• Home   /  
  • Archive by category "1"

Research Papers On Diabetes Type 2


L. Guariguata | D. R. Whiting | I. Hambleton | J. Beagley | U. Linnenkamp | J. E. Shaw

Introduction: Diabetes is a serious and increasing global health burden and estimates of prevalence are essential for appropriate allocation of resources and monitoring of trends. Methods: We conducted a literature search of studies reporting the age-specific prevalence for diabetes and used the Analytic Hierarchy Process to systematically select studies to generate estimates for 219 countries and territories. Estimates for countries without available source data were modelled from pooled estimates of countries that were similar in regard to geography, ethnicity, and economic development. Logistic regression was applied to generate smoothed age-specific prevalence estimates for adults 20-79 years which were then applied to population estimates for 2013 and 2035. Results: A total of 744 data sources were considered and 174 included, representing 130 countries. In 2013, 382 million people had diabetes; this number is expected to rise to 592 million by 2035. Most people with diabetes live in low- and middle-income countries and these will experience the greatest increase in cases of diabetes over the next 22 years. Conclusion: The new estimates of diabetes in adults confirm the large burden of diabetes, especially in developing countries. Estimates will be updated annually including the most recent, high-quality data available. © 2013.


Nathalie Esser | Sylvie Legrand-Poels | Jacques Piette | André J. Scheen | Nicolas Paquot

It is recognized that a chronic low-grade inflammation and an activation of the immune system are involved in the pathogenesis of obesity-related insulin resistance and type 2 diabetes. Systemic inflammatory markers are risk factors for the development of type 2 diabetes and its macrovascular complications. Adipose tissue, liver, muscle and pancreas are themselves sites of inflammation in presence of obesity. An infiltration of macrophages and other immune cells is observed in these tissues associated with a cell population shift from an anti-inflammatory to a pro-inflammatory profile. These cells are crucial for the production of pro-inflammatory cytokines, which act in an autocrine and paracrine manner to interfere with insulin signaling in peripheral tissues or induce β-cell dysfunction and subsequent insulin deficiency. Particularly, the pro-inflammatory interleukin-1β is implicated in the pathogenesis of type 2 diabetes through the activation of the NLRP3 inflammasome. The objectives of this review are to expose recent data supporting the role of the immune system in the pathogenesis of insulin resistance and type 2 diabetes and to examine various mechanisms underlying this relationship. If type 2 diabetes is an inflammatory disease, anti-inflammatory therapies could have a place in prevention and treatment of type 2 diabetes. © 2014 Elsevier Ireland Ltd.


Yeon Kyung Choi | Mi Kyung Kim | Kwi Hyun Bae | Hyun Ae Seo | Ji Yun Jeong | Won Kee Lee | Jung Guk Kim | In Kyu Lee | Keun Gyu Park

Aims: Irisin has been identified as a novel myokine that drives brown-fat-like conversion of white adipose tissue. In this cross-sectional study, we investigated whether serum irisin levels are decreased in patients with type 2 diabetes (T2D) compared with control subjects with normal glucose tolerance (NGT), and assessed the association between serum irisin levels and various metabolic parameters. Methods: The study population was selected from a population-based study and included 104 subjects with NGT and 104 subjects with new-onset T2D. Serum irisin and adiponectin levels and metabolic parameters were measured. Multivariate logistic regression analysis was performed to assess the association between irisin levels and newly diagnosed T2D. Results: Serum irisin levels were significantly decreased in the new-onset T2D group compared with the NGT control group (p= 0.003). In a multivariable model adjusted for various metabolic parameters, increased irisin levels were associated with reduced odds (OR 0.64, 95% CI 0.47-0.88, p= 0.006) of prevalent newly diagnosed T2D. Furthermore, multiple regression analysis showed that 2. h plasma glucose was an independent variable influencing serum irisin levels (p= 0.004). Conclusion: In the present study, we found that serum irisin levels were decreased in T2D patients and inversely associated with newly diagnosed T2D, suggesting that irisin may play a crucial role in glucose intolerance and T2D. © 2013 Elsevier Ireland Ltd.


Pablo Aschner | Henning Beck-Nielsen | Peter Bennett | Andrew Boulton | Ruth Colagiuri | Stephen Colagiuri | Marg McGill | Kyra Sim | Marion Franz | Roger Gadsby | Juan José Gagliardino | Philip Home | Sally Marshall | Susan Manley | Jean Claude Mbanya | Andrew Neil | Ambady Ramachandran | Vijay Viswanathan | Kaushik Ramaiya | Gojka Roglic | Nicolaas Schaper | Linda Siminerio | Alan Sinclair | Frank Snoek | Paul Van Crombrugge | Giacomo Vespasiani

Jessica Beagley | Leonor Guariguata | Clara Weil | Ayesha A. Motala

Aims: The prevalence of diabetes is rapidly increasing worldwide. Type 2 diabetes may remain undetected for many years, leading to severe complications and healthcare costs. This paper provides estimates of the prevalence of undiagnosed diabetes mellitus (UDM), using available data from high quality representative population-based sources. Methods: Data sources reporting both diagnosed and previously undiagnosed diabetes were identified and selected according to previously described IDF methodology for diabetes in adults (aged 20-79). Countries were divided into 15 data regions based on their geographic IDF Region and World Bank income classification. The median UDM proportion was calculated from selected data sources for each of data region. The number of UDM cases in 2013 was calculated from country, age and sex-specific estimates of known diabetes cases and data region-specific UDM proportion. Results: Of 744 reviewed data sources, 88 sources representing 74 countries had sufficient information and were selected for generation of estimates of UDM. Globally, 45.8%, or 174.8 million of all diabetes cases in adults are estimated to be undiagnosed, ranging from 24.1% to 75.1% across data regions. An estimated 83.8% of all cases of UDM are in low- and middle-income countries. At a country level, Pacific Island nations have the highest prevalence of UDM. Conclusions: There is a high proportion of UDM globally, and especially in developing countries. Further high-quality studies of UDM are needed to strengthen future estimates. © 2013 Elsevier Ireland Ltd.


Chris Patterson | Leonor Guariguata | Gisela Dahlquist | Gyula Soltész | Graham Ogle | Martin Silink

This paper describes the methodology, results and limitations of the 2013 International Diabetes Federation (IDF) Atlas (6th edition) estimates of the worldwide numbers of prevalent cases of type 1 diabetes in children ( < 15 years). The majority of relevant information in the published literature is in the form of incidence rates derived from registers of newly diagnosed cases. Studies were graded on quality criteria and, if no information was available in the published literature, extrapolation was used to assign a country the rate from an adjacent country with similar characteristics. Prevalence rates were then derived from these incidence rates and applied to United Nations 2012 Revision population estimates for 2013 for each country to obtain estimates of the number of prevalent cases.Data availability was highest for the countries in Europe (76%) and lowest for the countries in sub-Saharan Africa (8%). The prevalence estimates indicate that there are almost 500,000 children aged under 15 years with type 1 diabetes worldwide, the largest numbers being in Europe (129,000) and North America (108,700). Countries with the highest estimated numbers of new cases annually were the United States (13,000), India (10,900) and Brazil (5000). Compared with the prevalence estimates made in previous editions of the IDF Diabetes Atlas, the numbers have increased in most of the IDF Regions, often reflecting the incidence rate increases that have been well-documented in many countries.Monogenic diabetes is increasingly being recognised among those with clinical features of type 1 or type 2 diabetes as genetic studies become available, but population-based data on incidence and prevalence show wide variation due to lack of standardisation in the studies. Similarly, studies on type 2 diabetes in childhood suggest increased incidence and prevalence in many countries, especially in Indigenous peoples and ethnic minorities, but detailed population-based studies remain limited. © 2013 Elsevier Ireland Ltd.


Mark Peyrot | Katharina Kovacs Burns | Melanie Davies | Angus Forbes | Norbert Hermanns | Richard Holt | Sanjay Kalra | Antonio Nicolucci | Frans Pouwer | Johan Wens | Ingrid Willaing | Søren E. Skovlund

Aims: The Diabetes Attitudes Wishes and Needs 2 (DAWN2) study aims to provide a holistic assessment of diabetes care and management among people with diabetes (PWD), family members (FM), and healthcare professionals (HCPs) and explores potential drivers leading to active management. Methods: DAWN2 survey over 16,000 individuals (∼9000 PWD, ∼2000 FM of PWD, and ∼5000 HCPs) in 17 countries across 4 continents. Respondents complete a group-specific questionnaire; items are designed to allow cross-group comparisons on common topics. The questionnaires comprise elements from the original DAWN study (2001), as well as psychometrically validated instruments and novel questions developed for this study to assess self-management, attitudes/beliefs, disease impact/burden, psychosocial distress, health-related quality of life, healthcare provision/receipt, social support and priorities for improvement in the future. The questionnaires are completed predominantly online or by telephone interview, supplemented by face-to-face interviews in countries with low internet access. In each country, recruitment ensures representation of the diabetes population in terms of geographical distribution, age, gender, education and disease status. Discussion: DAWN2 aims to build on the original DAWN study to identify new avenues for improving diabetes care. This paper describes the study rationale, goals and methodology. © 2012 Elsevier Ireland Ltd.


L. Guariguata | U. Linnenkamp | J. Beagley | D. R. Whiting | N. H. Cho

Aims: We estimated the number of live births worldwide and by IDF Region who developed hyperglycaemia in pregnancy in 2013, including total diabetes in pregnancy (known and previously undiagnosed diabetes) and gestational diabetes. Methods: Studies reporting prevalence of hyperglycaemia first-detected in pregnancy (formerly termed gestational diabetes) were identified using PubMed and through a revi ew of cited literature. A simple scoring system was developed to characterise studies on diagnostic criteria, year study was conducted, study design, and representation. The highest scoring studies by country with sufficient detail on methodology for characterisation and reporting at least three age-groups were selected for inclusion. Forty-seven studies from 34 countries were used to calculate age-specific prevalence of hyperglycaemia first-detected in pregnancy in women 20-49 years. Adjustments were then made to account for heterogeneity in screening method and blood glucose diagnostic threshold in studies and also to align with recently published diagnostic criteria as defined by the WHO for hyperglycaemia first detected in pregnancy. Prevalence rates were applied to fertility and population estimates to determine regional and global prevalence of hyperglycaemia in pregnancy for 2013. An estimate of the proportion of cases of hyperglycaemia in pregnancy due to total diabetes in pregnancy was calculated using age- and sex-specific estimates of diabetes from the IDF Diabetes Atlas and applied to age-specific fertility rates. Results: The global prevalence of hyperglycaemia in pregnancy in women (20-49 years) is 16.9%, or 21.4 million live births in 2013. An estimated 16.0% of those cases may be due to total diabetes in pregnancy. The highest prevalence was found in the South-East Asia Region at 25.0% compared with 10.4% in the North America and Caribbean Region. More than 90% of cases of hyperglycaemia in pregnancy are estimated to occur in low- and middle-income countries. Conclusion: These are the first global estimates of hyperglycaemia in pregnancy and conform to the new WHO recommendations regarding diagnosis and also include estimates of live births in women with known diabetes. They indicate the importance of the disease from a public health and maternal and child health perspective, particularly in developing countries. © 2013 Elsevier Ireland Ltd.


T. Tamayo | J. Rosenbauer | S. H. Wild | A. M.W. Spijkerman | C. Baan | N. G. Forouhi | C. Herder | W. Rathmann

Diabetes is among the leading causes of death in the IDF Europe Region (EUR), continues to increase in prevalence with diabetic macro- and microvascular complications resulting in increased disability and enormous healthcare costs. In 2013, the number of people with diabetes is estimated to be 56 million in EUR with an overall estimated prevalence of 8.5%. However, estimates of diabetes prevalence in 2013 vary widely in the 56 diverse countries in EUR from 2.4% in Moldova to 14.9% in Turkey. Trends in diabetes prevalence also vary between countries with stable prevalence since 2002 for many countries but a doubling of diabetes prevalence in Turkey. For 2035, a further increase of nearly 10 million people with diabetes is projected for the EUR. Prevalence of type 1 has also increased over the past 20 years in EUR and there was estimated to be 129,350 cases in children aged 0-14 years in 2013. Registries provide valid information on incidence of type 1 diabetes with more complete data available for children than for adults.There are large differences in distribution of risk factors for diabetes at the population level in EUR. Modifiable risk factors such as obesity, physical inactivity, smoking behaviour (including secondhand smoking), environmental pollutants, psychosocial factors and socioeconomic deprivation could be tackled to reduce the incidence of type 2 diabetes in Europe.In addition, diabetes management is a major challenge to health services in the European countries. Improved networking practices of health professionals and other stakeholders in combination with empowerment of people with diabetes and continuous quality monitoring need to be further developed in Europe. © 2013 Elsevier Ireland Ltd.


Farhad M. Hasan | Mazen Alsahli | John E. Gerich

The kidney plays an important role in glucose homeostasis via its production, utilization, and, most importantly, reabsorption of glucose from glomerular filtrate which is largely mediated via the sodium glucose co-transporter 2 (SGLT2). Pharmacological inhibition of SGLT2 increases urinary glucose excretion and decreases plasma glucose levels in an insulin-independent manner. Agents that inhibit SGLT2 represent a novel class of drugs, which has recently become available for treatment of type 2 diabetes. This article summarizes the rationale for use of these agents and reviews available clinical data on their efficacy, safety, and risks/benefits. © 2014 Elsevier Ireland Ltd.


F. Rotella | E. Mannucci

Aim: The present meta-analysis is aimed at the assessment of the risk of incident clinical depression and/or depressive symptoms in patients with diabetes. Methods: A Medline search was performed on December 30th, 2011, using the search string: "diabetes AND (depression OR antidepressant)", selecting longitudinal studies that assessed the risk of incident depression in subjects with or without diabetes. Study design and characteristics were verified for each study. A meta-analysis was performed for unadjusted and adjusted risk ratios of incident depression in subjects with diabetes using a random effect model. Additional analyses were performed to assess heterogeneity, publication bias and specific hazard ratios for several possible confounders. Results: Of the 1898 retrieved studies, 16 were included in the meta-analysis, enrolling 497,223 subjects, with a mean follow-up of 5.8 years and 42,633 cases of incident depression. A higher incidence of depression was found in diabetic subjects (1.6% vs 1.4% yearly), with unadjusted and adjusted risk [95% confidence interval] of 1.29 [1.18-1.40] (p < 0.001) and 1.25 [1.10-1.44] (p= 0.001), respectively. Conclusions: Diabetes is associated with a significantly increased risk for depressive symptoms. Pathogenetic mechanisms connecting diabetes with depression deserve further exploration. © 2012 Elsevier Ireland Ltd.


Suzanne Geerlings | Vivian Fonseca | David Castro-Diaz | James List | Shamik Parikh

Predisposition to genital infections and urinary tract infections (UTIs) in type 2 diabetes mellitus (T2DM) results from several factors such as glucosuria, adherence of bacteria to the uroepithelium and immune dysfunction. The tendency to develop these infections could be even higher in patients with T2DM treated with the emerging class of sodium-glucose cotransporter-2 (SGLT2) inhibitors. Studies have shown that pharmacologically-induced glucosuria with SGLT2 inhibitors raises the risk of developing genital infections and, to a relatively lesser extent, UTIs. However, a definitive dose relationship of the incidence of these infections with the SGLT2 doses is not evident in the existing data. Therefore, the precise role of glucosuria as a causative factor for these infections is yet to be fully elucidated. © 2014 The Authors.


Xiaoying Zhou | Cuiling Zhang | Junbei Wu | Guoxin Zhang

Aims: Some studies have shown Helicobacter pylori (H. pylori) infection to be associated with diabetes mellitus, but the relationship remains controversial. This meta-analysis was designed to quantify the association between H. pylori infection and diabetes. Methods: A computerized search of PubMed and Embase was carried out. Studies that provided data on H. pylori infection in both diabetes and control groups were selected. An unconditional logistic regression model was used to analyze potential parameters related to H. pylori prevalence. Subgroup analyses were conducted for types of diabetes, methods of detection, geographical distribution, hemoglobin A1c (HbA1c) levels and evidence grade. Result: Forty-one studies were identified, involving 14,080 patients, with a total H. pylori infection rate of 42.29%. The OR for H. pylori infection was increased to 1.33 (95% CI: 1.08-1.64; P= 0.008) among the patients with diabetes. Subgroup analysis revealed a significantly higher infection rate of H. pylori in the type 2 diabetes group versus the control group: OR = 1.76, 95% CI: 1.40-2.21, P < 0.00001. Conclusions: The pooled data suggests a trend toward more frequent H. pylori infections in diabetes patients, especially in type 2 diabetes patients. As this is a meta-analysis of observational studies, more randomized controlled trials should be done in the future. © 2012 Elsevier Ireland Ltd.


A. S. Brazeau | H. Mircescu | K. Desjardins | C. Leroux | I. Strychar | J. M. Ekoé | R. Rabasa-Lhoret

Aims: Carbohydrate counting is an established approach used by patients with type 1 diabetes to improve their glycemic control. The aims of this study were to evaluate, in real life conditions, the accuracy of meal carbohydrate estimate and its impact on glycemic variability. Methods: In this cross-sectional study, we observed the ability of 50 adults (48% women) with type 1 diabetes (age: 42.7 ± 11.1 years); diabetes duration: 21.4 ± 12.7 years; HbA1c: 7.2 ± 1.2% (60 ± 10. mmol/mol) to accurately estimate carbohydrates by analyzing 72-h food records and their corresponding 72-h blood glucose excursions using a continuous glucose monitor. Results: The mean meal carbohydrate difference, between the patients' estimates and those assessed by a dietitian using a computerized analysis program, was 15.4±7.8g or 20.9±9.7% of the total CHO content per meal (72.4±34.7g per meal). Sixty-three percent of the 448 meals analyzed were underestimated. Greater differences in CHO's estimates predicted higher glycemic variability, as measured by the MAGE index and glucose standard deviation, and decreased time with glucose values between 4 and 10mmol/L (R 2 =0.110, 0.114 and 0.110, respectively; P < 0.05). Conclusion: Inaccurate carbohydrate counting is frequent and associated with higher daily blood glucose variability in adults with type 1 diabetes. © 2012 Elsevier Ireland Ltd.


Ziwen Liang | Qinan Wu | Bing Chen | Peiwu Yu | Hongliang Zhao | Xinshou Ouyang

Aims: The aim of this study was to evaluate the effect of laparoscopic Roux-en-Y gastric bypass (RYGB) surgery compared with usual care with and without Exenatide therapy in obese people with type 2 diabetes mellitus (T2DM) and hypertension. Methods: 108 obese T2DM with hypertension were enrolled and randomly allocated to usual care (group A), usual care plus Exenatide (group B), and RYGB surgery (group C). Demographic characteristics, metabolic parameters and cardiac structure/function along with inflammatory cytokines were measured and compared before and after 12 months. Results: At 12 months, diabetes remission had occurred in no patients in groups A and B versus 90% in group C, and there was a significant decrease in requirement of antihypertensive drugs in group C compared with groups A and B (P < 0.05). Other parameters (body mass index, hemoglobin A1c, homeostasis model assessment of insulin resistance, lipids), inflammation index (high sensitivity C-reactive protein, tumor necrosis factor-α, high molecular weight adiponectin) and cardiac structure (left ventricular mass index) were significantly improved in groups B and C, but patients in group C had the greatest degree of improvement (P < 0.05). Conclusion: RYGB surgery improves a number of parameters including cardiovascular function in obese hypertensive people with T2DM. This is likely to be due to, at least in part, an improvement in the abnormal metabolic panel and to reduced inflammation. © 2013 Elsevier Ireland Ltd.


Joao da Rocha Fernandes | Katherine Ogurtsova | Ute Linnenkamp | Leonor Guariguata | Till Seuring | Ping Zhang | David Cavan | Lydia E. Makaroff

© 2016 Elsevier Ireland Ltd. Aims: To estimate health expenditures due to diabetes in 2014 for the world and its regions. Methods: Diabetes-attributable health expenditures were estimated using an attributable fraction method. Data were sourced from International Diabetes Federation (IDF) estimates of diabetes prevalence, UN population projections, WHO annual health expenditure reports, and estimates of the cost ratio of people with and without diabetes. Health expenditures were calculated in both US dollars (USD) and international dollars (ID). Results: The average health expenditure per person with diabetes worldwide in 2014 was estimated to range from USD 1583 (ID 1742) to USD 2842 (ID 3110). The estimated annual global health expenditure attributable to diabetes ranged from USD 612 billion (ID 673 billion) to USD 1099 billion (ID 1202 billion). Together, the North America and Caribbean Region and the Europe Region were responsible for over 69% of the costs, and less than 10% of the costs were from the Africa Region, South East Asia Region, and Middle East and North Africa Region combined. The North America and Caribbean Region had the highest annual spending per person with diabetes (USD 7984 [ID 8040.39]), while the South East Asia Region had the lowest annual spending per person with diabetes (USD 92 [ID 234] ). Conclusions: Diabetes imposes a large economic burden on health care systems across the world, yet varies across world regions. Diabetes prevention and effective management of diabetes should be a public health priority to reduce the financial burden.


Zheng Wang | Song tao Lai | Li Xie | Jian dong Zhao | Ning yi Ma | Ji Zhu | Zhi gang Ren | Guo liang Jiang

© 2014 Elsevier Ireland Ltd. Aims: Recent epidemiological studies indicated that use of metformin might decrease the risk of various cancers among patients with type 2 diabetes mellitus (T2DM). However, its influence on pancreatic cancer was controversial. Therefore, we did a meta-analysis of currently available observational studies on the issue. Methods: We did a PubMed and ISI Web of Science search for observational articles. The pooled relative risk (RR) was estimated using a random-effect model. Heterogeneity was evaluated using I 2 statistic. Subgroup analysis was performed to explore the source of heterogeneity and confirm the overall estimates. Publication bias was also examined. Results: The analysis included 11 articles (13 studies) comprising 10 cohort studies and 3 case-control studies. Use of metformin was associated with a significant lower risk of pancreatic cancer [RR 0.63, 95% confidence internal (CI) 0.46-0.86, p=. 0.003]. In a total 11 subgroup analyses, 5 provided the consistent result with pooled effect estimates of overall analysis. No publication bias was detected by Begg's (. Z=. -0.79, p=. 0.428) and Egger's test (. t=. -0.92, p=. 0.378). Conclusions: From present observational studies, use of metformin appears to be associated with a reduced risk of pancreatic cancer in patients with T2DM. Further investigation is needed.


© 2015 Elsevier Ireland Ltd. Background: Mortality is an important measure of population health and is often used to assign priorities in health interventions. Estimating mortality due to diabetes has been challenging because more than a third of countries of the world have no reliable data available on mortality. Moreover estimating mortality attributable to Diabetes is especially challenging since most people die of a related vascular complication such as cardiovascular disease or renal failure. Aims: The aim of the study was to provide estimate of the number of deaths attributable to diabetes for the year 2013. Methods: A computerized disease model was used to obtain the estimates. Using WHO life tables for 2010 and IDF diabetes prevalence estimates for 2013, age and sex-specific relative risks of death for persons with diabetes were calculated, in order to estimate the number of deaths attributable to diabetes in people 20-79 years of age. Results: This model estimated that globally, 8.4% of all-cause deaths were attributable to diabetes in adults aged 20-79 years, almost 5.1 million deaths. A sensitivity analysis adjusting relative risks by 20% found that the estimate of diabetes-attributable mortality to lie between 5.1% of total mortality (3.3 million deaths) and 10.1% of total mortality (6.6 million deaths). The highest rates of diabetes-attributable mortality were found to be 25.7% in South-East Asian women aged between 50 and 59 years old. The highest number of deaths attributable to diabetes was found in countries with large populations: 1271,000 in China, 1065,000 deaths in India, 386,400 in Indonesia, 197,300 in the Russian Federation and 192,700 in the United States of America. Conclusions: Overall, 1 in 12 of global all-cause deaths were estimated to be attributable to diabetes in adults. In general, the number and proportion of deaths was slightly higher in women than in men.

Evidence reviews

Sodium‐glucose cotransporter (SGLT) 2 inhibitors for prevention or delay of type 2 diabetes mellitus and its associated complications in people at risk for the development of type 2 diabetes mellitus

The SGLT 2 inhibitors (such as canagliflozin, dapagliflozin and empagliflozin) are glucose‐lowering drugs that reduce blood glucose levels by increasing the secretion of glucose from the kidneys to the urine. SGLT 2 inhibitors were recently approved for the treatment of diabetes in people with type 2 diabetes mellitus. It is currently not known whether SGLT 2 inhibitors should be prescribed for people with raised blood glucose levels who do not meet the criteria for having type 2 diabetes. We wanted to find out whether these drugs would prevent or only delay the development of type 2 diabetes. Furthermore, we wanted to analyse the effects of SGLT 2 inhibitors on patient‐important outcomes such as complications of diabetes (for example kidney and eye disease, heart attacks, strokes), death from any cause, health‐related quality of life and side effects of the medications.

Pharmacotherapy for weight loss in adults with type 2 diabetes mellitus

Obesity is closely related to type 2 diabetes and weight reduction is an important part of the care delivered to obese persons with diabetes. This review of drugs for weight loss among adults with type 2 diabetes revealed weight loss of between 2.0 and 5.1 kg for fluoxetine, orlistat and sibutramine at follow‐up of up to 57 weeks. The long‐term effects remain uncertain. Adverse events were common in all three drugs: gastrointestinal side effects with orlistat; tremor, somnolence, and sweating with fluoxetine; and palpitations with sibutramine. There were few studies examining other drugs used for weight loss in populations with diabetes.

Chinese herbal medicines for type 2 diabetes mellitus

We are still waiting for firm evidence on Chinese herbal medicines for treatment of non‐insulin‐dependent diabetes. Although the use of herbal medicines for treatment of diabetes has a long history especially in the East, current evidence cannot warrant to support the routine use in clinical practice. This systematic review evaluates the effects of various herbal preparations (including single herbs or mixtures of different herbs) for treating people with type 2 diabetes. The review shows that some herbal medicines lower blood sugar and relieving symptoms in patients with diabetes. However, the methodological quality of the clinical trials evaluating these herbs is generally poor. The analyses also indicate that trials with positive findings are more likely to be associated with exaggerated effects. However, the trials did not report significant adverse effects. In conclusion, herbal medicines should not be recommended for routine use in diabetic patients of type 2 diabetes until we get scientifically sound trials. Testing the herbs in larger, well‐designed trials is needed in order to establish the necessary evidence for their use.

See all (1829)

Summaries for consumers

Sodium‐glucose cotransporter (SGLT) 2 inhibitors for prevention or delay of type 2 diabetes mellitus and its associated complications in people at risk for the development of type 2 diabetes mellitus

The SGLT 2 inhibitors (such as canagliflozin, dapagliflozin and empagliflozin) are glucose‐lowering drugs that reduce blood glucose levels by increasing the secretion of glucose from the kidneys to the urine. SGLT 2 inhibitors were recently approved for the treatment of diabetes in people with type 2 diabetes mellitus. It is currently not known whether SGLT 2 inhibitors should be prescribed for people with raised blood glucose levels who do not meet the criteria for having type 2 diabetes. We wanted to find out whether these drugs would prevent or only delay the development of type 2 diabetes. Furthermore, we wanted to analyse the effects of SGLT 2 inhibitors on patient‐important outcomes such as complications of diabetes (for example kidney and eye disease, heart attacks, strokes), death from any cause, health‐related quality of life and side effects of the medications.

Pharmacotherapy for weight loss in adults with type 2 diabetes mellitus

Obesity is closely related to type 2 diabetes and weight reduction is an important part of the care delivered to obese persons with diabetes. This review of drugs for weight loss among adults with type 2 diabetes revealed weight loss of between 2.0 and 5.1 kg for fluoxetine, orlistat and sibutramine at follow‐up of up to 57 weeks. The long‐term effects remain uncertain. Adverse events were common in all three drugs: gastrointestinal side effects with orlistat; tremor, somnolence, and sweating with fluoxetine; and palpitations with sibutramine. There were few studies examining other drugs used for weight loss in populations with diabetes.

Chinese herbal medicines for type 2 diabetes mellitus

We are still waiting for firm evidence on Chinese herbal medicines for treatment of non‐insulin‐dependent diabetes. Although the use of herbal medicines for treatment of diabetes has a long history especially in the East, current evidence cannot warrant to support the routine use in clinical practice. This systematic review evaluates the effects of various herbal preparations (including single herbs or mixtures of different herbs) for treating people with type 2 diabetes. The review shows that some herbal medicines lower blood sugar and relieving symptoms in patients with diabetes. However, the methodological quality of the clinical trials evaluating these herbs is generally poor. The analyses also indicate that trials with positive findings are more likely to be associated with exaggerated effects. However, the trials did not report significant adverse effects. In conclusion, herbal medicines should not be recommended for routine use in diabetic patients of type 2 diabetes until we get scientifically sound trials. Testing the herbs in larger, well‐designed trials is needed in order to establish the necessary evidence for their use.

See all (267)

One thought on “Research Papers On Diabetes Type 2

Leave a comment

L'indirizzo email non verrà pubblicato. I campi obbligatori sono contrassegnati *