Thiazolidinedione Essay

This article discusses the use of dulaglutide and sitagliptin in the management of type 2 diabetes. Dulaglutide is a recombinant GLP-1 Fc fusion protein, which acts by linking GLP-1 analog peptide and a variant of lgG4 Fc fragments in humans. As such, the analog of GLP-1 has posed effects and has shown elevated efficacies in the management of type 2 diabetes. The primary efficacy in the baseline of HbA was altered during the end of 52nd week. The objective of secondary efficacy included a change in HbA during the end of the 26th and 104th week. The percentage of patients achieved HbA targets ranged between 7.5% to 6.5% in a central laboratory and the body changed significantly. However, current treatment majorly focuses on increasing

Incretin based drugs have proven to be effective glucose-lowering agents (Butler et al, 2013). But there have been concerns with respect to the long-term consequences of using such therapies. The issues raised were regarding their causal relationship with acute pancreatitis (AP). There are clearly conflicting evidence that have been presented in preclinical studies and in epidemiologic studies which suggest an association which may or may not be a causal relationship between these drugs and AP. (Butler et al, 2013)

Diabetes is a growing concern and health challenge for the American people (b). Diabetes is a condition in which the body cannot react to insulin appropriately or either cannot produce insulin efficiently (w). “Without a properly functioning insulin signaling system, blood glucose levels become elevated and other metabolic abnormalities occur, leading to the development of serious, disabling complications” (w). There are numerous forms of diabetes amongst the nation, however, there are three main forms of diabetes. Most people have heard of type one diabetes, type two diabetes, and gestational diabetes because they are common. Type two diabetes deals with a resistance to insulin, while

There are many classes of medication which help control normal levels of glucose in the body. These medications work in different ways; sulfonylureas and meglitinides increase insulin production in different pathways, Thiazolidinediones increase insulin sensitivity by increasing the number of cells, Incretin mimetics increase insulin production as well as delay gastric emptying, Dipeptidyl Peptidase works in the gut, releasing incretin resulting in a prolonged secretion of insulin and Sodium glucose cotransporter reduces reabsorption of glucose and excreting excess glucose out of the urine (Demler & Rhoads, 2018).

Nobel Prize winner Dr. Fredrick Banning once said, “Insulin is not a cure for diabetes; it is a treatment. It enables the diabetic to burn sufficient carbohydrates so that proteins and fats may be added to the diet in sufficient quantities to provide energy for the economic burdens of life”(Banning, 1928). The American Diabetes Association (ADA), states that 9.3% of the population has diabetes, which is why it was the 7th leading cause of death in the Unites States in 2010. The Center for Control Disease (CDC), states individuals younger than 20 years were newly diagnosed with Type 2 Diabetes annually (CDC, 2010). Physicians often instruct patients affected by Type 2 diabetics, to watch their diet and sustain a healthy, more active lifestyle.

Type 2 Diabetes is the most common form of diabetes in adults. It accounts for approximately 90%-95% of diagnosed diabetes in adults in the United States (cdc.gov, n.d.). Newly diagnose cases of diabetes tripled from 1980-2011 in the United States. It is a costly and deadly disease. Because there are many comorbidities and complications associated with uncontrolled diabetes, it is essential to treat diabetes effectively. Clinicians deal with this ongoing problem on a daily basis. Therefore, new treatment options are needed. Diabetes can be treated and managed by regular physical activity, healthy eating, and by decreasing cardiovascular disease risk factors, such as high lipid levels, high to decrease blood glucose levels are important aspects of disease management. At this time, there are 14 classes of medications currently available to treat type 2 diabetes mellitus, however, only 36 % of the patients achieve glycemic control on their present medications. Also, the prevalence of type 2 diabetes continues to increase which escalates the medical cost to treat the disease. In 2012, the estimates cost of type 2 diabetes was $176 billion. The cost to treat this disease is going to continue to rise. Even though there are drugs available to treat type 2 diabetes, new treatment options with different mechanisms of action are needed to improve patient outcome through better glycemic control (Miller, Nguyen, Jia-Haur, Chihyi, & Nguyen, 2014).

As the incidence of type 2 diabetes is steadily increasing, the demand for treatment options is increasing. Dipeptidyl peptidase-4 inhibitors (DPP-4) are a new class of oral anti-hyperglycemic medications that target the incretin system found in the gut. Evidence has shown that treatment with DPP-4 inhibitors has shown significant reductions in HbA1c and increased pancreatic β-cell function without an increased risk of hypoglycemia. In this document, the pharmacology, clinical efficacy, and incidence of adverse effects will be reviewed in an attempt to target a patient population that would benefit the most from treatment with DPP-4 inhibitors.

Type II diabetes is a metabolic disease that affects many people of various ages, genders, and ethnicities all over the world. Many factors contribute to the disease, including

The pathophysiology of type 2 diabetes mellitus (T2DM) is complex and varied. The core defects of T2DM include quantitative and qualitative β-cell dysfunction, peripheral (skeletal muscle) insulin resistance, and elevated glucose production in the liver, as well as increased lipolysis when obesity is present. However, it is now being recognized that other known mechanisms, including increased glucagon, decreased incretin effect, increased glucose reabsorption in the kidneys and some neurotransmitter dysfunction, are also involved in the pathophysiology of T2DM1. The currently available antidiabetic agents have been developed to target one or more of the underlying defects or processes involved in T2DM2. Normally, glycemic control in patients

Diabetes mellitus (DM) is a chronic metabolic disease which is mainly caused by the abnormalities of insulin regulation to control glucose level in the blood, thus resulting hyperglycemia [1, 2]. There are currently two major distinct types of DM, namely type-1 and type-2 diabetes. Type-1 diabetes corresponds with the inability of pancreatic hormonal glands to produce sufficient insulin to effectively regulate blood-sugar level, therefore called insulin-dependent diabetes. On the other hand, patients with type-2 diabetes are not suffered from insulin deficiency but instead, the inability of their body to fully utilise the produced insulin, hence non-insulin-dependent diabetes [1, 2].

As the epidemic of type 2 diabetes continues to grow, newer and newer pathophysiologic mechanisms of diabetes are being uncovered. From a simplistic model of insulin deficiency and insulin resistance, researchers have moved to a multipronged explanation of the disease. In addition to the ominous octet, other eight players like catecholamines, vitamin D, renin–angiotensin system, testosterone, melatonin, thyroid disorder, renal gluconeogenesis, gastrin - all play important roles in the etiology of glucose intolerance in type 2 diabetic individuals. Collectively, these sixteen players comprise the sweet sixteen and demand that: The treatment should be based upon the reversal of these known pathogenic abnormalities and not simply on reducing

Type 2 Diabetes (T2D) is the most prevalent form of diabetes, accounting for 90%-­‐95% cases worldwide. It’s characterized by the decrease in insulin secretion from pancreatic β cells, as well as the decreased

This review addresses the open-label, 26-week, randomized, side-by-side comparison of exenatide and liraglutide, two glucagon-like peptide-1 (GLP-1) receptor agonists. Exenatide, a synthetic version of extendin-4, is a once-weekly injectable that is resistant to degradation by dipeptidyl peptidase-4 (DPP-4). The once-daily injectable, liraglutide, is an analog of human GLP-1 that has been engineered to resist degradation by DPP-4. Liraglutide is also 99% bound to albumin to avoid degradation by endogenous peptidases. Exenatide is released slowly over time and reaches steady-state concentrations at 6-10 weeks. Liraglutide reaches peak concentrations at 10-14 hours after injection. In previous studies, patients with type 2 diabetes

SGLT2 inhibitors include agents such as Invokana, Farxiga, and Jardiance and work by increasing glucose excretion in the urine. SGLT2 inhibitors, in this study showed, a relative risk less than 1 compared to the placebo and all other oral diabetic medications in question. The RR of SGLT2 versus the placebo was 0.61 in reducing CV mortality. Compared to DPP4 inhibitors, which include Januvia, Onglyza, and Tradjenta, SGLT2 inhibitors had a calculated relative risk of 0.61. Compared to thiazolidinediones, which include Actos and Avandia, SGLT2 inhibitors had a relative risk of 0.66. Compared to sulfonylureas, which include Amaryl, Glucotrol, and Diabeta, SGLT2 inhibitors had a relative risk of 0.52. Finally, compared to

According to the National Diabetes Statistics Report from The Centers for Disease Control and Prevention in 2012, it revealed that 29.1 million of the American population has diabetes with 1.7 million new diagnoses each year. Diabetes is the seventh leading cause of death in the United States and costs over 176 billion dollars per year. Diabetes mellitus is a metabolic disorder characterized by hyperglycemia due to the dysfunction of the pancreas. The two most common categories of diabetes mellitus are type 1 and type 2 (Huether & McCance, 2012). In order to understand the differences and similarities between type 1 and type 2, the pathophyisology, assessment findings, and treatments of each type will be examined.