Category Archives: Diabetes drug therapy

Premixed Insulin Analogues: A Comparison With Other Treatments for Type 2 Diabetes by the AHRQ

Clinical considerations on the use of premixed insulin analogues for type 2 diabetes. Effect on A1c levels, postprandial glucose levels. Comparison with oral diabetes drugs.Continue Reading

FDA: potential risk of HIV and hepatitis transmission when insulin pens and cartridges are shared

An excerpt of FDA’s press release issued  19th March 2009: The U.S. Food and Drug Administration today issued an alert to health care professionals reminding them that single-patient insulin pens and insulin cartridges should not be used to administer medication to multiple patients due to the potential risk of transmitting blood-borne pathogens such as HIVContinue Reading

AHRQ Comparative Effectiveness Review. Premixed insulin analogues for adults with type 2 diabetes.

From the AHRQ newsletter, December 18, 2008, Issue # 2. Comparative Effectiveness Review. Premixed Insulin Analogues for Adults With Type 2 Diabetes Premixed insulin preparations are an alternative that may permit a smaller number of daily insulin injections. Although oral diabetes medicines are used as first-line treatments in patients with type 2 diabetes, insulin isContinue Reading

Thiazolidinediones (glitazones) may increase the risk of fracture in women

From the excellent blog “Prescribing Advice for GPs“: “The Journal of the Canadian Medical Association (CMAJ) has published the results of a systematic review and meta-analysis that aimed to quantify the fracture risk associated with glitazone therapy. There is also an accompanying editorial. This study has also reached the general media (BBC). The analysis examined dataContinue Reading

NPS RADAR: Rosiglitazone is a third-line choice in diabetes type 2 treatment

Summary of the review of the NPS RADAR on rosiglitazone (Avandia) Rosiglitazone improves glycaemic control but there is a lack of evidence that it improves diabetes–related clinical complications and mortality. Prescribers should consider this —along with recently emerging safety information — when assessing the ratio of potential harms and benefits for each patient. Rosiglitazone isContinue Reading

Cardiovascular and mortality outcomes differences between rosiglitazone and pioglitazone

Comparison of Cardiovascular Outcomes in Elderly Patients With Diabetes Who Initiated Rosiglitazone vs Pioglitazone Therapy Wolfgang C. Winkelmayer, MD, ScD; Soko Setoguchi, MD, DrPH; Raisa Levin, MS; Daniel H. Solomon, MD, MPH Arch Intern Med. 2008;168(21):2368-2375. Background Recent meta-analyses have raised the possibility that rosiglitazone maleate may increase the risk of ischemic cardiovascular events, whereasContinue Reading

Animation: insulin secretion and sulfonylureas mechanism of action

Animation that depicts how sulfonylureas enhance insulin secretion by binding to specific beta cell receptors. Download availableContinue Reading

Jupiter trial: comments podcast by Therapeutics Initiative

The Therapeutics Initiative is an independent organization at The University of British Columbia dedicated to providing up to date, evidence based, practical information on rational drug therapy. They produced an excellent podcast about the recent JUPITER trial: Download podcast | Subscribe with iTunes | Show Notes Some official information about the trial: Rosuvastatin to PreventContinue Reading

How to titrate metformin: consensus statement on Diabetes Care

Below is a transcript of the latest statement (December 2008) published on Diabetes Care about the titration of metformin in the medical management of hyperglycemia in type 2 diabetes. TITRATION OF METFORMIN 1. Begin with low-dose metformin (500 mg) taken once or twice per day with meals (breakfast and/or dinner) or 850 mg once perContinue Reading

Metformin: consensus statement published on Diabetes Care

Below is a transcript of the latest statement (December 2008) published on Diabetes Care about the role of metformin in the medical management of hyperglycemia in type 2 diabetes. Metformin In most of the world, metformin is the only biguanide available. Its major effect is to decrease hepatic glucose output and lower fasting glycemia. Typically,Continue Reading

Glucagon-like peptide-1 agonists (exenatide): consensus statement published on Diabetes Care

Below is a transcript of the latest statement (December 2008) published on Diabetes Care, about the role of Glucagon-like peptide-1 agonists (exenatide) in the medical management of hyperglycemia in type 2 diabetes. Glucagon-like peptide-1 agonists (exenatide). Glucagon-like peptide-1 (GLP-1) 7–37, a naturally occurring peptide produced by the L-cells of the small intestine, potentiates glucose-stimulated insulinContinue Reading

DPP-4 inhibitors: consensus statement published on Diabetes Care. Diagram of its mechanism of action.

Below is a transcript of the latest statement (December 2008) published on Diabetes Care about the role of dipeptidyl peptidase four inhibitors in the medical management of hyperglycemia in type 2 diabetes. Dipeptidyl peptidase four inhibitors. GLP-1 and glucose-dependent insulinotropic peptide (GIP), the main insulinotropic peptides of intestinal origin (incretins), are rapidly degraded by dipeptidyl peptidase four (DPP-4).Continue Reading

Sulfonylureas: consensus statement published on Diabetes Care

Below is a transcript of the latest statement (December 2008) published on Diabetes Care about the role of sulfonylureas in the medical management of hyperglycemia in type 2 diabetes. Sulfonylureas. Sulfonylureas lower glycemia by enhancing insulin secretion (see mechanism of action). In terms of efficacy,  they appear to be similar to metformin, lowering A1C levels by 1.5 percentage points (26,49).Continue Reading

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