTs in type 2 diabetes.</p><p><strong>Materials and methods: </strong>This cross-sectional analysis of ClinicalTrials.gov included phase 2, 3 and 4 RCTs of drugs and biologicals, with enrollment ≥100, registered at ClinicalTrials.gov and started from 2014 through 2023.</p><p><strong>Results: </strong>A total of 278/594 (46.8%) trials had a limit of 90 years of age or less (primary outcome). The odds of the age limits were higher in RCTs funded from non-commercial sources (adjusted odds ratio (aOR), 2.83, 95% confidence interval (CI), 1.77-4.52; p < 0.001) and phase 2 trials (aOR, 2.38; 95% CI, 1.49-3.81; p < 0.001). A total of 542/594 (91.2%) trials had other relevant exclusion criteria, mostly those concerning comorbidities common in older patients (secondary outcome). However, none of the RCTs excluded patients with frailty which is a key factor determining the prognosis of older patients with diabetes. Only two trials enrolled solely older persons.</p><p><strong>Conclusions: </strong>Most RCTs in type 2 diabetes have the eligibility criteria limiting the enrollment of older patients. The age limits should be eliminated and patients should be excluded based on scientifically justified criteria especially those concerning comorbidities and frailty. Moreover, the benefits and harms of new drugs in older patients with multimorbidity and/or frailty should be assessed in dedicated phase 4 trials.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142890627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy of imeglimin treatment versus metformin dose escalation on glycemic control in subjects with type 2 diabetes treated with a dipeptidyl peptidase-4 inhibitor plus low-dose metformin: A multicenter, prospective, randomized, open-label, parallel-group comparison study (MEGMI study). 二肽基肽酶-4抑制剂联合低剂量二甲双胍治疗2型糖尿病患者,伊美霉素治疗与二甲双胍剂量递增对血糖控制的疗效:一项多中心、前瞻性、随机、开放标签、平行组比较研究(MEGMI研究)。
IF 5.4 2区 医学
Diabetes, Obesity & Metabolism Pub Date : 2024-12-26 DOI: 10.1111/dom.16150
Akihiro Takahashi, Hiroshi Nomoto, Hiroki Yokoyama, Kei Yokozeki, Sho Furusawa, Yuki Oe, Reina Kameda, Shinichiro Kawata, Arina Miyoshi, So Nagai, Aika Miya, Hiraku Kameda, Akinobu Nakamura, Tatsuya Atsumi
{"title":"Efficacy of imeglimin treatment versus metformin dose escalation on glycemic control in subjects with type 2 diabetes treated with a dipeptidyl peptidase-4 inhibitor plus low-dose metformin: A multicenter, prospective, randomized, open-label, parallel-group comparison study (MEGMI study).","authors":"Akihiro Takahashi, Hiroshi Nomoto, Hiroki Yokoyama, Kei Yokozeki, Sho Furusawa, Yuki Oe, Reina Kameda, Shinichiro Kawata, Arina Miyoshi, So Nagai, Aika Miya, Hiraku Kameda, Akinobu Nakamura, Tatsuya Atsumi","doi":"10.1111/dom.16150","DOIUrl":"https://doi.org/10.1111/dom.16150","url":null,"abstract":"<p><strong>Aims: </strong>To compare the efficacy of adding imeglimin versus that of metformin dose escalation on glycemic control in subjects with type 2 diabetes treated with a dipeptidyl peptidase-4 inhibitor plus low-dose metformin (500-1000 mg/day).</p><p><strong>Materials and methods: </strong>In this multicentre, open-labelled, prospective, randomized, parallel-group comparison study, the addition of imeglimin (2000 mg/day) or metformin escalation was applied for 24 weeks in eligible subjects. The primary endpoint was the mean change in glycated haemoglobin (HbA1c) over 24 weeks. As the secondary endpoints, the occurrence of adverse events, changes in metabolic parameters, biomarkers and factors associated with HbA1c improvement were analysed.</p><p><strong>Results: </strong>Seventy-three eligible subjects were enrolled. Of them, 65 participants comprised the full analysis set. At 24 weeks, the addition of imeglimin (n = 33) resulted in greater improvement in HbA1c compared with metformin dose escalation (n = 32) (from 7.61 ± 0.48% to 6.93 ± 0.49% in imeglimin and from 7.56 ± 0.61% to 7.09 ± 0.56% in metformin escalation; change difference: -0.21% [95% confidence interval: -0.41%, -0.01%] [p = 0.038]); however, seven subjects in the imeglimin group discontinued imeglimin because of serious adverse events on gastrointestinal tract. In intra-group pre/post comparisons, imeglimin treatment significantly reduced body weight and improved liver enzyme elevation. There was a significant correlation between improvement levels of HbA1c and indicators of fatty liver disease in the imeglimin group.</p><p><strong>Conclusions: </strong>Imeglimin in combination with a dipeptidyl peptidase-4 inhibitor and low-dose metformin improved HbA1c compared with metformin dose escalation.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142890626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Heterogeneous blood pressure treatment effects on cognitive decline in type 2 diabetes: A machine learning analysis of a randomized clinical trial. 异质性血压治疗对2型糖尿病认知能力下降的影响:一项随机临床试验的机器学习分析
IF 5.4 2区 医学
Diabetes, Obesity & Metabolism Pub Date : 2024-12-26 DOI: 10.1111/dom.16145
Xuan Zhao, Xiaoli Xu, Siyu Wang, Xiaoyun Zhang, Ruizhi Zheng, Kan Wang, Yu Xiang, Tiange Wang, Zhiyun Zhao, Mian Li, Jie Zheng, Min Xu, Jieli Lu, Yufang Bi, Yu Xu
{"title":"Heterogeneous blood pressure treatment effects on cognitive decline in type 2 diabetes: A machine learning analysis of a randomized clinical trial.","authors":"Xuan Zhao, Xiaoli Xu, Siyu Wang, Xiaoyun Zhang, Ruizhi Zheng, Kan Wang, Yu Xiang, Tiange Wang, Zhiyun Zhao, Mian Li, Jie Zheng, Min Xu, Jieli Lu, Yufang Bi, Yu Xu","doi":"10.1111/dom.16145","DOIUrl":"https://doi.org/10.1111/dom.16145","url":null,"abstract":"<p><strong>Aim: </strong>We aimed to identify the characteristics of patients with diabetes who can derive cognitive benefits from intensive blood pressure (BP) treatment using machine learning methods.</p><p><strong>Materials and methods: </strong>Using data from the Action to Control Cardiovascular Risk in Diabetes Memory in Diabetes (ACCORD-MIND) study, 1349 patients with type 2 diabetes who underwent BP treatment (intensive treatment targeting a systolic BP <120 mmHg vs. standard treatment targeting <140 mmHg) were included in the machine learning analysis. Seventy-nine variables correlated with diabetes and cognitive function were used to build the causal forest and causal tree models for identifying heterogeneous BP treatment effects on cognitive decline.</p><p><strong>Results: </strong>Our analyses identified four variables including urinary albumin-to-creatinine ratio (UACR, mg/g), Framingham 10-year cardiovascular risk score (FRS, %), triglycerides (TG, mmol/L) and diabetes duration, that categorized the participants into five subgroups with different risk benefits for cognitive decline from BP treatments. Subgroup 1 (UACR ≥65 mg/g) had an absolute risk reduction (ARR) of 15.36% (95% CI, 5.01%-25.46%) from intensive versus standard BP treatment (hazard ratio [HR], 0.36; 95% CI, 0.18-0.73). Subgroup 2 (UACR <65 mg/g, FRS ≥26%, TG <2.3 mmol/L and diabetes duration ≥9 years) had an ARR of 14.74% (95% CI, 4.56%-24.59%) from intensive versus standard BP treatment (HR, 0.34; 95% CI, 0.15-0.77). No significant benefits were found for other subgroups.</p><p><strong>Conclusions: </strong>Patients with type 2 diabetes with high UACR, or with low UACR and low TG, but high predicted cardiovascular risk and long diabetes duration were likely to derive cognitive benefits from intensive BP treatment.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142890629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信