ABSTRACT
@#AIM: To study glucagon-like peptide-1(GLP-1)analogues(liraglutide)in patients with mild to moderate nonproliferative diabetic retinopathy(NPDR)and the clinical efficacy of retinal neuroprotection.<p>METHODS: Sixty patients with type 2 diabetes mellitus with mild or moderate NPDR were treated in our department of endocrinology. They were randomly divided into two groups. Patients in the experimental group used metformin, insulin combined with liraglutide to regulate blood glucose, while the control group used metformin, insulin for hypoglycemia. Comparing the two groups of patients before and after the treatment, including HbA1c and pattern visual evoked potential(P-VEP)P100 amplitude and P100 latency, full field electroretinogram(F-ERG)oscillatory potentials(Ops)total amplitude, and light and dark adaptation 3.0 the amplitude of the a-, b-wave varies.<p>RESULTS: After 6mo treatment, the total amplitude of Ops in the experimental and control groups increased compared with that before treatment. The difference was statistically significant(all <i>P</i><0.01). And the total amplitude of Ops in the experimental group was higher than that of the control group, the difference was statistically significant(<i>P</i>=0.049). Meanwhile the b-wave amplitudes of the light and dark adaptation 3.0 in the experimental group were higher than those in the control group(<i>P</i>=0.001, <i>P</i>=0.014); however, there was no statistical significance in a-wave amplitude between the light and dark adaptation 3.0 in both groups after treatment(<i>P</i>=0.505, 0.441, 0.193, respectively). the b-wave amplitudes of the experimental group with dark and light adaptation 3.0 increased compared with that before treatment, and the difference was statistically significant(<i>P</i><0.01, <i>P</i>=0.019). The a-wave amplitude of light and dark adaptation in the experimental group increased compared with that before treatment, but the difference was not statistically significant(<i>P</i>=0.130, 0.147). <p>CONCLUSION: GLP-1 analogues can improve the function of retinal neurons in patients with mild to moderate NPDR to a certain extent, and have a positive effect on the prognosis of DR.
ABSTRACT
Resumen La diabetes mellitus tipo 2 es una de las enfermedades metabólicas que afecta a diferentes órganos, uno en el cual es el riñón. Una de las principales complicaciones microvasculares es la nefropatía diabética, siendo la principal causa de insuficiencia renal crónica a nivel mundial. De ahí la importancia de las recomendaciones en la utilización o no de los fármacos antihiperglicemiantes, basadas en sus efectos beneficiosos a nivel de la función renal en relación con la tasa de filtración glomerular estimada y la relación albumina/creatinina en pacientes con diabetes mellitus tipo 2 y enfermedad renal. En estudios recientes se han evaluado antihiperglicemiantes con un impacto beneficioso a nivel de desenlaces cardiovascular y renal. En el presente artículo se revisan las acciones y los efectos de los diferentes grupos de medicamentos como la metformina, los inhibidores de la dipeptidil peptidasa 4, los agonistas de la GLP-1, tiazolidinedionas, sulfonilureas, inhibidores del cotransportador de sodio-glucosa tipo 2 e insulinas en la función renal en cuanto a las dosis de cada fármaco, tanto el uso de dosis establecidas, disminución de la dosis o el no uso del medicamento con base en el empeoramiento de la tasa de filtración glomerular estimada. Con respecto a la metodología aplicada para el desarrollo del artículo, se seleccionó artículos a partir de palabras claves como diabetes mellitus tipo 2, antihiperglicemiantes en la función renal, tasa de filtración glomerular estimada y relación albumina/creatinina; se emplearon artículos de revistas reconocidas que no superaran 5 años en su publicación, sin embargo, se utilizaron artículos que superaran este tiempo, dado que aportaban datos importantes para el artículo de revisión.
Abstract Type 2 diabetes mellitus is one of the metabolic diseases that affects different organs, one of which is the kidney. One of the main microvascular complications is diabetic nephropathy, being the main cause of chronic renal failure worldwide. Hence the importance of recommendations on the use or non-use of antihyperglycemic drugs based on their beneficial effects on kidney function, expressed by the estimated glomerular filtration rate and the albumin / creatinine ratio in patients with type 2 diabetes mellitus and kidney disease. Recent studies have shown antihyperglycemic agents with beneficial impact in cardiovascular and renal endpoints. In the present article we will review the actions and effects of different groups of drugs such as metformin, inhibitors of dipeptidyl peptidase 4, GLP-1 agonists, thiazolidinediones, sulfonylureas, SGLT-2 inhibitors and insulins in renal function in relation to the doses of each drug, both the use of established doses, reduction of the dose or non-use of the drug based on the worsening of the estimated glomerular filtration rate. With respect to the methodology applied for the development of the article, a selection of articles was made based on key words such as type 2 diabetes mellitus, antihyperglycemic agents in renal function, estimated glomerular filtration rate and albumin/ creatinine ratio. Prestigious journal articles were used with less than 5 years since its publication, however articles that exceed this time were used as they provided important data in the review article.
Subject(s)
Humans , Blood Glucose/analysis , Diabetes Mellitus, Type 2/drug therapy , Renal Insufficiency, Chronic/complications , Metformin/antagonists & inhibitorsABSTRACT
@#Insulin as well as glucagon-like peptide 1(GLP-1)and its analogs are commonly used in treating type II diabetes. Both insulin and GLP-1 are endogenous peptides, and have advantages such as high efficiency and selectivity. However, there are some disadvantages to using regular insulin with slow effect, short-time effect and risk of hypoglycemia. Due to the elimination of kidneys and the metabolism of enzymes, the half-life of GLP-1 is so short that neither of them can stabilize glucose. Therefore, it is of great significance to study the long-acting strategy of insulin and GLP-1. Based on the long-acting strategy and pharmacological assessment of peptide drugs, this paper reviewed the latest progress of the related drugs that already on the market and under research to provide references for the design of novel long-acting insulin and GLP-1 analogs.
ABSTRACT
OBJECTIVE: To summarize the research progress of biopharmaceuticals for type 2 diabetes mellitus. METHODS: Both pharmaceuticals being studied and the classical ones were classified and described, with newly published articles introduced. RESULTS: The research progress of biopharmaceuticals for T2DM was comprehensively summarized. CONCLUSION: The discovery of novel targets and pathogenic mechanism has made biopharmaceuticals a potent weapon for T2DM therapy, however, further optimization is needed and multiple problems still remain to be solved.