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1.
J. physiol. biochem ; 80(1): 235-247, Feb. 2024. ilus, graf
Artigo em Inglês | IBECS | ID: ibc-229953

RESUMO

Both exercise and metformin are common effective clinical treatments of type 2 diabetic mellitus. This study investigated the functional role of exercise, metformin, and combination treatment on type 2 diabetic mellitus–induced muscle atrophy. In this experiment, a total of 10 BKS mice were set as the control group. A total of 40 BKS-db/db mice were randomly divided into the control group (db/db); the exercise intervention group (db/db + Ex), which ran on a treadmill at 7–12 m/min, 30–40 min/day, 5 days/week; the metformin administration group (db/db + Met), which was administered 300 mg/kg of metformin solution by gavage daily; and the exercise combined with metformin administration group (db/db + Ex + Met). After 8 weeks of intervention, their tibialis anterior muscles were removed. The levels of insulin signaling pathway proteins, ubiquitin proteasome, and autophagic lysosome–associated proteins were detected using western blot, the expression of MuRF1 and Atrogin-1 was detected using immunohistochemical staining, and the degradation of autophagosomes was detected using double-labeled immunofluorescence. The db/db mice exhibited reduced insulin sensitivity and inhibition of the autophagic–lysosome system, the ubiquitin–proteasome system was activated, and protein degradation was exacerbated, leading to skeletal muscle atrophy. Exercise and metformin and their combined interventions can increase insulin sensitivity, whereas exercise alone showed more effective in inhibiting the ubiquitin–proteasome system, improving autophagy levels, and alleviating skeletal muscle atrophy. Compared with metformin, exercise demonstrated superior improvement of muscle atrophy by promoting the synthesis and degradation of autophagy through the AMPK/ULK1 pathway. However, the combination treatment exhibits no synergistic effect on muscle atrophy. (AU)


Assuntos
Animais , Camundongos , Diabetes Mellitus Tipo 2/complicações , Atrofia Muscular , Exercício Físico , Metformina , Autofagia , Inibidores de Proteassoma
2.
Int. microbiol ; 27(1): 265-276, Feb. 2024. graf
Artigo em Inglês | IBECS | ID: ibc-230259

RESUMO

Background: Metformin (MET) is a first-line therapy for type-2 diabetes mellitus (T2DM). Liraglutide (LRG) is a glucagon-like peptide-1 receptor agonist used as a second-line therapy in combination with MET. Methods: We performed a longitudinal analysis comparing the gut microbiota of overweight and/or pre-diabetic participants (NCP group) with that of each following their progression to T2DM diagnosis (UNT group) using 16S ribosomal RNA gene sequencing of fecal bacteria samples. We also examined the effects of MET (MET group) and MET plus LRG (MET+LRG group) on the gut microbiota of these participants following 60 days of anti-diabetic drug therapy in two parallel treatment arms. Results: In the UNT group, the relative abundances of Paraprevotella (P = 0.002) and Megamonas (P = 0.029) were greater, and that of Lachnospira (P = 0.003) was lower, compared with the NCP group. In the MET group, the relative abundance of Bacteroides (P = 0.039) was greater, and those of Paraprevotella (P = 0.018), Blautia (P = 0.001), and Faecalibacterium (P = 0.005) were lower, compared with the UNT group. In the MET+LRG group, the relative abundances of Blautia (P = 0.005) and Dialister (P = 0.045) were significantly lower than in the UNT group. The relative abundance of Megasphaera in the MET group was significantly greater than in the MET+LRG group (P = 0.041). Conclusions: Treatment with MET and MET+LRG results in significant alterations in gut microbiota, compared with the profiles of patients at the time of T2DM diagnosis. These alterations differed significantly between the MET and MET+LRG groups, which suggests that LRG exerted an additive effect on the composition of gut microbiota.(AU)


Assuntos
Humanos , Diabetes Mellitus Tipo 2 , Metformina , Microbioma Gastrointestinal , Liraglutida/farmacologia , RNA Ribossômico 16S , Microbiologia , Técnicas Microbiológicas , China , Liraglutida/uso terapêutico
3.
J. physiol. biochem ; 80(1): 235-247, Feb. 2024. ilus, graf
Artigo em Inglês | IBECS | ID: ibc-EMG-580

RESUMO

Both exercise and metformin are common effective clinical treatments of type 2 diabetic mellitus. This study investigated the functional role of exercise, metformin, and combination treatment on type 2 diabetic mellitus–induced muscle atrophy. In this experiment, a total of 10 BKS mice were set as the control group. A total of 40 BKS-db/db mice were randomly divided into the control group (db/db); the exercise intervention group (db/db + Ex), which ran on a treadmill at 7–12 m/min, 30–40 min/day, 5 days/week; the metformin administration group (db/db + Met), which was administered 300 mg/kg of metformin solution by gavage daily; and the exercise combined with metformin administration group (db/db + Ex + Met). After 8 weeks of intervention, their tibialis anterior muscles were removed. The levels of insulin signaling pathway proteins, ubiquitin proteasome, and autophagic lysosome–associated proteins were detected using western blot, the expression of MuRF1 and Atrogin-1 was detected using immunohistochemical staining, and the degradation of autophagosomes was detected using double-labeled immunofluorescence. The db/db mice exhibited reduced insulin sensitivity and inhibition of the autophagic–lysosome system, the ubiquitin–proteasome system was activated, and protein degradation was exacerbated, leading to skeletal muscle atrophy. Exercise and metformin and their combined interventions can increase insulin sensitivity, whereas exercise alone showed more effective in inhibiting the ubiquitin–proteasome system, improving autophagy levels, and alleviating skeletal muscle atrophy. Compared with metformin, exercise demonstrated superior improvement of muscle atrophy by promoting the synthesis and degradation of autophagy through the AMPK/ULK1 pathway. However, the combination treatment exhibits no synergistic effect on muscle atrophy. (AU)


Assuntos
Animais , Camundongos , Diabetes Mellitus Tipo 2/complicações , Atrofia Muscular , Exercício Físico , Metformina , Autofagia , Inibidores de Proteassoma
4.
Pharm. pract. (Granada, Internet) ; 21(4)oct.- dec. 2023. tab, graf
Artigo em Inglês | IBECS | ID: ibc-229988

RESUMO

Background: Metformin is one of the most important treatments for type 2 diabetes mellitus (T2DM) patients. Mostly metformin has a safe profile but in some cases, it may cause some serious long-term hematological and neurological side effects mainly due to vitamin B12 deficiency. It is proven that there is a strong association between B12 deficiency and hematological and neurological manifestations, especially for T2DM patients on metformin. Hence, the American Diabetic Association (ADA) recommends vitamin B12 screening for those on metformin for a long duration. Objectives: To evaluate the knowledge and practice of family physicians among diabetic patients on metformin, and to evaluate the factors that enhance and prevent vitamin B12 screening. Method: A validated questionnaire was designed and distributed online for family medicine practitioners between the period of in June and September 2022. 147 family physicians participated in the study. A scoring system was used to calculate the knowledge, practice, and total scores. Results: The results reveal a high total knowledge score among participants about vitamin B12 manifestations and screening in T2DM patients. However, only half of the participants follow the ADA recommendations routinely (53.06)%. The total practice score is low as most participants (87.7%) answer only 9 of 18 questions correctly. Moreover, the results show that those who follow ADA recommendations routinely have better knowledge and practice scores (p-value 0.00406). Conclusion: More awareness about ADA recommendations and the practice of vitamin B12 screening in T2DM patients who use metformin for family physicians is required, either by encouraging them to order B12 through workshops and continuous learning programs or by the availability of tools needed to test B12 (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Conhecimentos, Atitudes e Prática em Saúde , Diabetes Mellitus Tipo 2/tratamento farmacológico , Metformina/uso terapêutico , Hipoglicemiantes/uso terapêutico , Deficiência de Vitamina B 12 , Inquéritos e Questionários
5.
Rev. clín. esp. (Ed. impr.) ; 223(9): 542-551, nov. 2023. tab
Artigo em Espanhol | IBECS | ID: ibc-226820

RESUMO

Introducción Los pacientes con diabetes mellitus (DM) e insuficiencia cardiaca (IC) presentan peor pronóstico a pesar de los avances terapéuticos en ambas enfermedades. Los inhibidores del cotransportador sodio-glucosa tipo 2 y agonistas del receptor de GLP-1 han demostrado beneficios cardiovasculares y se han posicionado como primer escalón en el tratamiento de DM en pacientes con IC o elevado riesgo cardiovascular. Sin embargo, en los ensayos pivotales la mayoría de los pacientes recibe tratamiento concomitante con metformina. Todavía no se han desarrollado ensayos clínicos aleatorizados para evaluar el impacto pronóstico de la metformina a nivel cardiovascular. Nuestro objetivo fue analizar si los pacientes con DM e IC aguda que recibían tratamiento con metformina en el momento del alta podrían presentar mejor pronóstico al año de seguimiento. Métodos Ensayo de cohortes prospectivo mediante el análisis combinado de los 2 principales registros españoles de IC: el Registro Epidemiology of Acute Heart Failure in Emergency Departments –EAHFE– y el Registro Nacional de Pacientes con Insuficiencia Cardiaca –RICA–. Resultados De un total de 4.403 pacientes con DM tipo 2, recibió tratamiento con metformina el 33% (1.453). Este grupo presentó una mortalidad significativamente inferior al año de tratamiento (22 versus 32%; test de Log Rank p<0,001). En el análisis ajustado de mortalidad, los pacientes que recibieron tratamiento con metformina presentaron menor mortalidad al año de seguimiento independientemente del resto de las variables (RR 0,814; IC 95% 0,712-0,930; p<0,01). Conclusiones Los pacientes con DM tipo 2 e IC aguda que recibieron metformina presentaron mejor pronóstico al año de seguimiento, por lo que consideramos que este fármaco debe continuar siendo un pilar fundamental en el tratamiento de estos pacientes (AU)


Introduction Patients with diabetes mellitus (DM) and heart failure (HF) have a worse prognosis despite therapeutic advances in both diseases. Sodium-glucose co-transporter type 2 and GLP-1 receptor agonists have shown cardiovascular benefits and have been positioned as the first step in the treatment of DM in patients with HF or high cardiovascular risk. However, in the pivotal trials the majority of patients receives concomitant treatment with metformin. Randomized clinical trials have not yet been developed to assess the prognostic impact of metformin at the cardiovascular level. Our objective was to analyze whether patients with DM and acute HF who receive treatment with metformin at the time of discharge may have had a better prognosis at one year of follow-up. Methods Prospective cohort trial using the combined analysis of the 2 main Spanish HF registries: the Epidemiology of Acute Heart Failure in Emergency Departments registry –EAHFE– and the National Registry of Patients with Heart Failure –RICA–. Results 33% (1453) of a total of 4403 patients with DM type 2 received treatment with metformin. This group presented significantly lower mortality after one year of treatment (22 vs. 32%; Log Rank test, p<0.001). In the adjusted analysis of mortality, patients receiving treatment with metformin had lower mortality at one year of follow-up regardless of the rest of the variables (RR 0.814; 95% CI: 0.712–0.930; p<0.01). Conclusions Patients with DM type 2 and acute HF who received metformin had a better prognosis after one year of follow-up, so we believe that this drug should continue to be a fundamental pillar in the treatment of these patients (AU)


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Insuficiência Cardíaca/tratamento farmacológico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Metformina/uso terapêutico , Hipoglicemiantes/uso terapêutico , Resultado do Tratamento , Estudos Prospectivos , Estudos de Coortes , Doença Aguda , Prognóstico
8.
Ars pharm ; 64(2): 100-122, abr.-jun. 2023. ilus, tab, graf
Artigo em Inglês | IBECS | ID: ibc-217816

RESUMO

Introducción: El Síndrome del Ovario Poliquístico (SOP) es un trastorno hormonal que afecta al 5-10% de las mujeres que se encuentran en edad reproductiva. este metanálisis tiene como objetivo evaluar la eficacia de la metformina y la exenatida, respectivamente, y comparar la eficacia de ambos fármacos utilizando el Índice de Masa Corporal (IMC), el colesterol de lipoproteínas de baja densidad (LDL-C), el colesterol de lipoproteínas de alta densidad (HDL-C) y los niveles de testosterona. Método: En este estudio se consultaron Scopus, Science Direct, Oxford Journal, Wiley Online Library y Medline a través del motor de búsqueda PubMed. El análisis estadístico de los estudios incluidos se realizó mediante el software RevMan 5.4. Resultados: Hubo 6 estudios incluidos en el análisis del estudio. Hubo una reducción significativa en el IMC de las pacientes con SOP con exenatida frente a metformina (diferencia de medias = 0,51; intervalo de confianza (IC) del 95 % = 0,07; 0,96; I 2 = 52 %; p = 0,02). También hubo una reducción significativa en el nivel de testosterona de los pacientes con SOP con exenatida frente a metformina (diferencia de medias = 0,15; intervalo de confianza (IC) del 95 % = 0,07; 0,22;I 2 = 0 %; p = 0,0002). No hubo efecto sobre la media de LDL-C y de HDL-C cuando se comparó entre metformina y exenatida. Este muestra que la exenatida es eficaz para reducir el IMC y los niveles de testosterona en pacientes con SOP. Conclusiones: Hubo una reducción significativa en el IMC y los niveles de testosterona de los pacientes con SOP cuando se usó exenatida en comparación con metformina. Sin embargo, no hubo efecto sobre la media de los niveles de LDL-C y HDL-C de las pacientes con SOP. (AU)


Introduction: Polycystic Ovary Syndrome (PCOS) is a hormonal disorder that affects 5-10% of women who are their reproductive age. This meta-analysis aims to evaluate the efficacy of metformin and exenatide, respectively, and to compare the efficacy of both drugs using Body Mass Index (BMI), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and testosterone level. Method: Scopus, Science Direct, Oxford Journal, Wiley Online Library, and Medline (through the PubMed search engine) were used in this study. Statistical analysis of the included studies was done using the RevMan 5.4 software. Results: There were 6 studies included in the analysis of the study. There was a significant reduction in BMI of PCOS patients with exenatide versus metformin (mean difference = 0.51; 95% confidence interval (CI)= 0.07, 0.96, I 2= 52%; p=0.02). There was also a significant reduction in the testosterone level of PCOS patients with exenatide versus met-formin (mean difference = 0.15; 95% confidence interval (CI)= 0.07, 0.22, I 2= 0%; p=0.0002). There was no effect on the mean of LDL-C and of HDL-C when compared between metformin and exenatide This meta-analysis shows that exenatide is effective in reducing BMI and testosterone levels in PCOS patients. Conclusions: There were a significant reduction in BMI and testosterone levels of PCOS patients when exenatide was used as compared to metformin. However, there was no effect on the mean of the LDL-C and HDL-C levels of the PCOS patients. (AU)


Assuntos
Humanos , Feminino , Síndrome do Ovário Policístico/tratamento farmacológico , Metformina/uso terapêutico , Exenatida/uso terapêutico , Índice de Massa Corporal , LDL-Colesterol , HDL-Colesterol , Testosterona
10.
Farm. comunitarios (Internet) ; 15(1): 72-77, ene. 2023. tab
Artigo em Espanhol | IBECS | ID: ibc-215170

RESUMO

Varón, viudo, fumador de 20 cigarrillos/día, 75 años, que vive solo, acude a la farmacia para recoger medicación. Observamos un exceso de cajas de metformina en receta electrónica, ya que siempre dice “que tiene todavía en casa”. Es un paciente seleccionado por su hospital de referencia para ser incluido en el proyecto “Telémaco”, ya que utiliza medicación de dispensación hospitalaria. Prestamos atención farmacéutica con un enfoque multidisciplinar y multidimensional, según la metodología Capacidad-Motivación-Oportunidad, lo que nos permite trabajar en colaboración con el servicio de farmacia hospitalaria por unos objetivos comunes, tras la estratificación del paciente. El resultado final es el control de sus problemas de salud, trabajando de manera conjunta para conseguir el mismo objetivo, facilitando el soporte asistencial y aquellos recursos sociales que mejor se adaptan a las necesidades del paciente, para alcanzar el óptimo estado de bienestar y calidad de vida del paciente.Este modelo de atención farmacéutica supone un cambio en la forma de trabajar y registrar las intervenciones farmacéuticas, tal y cómo la conocíamos hasta ahora a nivel de las farmacias comunitarias y de los hospitales. Se presta una atención farmacéutica dual, ya que surge de la combinación de la atención presencial con la atención digital, gracias al soporte de las nuevas tecnologías para estar más cerca de los profesionales, acompañando a los pacientes, aumentando sus conocimientos y optimizando el tiempo de respuesta, en coordinación con su equipo asistencial.Supone una optimización de los recursos, dedicando más tiempo y esfuerzo a aquellos pacientes que más lo necesitan.Se trabaja por objetivos a partir de la entrevista con el paciente, generando intervenciones orientadas a las características específicas de cada paciente.Es un modelo de atención farmacéutica continuada... (AU)


Assuntos
Humanos , Masculino , Idoso , Serviços Comunitários de Farmácia , Serviço de Farmácia Hospitalar , Cooperação Técnica , Telemedicina , Metformina/administração & dosagem , Disponibilidade de Medicamentos Via Internet
11.
J. physiol. biochem ; 78(4): 869-883, nov. 2022.
Artigo em Inglês | IBECS | ID: ibc-216178

RESUMO

The main goal of this study was to investigate the molecular changes in pancreatic progenitor cells subject to high glucose, aspartame, and metformin in vitro. This scope of work glucose, aspartame, and metformin were exposed to pancreatic islet derived progenitor cells (PID-PCs) for 10 days. GLUT1’s role in beta-cell differentiation was examined by using GLUT1 inhibitor WZB117. Insulin+ cell ratio was measured by flow cytometry; the expression of beta-cell differentiation related genes was shown by RT-PCR; mitochondrial mass, mitochondrial ROS level, cytoplasmic Ca2+, glucose uptake, and metabolite analysis were made fluorometrically and spectrophotometrically; and proteins involved in related molecular pathways were determined by western blotting. Findings showed that glucose or aspartame exposed cells had similar metabolic and gene expression profile to control PID-PCs. Furthermore, relatively few insulin+ cells in aspartame treated cells were determined. Aspartame signal is transmitted through PLCβ2, CAMKK2 and LKB1 in PID-PCs. The most obvious finding of this study is that metformin significantly increased beta-cell differentiation. The mechanism involves suppression of the sweet taste signal’s molecules T1R3, PLCβ2, cytoplasmic Ca+2, and AKT in addition to the direct effect of metformin on mitochondria and AMPK, and the energy metabolism of PID-PCs is remodelled in the direction of oxidative phosphorylation. These findings are very important in terms of determining that metformin stimulates the mitochondrial remodeling and the differentiation of PID-PCs to beta-cells and thus it may contribute to the compensation step, which is the first stage of diabetes development. (AU)


Assuntos
Humanos , Células-Tronco/metabolismo , Metformina/farmacologia , Aspartame , Diferenciação Celular , Fosfolipase C beta , Insulina , Proteínas Proto-Oncogênicas c-akt/metabolismo
12.
Farm. comunitarios (Internet) ; 14(Supl 1): 1, junio 2022. tab
Artigo em Espanhol | IBECS | ID: ibc-209463

RESUMO

JUSTIFICACIÓN: varón, viudo, fumador, 75 años, polimedicado que acude a la farmacia para recoger su medicación. Vive solo, fumador de 20 cigarrillos al día. Al retirar la medicación, vemos que tiene un exceso de cajas de metformina en receta electrónica, ya que siempre dice “que tiene todavía en casa”. Es un paciente seleccionado para participar en el proyecto “Telémaco” (proyecto de AF que permite evaluar la experiencia del paciente con un modelo de AF telemática coordinada entre FC Y FC).OBJETIVOS: prestar una AF multidisciplinar y multidimensional, según la estratificación del paciente basada en el modelo CMO(1), utilizando una taxonomía común en el registro de las intervenciones farmacéuticas.MATERIAL Y MÉTODOS: el paciente tiene un nivel de estratificación 1, y el objetivo que se persigue con su farmacoterapia es aumentar un 80% la adherencia farmacológica. Utiliza metformina (1-0-1), dapaglifozina (0-0-1), glargina (0-0-12), Enlapril/HCTZ 20/12,5 (1-0-0), Bromuro tiotropio (0-0- 1), Nintedanib 150 mg (1-0-1), Aceite de pescado/ác.docosahexaenoico/ác.eicosapentaenoico (0-0-1), Simvastatina 20 mg (0-0-1), Ácido fólico (1-0-0).Me coordino con la farmacéutica hospitalaria para “preparar bandejas de medicación semanal” ya que nos solicitan que no extraigamos la medicación hospitalaria del blíster hasta su ingesta. En la primera visita programada por videollamada que se hace en la FC con el paciente y la FH, se registran 8 intervenciones farmacéuticas: Revisión y validación, Revisión y validación concomitante, Revisión de objetivos, Coordinación, Planificación, Seguridad, Seguimiento Especial y Adherencia. Se inicia la fase de estudio, según FORO AF-FC, observando que el paciente padece diarrea desde que inicia el tratamiento con Nintedanib 150 mg y le impide ser autónomo en desplazamientos. (AU)


Assuntos
Humanos , Masculino , Idoso , Farmácia , Assistência Farmacêutica , Pacientes , Metformina , Preparações Farmacêuticas
13.
Aten. prim. (Barc., Ed. impr.) ; 54(6): 102354, Jun 2022.
Artigo em Espanhol | IBECS | ID: ibc-205031

RESUMO

Objetivo: Revisar y discutir la evidencia actual del uso de la metformina como herramienta terapéutica en enfermedades cutáneas. Diseño. Artículo original. Investigación cualitativa. Revisión narrativa. Emplazamiento: Aragón y Murcia, España. Participantes: Médicos Internos Residentes de Dermatología Médico-Quirúrgica y Venereología y de Atención Primaria y Comunitaria. Métodos: Se ha realizado una revisión narrativa utilizando la base de datos bibliográfica PubMed con fecha de búsqueda el 27 de enero de 2022. Resultados: La metformina ha demostrado ser efectiva en el tratamiento de dermatosis inflamatorias tales como el acné, hidrosadenitis supurativa, psoriasis y dermatitis de contacto alérgica. También ha demostrado propiedades antitumorales frente al carcinoma basocelular, carcinoma espinocelular y melanoma. De forma adicional, se ha descrito efectos beneficiosos del tratamiento adyuvante con metformina en pacientes con carcinoma basocelular que reciben terapia fotodinámica. En pacientes con dermatosis relacionadas con endocrinopatías tales como el hirsutismo, la acantosis nigricans y los xantomas eruptivos, el tratamiento con metformina ha demostrado efectividad terapéutica. El tratamiento tópico con metformina ha demostrado ser eficaz en el tratamiento del melasma. Finalmente se ha propuesto como un fármaco con propiedades antienvejecimiento cutáneo y favorecedoras de la cicatrización. Para ninguna de las indicaciones previamente descritas se han objetivado efectos adversos graves. Conclusiones: La metformina es un tratamiento efectivo y seguro en el esquema terapéutico de dermatosis inflamatorias, neoplasias cutáneas, dermatosis relacionadas con endocrinopatías, melasma, envejecimiento cutáneo y cicatrización.(AU)


Objetive: To review and discuss the current evidence of the use of metformin as a therapeutic tool in frequent skin diseases. Design: Original article. Qualitative research. Narrative review. Location: Aragon and Murcia, Spain. Participants: Resident Physicians. Dermatology and Primary Health Care. Method: A narrative review has been carried out using the PubMed bibliographic database, being the search date the 27th of January of 2022. Results: Metformin has proven to be effective in the treatment of inflammatory skin diseases such as acne, hidradenitis suppurativa, psoriasis and allergic contact dermatitis. It has also shown antitumor properties regarding basal cell carcinoma, squamous cell carcinoma and melanoma. Additionally, beneficial effects of adjuvant treatment with metformin have been described in patients with basal cell carcinoma receiving photodynamic therapy. In patients with endocrinology-related dermatosis such as hirsutism, acanthosis nigricans and eruptive xanthomas, treatment with metformin has demonstrated therapeutic effectiveness. Topical treatment with metformin has also been useful in the treatment of melasma. Finally, it has been proposed as a drug with anti-aging and wound-healing promoting properties. Severe adverse effects have not been observed for any of the previously described indications, being this a well-tolerated treatment. Conclusions: Metformin is an effective and safe adjuvant in the therapeutic scheme of various inflammatory dermatoses, skin neoplasms, endocrinology-related dermatosis, melasma, skin aging and wound healing processes.(AU)


Assuntos
Humanos , Masculino , Feminino , Metformina , Dermatopatias , Dermatopatias/diagnóstico , Dermatopatias/etiologia , Dermatopatias/tratamento farmacológico , Dermatologia , Pele , Diabetes Mellitus Tipo 2/tratamento farmacológico , Atenção Primária à Saúde
14.
Pediatr. aten. prim ; 23(92): 426-432, oct.- dic. 2021.
Artigo em Espanhol | IBECS | ID: ibc-222907

RESUMO

Conclusiones de los autores del estudio: la metformina, asociada a intervenciones en el estilo de vida, puede tener un efecto favorable pequeño en el z-score del índice de masa corporal y en la resistencia a la insulina. Muestra un perfil de seguridad aceptable en niños y adolescentes con obesidad. La calidad de las pruebas disponibles es variable. Comentario de los revisores: el tratamiento farmacológico de la obesidad podría ayudar a conseguir metas a corto y medio plazo, pero se desconoce su efecto a largo plazo. La utilización de la metformina, además de su modesto efecto sobre el índice de masa corporal, presenta efectos secundarios gastrointestinales frecuentes que pueden reducir el cumplimiento. Se podría valorar su uso individualizado en casos concretos de obesidad, sobre todo si presentan repercusión metabólica (AU)


Authors’ conclusions: metformin associated with lifestyle interventions may have a small favorable effect on BMI z-score and insulin resistance. It shows an acceptable safety profile in children and adolescents with obesity. The quality of the available evidence is variable. Reviewers’ commentary: obesity drug therapy could help to achieve targets in the short and medium term, but the effect in the long term remains unknown. Metformin has a modest effect on BMI and produces frequent gastrointestinal adverse events that could reduce completion of treatments. Individual use of metformin could be proposed in specific obesity cases, especially if they present metabolic consequences (AU)


Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Metformina/uso terapêutico , Hipoglicemiantes/uso terapêutico , Obesidade/tratamento farmacológico , Ensaios Clínicos Controlados Aleatórios como Assunto , Obesidade Pediátrica/tratamento farmacológico , Prática Clínica Baseada em Evidências
15.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 48(3): [100636], Jul-Sep. 2021. tab
Artigo em Espanhol | IBECS | ID: ibc-219570

RESUMO

Antecedentes: La diabetes gestacional es una condición en la que una mujer sin diabetes previa desarrolla intolerancia a la glucosa en cualquier momento del embarazo y puede o no resolverse al término de la gestación. La metformina, del grupo de las biguanidas, se considera manejo alternativo de la diabetes gestacional, incluido en el listado de los medicamentos esenciales por la OMS. El objetivo del presente fue identificar la incidencia de complicaciones obstétricas y perinatales en mujeres con diabetes gestacional que son sometidas a tratamiento con metformina. Material y método: Estudio transversal, con análisis comparativo de los resultados perinatales del tratamiento de diabetes gestacional. Donde el grupo 1 corresponde a pacientes que realizaron únicamente dieta y ejercicio y el grupo 2 a pacientes a las que además se les pautó metformina. Resultados: Fueron incluidas un total de 104 pacientes, edad materna promedio de 35 años, con ganancia ponderal de 10kg, media de peso al nacimiento de 3082 gramos. En el grupo 1 45,2%(n=47) con mayor ganancia ponderal materna y aumento en la incidencia de enfermedades hipertensivas del embarazo (9 casos de hipertensión gestacional y una preeclampsia con criterios de severidad); en contraste con el grupo 2, 54,8%(n=57) donde se reporta menor edad gestacional al nacimiento y un nacimiento pretérmino. Conclusiones: Con los resultados observados se demuestra que el uso de metformina para lograr el control metabólico de las pacientes con diabetes gestacional es una opción viable.(AU)


Background: Gestational diabetes is a condition in which a woman without previous diabetes develops glucose intolerance at any time during pregnancy, and may or may not be resolved at the end of gestation. Metformin, from the biguanide group, is considered as an alternative for the management of gestational diabetes, and is listed in essential drugs by the WHO. The objective of this study was to identify the incidence of obstetric and perinatal complications in women with gestational diabetes undergoing treatment with metformin. Material and method: A cross-sectional study was carried out, with comparative analysis of the perinatal outcomes of Gestational Diabetes treatment with lifestyle modification with and without metformin. Group 1 corresponded to patients who only performed exercise and diet, and Group 2 to patients who were also prescribed metformin. Results: A total of 104 patients were included. The mean maternal age was 35.05 years, with weight gain of 10kg. The mean birth weight was 3082 grams. Group 1, 45.2% (n=47) with greater maternal weight gain and increased incidence of hypertensive diseases of pregnancy (9 cases of gestational hypertension and 1 pre-eclampsia with severity criteria); in contrast to group 2, 54.8% (n=57) where 1 preterm birth and a lower gestational age at birth was reported. Conclusions: With the results observed, it is shown that the use of metformin to achieve metabolic control of patients with gestational diabetes is a viable option.(AU)


Assuntos
Humanos , Feminino , Gravidez , Diabetes Gestacional , Metformina , Perinatologia , Complicações na Gravidez , Ginecologia , Estudos Transversais
16.
Clin. transl. oncol. (Print) ; 23(2): 275-282, feb. 2021.
Artigo em Inglês | IBECS | ID: ibc-220611

RESUMO

Objective Recently, numerous studies have yielded inconsistent results regarding the effect of metformin on esophageal cancer risk in type 2 diabetes mellitus patients. The purpose of this study is to systematically assess this effect using meta-analysis. Methods We searched clinical studies on metformin and esophageal cancer risk in PubMed, Embase, and the Cochrane Library. After literature screening, a series of meta-analyses were conducted using RevMan 5.3 software. The pooled hazard ratio (HR) and the corresponding 95% confidence interval (CI) were used as the effect size. Results Five eligible studies (four cohort studies and one case–control study) were included for our meta-analysis using a random-effect model. The analysis showed that metformin could not reduce esophageal cancer risk in type 2 diabetes mellitus patients (HR 0.88, 95% CI 0.60–1.28, P > 0.05). Subgroup analyses by geographic location showed that metformin significantly reduced esophageal cancer risk in Asian patients with type 2 diabetes mellitus (HR 0.59, 95% CI 0.39–0.91, P = 0.02), without heterogeneity between studies (P = 0.80 and I2 = 0%). Conclusions Overall, our systematic review and meta-analysis demonstrate that metformin does not reduce esophageal cancer risk in type 2 diabetes mellitus patients. However, a significant reduction in esophageal cancer risk in Asian populations remains to be clarified (AU)


Assuntos
Humanos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/etnologia , Neoplasias Esofágicas/etnologia , Neoplasias Esofágicas/prevenção & controle , Hipoglicemiantes , Metformina/administração & dosagem , Estudos Retrospectivos , Estudos de Casos e Controles , Intervalos de Confiança , Estudos Prospectivos
17.
Rev. clín. esp. (Ed. impr.) ; 221(2): 101-108, feb. 2021. ilus
Artigo em Espanhol | IBECS | ID: ibc-225687

RESUMO

La diabetes tipo 2 constituye un problema de salud de elevada prevalencia y morbimortalidad. El tratamiento médico tiene una complejidad creciente en relación con las diversas situaciones clínicas del paciente. Este artículo recoge un documento de consenso de las recomendaciones para el tratamiento médico de la diabetes tipo 2 del Grupo de Diabetes, Obesidad y Nutrición de la Sociedad Española de Medicina Interna. El objetivo principal de este artículo es facilitar la toma de decisiones terapéuticas para mejorar la atención de los pacientes con diabetes. El documento prioriza los tratamientos con beneficios cardiovasculares, especialmente la insuficiencia cardíaca, y renales (AU)


Type 2 diabetes mellitus is a major health problem with high prevalence, morbidity and mortality, and its medical treatment is growing in complexity due to patients’ diverse clinical conditions. This article presents a consensus document by the Diabetes, Obesity and Nutrition Group of the Spanish Society of Internal Medicine, with recommendations for the medical treatment of type 2 diabetes mellitus. The main objective of this article is to facilitate the therapeutic decision-making process to improve the care of patients with diabetes. The document prioritises treatments with cardiovascular benefits, especially those that benefit patients with heart and renal failure (AU)


Assuntos
Humanos , Diabetes Mellitus Tipo 2/terapia , Metformina/uso terapêutico , Hipoglicemiantes/uso terapêutico , Doenças Cardiovasculares , Sociedades Médicas , Fatores de Risco , Espanha
19.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) ; 46(6): 415-424, sept. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-200415

RESUMO

La prevalencia de la diabetes tipo 2 diagnosticada en la infancia/juventud está aumentando y se caracteriza por una disminución acelerada de la función de las células beta pancreáticas y resistencia a la insulina. Los principales factores de riesgo para su desarrollo son obesidad e inactividad física. Los criterios diagnósticos son similares a los utilizados en adultos, aunque la HbA1c como método diagnóstico está cuestionada. Las complicaciones son más agresivas que en la diabetes tipo 2 del adulto, siendo la nefropatía la más frecuente. Las complicaciones macrovasculares aparecen precozmente y su mortalidad es elevada. La alimentación saludable y el ejercicio físico continuado son los pilares básicos del tratamiento, y la metformina, insulina y liraglutide (aprobado por la FDA en Estados Unidos) las opciones farmacológicas con indicación en esta población. Es importante establecer modelos de transición de la atención pediátrica a la atención adulta para garantizar la continuidad asistencial y evitar pérdidas en el seguimiento de estos pacientes


The prevalence of type 2 diabetes (DM2) diagnosed in childhood and adolescence is currently increasing, and is characterised by a rapidly progressive decline in beta-cells and insulin resistance. Physical inactivity and obesity are the main risk factors for its development. Diagnostic criteria are similar to those used in adults, although HbA1c as a diagnostic method is questioned. Diabetes-related complications are more aggressive than in adults. Diabetic nephropathy is the most frequent complication in the young population and macrovascular complications appear early, leading to high mortality rates. Healthy lifestyles are the basis of the treatment, and metformin, insulin and liraglutide (approved by FDA for its use in the United States) are the pharmacological options indicated in this population. It is important to establish models of health care transition from paediatric to adult care to ensure continuity of care and avoid patient disengagements


Assuntos
Humanos , Diabetes Mellitus Tipo 2/terapia , Obesidade/epidemiologia , Comportamento Sedentário , Nefropatias Diabéticas/epidemiologia , Síndrome Metabólica/epidemiologia , Fatores de Risco , Diabetes Mellitus Tipo 2/epidemiologia , Complicações do Diabetes/epidemiologia , Hemoglobinas Glicadas/análise , Atenção Primária à Saúde/tendências , Estilo de Vida Saudável/classificação , Metformina/uso terapêutico , Adolescente , Adulto Jovem/estatística & dados numéricos
20.
Rev. clín. esp. (Ed. impr.) ; 220(5): 305-314, jun.-jul. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-194971

RESUMO

La diabetes mellitus tipo2 (DM2) es una enfermedad progresiva cuyos cambios fisiopatológicos se producen varios años antes de su detección. Un abordaje basado en el desarrollo fisiopatológico de la DM2 y sus complicaciones enfatiza la importancia de una intervención temprana e intensiva, no solo para prevenir la disfunción de las células beta, sino también para actuar sobre los posibles factores de riesgo cardiovascular asociados antes de alcanzar los umbrales glucémicos fijados actualmente para el diagnóstico de la DM2. En el terreno de la DM2 de reciente diagnóstico, el estudio VERIFY ha mostrado que el tratamiento precoz combinado con metformina-vildagliptina proporciona mejoras relevantes en el control glucémico a largo plazo y puede influir positivamente en la evolución de la enfermedad


Type 2 diabetes mellitus (DM2) is a progressive disease whose pathophysiological changes occur several years before its detection. An approach based on the pathophysiological development of DM2 and its complications emphasises the importance of early and intensive intervention, not only to prevent beta-cell dysfunction but also to act on the potential associated cardiovascular risk factors before reaching the blood glucose thresholds currently set for diagnosing DM2. In the field of recently diagnosed DM2, the VERIFY study has shown that early treatment combined with metformin-vildagliptin provides relevant improvements in long-term glycaemic control and can positively affect the disease's progression


Assuntos
Humanos , Feminino , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Insulina/uso terapêutico , Inibidores do Transportador 2 de Sódio-Glicose/uso terapêutico , Metformina/uso terapêutico , Hipoglicemiantes/uso terapêutico , Terapia Combinada , Fatores de Risco , Índice Glicêmico , Diagnóstico Precoce
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