27
91.15
3.38
77

Recent PublicationsView all

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Canagliflozin is a sodium glucose co-transporter 2 inhibitor developed for the treatment of type 2 diabetes mellitus (T2DM). This randomised, double-blind, placebo-controlled, Phase 3 study evaluated the efficacy and safety of canagliflozin as an add-on to metformin plus sulphonylurea in patients with T2DM. Patients (N = 469) received canagliflozin 100 or 300 mg or placebo once daily during a 26-week core period and a 26-week extension. Prespecified primary end-point was change in HbA1c at 26 weeks. Secondary end-points included change in HbA1c at week 52 as well as proportion of patients achieving HbA1c < 7.0%, change in fasting plasma glucose (FPG) and systolic blood pressure, and per cent change in body weight, high-density lipoprotein cholesterol, and triglycerides (weeks 26 and 52). HbA1c was significantly reduced with canagliflozin 100 and 300 mg vs. placebo at week 26 (-0.85%, -1.06%, and -0.13%; p < 0.001); these reductions were maintained at week 52 (-0.74%, -0.96%, and 0.01%). Both canagliflozin doses reduced FPG and body weight vs. placebo at week 26 (p < 0.001) and week 52. Overall adverse event (AE) rates were similar across groups over 52 weeks, with higher rates of genital mycotic infections and osmotic diuresis-related AEs seen with canagliflozin vs. placebo; these led to few discontinuations. Increased incidence of documented, but not severe, hypoglycaemia episodes was seen with canagliflozin vs. placebo. Canagliflozin improved glycaemic control, reduced body weight, and was generally well tolerated in T2DM patients on metformin plus sulphonylurea over 52 weeks.
    Full-text · Article · Oct 2013 · International Journal of Clinical Practice
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVE Fasting is not routinely recommended for renal function tests, despite the known effects of cooked meat on creatinine. We therefore studied variation in creatinine and estimate glomerular filtration rate (eGFR) following a standardised cooked meat meal in 80 subjects: healthy volunteers, diabetes patients with chronic kidney disease (CKD) stages 1 & 2, 3A, 3B and 4 (n=16/group).RESEARCH DESIGN AND METHODS The interventions were a standardised cooked meat and a non-meat meal, each providing approximately 54g protein, together with 250 mls of water, on separate days. Fasting and post-prandial blood samples at 1, 2, and 4 hours were drawn for creatinine measurement using kinetic alkaline picrate assay on an Olympus AU640 analyser. The modified 4-variable MDRD equation traceable to isotope dilution mass spectrometry creatinine was used to calculate eGFR.RESULTSConsumption of a standardised cooked meat meal significantly increased serum creatinine and resulted in significant fall in eGFR in all stages of CKD studied; 6 of 16 CKD 3a patients were misclassified as CKD 3b. This effect of cooked meat on serum creatinine disappears after 12 hours of fasting in all study participants.CONCLUSIONS Creatine in meat is converted to creatinine on cooking which is absorbed causing significant increases in serum creatinine. This could impact management as threshold for commencing and withdrawing certain medications and expensive investigations is defined by eGFR. eGFR calculated using fasting serum creatinine would be a better reflection of kidney function in these patients.
    Full-text · Article · Sep 2013 · Diabetes care
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The relationships between night eating, poor sleep quality, and obesity-related comorbidity in a severely obese UK clinic population is unknown. We used validated tools to identify prevalence and to explore this relationship. Consecutive consenting clinic attendees completed the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Score (ESS), and Night Eating Questionnaire (NEQ) to identify sleep quality, excessive daytime sleepiness (EDS) (a surrogate marker for suspected obstructive sleep apnea [OSA]), and night eating, respectively. Proportions of individuals above and below tool cutoff points were compared. Pearson product moment correlation coefficients examined relationships between total scores. Reported prevalence from 144 participants (mean body mass index [BMI] 46.9 [9.5]kg/m(2); age 44.6 [12.1]years; 68% women) had poor sleep quality (73.0%), suspected OSA (30.8%), and night-eating behavior (2.8%). The strongest correlation between PSQI and NEQ scores (r=0.54; P<.001) was undiminished after controlling for EDS. Although significantly correlated, PSQI and ESS scores (r=0.31; P<.001) reduced after controlling for night eating (r=0.21; P=.02). Correlation between NEQ and ESS scores (r=0.26; P=.002) was smaller and nonsignificant after controlling for sleep quality (r=0.12; P=.18). Poor sleep quality is common in severe obesity, though night eating is rare. The association between poor sleep quality and night eating is not influenced by the presence of EDS.
    Full-text · Article · Aug 2013 · Sleep Medicine
Information provided on this web page is aggregated encyclopedic and bibliographical information relating to the named institution. Information provided is not approved by the institution itself. The institution’s logo (and/or other graphical identification, such as a coat of arms) is used only to identify the institution in a nominal way. Under certain jurisdictions it may be property of the institution.