Prescription Drugs 2 Go

Conclusions: Exenatide therapy in insulin-treated type 2 diabetes and obesity was associated with very significant reductions in weight and insulin doses. Exenatide should be considered in people with type 2 diabetes on insulin and have obesity, weight gain and poor glycaemic control. (Source: QJM)

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This report aims to provide information on new drug developments to support a new drugs update to the 2008 guideline. It reviewed concerns about the safety of the thiazolidinediones as well as the following newer agents available for blood glucose control in type 2 diabetes:
 
. Glucagon-like peptide-1 (GLP-1) analogue exenatide . Dipeptidyl peptidase-4 (DPP-4) inhibitors sitagliptin and vildagliptin . Long-acting insulin analogues glargine and detemir
 
The HTA concluded “Exenatide, the gliptins and detemir were all clinically effective. The long-acting insulin analogues glargine and detemir appeared to have only slight clinical …

Conclusions:
Patients receiving exenatide received significantly lower amounts of exogenous insulin to control plasma glucose levels. Exenatide was well tolerated and potentially represents a novel agent to attenuate hyperglycemia in the critical care setting.Trial registration: NCT00673309. (Source: Critical Care)

Type 2 diabetes is treated by a stepwise approach, starting with lifestyle changes at early stages (enforced by structured education for patients), combined with one or several glucose-lowering agents. Because of the progressive nature of the disease, an increasing number of glucose-lowering drugs have to be used with advancing diabetes duration. In The Lancet today, Richard Bergenstal and colleagues report the results of DURATION-2, comparing exenatide once weekly with either sitagliptin (an inhibitor of dipeptidyl peptidase-4) or pioglitazone (a thiazolidinedione), and Michaela Diamant and colleagues report the results of DURATION-3, …

Conclusion ischemic acute renal failure is supposed to be the consequence of the extracellular volume contraction caused by exenatide
(the result of continuous nausea and vomiting). This adverse effect could be caused by the co-administration of diuretics
and angiotensin II receptor antagonists.
Content Type Journal ArticleCategory Case ReportDOI 10.1007/s11096-010-9423-8Authors
Alfonso López-Ruiz, Reina Sofía University Hospital Diabetes Unit 30003 Murcia SpainCristina del Peso-Gilsanz, Reina Sofía University Hospital Diabetes Unit 30003 Murcia SpainAmparo Meoro-Avilés, Reina Sofía University Hospital Diabetes Unit 30003 Murcia SpainJosé Soriano-Palao, Reina Sofía University Hospital Diabetes Unit 30003 Murcia SpainAlberto Andreu, …

Most patients with type 2 diabetes begin pharmacotherapy with metformin, but eventually need additional treatment. We assessed the safety and efficacy of once weekly exenatide, a glucagon-like peptide 1 receptor agonist, versus maximum approved doses of the dipeptidyl peptidase-4 inhibitor, sitagliptin, or the thiazolidinedione, pioglitazone, in patients treated with metformin. (Source: LANCET)

Source: Diabetes Care
Area: News
According to the results of an analysis published in Diabetes Care, there was no evidence that exenatide or sitagliptin increased the risk of acute pancreatitis.  There was however an increased risk of AP seen in patients with diabetes compared to those without diabetes.
 
The authors performed a retrospective cohort study of a large medical and pharmacy claims database, and analysed data for 786,656 patients.  The risk of AP for diabetic versus non-diabetic patients and for patients treated with exenatide and sitagliptin versus control diabetes medication …

Background:
Activation of glucagon-like peptide-1 (GLP-1) receptors improves insulin sensitivity and induces vasodilatation and diuresis. AC3174 is a peptide analogue with pharmacologic properties similar to the GLP-1 receptor agonist, exenatide. Hypothetically, chronic AC3174 treatment could attenuate salt-induced hypertension, cardiac morbidity, insulin resistance, and renal dysfunction in Dahl salt-sensitive (DSS) rats.
Methods:
DSS rats were fed low salt (LS, 0.3% NaCl) or high salt (HS, 8% NaCl) diets. HS rats were treated with vehicle, AC3174 (1.7 pmol/kg/min), or GLP-1 (25 pmol/kg/min) for 4 weeks via subcutaneous infusion. Other HS rats received captopril (150 mg/kg/day) …

Should these GLP-1 receptor agonists for type 2 diabetes be considered the same? Medscape Pharmacists (Source: Medscape Today Headlines)

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Source: National Prescribing Service
Area: News
A RADAR (Rational Assessment of Drugs and Research) review on dipeptidyl peptidase-4 inhibitors (’gliptins’) for type 2 diabetes mellitus has been published and is available via the link below. This review was completed on behalf of the National Prescribing Service (NPS), which is an independent Australian organisation supporting the quality use of medicines.
 
The authors highlight the following summary points (taken directly from the source):
. Sitagliptin and vildagliptin are dipeptidyl peptidase-4 (DPP-4) inhibitors (’gliptins’). They provide similar improvements in glycaemic control for people with …