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Minimising harms of tight glycaemic control in older patients with type 2 diabetes.
Afr J Prim Health Care Fam Med
December 2024
Department of Anaesthesiology, Pharmacology and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver.
In older adults with type 2 diabetes (T2DM), tight glycaemic control (HbA1c 7%) can result in more harm than benefit, especially when using insulin or sulfonylureas. Older adults are at higher risk for adverse drug events, especially hypoglycaemia, which may cause falls, confusion and hospitalisations. This Therapeutic Letter evaluates the risks of tight glycaemic control in older adults with T2DM, focusing on deprescribing diabetes medications in those over 65, especially those with multimorbidity and polypharmacy.
View Article and Find Full Text PDFMapping the effectiveness and risks of GLP-1 receptor agonists.
Nat Med
January 2025
Clinical Epidemiology Center, Research and Development Service, VA St. Louis Health Care System, St. Louis, MO, USA.
Glucagon-like peptide 1 receptor agonists (GLP-1RAs) are increasingly being used to treat diabetes and obesity. However, their effectiveness and risks have not yet been systematically evaluated in a comprehensive set of possible health outcomes. Here, we used the US Department of Veterans Affairs databases to build a cohort of people with diabetes who initiated GLP-1RA (n = 215,970) and compared them to those who initiated sulfonylureas (n = 159,465), dipeptidyl peptidase 4 (DPP4) inhibitors (n = 117,989) or sodium-glucose cotransporter-2 (SGLT2) inhibitors (n = 258,614), a control group composed of an equal proportion of individuals initiating sulfonylureas, DPP4 inhibitors and SGLT2 inhibitors (n = 536,068), and a control group of 1,203,097 individuals who continued use of non-GLP-1RA antihyperglycemics (usual care).
View Article and Find Full Text PDFComputational insights into marine natural products as potential antidiabetic agents targeting the SIK2 protein kinase domain.
SAR QSAR Environ Res
December 2024
Structural Biology and Biocomputing Lab, Department of Bioinformatics, Alagappa University, Karaikudi, India.
Diabetes mellitus (DM) affects over 77 million adults in India, with cases expected to reach 134 million by 2045. Current treatments, including sulfonylureas and thiazolidinediones, are inadequate, underscoring the need for novel therapeutic strategies. This study investigates marine natural products (MNPs) as alternative therapeutic agents targeting SIK2, a key enzyme involved in DM.
View Article and Find Full Text PDFNeuroendocrine tumors and diabetes mellitus: which treatment and which effect.
Endocrine
January 2025
Unit of Endocrinology, Department of Clinical and Molecular Medicine, ENETS Center of Excellence, Sapienza University of Rome, Rome, Italy.
Diabetes mellitus (DM) and neuroendocrine tumors (NET) can exert unfavorable effects on each other prognosis. In this narrative review, we evaluated the effects of NET therapies on glycemic control and DM management and the effects of anti-diabetic therapies on NET outcome and management. For this purpose, we searched the PubMed, Science Direct, and Google Scholar databases for studies reporting the effects of NET therapy on DM as well as the effect of DM therapy on NET.
View Article and Find Full Text PDFBiased allele transmission for herbicide resistance: a conditional gene drive.
Planta
December 2024
AgResearch, Christchurch, New Zealand.
Herbicide application to plants heterozygous for herbicide resistance results in distorted segregation favoring resistant allele transmission resulting in a conditional gene drive. Brassica napus plants heterozygous for an allele conferring sulfonylurea resistance at a single locus exhibit normal Mendelian inheritance. However, following application of the herbicide, highly distorted segregation of herbicide resistance occurs among progeny.
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