Real World Effectiveness of fixed combination of glargine 100 U/ml and lixisenatide therapy in outpatients with Type 2 Diabetes: A Retrospective Cohort Study SOLO

Background: The effectiveness and safety of a fixed combination of insulin glargine 100 ME/ml and lixisenatide for treatment of patients with type 2 diabetes (T2DM) has been demonstrated in randomized clinical trials, but there are still not enough data of it`s usage of it real clinical practice.Aim: To describe the baseline characteristics of patients with T2DM who started treatment with a fixed ratio combination of insulin glargine 100 ME/ml and lixisenatide in the period from November 2018 to July 2020, and to evaluate the effectiveness of using fixed combination of insulin glargine 100 ME/ml and lixisenatide in for 6–12 months of therapy in a real outpatient practice.Materials and methods: SOLO was a retrospective cohort multicentre study conducted in Russia, Moscow. Adults (≥18 years) with T2DM and HbA1c≥7% in case of availability of medical records during ≥180 days before and ≥1 HbA1c level during 150–210 days after start of treatment with Soliqua SoloStar® were eligible.Results: A total of 383 people with T2DM were included. Baseline characteristics were the following (mean±SD): age 59.9±8.3 years; BMI 36.4±6.3 kg/m2; proportion of patients with BMI≥35 kg/m2 — 52.2%; HbA1c 9.14±1.08%. 65% of patients received oral antidiabetic drugs (OAD) before start of treatment with fixed combination of insulin glargine 100 ME/ml and lixisenatide ; 31.3% of patients were switched from combination of OAD with basal insulin, 1.04% of patients received other therapy (GLP-1 RA, basal-bolus insulin treatment, basal insulin monotherapy), and 2.61% of patients did not receive any hypoglycemic therapy. HbA1c level was 7.78±0.8% after 6 months of treatment and 7.4±0.61% after 12 months. There was a significant decrease of body weight from the baseline value 101.62±20.64 kg by 1.96±4.03 kg at month 6 and by 3.13±4.71 kg at month 12 (p<0.001) Overall, 4 patients (1.04%) reported symptomatic hypoglycemia (glycemia ≤3.9 mmol/L); no episodes of severe hypoglycemia were registered.Conclusion: In a real-life setting in Russia, initiation of a fixed combination of insulin glargine 100 ME/ ml and lixisenatide in people with T2DM uncontrolled on OADs or combination of OADs with basal insulin resulted resulted in an improved glycemic control and body weight change with low risk of hypoglycemia compared to baselin

Influence of type 2 sodium-glucose co-transporter inhibitors (dapagliflozin) on the indicators of total mortality in patients with type 2 diabetes (CARDIA-MOS study, Moscow)

BACKGROUND: The widespread use in clinical practice of drugs with cardio- and nephroprotective properties, in particular, sodium-glucose cotransporter type 2 inhibitors (SGLT2i), is based on the results of large-scale international randomized trials. Meanwhile, there are no data demonstrating the possibility of the influence of these drugs on mortality rates in real clinical practice in Russian patients. To study this issue, a CARDIA-MOS study was conducted on a population of patients with type 2 diabetes (T2DM) in Moscow.AIM: To study the effect of SGLT2i on the total mortality of patients with T2DM in Moscow.MATERIALS AND METHODS: To assess the frequency of different outcomes, two samples of patients were formed according to predetermined criteria: 1) patients who started therapy with SGLT2i (dapagliflozin) in 2017; 2) a control group of patients corresponding to the main group in terms of key indicators: age, duration of T2DM, presence of cardiovascular diseases, use of insulin therapy, HbA1c level.RESULTS: Firstly, an analysis of the data of 499 patients who started treatment with dapagliflozin in 2017, as well as 499 patients in the control group (n = 998) was made. The baseline characteristics of the patients were generally comparable. Pre-study SBP and HbA1c were worse in the dapagliflozin group. The use of dapagliflozin was associated with a 39% reduction in the relative risk of death from all causes (RR 0.614, 95% CI 0.417–0.903, p = 0.013), led to a decrease in HbA1c levels by 0.8% (from 8.5 to 7.7%, p<0.001) for 48 months. observations. The safety profile of dapagliflozin was comparable to that of the control groupCONCLUSION: The use of dapagliflozin in the treatment of patients with T2DM can reduce overall mortality and improve glycemic control

Candidate Genes of Regulation of Skeletal Muscle Energy Metabolism in Athletes

All biological processes associated with high sports performance, including energy metabolism, are influenced by genetics. DNA sequence variations in such genes, single nucleotide variants (SNVs), could confer genetic advantages that can be exploited to achieve optimal athletic performance. Ignorance of these features can create genetic “barriers” that prevent professional athletes from pursuing a career in sports. Predictive Genomic DNA Profiling reveals single nucleotide variations (SNV) that may be associated with better suitability for endurance, strength and speed sports. (1) Background: To conduct a research on candidate genes associated with regulation of skeletal muscle energy metabolism among athletes. (2) Methods: We have searched for articles in SCOPUS, Web of Science, Google Scholar, Clinical keys, PubMed, e-LIBRARY databases for the period of 2010–2020 using keywords and keywords combinations; (4) Conclusions: Identification of genetic markers associated with the regulation of energy metabolism in skeletal muscles can help sports physicians and coaches develop personalized strategies for selecting children, teenagers and young adults for endurance, strength and speed sports (such as jogging, middle or long distance runs). However, the multifactorial aspect of sport performances, including impact of genetics, epigenetics, environment (training and etc.), is important for personalized strategies for selecting of athletes. This approach could improve sports performance and reduce the risk of sports injuries to the musculoskeletal system

The “Angiogenic Switch” and Functional Resources in Cyclic Sports Athletes

Regular physical activity in cyclic sports can influence the so-called “angiogenic switch”, which is considered as an imbalance between proangiogenic and anti-angiogenic molecules. Disruption of the synthesis of angiogenic molecules can be caused by local changes in tissues under the influence of excessive physical exertion and its consequences, such as chronic oxidative stress and associated hypoxia, metabolic acidosis, sports injuries, etc. A review of publications on signaling pathways that activate and inhibit angiogenesis in skeletal muscles, myocardium, lung, and nervous tissue under the influence of intense physical activity in cyclic sports. Materials: We searched PubMed, SCOPUS, Web of Science, Google Scholar, Clinical keys, and e-LIBRARY databases for full-text articles published from 2000 to 2020, using keywords and their combinations. Results: An important aspect of adaptation to training loads in cyclic sports is an increase in the number of capillaries in muscle fibers, which improves the metabolism of skeletal muscles and myocardium, as well as nervous and lung tissue. Recent studies have shown that myocardial endothelial cells not only respond to hemodynamic forces and paracrine signals from neighboring cells, but also take an active part in heart remodeling processes, stimulating the growth and contractility of cardiomyocytes or the production of extracellular matrix proteins in myofibroblasts. As myocardial vascularization plays a central role in the transition from adaptive heart hypertrophy to heart failure, further study of the signaling mechanisms involved in the regulation of angiogenesis in the myocardium is important in sports practice. The study of the “angiogenic switch” problem in the cerebrovascular and cardiovascular systems allows us to claim that the formation of new vessels is mediated by a complex interaction of all growth factors. Although the lungs are one of the limiting systems of the body in cyclic sports, their response to high-intensity loads and other environmental stresses is often overlooked. Airway epithelial cells are the predominant source of several growth factors throughout lung organogenesis and appear to be critical for normal alveolarization, rapid alveolar proliferation, and normal vascular development. There are many controversial questions about the role of growth factors in the physiology and pathology of the lungs. The presented review has demonstrated that when doing sports, it is necessary to give a careful consideration to the possible positive and negative effects of growth factors on muscles, myocardium, lung tissue, and brain. Primarily, the “angiogenic switch” is important in aerobic sports (long distance running). Conclusions: Angiogenesis is a physiological process of the formation of new blood capillaries, which play an important role in the functioning of skeletal muscles, myocardium, lung, and nervous tissue in athletes. Violation of the “angiogenic switch” as a balance between proangiogenic and anti-angiogenic molecules can lead to a decrease in the functional resources of the nervous, musculoskeletal, cardiovascular, and respiratory systems in athletes and, as a consequence, to a decrease in sports performance

Association of the ACTN3 Gene’s Single-Nucleotide Variant Rs1815739 (R577X) with Sports Qualification and Competitive Distance in Caucasian Athletes of the Southern Urals

An elite athlete’s status is associated with a multifactorial phenotype depending on many environmental and genetic factors. Of course, the peculiarities of the structure and function of skeletal muscles are among the most important characteristics in the context of athletic performance. Purpose: To study the associations of SNV rs1815739 (C577T or R577X) allelic variants and genotypes of the ACTN3 gene with qualification and competitive distance in Caucasian athletes of the Southern Urals. Methods: A total of 126 people of European origin who lived in the Southern Urals region took part in this study. The first group included 76 cyclical sports athletes (speed skating, running disciplines in track-and-field): SD (short distances) subgroup—40 sprinters (mean 22.1 ± 2.4 y.o.); LD (long distances) subgroup—36 stayer athletes (mean 22.6 ± 2.7 y.o.). The control group consisted of 50 healthy nonathletes (mean 21.4 ± 2.7 y.o.). We used the Step One Real-Time PCR System (Applied Biosystems, USA) device for real-time polymerase chain reaction. Results: The frequency of the major allele R was significantly higher in the SD subgroup compared to the control subgroup (80% vs. 64%; p-value = 0.04). However, we did not find any significant differences in the frequency of the R allele between the athletes of the SD subgroup and the LD subgroup (80% vs. 59.7%, respectively; p-value > 0.05). The frequency of the X allele was lower in the SD subgroup compared to the LD subgroup (20% vs. 40.3%; p-value = 0.03). The frequency of homozygous genotype RR was higher in the SD subgroup compared to the control group (60.0% vs. 34%; p-value = 0.04). The R allele was associated with competitive distance in the SD group athletes compared to those of the control group (OR = 2.45 (95% CI: 1.02–5.87)). The X allele was associated with competitive distance in the LD subgroup compared to the SD subgroup (OR = 2.7 (95% CI: 1.09–6.68)). Conclusions: Multiplicative and additive inheritance models demonstrated that high athletic performance for sprinters was associated with the homozygous dominant genotype 577RR in cyclical sports athletes of Caucasian origin in the Southern Urals