Type 2 Diabetes: A Case Study

A person with type 2 diabetes may be treated with insulin as well as an oral hyperglycaemic drug. Discuss why this combination may be prescribed.

There was total of 76 patients with AF receiving Dabigatran during the study period. The mean age was 67.9 ±1.5 years (range 29 - 98 years), males (52.6%, 66.3 ±1.7 years), and females (47.4%, 69.6 ±1.1years). The age group stratifications revealed the highest age group was those between 61 to 80 years (60.5%). The majority (73.7%) was ≤75 years, [Table 1]. 76.3% used Dabigatran 150 mg. The mean CHA2DS2, CHA2DS2-VASc, HAS-BLED score were 2.38 ±1.46, 3.54 ±1.82, and 3.46 ±1.205, respectively, [Table 2].

The change in glucagon correlates linearly with improvement in glucose tolerance. Since these drugs improve insulin secretion in response to an increase in blood glucose, it seems appropriate to pair them with drugs that have a different mechanism of action, such as insulin sensitizers or Metformin. In fact, improvements in fasting and postprandial glucose levels, improved beta-cell function, and improvement in HbA1c levels have been demonstrated in numerous clinical trials using different gliptins as monotherapy and in combination with various type 2 diabetes medications, including insulin.1

Invokana (canagliflozin) is an oral diabetic medication used to help control blood sugar levels in type 2 diabetics. Type 2 diabetes is a condition, usually with an onset in adulthood, in which the body cannot make enough insulin. Canagliflozin works with the kidneys to help get rid of glucose from the bloodstream. (drugs.com, 2015) It is suggested that with a healthy diet and adequate exercise this medication has the ability to control type 2 diabetes.

This was a single-dose, randomized, open-label, 2-period, 2-way crossover study conducted study. Patients were randomized to 1 of 2 dosing sequences: a single oral administration of a fixed-dose glimepiride 1-mg + metformin 500-mg combination tablet (test) followed by single oral administration of a fixed-dose glimepiride 2 mg + metformin 500 mg combination tablet (reference), separated by a 1-week

Furthermore, with the pharma logical treatments included in this article for the treatment of Type 2 Diabetes, many individuals will be prevented from developing CVD complications. Studies have shown the importance of patients being compliant with treatment leading to positive health outcomes. With the continued care given to these patients with Type 2 Diabetes many are able to have healthier lifestyles

In the post-hoc analysis, looking at regional differences between the Americas and Eastern Europe, there were more events in the Americas (31.8%) versus Eastern Europe (8.4%) in both the spironolactone and placebo groups. HR 3.96 (95% CI:3.22-4.88; P<0.001) (adjusted Cox model). Spironolactone also had significant outcomes in the Americas group: Spironolactone 242 (27.3%) versus placebo 280 (31.8%) (HR-0.82; 95% CI (0.69-0.98), p-0.026).

Randomization: Patients were randomly drafted in a 1:1 ration to either the once-daily Simvastatin 40 mg + Ezetimibe 25 mg (Simvastatin-Ezetimibe group) or once-daily Simvastatin 40 mg + Placebo

3) Compared two drugs of interest. 4) Have similar groups, allocation concealment, baseline validity and reliability of measures in order to eliminate bias of studies 5) Have low risk of bias. 6) Patients that receive medication treatment within twelve months after diagnosis. The strength of evidence was graded as high, moderate, low or insufficient based on established guidelines on four criteria: a) Risk of bias b) Consistency c) Directness d) Precision

The analysis involved four small, randomised controlled trials that compared the impact of the two drugs on ICP and cerebral perfusion pressure (CPP). Two of these studies also included the impact the two drugs had on mortality and GOS.

Maybe we will get more improvement in the clinical outcomes over extended and intermittent dosing form. Actually, that is difficult to apply in clinical practice because usually critically ill patients in the ICU received multiple drugs that make it hard for the nurse to give a continuous infusion of specific drug therapy and in the same time she has to give the other

3-5 Most events occur relatively early (2–3 months from initiation) in the course of treatment and mainly in patients with cardiovascular comorbidities or prior exposure to other cardiotoxic medications, supporting the theory of cumulative cardiotoxicity. Any grade of hypertension was noted in 14.3% in the pooled safety analysis, in 25% in the ENDEAVOR trial, in 14.3% in the ASPIRE trial and in 7% in the CHAMPION-1 trial at 70mg/m2 dose group. In the ENDEAVOR trial (where carfilzomib dose was 20/56mg/m2), the incidence of any grade cardiac AE was higher (18%) compared to the pooled safety analysis of the phase II trials (12.3%, where most patients were treated with 20/27mg/m2) and the ASPIRE trial (12.3%, where carfilzomib dose was 20/27mg/m2) could not lead us to defintive conclusions, as the infusion times also differed (30 min vs. ~10 min) [24, 25, 36]. The pooled safety analysis recognized cardiac AEs ≥Grade 3 in 7.6% of cases, similar to the carfilzomib arms of both ENDEAVOR and ASPIRE trials. In these two phase III trials, the incidence of cardiac AE was higher in the carfilzomib arms compared to the control arms, but a dose-dependent effect could not be proved. Even in the CHAMPION-1 study, where a dose of 70mg/m2 was infused over 30 minutes in patients with RR-MM once weekly, the proportions of any grade cardiotoxicity is less than 10% [42]. In a recent detailed analysis of 60 consecutive MM patients who received carfilzomib-based regimens, 12% (95%CI: 3.8%-20%) experienced a reversible reduction of LVEF by 20%. The incidence of LVEF reduction was 5% at 3 months, 8% at 6 months, 10% at 12 months, and 12% at 15 months, whereas the

Based on our analysis when patients taking both CBZ and VPA together, the estimate of LTG CL was 2.16 L/hr which is the same for patients on LTG monotherapy. This indicates that the induction and inhibition effects of both CBZ and VPA are balanced, which suggests that there is no need for dosage adjustment, however further studies are

It is very important that you allow the doctor to check your progress through regular visits, to ensure this drug is working properly.

One sensitivity analysis was conducted to evaluate a scenario where ezetimibe was removed from therapy if not effective at getting patients to goal. For example, in patients on atorvastatin 80 mg plus ezetimibe but not at goal, we removed ezetimibe (with adjustments of a corresponding increase in LDL-C) and added alirocumab instead. Additionally, a separate sensitivity analyses was conducted to determine the impact of lowering the LDL-C goal to the achieved levels seen in the IMPROVE-IT study, 55 mg/dL. Finally, we also simulated a scenario which only allowed for alirocumab if the LDL-C was > 75mg/dL. In other words, if oral intensification was successful at achieving an LDL-C < 75 mg/dL, we made the assumption that most physicians would think that level of attainment was sufficient in lieu of adding