Category Archives: Diabetes drug therapy

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

The US Agency for Research and Quality (AHRQ) issued this month a clinical summary guide comparing premixed insulin analogues with other treatments for type 2 diabetes.

The clinical bottom line of the summary:

Premixed insulin analogues and premixed human insulin have similar effects on glycosylated hemoglobin (A1c), and rates of hypoglycemia are similar.

Premixed insulin analogues help achieve lower postprandial glucose levels than premixed human insulin.

Premixed insulin analogues help achieve lower A1c levels than long-acting insulin analogues used alone, but rates of hypoglycemia are higher.

Premixed insulin analogues are linked with more episodes of hypoglycemia than oral diabetes drugs.

Premixed insulin analogues help achieve lower A1c levels than oral diabetes drugs used alone.

Premixed Insulin Analogues: A Comparison With Other Treatments for Type 2 Diabetes. Clinician Summary Guide

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 HIV…

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 is…Continue 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 data…Continue 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 is…Continue 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, whereas…

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 Prevent…

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,…

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 insulin…

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).…

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).…

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