Metabolic Outcomes in Obese Patients after Bariatric Embolization of the Left Gastric Vessel

The prevalence of overweight and obesity is growing rapidly in the modern world. Currently more than 600 million people are obese, over 2 billion people are overweight. By 2025, according to World Health Organization experts (WHO), the number of people with obesity will increase almost twofold and will make from 30 to 50 percent of the population in economically developed countries. Embolization of the left gastric artery is an innovative, minimally invasive method of treating obesity, which allows to reduce body weight six months after its implementation by 17–18% on average. This technique, long used in emergency medicine as a method to stop gastric bleeding, has a new potential in the treatment of obesity. In this manuscript we present a pilot study examining the effects of bariatric embolization of the left gastric artery on the parameters of fat and carbohydrate metabolism in obese patients. We also present a case report illustrating the weight loss and the metabolic benefits of the left gastric artery embolization

Vildagliptin: optimal control in type 2 diabetes mellitus treatment

Incretin hormones are important for normal pancreatic islet function and glucose homeostasis. Sensitivity to glucose of the α- and β-cells of the pancreas is diminished in type 2 diabetes mellitus (T2DM), leading to impaired insulin secretion, insulin resistance due to elevated glucagon levels in hyperglycaemia and impaired glucagon counterregulation in hypoglycaemia. In addition, T2DM is associated with increased lipotoxicity-induced insulin resistance. This article is a comprehensive review of the safety and efficacy of vildagliptin in patients with T2DM and evaluates the extra-pancreatic effects of incretin-based therapies. Clinical evidence has proven that vildagliptin effectively decreases HbA1c with a low risk of hypoglycaemia and is weight neutral. Vildagliptin also suppresses postprandial triglyceride (TG)-rich lipoprotein levels after ingestion of fat-rich meals and reduces fasting lipolysis, suggesting inhibition of fat absorption and reduced TG stores in non-fat tissues

Rol' beta-kletok v regulyatsii gomeostaza glyukozyv norme i pri sakharnom diabete 2 tipa

В последние годы основные усилия ученых были сконцентрированы на изучении островковых клеток поджелудочной железы. Было установлено, что поджелудочная железа у человека содержит от 1 до 3 млн островковых клеток, что составляет около 1% от общей массы панкреатической ткани. В свою очередь, островковая клетка является самостоятельным органом, предназначенным для производства и секреции инсулина в необходимое время и в необходимых количествах

Sekretsiya insulina v normei pri sakharnom diabete 2 tipa

Для того, чтобы попасть в головной мозг, глюкоза с помощью специального транспортного белка ? ГЛЮТ-1 вначале проникает через гематоэнцефалический барьер. Причем этот процесс контролируется с помощью специальных сенсоров, кстати представляющих из себя КАТФ-зависимые каналы. В этой связи важно напомнить, что указанные сенсоры четко контролируют уровень глюкозы, поступающей в головной мозг. Его снижение вызовет развитие нейрогликопении, а повышение уровня глюкозы, поступающей в головной мозг, будет способствовать развитию нейроглюкотоксичности. Этот процесс носит название пластичность, и в этом случае под этим термином подразумевают память на определенные требуемые уровни глюкозы. Таким образом, исследования последних лет реально расширяют наши представления о роли КАТФ-зависимых каналов в регуляции гомеостаза глюкозы

Efficacy and safety of metformin-sitagliptin combination for the treatment of patients with diabetes mellitus and obesity

Aim. To elucidate therapeutic effect of metformin-sitaglitin combination on the dynamics of indices of insulin resistance and functional activity of pancreaticbeta-cells, lipid metabolism and body weight in patients with type 2 diabetes mellitus (DM2) and obesity. Materials and methods. The study included 32 patients treated by a combination of metformin (500-2550 mg/day) and sitagliptin (100 mg) for18 weeks. Standard parameters of carbohydrate and lipid metabolism, body mass index (BMI), blood adiponectin and leptin levels were measured, indices of insulin resistance and functional activity of pancreatic beta-cells were calculated. Results. Therapy with metformin-sitagliptin combination ensured compensation of fasting and postprandial hyperglycemia, reduced HbA1c level, increasedfunctional activity of beta-cells, decreased peripheral insulin resistance and BMI, had beneficial effect on lipid metabolism and hormonalactivity of adipose tissue. Conclusion. Metformin-sitagliptin combination can be recommended as a clinically efficacious modality for the treatment of patients with diabetesmellitus and obesity

Pharmalogical effects and results of clinical trials of the first incretinomimetic exenatide

The review is devoted to the pharmacological effects, the results of clinical trials, safety and the research perspectives of the first incretinomimetic exenatid

Rannyaya kombinirovannaya terapiya pri sakharnom diabete 2 tipa

According to the International Diabetes Federation there are at least 285 million people suffering from diabetes mellitus (DM) in the world, and by2030 this figure is likely to be more than 438 million people, mostly at the expense of patients with type 2 diabetes (T2DM) . According to the Stateregister of diabetic patients on January 1, 2010 in Russia there are over 3.1 million patients with diabetes, among them 2,822,634 with T2DM.Diabetes is the leading cause of blindness in adults aged 20-74 years, non-traumatic lower limb amputations, and the last stage of kidney failure.More than 50-80% of patients with diabetes die of cardiovascular complications. In addition, people with T2DM live almost 10 years less than peoplewithout diabetes. With regard to the effective management of diabetes, there is strong evidence showing that improved glycemic control can significantlyreduce the risk of late complications of the disease. The project Consensus of the Russian Association of Endocrinologists (RAE) was publishedin 2011. The main emphasis in this project is on individual approach to treatment of the patient. According to the recommendations of experts RAEmonotherapy antidiabetic agents in combination with lifestyle modification is possible only at the initial level of HbA1c 6,5-7,5%. At the initial levelof HbA1c 7,6-9,0% combined therapy should be started immediately, and at the level of HbA1c above 9.0% insulin therapy should be assigned. It isimportant to note that the priority in the choice of treatment should be safety and efficacy. For one of the most efficient is the combination of metforminand DPP-4 inhibito

First GLP-1 analog liraglutide: the result of clinical trails on efficacy

This review analytically considers the results of clinical trials on efficacy and safety and clinical perspectives of GLP-1 analog liraglutid

Efficacious and safe management of type 2 diabetes mellitus using DPP-4 inhibitors

Diabetes mellitus (DM) is believed to be the third most frequent direct cause of death after cardiovascular and oncological diseases. Therefore, solutionof DM-related problems is a major challenge facing health authorities in many countries. No doubt, strict control of glycemia is an indispensablecondition for the reduction of the frequency of diabetic complications. Indeed, many strategies developed in the recent years allowed metabolic controlin DM patients to be significantly improved. Basic and clinical research of the last decade provided a basis for the development of highly promisingtrends in the treatment of CD2, such as the use of incretins. Inhibitors of dipeptylpeptidase-4 (DPP-4) including Galvus (vildagliptin) and GalvusMet (vildagliptin + metformin) have been available in this country for the last 2 years. International studies showed high efficiency and safety of bothagents. They help to achieve adequate glycemic control in the absence of side effects and complications. Galvus significantly reduces daily variabilityof glycemia that is known to be a risk factor of severe vascular complications of DM. Another advantage of these drugs is they can be used by agedpatients at risk of cardiovascular disorders suffering hypertension. An example of combined therapy using Galvus Met in a DM2 patient is presenteddemonstrating markedly improved glycemic control, blood glucose dynamics, and quality of life. Galvus and Galvus Met can be prescribed as aninitial treatment in combination with all traditional oral hypoglycemic agents and insulin

Efficacy and safety of glimepiride as initial treatment in Russian patients with type 2 diabetes mellitus

Aim.  To investigate the efficacy and safety of glimepiride as initial mono-therapy in type 2 diabetes patients (T2DM). Materials and Methods. This is a multi-center, open-label prospective observational study. 245 treatment-naive T2DM patients, who had not achieved glycemic goals on lifestyle therapy during first 12 weeks after the diagnosis, were enrolled in this study. Anti-diabetes treatment was initiated with glimepiride and continued during the 6-month follow-up period. Prescription of the initial dose (1 mg per day) and further dose adjustments were carried out by the attending physician in accordance with the glimepiride data sheet. Dynamics of HbA1c, fasting plasma glucose (FPG), 2 h postprandial blood glucose (2hPPG), weight and waist circumference, as well as the incidence of hypoglycemia were the evaluated parameters. Results. The baseline HbA1c (mean: 7.9?0.5%; female: 7.8?0.4% ; male: 8.0?0.6%) was significantly reduced at week 12 (mean 7.2?0.6%,