Real-world GLP-1 RA therapy in type 2 diabetes: A long-term effectiveness observational study.

AIMS: To evaluate in a real-world setting the effectiveness and tolerability of available GLP-1 RA drugs in patients with type 2 diabetes after a prolonged follow-up. MATERIALS AND METHODS: Observational, retrospective, single-centre study in patients starting GLP-1 RA therapy. Change in HbA1c, fasting plasma glucose (FPG) and body mass index (BMI) along with gastrointestinal (GI) adverse events and withdrawal from GLP-1 RA therapy were evaluated. Lack of efficacy of GLP-1 RA therapy according to prespecified goals was also measured. RESULTS: A total of 735 patients were included, mean age 59.7 years, duration of diabetes 9.01 years, HbA1c 8.18% and BMI 38.56 kg/m2. Average follow-up was 18.97 months (range 4.2-39.09). All HbA1c (0.93%; P < 0.01), FPG (24 mg/dL; P < 0.01) and BMI (1.55 kg/m2; P < 0.05) were significantly reduced from baseline and maintained throughout follow-up, regardless of prescribed GLP-1 RA. GI adverse events were present in 13.81% of patients at first follow-up visit, 37.07% of patients discontinued GLP-1 RA treatment, and 38.63% did not meet efficacy goals. CONCLUSIONS: In a real-world setting, GLP-1 RA therapy is largely prescribed in severely obese patients with a long-standing and poorly controlled diabetes. All prescribed GLP-1 RAs significantly decreased HbA1c, FPG and BMI. GI adverse events affected a low proportion of patients. Inversely, a high proportion of patients did not meet efficacy goals and/or discontinued GLP-1 RA treatment. Baseline characteristics of patients and lack of adherence may represent important issues underlying differences in effectiveness in real-world studies versus randomized trials.

Síndrome hypoparathyroidism-deafness-renal dysplasia: descripción de un caso / The hypoparathyroidism-deafness-renal dysplasia syndrome: A case report

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Photoinduced Electron Transfer in Pentaammineruthenium(II) Complexes of 1-(4-Cyanophenyl)imidazole.

A new bridging ligand, 1-(4-cyanophenyl)imidazole (CPI) has been prepared, as well as its N-methylated derivative 1-methyl-3-(4-cyanophenyl)imidazolium iodide (CPI-Me(+)I(-)). The mononuclear and binuclear complexes [(NH(3))(5)Ru-CPI-Me](3+) and [(NH(3))(5)Ru-CPI-Ru(NH(3))(5)](4+) have been obtained. Free CPI is planar, according to theoretical calculations (MMX and MNDO), and its luminescence properties suggest the occurence of a twisted internal charge transfer (TICT) state. The comparison of the two ruthenium complexes reveals the spectral and electrochemical features of coordination by the cyanophenyl or by the imidazole groups. Controlled oxidation of the binuclear complex [(NH(3))(5)Ru-CPI-Ru(NH(3))(5)](4+) yields the mixed valence species [(NH(3))(5)Ru-CPI-Ru(NH(3))(5)](5+) in which the ruthenium coordinated to the cyanophenyl group is ruthenium(II) while the ruthenium linked to imidazole is ruthenium(III). An intervalence band is observed at 640 nm (epsilon = 188), from which the effective metal-metal coupling through the bridging ligand is determined as 0.032 eV. This value is satisfactorily reproduced by a theoretical calculation using the effective Hamiltonian theory. Finally the binuclear complex exhibits a weak luminescence when excited either on the ligand band near 260 nm or on the metal-to-ligand charge transfer band near 410 nm. The CPI ligand is the first example of a TICT-forming species with appreciable coupling between metallic sites and can be considered as a first step toward a molecular switch.