Comparison of orlistat and orlistat plus metformin therapy between diabetic and nondiabetic groups.

OBJECTIVE: The objective of this study was to examine the effects of orlistat use on metabolic control and weight loss in diabetic and nondiabetic patients. METHODS: A total of 119 patients with body mass index≥40 kg/m2 and receiving orlistat therapy, who applied to the Endocrinology polyclinic between January 2016 and October 2019, were included. The patients' weight changes and biochemical values (i.e., fasting glucose, HbA1c, ALT, creatinine, and lipid parameters) were evaluated at the drug beginning and the last polyclinic control. The patients were divided into groups, whether they had diabetes or used metformin, and compared. RESULTS: The mean age of the 119 patients in the study was 45.3±11.5 years. A total of 94.1% of the patients were females and 5.9% were males. A total of 38.7% of the patients had diabetes and 29.4% had prediabetes. When the patients were compared to whether they had diabetes or used metformin, there was a statistically significant difference between the groups according to weight loss. The mean weight change of patients without diabetes and receiving metformin and orlistat was statistically significantly higher than that of patients with diabetes and receiving metformin and orlistat. DISCUSSION: It was determined that the weight loss effect of orlistat in obesity was seen in all groups, but this effect decreased in the diabetic group.

Clinical research of insulin glargine U300 in type 1 diabetes mellitus patients with frequent hypoglycaemia: real-world experience.

INTRODUCTION: We aimed to see whether insulin glargine U300 can provide better blood glucose control while reducing hypoglycaemia in a more homogeneous population compared to previous studies. MATERIAL AND METHODS: The retrospective study included type 1 diabetes mellitus (T1DM) patients with frequent hypoglycaemia. For evaluation of fasting blood glucose, haemoglobin glycated (HbA1c) and weight at 6 months and 12 months (final), observation windows of 120-240 days (4-8 months) and 240-480 days (9-16 months) after insulin glargine U300 initiation, respectively, were permitted. Mean follow-up time was 12 months. Hypoglycaemia was defined as blood glucose level < 70 mg/dl, either symptomatic or asymptomatic, measured in hospital or at home. RESULTS: Forty-four patients were included in the study, and 35 patients completed the study - 20 (57.1%) females and 15 (42.9%) males, with a mean age of 24.1 ±6.6 years. Mean body mass index was 24.4 ±7.4 kg/m2. A significant decrease was not found between baseline and HbA1c values at 6 months (p = 0.199), but a significant decrease was found in the final period (between 9-16 months) (p = 0.025). Hypoglycaemic events occurred in all patients (100%) before using insulin glargine U300, while the incidence of hypoglycaemic events gradually decreased to 74.3%, 68.6%, and 68.6% between months 1-3, 3-6, and 6-9, respectively. Of the 26 patients who declared their level of satisfaction, 23 (88.5%) were satisfied, 2 (7.7%) indicated that there was no significant difference, and 1 (3.8%) patient was unsatisfied. CONCLUSIONS: Over 9-16 months of follow-up, insulin glargine U300 led to a significant reduction not only of HbA1c levels but also of the frequency of hypoglycaemia, and also yielded high satisfaction rates.

Clinical research of insulin glargine U300 basal-bolus therapy and insulin degludec/aspart co-formulation in type 2 diabetes mellitus: A real world experience.

AIMS: Insulin degludec/aspart (IDegAsp) and insulin glargine U300 (IGlarU300) have recently emerged as popular new-generation insulin analogues. The aim of this real-life study was to investigate the patient profiles in which IGlarU300 and IDegAsp were preferred and the insulin combinations after which each of them were mostly used and also to analyse the effect of these two insulin analogues on blood glucose regulation and hypoglycaemia. MATERIALS AND METHODS: The retrospective study included 174 patients that were switched from basal insulin, basal-bolus insulin, or premixed insulin to IGlarU300 or IDegAsp due to uncontrolled blood glucose levels or history of hypoglycaemia. Hypoglycaemia, body weight, body mass index (BMI), fasting plasma glucose (FPG) and HbA1c levels over 3-month periods were evaluated for each patient. RESULTS: There were 84 and 90 patients in the IGlarU300 and IDegAsp groups, respectively. Body weight was similar in both groups. Baseline FPG and HbA1c levels in the IGlarU300 and IDegAsp groups were 9.0%, 175.5 mg/dL and 9.4%, 193.5 mg/dL, respectively. A significant decrease was found in FPG and HbA1c levels in both groups (138.5, 7.8 vs 141.5, 8.2; P < .001 for all). Moreover, a significant weight gain was observed in both groups (P < .05 for both). The prevalence of hypoglycaemia in both groups decreased significantly and consistently between months 1 and 9 (P < .001). At month 12, although this decrease continued in the IGlarU300 group (P = .013), no significant decrease was observed in the IDegAsp group (P = .057). CONCLUSION: Both twice-daily IDegAsp ± bolus insulin and IGlarU300 basal bolus insulin therapies are effective and safe treatment modalities.

Diagnostic and prognostic value of tumor M2-pyruvate kinase levels in patients with colorectal canhcer.

BACKGROUND/AIMS: Screening for precancerous lesions is important for the diagnosis and treatment of colorectal tumors. We investigated M2-pyruvate kinase levels in patients with colorectal polyps and carcinoma and assessed factors affecting M2-pyruvate kinase levels. MATERIALS AND METHODS: Eighty-five patients who had undergone colonoscopic examination and who were diagnosed with a neoplastic lesion were included. Patients were divided into two groups according to the macroscopic diagnosis of polyp or carcinoma. According to histopathological evaluation, specimens were grouped as nonneoplastic lesions, tubular adenoma, tubulovillous adenoma and adenocarcinoma. M2-pyruvate kinase levels were measured with the Tumor M2-pyruvate kinase ELISA kit. RESULTS: Mean M2-pyruvate kinase levels were 76.1±57.73 (13.1-288.22) IU/ml. We did not find a correlation between M2-pyruvate kinase levels and age, gender, smoking, alcohol and aspirin consumption and colorectal cancer family history. There was a relationship between body mass index and M2-pyruvate kinase level (p=0.022). The carcinoma group had the highest levels of M2-pyruvate kinase both endoscopically and histopathologically (p=0.009, p=0.019 respectively). M2-pyruvate kinase levels of patients who died were significantly higher than patients who survived (p=0.001). Enzyme values were significantly lower in diabetic patients than nondiabetics (p=0.04); and chronic renal failure patients had higher levels (p=0.045). CONCLUSION: Serum M2-pyruvate kinase levels may be useful in distinguishing malignant and benign lesions of the colon and may provide insight in terms of survival.