Availability and affordability of essential medicines for diabetes across high-income, middle-income, and low-income countries: a prospective epidemiological study
Publication date: Available online 28 August 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s): Clara K Chow, Chinthanie Ramasundarahettige, Weihong Hu, Khalid F AlHabib, Alvaro Avezum, Xiaoru Cheng, Jephat Chifamba, Gilles Dagenais, Antonio Dans, Bonaventure A Egbujie, Rajeev Gupta, Romaina Iqbal, Noorhassim Ismail, Mirac V Keskinler, Rasha Khatib, Lanthé Kruger, Rajesh Kumar, Fernando Lanas, Scott Lear, Patricio Lopez-JaramilloSummaryBackgroundData are scarce on the availability and affordability of essential medicines for diabetes. Our aim was to examine the availability and affordability of metformin, sulfonylu...
Source: The Lancet Diabetes and Endocrinology - August 29, 2018 Category: Endocrinology Source Type: research
Pharmacotherapy for gestational diabetes.
Authors: Patti AM, Giglio RV, Pafili K, Rizzo M, Papanas N Abstract INTRODUCTION: Gestational diabetes mellitus (GDM) represents impaired carbohydrate metabolism during pregnancy and is characterized by progressive insulin resistance and compensatory hyperinsulinaemia. If inadequately treated, it may lead to fetal macrosomia and other adverse outcomes. Areas covered: In this review, the authors summarize the current evidence from studies on the use of insulin and other agents for the treatment of women with GDM. Expert opinion: Lifestyle management is of paramount importance for the treatment of GDM. In ph...
Source: Expert Opinion on Pharmacotherapy - August 25, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research
High-density lipoprotein inhibits serum amyloid A-mediated reactive oxygen species generation and NLRP3 inflammasome activation [Lipids]
Serum amyloid A (SAA) is a high-density apolipoprotein whose plasma levels can increase more than 1000-fold during a severe acute-phase inflammatory response and are more modestly elevated in chronic inflammation. SAA is thought to play important roles in innate immunity, but its biological activities have not been completely delineated. We previously reported that SAA deficiency protects mice from developing abdominal aortic aneurysms (AAAs) induced by chronic angiotensin II (AngII) infusion. Here, we report that SAA is required for AngII-induced increases in interleukin-1β (IL-1β), a potent proinflammatory cytokine tha...
Source: Journal of Biological Chemistry - August 24, 2018 Category: Chemistry Authors: Preetha Shridas, Maria C. De Beer, Nancy R. Webb Tags: Immunology Source Type: research
Oxidative Stress is the Principal Contributor to Inflammasome Activation in Retinal Pigment Epithelium Cells with Defunct Proteasomes and Autophagy
Conclusion: Our data suggest that oxidative stress strongly contributes to the NLRP3 inflammasome activation upon dysfunctional cellular clearance. Clarification of inflammasome activation mechanisms provides novel options for alleviating pathological inflammation present in aggregation diseases, such as age-related macular disease (AMD) and Alzheimer ’s disease.Cell Physiol Biochem 2018;49:359 –367 (Source: Cellular Physiology and Biochemistry)
Source: Cellular Physiology and Biochemistry - August 23, 2018 Category: Cytology Source Type: research
Sulfonylurea receptor 1 expression is variable in adult and pediatric brain tumors.
CONCLUSION: SUR1 is a putative therapeutic target to reduce neuroinflammation in adult and pediatric brain tumors. Inhibition of SUR1 may result in neuronal stabilization in glioblastoma, cerebral metastases, and posterior fossa ependymoma and reduced edema in medulloblastoma. . PMID: 30079884 [PubMed - as supplied by publisher] (Source: Clinical Neuropathology)
Source: Clinical Neuropathology - August 6, 2018 Category: Pathology Authors: Thompson EM, Halvorson K, McLendon R Tags: Clin Neuropathol Source Type: research
Research Gaps in Gestational Diabetes Mellitus: Executive Summary of a National Institute of Diabetes and Digestive and Kidney Diseases Workshop.
This article summarizes the proceedings of the workshop. In early pregnancy, the appropriate diagnostic criteria for the diagnosis of GDM remain poorly defined, and an effect of early diagnosis and treatment on the risk of adverse outcomes has not been demonstrated. Despite many small randomized controlled trials of glucose-lowering medication treatment in GDM, our understanding of medication management of GDM is incomplete as evidenced by discrepancies among professional society treatment guidelines. The comparative effectiveness of insulin, metformin, and glyburide remains uncertain, particularly with respect to long-ter...
Source: Obstetrics and Gynecology - July 10, 2018 Category: OBGYN Authors: Wexler DJ, Powe CE, Barbour LA, Buchanan T, Coustan DR, Corcoy R, Damm P, Dunne F, Feig DS, Ferrara A, Harper LM, Landon MB, Meltzer SJ, Metzger BE, Roeder H, Rowan JA, Sacks DA, Simmons D, Umans JG, Catalano PM Tags: Obstet Gynecol Source Type: research
A cautionary response to SMFM statement: pharmacological treatment of gestational diabetes
Use of oral agents to treat gestational diabetes mellitus remains controversial. Recent recommendations from the Society for Maternal-Fetal Medicine assert that metformin may be a safe first-line alternative to insulin for gestational diabetes mellitus treatment and preferable to glyburide. However, several issues should give pause to the widespread adoption of metformin use during pregnancy. Fetal concentrations of metformin are equal to maternal, and metformin can inhibit growth, suppress mitochondrial respiration, have epigenetic modifications on gene expression, mimic fetal nutrient restriction, and alter postnatal glu...
Source: American Journal of Obstetrics and Gynecology - June 27, 2018 Category: OBGYN Authors: Linda A. Barbour, Christina Scifres, Amy M. Valent, Jacob E. Friedman, Thomas Buchanan, Donald Coustan, Kjersti Aagaard, Kent L. Thornburg, Patrick M. Catalano, Henry Galan, William W. Hay, Antonio E. Frias, Kartik Shankar, Rebecca A. Simmons, Robert G. M Tags: Viewpoint Source Type: research
A Cautionary Response to SMFM Statement: Pharmacological Treatment of Gestational Diabetes
Use of oral agents to treat gestational diabetes mellitus (GDM) remains controversial. Recent recommendations from the Society for Maternal Fetal Medicine (SMFM) assert that metformin may be a safe first line alternative to insulin for GDM treatment and preferable to glyburide. However, several issues should give pause to the widespread adoption of metformin use during pregnancy. Fetal concentrations of metformin are equal to maternal, and metformin can inhibit growth, suppress mitochondrial respiration, have epigenetic modifications on gene expression, mimic fetal nutrient restriction, and alter postnatal gluconeogenic re...
Source: American Journal of Obstetrics and Gynecology - June 27, 2018 Category: OBGYN Authors: Linda A. Barbour, Christina Scifres, Amy M. Valent, Jacob E. Friedman, Thomas Buchanan, Donald Coustan, Kjersti Aagaard, Kent L. Thornburg, Patrick M. Catalano, Henry Galan, William W. Hay, Antonio E. Frias, Kartik Shankar, Rebecca A. Simmons, Robert G. M Source Type: research
Needle beats pill in gestational diabetes mellitus
Needle beats pill in gestational diabetes mellitus, Published online: 25 June 2018; doi:10.1038/s41574-018-0050-0Given the steady increase in the use of oral antidiabetic medication, better knowledge of their effects on neonatal outcomes in gestational diabetes mellitus is essential. Recently, Marie-Victoire Sénat and colleagues investigated the use of glyburide over standard insulin treatment in a noninferiority multicentre randomized trial, which found higher risk of perinatal complications under glyburide therapy. (Source: Nature Reviews Endocrinology)
Source: Nature Reviews Endocrinology - June 25, 2018 Category: Endocrinology Authors: Alexandra Kautzky-Willer J ürgen Harreiter Source Type: research
Serious hypoglycemia and use of warfarin in combination with sulfonylureas or metformin.
This article is protected by copyright. All rights reserved. PMID: 29885251 [PubMed - as supplied by publisher] (Source: Clinical Pharmacology and Therapeutics)
Source: Clinical Pharmacology and Therapeutics - June 9, 2018 Category: Drugs & Pharmacology Authors: Nam YH, Brensinger CM, Bilker WB, Leonard CE, Han X, Hennessy S Tags: Clin Pharmacol Ther Source Type: research
Long-Term Outcomes in Patients Aged
Background and Purpose—We aimed to determine whether subjects aged ≤70 years who were treated with intravenous glyburide (RP-1127; BIIB093; glibenclamide) would have better long-term outcomes than those who received placebo.Methods—GAMES-RP (Glyburide Advantage in Malignant Edema and Stroke–Remedy Pharmaceuticals) was a prospective, double-blind, randomized, placebo-controlled phase 2 clinical trial. Eighty-six participants, aged 18 to 80 years, who presented to 18 centers with large hemispheric infarction (baseline diffusion-weighted imaging volumes, 82–300 cm3) randomized within 10 hours of symptom onset were e...
Source: Stroke - May 25, 2018 Category: Neurology Authors: Kevin N. Sheth, Nils H. Petersen, Ken Cheung, Jordan J. Elm, Holly E. Hinson, Bradley J. Molyneaux, Lauren A. Beslow, Gordon K. Sze, J. Marc Simard, W. Taylor Kimberly Tags: Treatment, Ischemic Stroke Original Contributions Source Type: research
NLRP3 Inflammasome Is Involved in Q-VD-OPH Induced Necroptosis Following Cerebral Ischemia-Reperfusion Injury.
In this study, we determined the optimal dose of Q-VD-OPH, which induces necroptosis in rats by the middle cerebral artery occlusion, followed by reperfusion. Furthermore, we report that the NLRP3 inflammasome is involved in necroptosis, with levels of NLRP3 inflammasome proteins as well as inflammatory cytokines, such as IL-1β, being elevated. We also demonstrated that NLRP3 was not only expressed in microglia and vascular endothelial cell, but also in neurons when necroptosis is induced with Q-VD-OPH. Inhibition of NLRP3 by glyburide strongly suppressed the expression of NLRP3 inflammasome proteins and IL-1β, and marke...
Source: Neurochemical Research - May 25, 2018 Category: Neuroscience Authors: Teng X, Chen W, Liu Z, Feng T, Li H, Ding S, Chen Y, Zhang Y, Tang X, Geng D Tags: Neurochem Res Source Type: research
Metformin for the prevention of hypertensive disorders of pregnancy in women with gestational diabetes and obesity: a systematic review and meta-analysis.
CONCLUSIONS: There is a high probability that metformin use is associated with a reduced HDP incidence when compared to other treatments and placebo. The small number of studies included in the analysis, the low quality of evidence and the clinical heterogeneity preclude the generalization of these results to broader populations. Given the clinical importance of this topic and the magnitude of effect observed in this meta-analysis, further prospective trials are urgently needed. This article is protected by copyright. All rights reserved. PMID: 29749110 [PubMed - as supplied by publisher] (Source: The Ultrasound Re...
Source: The Ultrasound Review of Obstetrics and Gynecology - May 10, 2018 Category: Radiology Authors: Kalafat E, Sukur YE, Abdulkadir, Thilaganathan B, Khalil A Tags: Ultrasound Obstet Gynecol Source Type: research
Effect of Glyburide vs Subcutaneous Insulin on Perinatal Complications in Gestational Diabetes
This noninferiority randomized clinical trial compares the effects of glyburide vs subcutaneous insulin on macrosomia, neonatal hypoglycemia, and hyperbilirubinemia in infants born to women with gestational diabetes. (Source: JAMA)
Source: JAMA - May 1, 2018 Category: General Medicine Source Type: research
Insulin vs Glyburide for Gestational Diabetes
In 2017, gestational diabetes occurred in approximately 14% of pregnancies throughout the world, ranging from 9% in Africa to 12.6% in North America to 21% in Southeast Asia. Although there is not yet global agreement regarding diagnostic criteria for gestational diabetes, there is agreement on the complications of this disorder, including an increased risk of cesarean delivery and preeclampsia in mothers, macrosomia with possible birth injury and neonatal hypoglycemia and jaundice in infants, childhood obesity, and type 2 diabetes in both mothers and offspring. Maternal hyperglycemia, in addition to excess lipids and amin...
Source: JAMA - May 1, 2018 Category: General Medicine Source Type: research