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In response to a requirement of regulatory bodies for antidiabetic trials to now include CV outcomes assessment, data of 5 such outcomes trials are now available. The relationships between markers of glucose homeostasis and AF have not been widely studied. Recent outcome trials of novel antidiabetic drugs shed new light on why diabetes patients develop heart disease.
In Korean people, the magnitude of sugar-sweetened carbonated beverage consumption was associated with asymptomatic coronary atherosclerosis as measured by coronary artery calcium.
Prospective cohort study data show that in high-risk T2DM patients, the relationship between HDL-C levels and CV event risk is dependent on LDL-C levels and higher HDL-c is not always beneficial. The IAS Severe FH Panel aimed to characterise the severe FH phenotype and make recommendations on how to stratify CVD risk and whom to prescribe the novel lipid-lowering treatments. EAS 2016 European guidelines on cardiovascular disease prevention from the Sixth Joint Task Force provide up-to-date accessible recommendations for lipid control for clinicians in their routine practice.
EAS 2016 Gene therapy targeted at LDLR and HMGCR decreased LDL-c level and slowed atherosclerosis in mice. Prof Lambers Heerspink reviews potential mechanisms beyond glucose lowering, explaining the positive cardiovascular outcomes of SGLT2 inhibition as seen in the EMPA REG Outcomes trial.
The main indications of oral antidiabetic medication include: type 2 diabetes mellitus, which is not regulated only with properly prescribed and rigorously observed diet. Type 2 diabetes mellitus, which can be balanced with diet, but because the patient is undisciplined, this goal can not be achieved (the medication does not improve glucose balance).
Combinations: Glibomet (metformin + glibenclamide), Avandamet (rosiglitazone + metformin), Competact (pioglitazone + metformin), Janumet (sitagliptin + metformin). Sulphonylurea drugs used by almost half a century, to treat type 2 diabetes, are indicate in normal weight patients who have type 2 diabetes and in obese patients if they can not tolerate metformin. After ingestion, sulphonylurea drugs are rapidly absorbed in the intestine, pass into the bloodstream, where they bind to specific proteins (albumin, in particular) and reach the liver where they are metabolized into inactive byproducts. Sulphonylureas can not be associate with each other, but may be associated with biguanides, thiazolidinediones, and even with insulin therapy. After ingestion, metformin is absorbed at intestinal level, disseminate in the body and is excreted in urine and faeces, unchanged. Biguanides may be associated with sulphonylureas, with thiazolidinediones and with insulin in both type 2 and type 1 diabetes. The two used thiazolidinediones are pioglitazone and rosiglitazone, the latter being less used these days, because it is considered that increase the risk of cardiovascular complications. After oral administration, meglitinides are absorbed at intestinal level, are metabolized in the liver and will result inactive byproducts, which are excreted into the bile. Considering that this class of oral antidiabetic medication has a short half-life, meglitinides are useful in correcting postprandial hyperglycemia. Alpha glucosidase inhibitors are used to treat type 2 diabetes, which is inadequately controlled by diet.
Januvia (sitagliptin), a drug that inhibits the destruction of GLP-1 blood levels, so will extended the action of GLP-1 and will increase the insulin secretion.
The product consists of Afrezza Inhalation Powder delivered using a small, discreet and easy-to-use inhaler. The drug’s safety and effectiveness were evaluated in a total of 3,017 participants–1,026 participants with type 1 diabetes and 1,991 patients with type 2 diabetes. Afrezza has a Boxed Warning advising that acute bronchospasm has been observed in patients with asthma and chronic obstructive pulmonary disease (COPD).


The FDA approved Afrezza with a Risk Evaluation and Mitigation Strategy, which consists of a communication plan to inform health care professionals about the serious risk of acute bronchospasm associated with Afrezza. The Diabetes Media Foundation is a 501(c)(3) tax-exempt nonprofit media organization devoted to informing, educating, and generating community around living a healthy life with diabetes.
Diabetes mellitus is associated with metabolic disorders, it is based on inadequate absorption of glucose by the body. Not eating for diabetes and how to determine the required rate of uglevodosoderjati products?
For diabetes patients are overweight, to enhance the feeling of saturation, it is necessary to include in the diet such vegetables as fresh and pickled cabbage, lettuce, spinach, green peas, cucumbers, tomatoes. There are several options diets for diabetics, but in almost home, you can use one (diet 9), which can easily be adapted to the treatment of any patient, eliminating or adding a particular food or foods. On our website describes the most common disease of adults and children, causes and symptoms of these diseases, as well as the most effective treatments for these diseases.
The information on this health site are for informational purposes only, professional diagnosis and treatment of the disease should be done by the doctor in the clinic. In the Atherosclerosis Risk in Communuties study (ARIC) this association was studied in a population of white subjects and African-Americans. Elimination is predominantly renal, with the exception of gliquidone that is eliminated in the bile in proportion of 95%. Sulphonylureas are fixing on specific receptors and acts through the potassium channel from the pancreatic and the extra-pancreatic level. The main side effect of sulphonylureas is hypoglycaemia (favored by a high dose, kidney failure, liver failure, alcohol consumption, intense physical effort, age over 70 years).
Biguanides increase insulin action by binding to specific receptors, decrease intestinal absorption of carbohydrates and decrease anaerobic gluconeogenesis. Digestive manifestations, especially epigastric pain and diarrhea, occur in approximately 20% of cases and it is requiring a dose reduction or even quitting to this class of oral antidiabetic medication. Thiazolidinediones lower blood glucose levels by reducing insulinresistance in adipose tissue, in the muscle and in the liver, thus increasing insulin sensitivity, in this way it favors the hypoglycemic action of insulin. Before and during treatment with thiazolidinediones, is necessary to control liver enzymes (AST, ALT in particular).
This drugs are fixing on specific sites of potassium channels and increase insulin secretion stimulated by glucose level if there is a residual function of pancreatic beta cells. Alpha glucosidase inhibitors are reversibly binding to alpha-glucosidase enzymes of small intestine cells, enzymes that are designed to split disaccharides and oligosaccharides, thus preventing the digestion and absorption of carbohydrates, along the small intestine.
Alpha glucosidase inhibitors can cause a slight weight gain, abdominal bloating, flatulence, abdominal discomfort, diarrhea, and rarely can cause liver test abnormalities. GLP-1 is a substance secreted by the body that stimulates insulin secretion, but has other beneficial effects such as delayed passage of food from the stomach into the small intestine and stimulating satiety. FDA approved Mannkind Corporation’s Afrezza (insulin human) Inhalation Powder, a rapid-acting inhaled insulin, to improve glycemic control in adults with diabetes mellitus.
Administered at the start of a meal, Afrezza dissolves rapidly upon inhalation to the deep lung and delivers insulin quickly to the bloodstream. The efficacy of mealtime Afrezza in adult patients with type 1 diabetes patients was compared to mealtime insulin aspart (fast-acting insulin), both in combination with basal insulin (long-acting insulin) in a 24 week study.
Afrezza must be used in combination with long-acting insulin in patients with type 1 diabetes, and it is not recommended for the treatment of diabetic ketoacidosis, or in patients who smoke.
Afrezza should not be used in patients with chronic lung disease, such as asthma or COPD because of this risk.


All uglevodsoderzhashchie products differ significantly in their physical properties, composition, caloric value.
Regardless of the type and quantity of the product, whether it is bread or an Apple, one bread unit contains 12-15 grams of digestible carbohydrates. Because for them it is important to observe daily the daily requirement of carbohydrates, corresponding to injected insulin.
To answer all these questions, the patient with diabetes need to be trained in special schools for people with diabetes. To improve liver function, which greatly affected by diabetes, you need to enter in the diet products that contain lipotropic factors (cheese, soy, oatmeal and others), as well as to limit in the diet of meat, fish soup and fried foods. With a doctor’s permission, you can use sweet dishes and specially prepared diabetic products. At pancreatic level, increase insulin secretion and at the level of pancreatic beta cells, they increase the number of insulin receptors. Other adverse effects consist of digestive manifestations (nausea, epigastric pain, liver pain) and of haematological manifestations (pancytopenia, autoimmune hemolytic anemia, thrombocytopenia). This class of oral antidiabetic medication is well tolerated in general, however, sometimes may occur mild edema of the lower limbs, through the loss of elimination of salt and water, which, on the one hand, may decrease hemoglobin, with the appearance of anemia, and on the other hand, requires to be administered with caution to patients with type 2 diabetes and heart failure. Thus, carbohydrates reach into the colon and are metabolized by bacteria, found at this level, in short-chain fatty acids and then are eliminated.
The administration of this drug is by subcutaneous injection, like insulin, in a fixed dose, 2 times a day with pre-filled pen, initially every 5 micrograms twice a day, then 10 micrograms twice a day. Afrezza is administered at the beginning of each meal, or within 20 minutes after starting a meal.
Peak insulin levels are achieved within 12 to 15 minutes of administration, and decline to baseline by approximately 180 minutes. The most common adverse reactions associated with Afrezza in clinical trials were hypoglycemia, cough, and throat pain or irritation. For moderate and severe form of diabetes diet must be combined with the receiving antidiabetic agents or insulin. At extra-pancreatic sulphonylurea drugs decrease hepatic gluconeogenesis (glucose synthesis from non-carbohydrate sources), increased glycolysis and enhances insulin action in skeletal muscle and in adipose tissue. Thiazolidinediones can cause hypercholesterolemia and triglycerides disorders and for this reason, blood fats should be checked periodically. Afrezza was studied in adults with type 2 diabetes in combination with oral antidiabetic drugs; the efficacy of mealtime Afrezza in type 2 diabetes patients was compared to placebo inhalation in a 24 week study.
In diabetes mellitus type I, the occurrence of which is connected with the destruction of the beta cells of the pancreas and insulin deficiency, the primary method of substitution treatment is insulin therapy.
It is equally difficult to determine and the necessary amount of daily allowance products, without having special knowledge and not seeing understandable guidelines. Thanks to the introduction of the concept of bread units patients with diabetes had the opportunity to properly plan the menus, correctly replacing some of uglevodsoderzhashchie other products. At week 24, treatment with Afrezza plus oral antidiabetic drugs provided a mean reduction in HbA1c that was statistically significantly greater compared to the HbA1c reduction observed in the placebo group. To ease the task, nutritionists was introduced notional concept, used for diabetes patients – bread unit.



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