The risk of hypoglycemia with sulfonylureas is higher in the presence of diabetic nephropathy. Selective DPP-4 inhibitors lead to physiologic increases in the incretins GLP-1 and gastric inhibitory polypeptide and preferable for the management of postprandial hyperglycemia due to lack of many adverse effects observed with other diabetes medications

Abbas, Ahmad L.

Fadieieva, Hanna Anatoliivna

Фадеева, Анна Анатольевна

Фадєєва, Ганна Анатоліївна

Electronic Sumy State University Institutional Repository

 3  МІНІСТЕРСТВО ОСВІТИ ТА НАУКИ УКРАЇНИ СУМСЬКИЙ ДЕРЖАВНИЙ УНІВЕРСИТЕТ МЕДИЧНИЙ ІНСТИТУТ     АКТУАЛЬНІ ПИТАННЯ ТЕОРЕТИЧНОЇ ТА КЛІНІЧНОЇ МЕДИЦИНИ Topical Issues of Theoretical and Clinical Medicine      ЗБІРНИК ТЕЗ ДОПОВІДЕЙ V Міжнародної науково-практичної конференції студентів та молодих вчених (м. Суми, 20-21 квітня 2017 року)    Суми Сумський державний університет 2017   276 АКТУАЛЬНІ ПИТАННЯ ТЕОРЕТИЧНОЇ ТА КЛІНІЧНОЇ МЕДИЦИНИ Results: Among 412 patients with diabetes 28 persons (6,8±1,24%) were diagnosed with cancer in comparing to 14 persons (3,9±0,98%) among 402 patients without diabetes (p<0.05). Patients with type 2 diabetes have the higher risk of development of cancer (OR=1.87; 95 % CI: 0.9 to 3.5; P = 0.05).  Diabetic patients of the both groups were representative of the duration of diabetes, BMI, mean baseline HbA1C.  HOMA index in diabetic patients of the 1st group was higher (6,3±0,46) compared with HOMA (5,0±0,39) of the 2nd group (p<0.05). From the 2nd group, 20 (71.4%) subjects had IR compared with 26 subjects (92.8%) from the 1st group (OR=5.2; 95 % CI: 0.9 to 27.2; P=0.05).   Conclusion: Patients with type 2 diabetes have the increased risk of development of cancer. Insulin resistance may lead to an increased risk of malignant tumors.    ADVANTAGES OF INCRETIN-BASED TREATMENT IN MANAGEMENT OF TYPE 2 DIABETES Abbas Ahmad L., Fadieieva G.A. Sumy State University, Department of Internal Medicine postgraduate education The risk of hypoglycemia with sulfonylureas is higher in the presence of diabetic nephropathy. Selective DPP-4 inhibitors lead to physiologic increases in the incretins GLP-1 and gastric inhibitory polypeptide and preferable for the management of postprandial hyperglycemia due to lack of many adverse effects observed with other diabetes medications.  Study objectives: to assess the effect of sitagliptin when added on to ongoing metformin therapy in patients with type 2 diabetes and diabetic nephropathy.  Methods: 65 patients with type 2 diabetes, stage 2 or 3 of chronic kidney disease (CKD) and inadequate glycemic control defined as HbA1c ≥7.0% and ≤10.0% took part in this study. Before randomization they were on stable dose of metformin (2g/day) for 12 weeks. 35 patients of the 1st group continued treatment by metformin in combination with 2mg glimepiride. 30 patients of the 2nd group had received sitagliptin at 50 mg/day in addition to metformin. All patients received dietary and lifestyle advice. 20 healthy persons were in control group. The levels of glycosylated haemoglobin (HbA1C), fasting plasma glucose (FPG), postprandial glucose (PG) were explored. Statistical processing of results was carried out using SPSS statistics 21.  Results: Patients of the both groups were representative of the duration of diabetes, stage of CKD, mean baseline HbA1C.  In 3 months of treatment glycemic control improved similarly in both groups. Antihyperglycemic therapy with sitagliptin lead to reduction in levels of HbA1C from (8,9±0,14) to (7,4±0,12) % (p<0.05). HbA1C of patients from the 2nd group in 3 months after treatment was (7,2±0,14) % (p>0.05).  During treatment period (22.9±7.2) % of patients from the 1st group reported hypoglycemia compared to (6.6±4.63) % persons of the 2nd group (p<0.05).  Conclusion: Adding a sitagliptin to background metformin therapy in poorly controlled patients with diabetic kidney disease leads to improvement in glycemic control and low risk of hypoglycemia compared with sulfonylurea.   

Advantages of incretin-based treatment in management of type 2 diabetes

SocioEconomic Challenges Journal (Sumy State University)

 3  
МІНІСТЕРСТВО ОСВІТИ ТА НАУКИ УКРАЇНИ 
СУМСЬКИЙ ДЕРЖАВНИЙ УНІВЕРСИТЕТ 
МЕДИЧНИЙ ІНСТИТУТ 
 
 
 
 
АКТУАЛЬНІ ПИТАННЯ 
ТЕОРЕТИЧНОЇ ТА КЛІНІЧНОЇ МЕДИЦИНИ 
Topical Issues of Theoretical and Clinical Medicine 
 
 
 
 
 
ЗБІРНИК ТЕЗ ДОПОВІДЕЙ 
V Міжнародної науково-практичної конференції студентів та молодих вчених 
(м. Суми, 20-21 квітня 2017 року) 
 
 
 
Суми 
Сумський державний університет 
2017 
 
 
276 АКТУАЛЬНІ ПИТАННЯ ТЕОРЕТИЧНОЇ ТА КЛІНІЧНОЇ МЕДИЦИНИ 
Results: Among 412 patients with diabetes 28 persons (6,8±1,24%) were diagnosed with 
cancer in comparing to 14 persons (3,9±0,98%) among 402 patients without diabetes (p<0.05). 
Patients with type 2 diabetes have the higher risk of development of cancer (OR=1.87; 95 % CI: 
0.9 to 3.5; P = 0.05).  
Diabetic patients of the both groups were representative of the duration of diabetes, BMI, mean 
baseline HbA1C.  
HOMA index in diabetic patients of the 1st group was higher (6,3±0,46) compared with HOMA 
(5,0±0,39) of the 2nd group (p<0.05). From the 2nd group, 20 (71.4%) subjects had IR compared 
with 26 subjects (92.8%) from the 1st group (OR=5.2; 95 % CI: 0.9 to 27.2; P=0.05).   
Conclusion: Patients with type 2 diabetes have the increased risk of development of cancer. 
Insulin resistance may lead to an increased risk of malignant tumors.  
 
 
ADVANTAGES OF INCRETIN-BASED TREATMENT IN MANAGEMENT 
OF TYPE 2 DIABETES 
Abbas Ahmad L., Fadieieva G.A. 
Sumy State University, Department of Internal Medicine postgraduate education 
The risk of hypoglycemia with sulfonylureas is higher in the presence of diabetic nephropathy. 
Selective DPP-4 inhibitors lead to physiologic increases in the incretins GLP-1 and gastric inhibitory 
polypeptide and preferable for the management of postprandial hyperglycemia due to lack of many 
adverse effects observed with other diabetes medications.  
Study objectives: to assess the effect of sitagliptin when added on to ongoing metformin therapy 
in patients with type 2 diabetes and diabetic nephropathy.  
Methods: 65 patients with type 2 diabetes, stage 2 or 3 of chronic kidney disease (CKD) and 
inadequate glycemic control defined as HbA1c ≥7.0% and ≤10.0% took part in this study. Before 
randomization they were on stable dose of metformin (2g/day) for 12 weeks. 35 patients of the 1st 
group continued treatment by metformin in combination with 2mg glimepiride. 30 patients of the 2nd 
group had received sitagliptin at 50 mg/day in addition to metformin. All patients received dietary 
and lifestyle advice. 20 healthy persons were in control group. 
The levels of glycosylated haemoglobin (HbA1C), fasting plasma glucose (FPG), postprandial 
glucose (PG) were explored. Statistical processing of results was carried out using SPSS statistics 21.  
Results: Patients of the both groups were representative of the duration of diabetes, stage of CKD, 
mean baseline HbA1C.  
In 3 months of treatment glycemic control improved similarly in both groups. 
Antihyperglycemic therapy with sitagliptin lead to reduction in levels of HbA1C from (8,9±0,14) to 
(7,4±0,12) % (p<0.05). HbA1C of patients from the 2nd group in 3 months after treatment was 
(7,2±0,14) % (p>0.05).  
During treatment period (22.9±7.2) % of patients from the 1st group reported hypoglycemia 
compared to (6.6±4.63) % persons of the 2nd group (p<0.05).  
Conclusion: Adding a sitagliptin to background metformin therapy in poorly controlled patients 
with diabetic kidney disease leads to improvement in glycemic control and low risk of hypoglycemia 
compared with sulfonylurea. 
  


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Advantages of incretin-based treatment in management of type 2 diabetes

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SocioEconomic Challenges Journal (Sumy State University)