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  1. Article ; Online: Real-world effectiveness and safety of insulin glargine 300 U/ml in insulin-naïve people with type 2 diabetes in the Latin America region: A subgroup analysis of the ATOS.

    Vargas-Uricoechea, Hernando / Burga Nuñez, José Luis / Rosas Guzmán, Juan / Silva-Gomez, Liliana / Beltran, Sergio / Sañudo-Maury, María Elena

    Diabetes, obesity & metabolism

    2022  Volume 25, Issue 1, Page(s) 238–247

    Abstract: Aim: To evaluate the real-world effectiveness and safety of insulin glargine 300 U/ml (Gla-300) in achieving glycaemic goals in insulin-naïve people with type 2 diabetes (T2D) in Mexico, Colombia and Peru (Latin America region) in the A Toujeo ... ...

    Abstract Aim: To evaluate the real-world effectiveness and safety of insulin glargine 300 U/ml (Gla-300) in achieving glycaemic goals in insulin-naïve people with type 2 diabetes (T2D) in Mexico, Colombia and Peru (Latin America region) in the A Toujeo Observational Study (ATOS).
    Materials and methods: ATOS was a multicentre, prospective, 12-month observational study, which included 4422 insulin-naïve adults (age ≥ 18 years) with T2D uncontrolled (HbA1c > 7% and ≤11%) on at least one oral antidiabetic drug (OAD) who initiated Gla-300 treatment as per routine practice. The primary endpoint was the percentage of participants achieving their predefined individualized HbA1c goal at month 6. Key secondary endpoints included change from baseline in HbA1c, fasting plasma glucose (FPG), fasting self-monitored blood glucose (SMBG), body weight and incidence of hypoglycaemia.
    Results: In this subgroup analysis, a total of 314 participants with T2D received Gla-300. At baseline, mean ± SD age was 56.0 ± 11.6 years, duration of diabetes was 9.7 ± 6.6 years and 65.9% of participants were on at least two OADs. The individualized HbA1c target was achieved by 25.8% of participants (95% confidence interval [CI]: 20.3-31.9) at month 6 and by 35.3% (95% CI: 28.5-42.5) at month 12. Gla-300 treatment improved glycaemic control with meaningful reductions in mean HbA1c, FPG and fasting SMBG. The incidence of hypoglycaemia reported was low and body weight remained stable.
    Conclusions: In a real-world setting in the Latin America region, the initiation of Gla-300 in people with T2D uncontrolled on OADs resulted in improved glycaemic control with a low incidence of hypoglycaemia and no change in body weight.
    MeSH term(s) Humans ; Adolescent ; Adult ; Middle Aged ; Aged ; Insulin Glargine/adverse effects ; Insulin ; Diabetes Mellitus, Type 2/drug therapy ; Prospective Studies ; Body Weight
    Chemical Substances Insulin Glargine (2ZM8CX04RZ) ; Insulin
    Language English
    Publishing date 2022-10-09
    Publishing country England
    Document type Observational Study ; Journal Article
    ZDB-ID 1454944-x
    ISSN 1463-1326 ; 1462-8902
    ISSN (online) 1463-1326
    ISSN 1462-8902
    DOI 10.1111/dom.14868
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  2. Article ; Online: SGLT2 Inhibitors in Diabetes Mellitus Treatment.

    Rosas-Guzman, Juan / Rosas-Saucedo, Juan / Romero-Garcia, Alma R J

    Reviews on recent clinical trials

    2017  Volume 12, Issue 1, Page(s) 8–18

    Abstract: Type 2 Diabetes Mellitus (T2DM) is a chronic illness with high prevalence in Mexico, Latin- America, and the world and is associated to high morbidity, disability, and mortality rate, especially in developing countries. T2DM physiopathology is very ... ...

    Abstract Type 2 Diabetes Mellitus (T2DM) is a chronic illness with high prevalence in Mexico, Latin- America, and the world and is associated to high morbidity, disability, and mortality rate, especially in developing countries. T2DM physiopathology is very complex; insulin resistance in the muscle, liver, and adipose tissue, a reduction in the production of incretins (mainly GLP-1) in the intestine, increased glucagon synthesis, an insufficient response of insulin generation, and increased glucose reabsorption in the kidney lead all together to an hyperglycemic state, which has been closely associated with the development of micro and macrovascular complications. Sodium Glucose Linked Transporter 2 inhibitors (SGLT2i) are the most recent therapeutic class available for treating T2DM. SGLT2i central effect is a glycosuric action, and they can reverse the deleterious effect of tubular reabsorption of glucose in the diabetic patient resulting in greater hyperglycemia. Because their mechanism of action is completely different to current drugs, they can be considered as monotherapy or in combination with any other oral or parenteral medication, including different types of insulin or its analogues. This therapeutic synergy accomplishes a greater percentage of patients achieving glycemic control goals.
    Language English
    Publishing date 2017
    Publishing country United Arab Emirates
    Document type Journal Article
    ZDB-ID 2251879-4
    ISSN 1876-1038 ; 1574-8871
    ISSN (online) 1876-1038
    ISSN 1574-8871
    DOI 10.2174/1574887111666160829145810
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Documento de consenso sobre el uso de iSGLT2 en pacientes con enfermedad renal crónica y diabetes.

    Correa-Rotter, Ricardo / Rosas-Guzmán, Juan / Méndez-Durán, Antonio / Sebastián-Díaz, Mario A / Díaz-Avendaño, Odette Del C / Mehta-Pravin, Roopa / Alcocer-Gamba, Marco A

    Gaceta medica de Mexico

    2021  Volume 158, Issue M2, Page(s) M1–M12

    Abstract: La enfermedad renal crónica (ERC) del paciente diabético es frecuentemente una consecuencia directa de la diabetes mellitus (DM) de larga evolución y se la conoce como nefropatía diabética. En México cerca del 50% de los pacientes en terapia sustitutiva ... ...

    Title translation Consesus document in the use of SGLT inhibitors in patients with diabetes and chronic kidney disease.
    Abstract La enfermedad renal crónica (ERC) del paciente diabético es frecuentemente una consecuencia directa de la diabetes mellitus (DM) de larga evolución y se la conoce como nefropatía diabética. En México cerca del 50% de los pacientes en terapia sustitutiva de la función renal tienen ERC por DM, y este porcentaje podría aumentar en los próximos años. Nuevas opciones terapéuticas, combinadas con cambios en el estilo de vida, han mejorado el control de la glucemia y pueden contribuir sustancialmente a retrasar la aparición o la progresión a estadios avanzados de la ERC. Las sociedades científicas internacionales han elaborado guías clínicas para el diagnóstico y manejo de la nefropatía diabética, sin embargo, en algunos puntos estas recomendaciones no se adaptan a la realidad mexicana. Se presentan las conclusiones de un consenso realizado por especialistas mexicanos sobre diabetes y ERC, con especial énfasis en el uso de los inhibidores del cotransportador de sodio-glucosa.
    Chronic kidney disease (CKD) in the diabetic patient is mainly a consequence of long-term diabetes mellitus itself. In Mexico approximately 50% of patients on dialysis are diabetics and this will could increase in the coming years. New therapeutic options available, combined with lifestyle changes, have improved glycemic control and may contribute to delay the onset as well as the progression of CKD. International scientific societies have developed clinical guidelines for the diagnosis and management of CKD in diabetics, although in some points, these recommendations are not adapted to the Mexican reality. We hereby present the conclusions of the consensus reached by Mexican specialists on diabetic nephropathy.
    MeSH term(s) Diabetes Mellitus/epidemiology ; Humans ; Mexico/epidemiology ; Renal Dialysis ; Renal Insufficiency, Chronic/epidemiology ; Retrospective Studies
    Language English
    Publishing date 2021-12-30
    Publishing country Mexico
    Document type Journal Article
    ZDB-ID 425456-9
    ISSN 0016-3813
    ISSN 0016-3813
    DOI 10.24875/GMM.M21000595
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Long-term changes in cardiovascular risk markers during administration of exenatide twice daily or glimepiride: results from the European exenatide study.

    Simó, Rafael / Guerci, Bruno / Schernthaner, Guntram / Gallwitz, Baptist / Rosas-Guzmàn, Juan / Dotta, Francesco / Festa, Andreas / Zhou, Ming / Kiljański, Jacek

    Cardiovascular diabetology

    2015  Volume 14, Page(s) 116

    Abstract: Objective: The risk of cardiovascular morbidity and mortality is significantly increased in patients with diabetes; thus, it is important to determine whether glucose-lowering therapy affects this risk over time. Changes in cardiovascular risk markers ... ...

    Abstract Objective: The risk of cardiovascular morbidity and mortality is significantly increased in patients with diabetes; thus, it is important to determine whether glucose-lowering therapy affects this risk over time. Changes in cardiovascular risk markers were examined in patients with type 2 diabetes treated with exenatide twice daily (a glucagon-like peptide-1 receptor agonist) or glimepiride (a sulfonylurea) added to metformin in the EURopean EXenAtide (EUREXA) study.
    Research design and methods: Patients with type 2 diabetes failing metformin were randomized to add-on exenatide twice daily (n = 515) or glimepiride (n = 514) until treatment failure defined by hemoglobin A1C. Anthropomorphic measures, blood pressure (BP), heart rate, lipids, and high-sensitivity C-reactive protein (hsCRP) over time were evaluated.
    Results: Over 36 months, twice-daily exenatide was associated with improved body weight (-3.9 kg), waist circumference (-3.6 cm), systolic/diastolic BP (-2.5/-2.6 mmHg), high-density lipoprotein (HDL)-cholesterol (0.05 mmol/L), triglycerides (-0.2 mmol/L), and hsCRP (-1.7 mg/L). Heart rate did not increase (-0.3 beats/minute), and low-density lipoprotein-cholesterol (0.2 mmol/L) and total cholesterol (0.1 mmol/L) increased slightly. Between-group differences were significantly in favor of exenatide for body weight (P < 0.0001), waist circumference (P < 0.001), systolic BP (P < 0.001), diastolic BP (P = 0.023), HDL-cholesterol (P = 0.001), and hsCRP (P = 0.004). Fewer patients randomized to exenatide twice daily versus glimepiride required the addition of at least one antihypertensive (20.4 vs 26.4%; P = 0.026) or lipid-lowering medication (8.4 vs 12.8%; P = 0.025).
    Conclusions: Add-on exenatide twice daily was associated with significant, sustained improvement in several cardiovascular risk markers in patients with type 2 diabetes versus glimepiride.
    Clinical trial registration: NCT00359762, http://www.ClinicalTrials.gov.
    MeSH term(s) Aged ; Biomarkers/blood ; Blood Glucose/drug effects ; Blood Glucose/metabolism ; Blood Pressure/drug effects ; C-Reactive Protein/metabolism ; Cardiovascular Diseases/blood ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/etiology ; Cardiovascular Diseases/physiopathology ; Cardiovascular Diseases/prevention & control ; Diabetes Mellitus, Type 2/blood ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/diagnosis ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/physiopathology ; Drug Administration Schedule ; Drug Therapy, Combination ; Europe ; Female ; Glycated Hemoglobin A/metabolism ; Heart Rate/drug effects ; Humans ; Hypoglycemic Agents/administration & dosage ; Hypoglycemic Agents/adverse effects ; Incretins/administration & dosage ; Incretins/adverse effects ; Lipids/blood ; Male ; Metformin/administration & dosage ; Middle Aged ; Peptides/administration & dosage ; Peptides/adverse effects ; Risk Factors ; Sulfonylurea Compounds/administration & dosage ; Sulfonylurea Compounds/adverse effects ; Time Factors ; Treatment Outcome ; Venoms/administration & dosage ; Venoms/adverse effects
    Chemical Substances Biomarkers ; Blood Glucose ; Glycated Hemoglobin A ; Hypoglycemic Agents ; Incretins ; Lipids ; Peptides ; Sulfonylurea Compounds ; Venoms ; hemoglobin A1c protein, human ; glimepiride (6KY687524K) ; C-Reactive Protein (9007-41-4) ; Metformin (9100L32L2N) ; exenatide (9P1872D4OL)
    Language English
    Publishing date 2015-09-04
    Publishing country England
    Document type Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ISSN 1475-2840
    ISSN (online) 1475-2840
    DOI 10.1186/s12933-015-0279-z
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  5. Book ; Article ; Online: Control of type 2 diabetes mellitus among general practitioners in private practice in nine countries of Latin America

    Lopez Stewart, Gloria / Tambascia, Marcos / Rosas Guzmán, Juan / Etchegoyen, Federico / Ortega Carrión, Jorge / Artemenko, Sofia

    2015  

    Keywords Diabetes Mellitus ; Type 2 ; Diabetes Complications ; Health Services Accessibility ; Patient compliance ; Latin America ; Diabetes Mellitus Tipo 2 ; Complicaciones de la Diabetes ; Accesibilidad a los Servicios de Salud ; Coperación del paciente ; América Latina ; Medicina de Família e Comunidade ; Condutas na Prática dos Médicos ; Prática Privada ; Glicemia ; Comorbidade ; Estudos Transversais ; Dieta para Diabéticos ; Terapia por Exercício ; Hemoglobina A Glicosilada ; Hipoglicemiantes ; Estilo de Vida ; Cooperação do Paciente
    Publishing date 2015-08-25T14:52:04Z
    Document type Book ; Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article: Control of type 2 diabetes mellitus among general practitioners in private practice in nine countries of Latin America.

    Lopez Stewart, Gloria / Tambascia, Marcos / Rosas Guzmán, Juan / Etchegoyen, Federico / Ortega Carrión, Jorge / Artemenko, Sofia

    Revista panamericana de salud publica = Pan American journal of public health

    2007  Volume 22, Issue 1, Page(s) 12–20

    Abstract: Objectives: To better understand how diabetes care and control are being administered by general practitioners/nonspecialists in private practice in nine countries of Latin America, and to identify the most significant patient- and physician-related ... ...

    Abstract Objectives: To better understand how diabetes care and control are being administered by general practitioners/nonspecialists in private practice in nine countries of Latin America, and to identify the most significant patient- and physician-related barriers to care.
    Methods: A multicenter, cross-sectional, epidemiological survey was conducted in nine countries in Latin America: Argentina, Brazil, Chile, Costa Rica, Ecuador, Guatemala, Mexico, Peru, and Venezuela. General practitioners in private practice were asked to provide care and control data for patients 18 to 75 years of age with type 2 diabetes mellitus (T2DM), including demographics, medical and medication history, laboratory exams, and information on the challenges of patient management.
    Results: Of the 3 592 patient questionnaires returned by 377 physicians, 60% of the patients had a family history of diabetes, 58% followed a poor diet, 71% were sedentary, and 79% were obese or overweight. Poor glycemic control (fasting blood glucose >or= 110 mg/dL) was observed in 78% of patients. The number of patients with HbA1c < 7.0% was 43.2%. Glycemic control decreased significantly with increased duration of T2DM. Comorbid conditions associated with T2DM were observed in 86% of patients; insulin use and comorbid conditions, especially those associated with microvascular complications, increased significantly disease duration. Ensuring compliance with recommended diet and exercise plans was the most-cited patient management challenge.
    Conclusions: Blood glucose levels are undercontrolled in T2DM patients in the private health care system in Latin America, particularly among those who have had the disease the longest (>15 years). Considering the differences between private and public health care in Latin America, especially regarding the quality of care and access to medication, further studies are called for in the public setting. Overall, a more efficient and intensive program of T2DM control is required, including effective patient education programs, adjusted to the realities of Latin America.
    MeSH term(s) Adolescent ; Adult ; Aged ; Blood Glucose/analysis ; Comorbidity ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/blood ; Diabetes Mellitus, Type 2/epidemiology ; Diabetes Mellitus, Type 2/therapy ; Diet, Diabetic ; Exercise Therapy ; Family Practice/statistics & numerical data ; Female ; Glycated Hemoglobin A/analysis ; Humans ; Hypoglycemic Agents/therapeutic use ; Latin America/epidemiology ; Life Style ; Male ; Middle Aged ; Patient Compliance ; Practice Patterns, Physicians'/statistics & numerical data ; Private Practice/statistics & numerical data
    Chemical Substances Blood Glucose ; Glycated Hemoglobin A ; Hypoglycemic Agents
    Language English
    Publishing date 2007-10-03
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 1376934-0
    ISSN 1680-5348 ; 1020-4989
    ISSN (online) 1680-5348
    ISSN 1020-4989
    DOI 10.1590/s1020-49892007000600002
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    Zs.A 4694: Show issues Location:
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