59 research outputs found
Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12 deficiency: randomised placebo controlled trial
Objectives To study the effects of metformin on the incidence of vitamin B-12 deficiency (<150 pmol/l), low concentrations of vitamin B-12 (150-220 pmol/l), and folate and homocysteine concentrations in patients with type 2 diabetes receiving treatment with insulin
Combination of insulin and metformin in the treatment of type 2 diabetes
WSTĘP. Celem pracy była ocena działania metabolicznego metforminy
w porównaniu z placebo, u chorych na cukrzycę typu 2, leczonych według schematu
intensywnej insulinoterapii.
MATERIAŁ I METODY. Metformina poprawia kontrolę glikemii u osób
ze źle wyrównaną cukrzycą typu 2. Dotychczas nie zbadano jej wpływu u chorych
na cukrzycę typu 2, leczonych metodą intensywnej insulinoterapii. Grupa 390 chorych
na cukrzycę typu 2, stosujących insulinę, uczestniczyła w randomizowanym, kontrolowanym,
przeprowadzonym metodą podwójnie ślepej próby badaniu z zaplanowaną pośrednią
analizą po 16 tygodniach leczenia. Uczestników badania wybrano z 3 przyszpitalnych
przychodni i losowo przydzielono do grup, przyjmujących placebo lub metforminę
w uzupełnieniu insulinoterapii. Podczas badania prowadzono intensywną kontrolę
glikemii z natychmiastowym dostosowaniem dawki insuliny, zgodnie ze ścisłymi wytycznymi.
Określano wskaźniki kontroli glikemii, zapotrzebowanie na insulinę, masę ciała,
ciśnienie tętnicze, stężenie lipidów, incydenty hipoglikemii i inne działania
niepożądane.
WYNIKI. Sposród 390 osób 37 nie ukończyło badania (12 w grupie
otrzymującej placebo i 25 w grupie leczonej metforminą). U osób, które ukończyły
16-tygodniowy okres leczenia zastosowanie metforminy w porównaniu z placebo powodowało
poprawę kontroli glikemii (średnia glikemia podczas 16 tygodni 7,8 vs. 8,8 mmol/l,
p = 0,006; średnie stężenie HbA1c 6,9 vs. 7,6%, p < 0,0001), zmniejszone
zapotrzebowanie na insulinę (63,8 vs. 71,3 j.; p < 0,0001), mniejszy przyrost
masy ciała (-0,4 vs. +1,2 kg; p < 0,01) i zmniejszenie stężenia cholesterolu frakcji
LDL (-0,21 vs. -0,02 mmol/l; p < 0,01). Ryzyko wystąpienia hipoglikemii było podobne.
WNIOSKI. U chorych na cukrzycę typu 2, leczonych intensywnie
insuliną, skojarzenie insuliny z metforminą powoduje lepsze wyrównanie glikemii
w porównaniu z monoterapią insuliną, a jednocześnie zmniejsza zapotrzebowanie
na insulinę i ogranicza przyrost masy ciała.INTRODUCTION. To investigate the metabolic effects
of metformin, as compared with placebo, in type 2
diabetic patients intensively treated with insulin.
MATERIAL AND METHODS. Metformin improves glycemic
control in poorly controlled type 2 diabetic
patients. Its effect in type 2 diabetic patients who
are intensively treated with insulin has not been studied.
A total of 390 patients whose type 2 diabetes
was controlled with insulin therapy completed a randomized
controlled double-blind trial with a planned
interim analysis after 16 weeks of treatment.The
subjects were selected from three outpatient clinics
in regional hospitals and were randomly assigned to either the placebo or metformin group, in addition
to insulin therapy. Intensive glucose monitoring
with immediate insulin adjustments according
to strict guidelines was conducted. Indexes of glycemic
control, insulin requirements, body weight,
blood pressure, plasma lipids, hypoglycemic events,
and other adverse events were measured.
RESULTS. Of the 390 subjects, 37 dropped out (12 in
the placebo and 25 in the metformin group). Of those
who completed 16 weeks of treatment, metformin
use, as compared with placebo, was associated
with improved glycemic control (mean daily glucose
at 16 weeks 7.8 vs. 8.8 mmol/l, P = 0.006; mean
GHb 6.9 vs. 7.6%, P < 0.0001); reduced insulin requirements
(63.8 vs. 71.3 IU, P < 0.0001); reduced
weight gain (–0.4 vs. +1.2 kg, P < 0.01); and decreased
plasma LDL cholesterol (–0.21 vs. –0.02 mmol/l,
P < 0.01). Risk of hypoglycemia was similar in both
groups.
CONCLUSIONS. In type 2 diabetic patients who are
intensively treated with insulin, the combination of
insulin and metformin results in superior glycemic
control compared with insulin therapy alone, while
insulin requirements and weight gain are less
Prevalence of vitamin B12 deficiency in type 2 diabetic patients using metformin: a cross-sectional study
Structural heterogeneity in a phototransformable fluorescent protein impacts its photochemical properties
International audiencePhotoconvertible fluorescent proteins (PCFP) are important cellular markers in advanced imaging modalities such as photoactivatable localization microscopy (PALM). However, their complex photophysical and photochemical behavior hampers applications such as quantitative and single‐particle‐tracking PALM. This work employs multidimensional NMR combined with ensemble fluorescence measurements to show that the popular mEos4b in its Green state populates two conformations (A and B), differing in side‐chain protonation of the conserved residues E212 and H62, altering the hydrogen‐bond network in the chromophore pocket. The interconversion (protonation/deprotonation) between these two states, which occurs on the minutes time scale in the dark, becomes strongly accelerated in the presence of UV light, leading to a population shift. This work shows that the reversible photoswitching and Green‐to‐Red photoconversion properties differ between the A and B states. The chromophore in the A‐state photoswitches more efficiently and is proposed to be more prone to photoconversion, while the B‐state shows a higher level of photobleaching. Altogether, this data highlights the central role of conformational heterogeneity in fluorescent protein photochemistry
Does metformin decrease blood pressure in type 2 diabetic patients?
We assess the level of extent to which Does metformin decrease blood pressure in type 2 diabetic patients. Diabetes Care 52, supplement 1: A171 (731-P). American Diabetes Association, New Orleans, June 200
Effect of short-term treatment with metformin on serum concentrations of homocysteine, folate and vitamin B12 in type 2 diabetes mellitus: a randomized, placebo-controlled trial.
We address and compared the Effect of short-term treatment with metformin on serum concentrations of homocysteine, folate and vitamin B12 in type 2 diabetes mellitus: a randomized, placebo-controlled trial. Diabetes Care 52, supplement 1: A171 (732-P). American Diabetes Association, New Orleans, June 200
Long-term effects of metformin on metabolism and microvascular and macrovascular disease in patients with type 2 diabetes mellitus
We investigated whether metformin hydrochloride has sustained beneficial metabolic and (cardio) vascular effects in patients with type 2 diabetes mellitus (DM2). We studied 390 patients treated with insulin in the outpatient clinics of 3 hospitals in a randomized, placebo-controlled trial with a follow-up period of 4.3 years. Either metformin hydrochloride, 850 mg, or placebo (1-3 times daily) was added to insulin therapy. The primary end point was an aggregate of microvascular and macrovascular morbidity and mortality. The secondary end points were microvascular and macrovascular morbidity and mortality, as separate aggregate scores. In addition, effects on hemoglobin A(1c) (HbA(1c)), insulin requirement, lipid levels, blood pressure, body weight, and body mass index were analyzed. Metformin treatment prevented weight gain (mean weight gain, -3.07 kg [range, -3.85 to -2.28 kg]; P < .001), improved glycemic control (mean reduction in HbA(1c) level, 0.4% percentage point [95% CI, 0.55-0.25]; P < .001) (where CI indicates confidence interval), despite the aim of similar glycemic control in both groups, and reduced insulin requirements (mean reduction, 19.63 IU/d [95% CI, 24.91-14.36 IU/d]; P < .001). Metformin was not associated with an improvement in the primary end point. It was, however, associated with an improvement in the secondary, macrovascular end point (hazard ratio, 0.61 (95% CI, 0.40-0.94; P = .02), which was partly explained by the difference in weight. The number needed to treat to prevent 1 macrovascular end point was 16.1 (95% CI, 9.2-66.6). Metformin, added to insulin in patients with DM2, improved body weight, glycemic control, and insulin requirements but did not improve the primary end point. Metformin did, however, reduce the risk of macrovascular disease after a follow-up period of 4.3 years. These sustained beneficial effects support the policy to continue metformin treatment after the introduction of insulin in any patient with DM2, unless contraindicated. Trial Registration ClinicalTrials.gov Identifier: NCT0037538
First results on the Effects of metformin on endothelial function and inflammatory activity in type 2 diabetes mellitus: the HOME study, a randomized placebo-controlled trial
From the Study HOME, the first results on the Effects of metformin on endothelial function and inflammatory activity in type 2 diabetes mellitus: the HOME study is a randomized placebo-controlled trial. Abstract 1, Klinische Endocrinologiedagen, Doorwerth, February 2004
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