For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
10
views
18
references
 Top references
cited by
1
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      98
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Modern Sulfonylureas Strike Back – Exploring the Freedom of Flexibility

      editorial

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          This editorial discusses the concept of flexibility in diabetes care. Flexibility of an oral antidiabetic drug (OAD) is defined as its ability to be used efficaciously and safely, in flexible, convenient doses and frequencies, at flexible timings of administration. This flexibility also includes OAD usage alone or in combination with a wide spectrum of drugs, in a wide spectrum of patients, irrespective of their age, gender, health status, or dietary patterns, with flexible dose titration, glucose monitoring and healthcare contact schedules. This editorial examines the flexibility of the modern sulfonylureas such as gliclazide extended (modified) release (MR) preparation in the management of diabetes. Using evidence-based rationale, we demonstrate that gliclazide MR is a flexible, and useful option for the management of type 2 diabetes.

          Related collections

          Most cited references18

          • Record: found
          • Abstract: found
          • Article: not found

          Diabetic kidney disease: a report from an ADA Consensus Conference.

          Katherine Tuttle, George L. Bakris, Rudolf W. Bilous … (2014)
          The incidence and prevalence of diabetes mellitus have grown significantly throughout the world, due primarily to the increase in type 2 diabetes. This overall increase in the number of people with diabetes has had a major impact on development of diabetic kidney disease (DKD), one of the most frequent complications of both types of diabetes. DKD is the leading cause of end-stage renal disease (ESRD), accounting for approximately 50% of cases in the developed world. Although incidence rates for ESRD attributable to DKD have recently stabilized, these rates continue to rise in high-risk groups such as middle-aged African Americans, Native Americans, and Hispanics. The costs of care for people with DKD are extraordinarily high. In the Medicare population alone, DKD-related expenditures among this mostly older group were nearly $25 billion in 2011. Due to the high human and societal costs, the Consensus Conference on Chronic Kidney Disease and Diabetes was convened by the American Diabetes Association in collaboration with the American Society of Nephrology and the National Kidney Foundation to appraise issues regarding patient management, highlighting current practices and new directions. Major topic areas in DKD included (1) identification and monitoring, (2) cardiovascular disease and management of dyslipidemia, (3) hypertension and use of renin-angiotensin-aldosterone system blockade and mineralocorticoid receptor blockade, (4) glycemia measurement, hypoglycemia, and drug therapies, (5) nutrition and general care in advanced-stage chronic kidney disease, (6) children and adolescents, and (7) multidisciplinary approaches and medical home models for health care delivery. This current state summary and research recommendations are designed to guide advances in care and the generation of new knowledge that will meaningfully improve life for people with DKD.
          Article 0 comments Cited 229 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Years of life gained by multifactorial intervention in patients with type 2 diabetes mellitus and microalbuminuria: 21 years follow-up on the Steno-2 randomised trial

            Peter Gæde, Jens Oellgaard, Bendix Carstensen … (2016)
            Aims/hypothesis The aim of this work was to study the potential long-term impact of a 7.8 years intensified, multifactorial intervention in patients with type 2 diabetes mellitus and microalbuminuria in terms of gained years of life and years free from incident cardiovascular disease. Methods The original intervention (mean treatment duration 7.8 years) involved 160 patients with type 2 diabetes and microalbuminuria who were randomly assigned (using sealed envelopes) to receive either conventional therapy or intensified, multifactorial treatment including both behavioural and pharmacological approaches. After 7.8 years the study continued as an observational follow-up with all patients receiving treatment as for the original intensive-therapy group. The primary endpoint of this follow-up 21.2 years after intervention start was difference in median survival time between the original treatment groups with and without incident cardiovascular disease. Non-fatal endpoints and causes of death were adjudicated by an external endpoint committee blinded for treatment allocation. Results Thirty-eight intensive-therapy patients vs 55 conventional-therapy patients died during follow-up (HR 0.55 [95% CI 0.36, 0.83], p = 0.005). The patients in the intensive-therapy group survived for a median of 7.9 years longer than the conventional-therapy group patients. Median time before first cardiovascular event after randomisation was 8.1 years longer in the intensive-therapy group (p = 0.001). The hazard for all microvascular complications was decreased in the intensive-therapy group in the range 0.52 to 0.67, except for peripheral neuropathy (HR 1.12). Conclusions/interpretation At 21.2 years of follow-up of 7.8 years of intensified, multifactorial, target-driven treatment of type 2 diabetes with microalbuminuria, we demonstrate a median of 7.9 years of gain of life. The increase in lifespan is matched by time free from incident cardiovascular disease. Trial registration: ClinicalTrials.gov registration no. NCT00320008. Funding: The study was funded by an unrestricted grant from Novo Nordisk A/S. Electronic supplementary material The online version of this article (doi:10.1007/s00125-016-4065-6) contains peer-reviewed but unedited supplementary material, which is available to authorised users.
            Article 0 comments Cited 151 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Impact of glucose-lowering drugs on cardiovascular disease in type 2 diabetes.

              Ele Ferrannini, Ralph A. DeFronzo (2015)
              Type 2 diabetes mellitus (T2DM) is characterized by multiple pathophysiologic abnormalities. With time, multiple glucose-lowering medications are commonly required to reduce and maintain plasma glucose concentrations within the normal range. Type 2 diabetes mellitus individuals also are at a very high risk for microvascular complications and the incidence of heart attack and stroke is increased two- to three-fold compared with non-diabetic individuals. Therefore, when selecting medications to normalize glucose levels in T2DM patients, it is important that the agent not aggravate, and ideally even improve, cardiovascular risk factors (CVRFs) and reduce cardiovascular morbidity and mortality. In this review, we examine the effect of oral (metformin, sulfonylureas, meglitinides, thiazolidinediones, DPP4 inhibitors, SGLT2 inhibitors, and α-glucosidase inhibitors) and injectable (glucagon-like peptide-1 receptor agonists and insulin) glucose-lowering drugs on established CVRFs and long-term studies of cardiovascular outcomes. Firm evidence that in T2DM cardiovascular disease can be reversed or prevented by improving glycaemic control is still incomplete and must await large, long-term clinical trials in patients at low risk using modern treatment strategies, i.e., drug combinations designed to maximize HbA1c reduction while minimizing hypoglycaemia and excessive weight gain.
              Article 0 comments Cited 81 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (nlm-ta): Eur Endocrinol
                Journal ID (iso-abbrev): Eur Endocrinol
                Journal ID (publisher-id): EE
                Title: European Endocrinology
                Publisher: Touch Medical Media
                ISSN (Print): 1758-3772
                ISSN (Electronic): 1758-3780
                Publication date (Print): September 2018
                Publication date (Electronic): 10 September 2018
                Volume: 14
                Issue: 2
                Pages: 20-22
                Affiliations
                [1 ] Department of Endocrinology, Bharti Hospital, Karnal, India
                [2 ] Department of Endocrinology, Maharaja Agrasein Hospital, New Delhi, India
                Author notes
                Corresponding Author: Sanjay Kalra, Department of Endocrinology, Bharti Hospital, Karnal, India. E: brideknl@ 123456gmail.com

                Disclosure: Sanjay Kalra and Deepak Khandelwal have nothing to disclose in relation to this paper.

                Article
                DOI: 10.17925/EE.2018.14.2.20
                PMC ID: 6182917
                SO-VID: 2ae6b38a-cacb-49e9-b093-f0bd12569a4d
                Copyright © © The Author(s) 2018
                License:

                This article is published under the Creative Commons Attribution Noncommercial License, which permits any non-commercial use, distribution, adaptation and reproduction provided the original author(s) and source are given appropriate credit. © The Authors 2018.

                Review Process: This article is a short opinion piece and has not been submitted to external peer reviewers, but was reviewed for accuracy by the editorial board before publication.

                Authorship: All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship of this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published.

                History
                Date received : 21 June 2018
                Date accepted : 30 July 2018
                Page count
                Pages: 3
                Funding
                Support: No funding was received for the publication of this article.
                Categories
                Subject: Diabetes

                Keywords: modern sulfonylureas,patient centred care,sulfonylureas,type 2 diabetes mellitus,flexibility
                Data availability:
                Keywords: modern sulfonylureas, patient centred care, sulfonylureas, type 2 diabetes mellitus, flexibility

                Comments

                Comment on this article

                scite_

                Similar content98

                See all similar

                Cited by1

                See all cited by

                Most referenced authors255

                See all reference authors