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Objective: To measure changes in lipid and glucose parameters after initiating statin therapy. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Pathology and Medicine, Naval Hospital, Islamabad Pakistan, from Nov 2018 to Oct 2020. Methodology: Thirty-nine male individuals participated in the study after a detailed explanation and consenting procedure. At the outset of the study, baseline testing of fasting plasma glucose and lipid parameters was done. Participants were then started with 10 mg of Atorvastatin/day for six weeks, with visits every two weeks for testing for lipids and glucose. Results: The mean age of participants was 42.47+11.65 years.%Δ (change) in mean (X) from baseline to result of last reading at six weeks for various evaluated parameters were as:%ΔX Fasting plasma glucose = +91.45,%ΔX total cholesterol=-139.63,%ΔX fasting triglycerides=-1.04%ΔX LDLc=-150.49 and%ΔXHDLc=-105.25. For HDLC, 14/31 showed a rise in levels compared to 17/31, who demonstrated a downward trend after starting statin therapy, indicating a differential response among subjects taking statin therapy. Conclusion: Mean glucose levels increased from baseline to six weeks, whereas the mean of all lipid indices (including HDLc) declined in subjects on statin therapy. [ABSTRACT FROM AUTHOR]

Background and Aim: Regarding the controversy about the effects of atorvastatin on blood glucose control and diabetes, we evaluated the effects of atorvastatin on blood glucose and insulin resistance in the present study. Materials and Methods: 88 type two diabetic patients (T2DP), were treated with anti-diabetes oral agents were enrolled in a double blind randomized clinical trial, placebo control. Then they were randomly classified into two 44 cases groups. The intervention group took atorvastatin 40 mg daily and control group took placebo for three months and fasting blood glucose (FBS), insulin resistance, HbA1c and lipid profile were measured and compared at the beginning and the end of the study. Data were analyzed using student t-test and paired t-test. Ethical Considerations: This study with research ethics code IR.ARAKMU.REC.90.108.10 has been approved by research ethics committee at Arak University of Medical Sciences. Findings: After three months, insulin, insulin resistance and HbA1c decreased significantly in the intervention group than control group, while FBS nonsignificantly decreased. Total cholesterol and LDL cholesterol (Low density Lipoprotein) were also decreased. Conclusion: It seems atorvastatin is effective to decrease FBS and insulin resistance in diabetic patients. [ABSTRACT FROM AUTHOR]

Long‐term prolactin excess is often accompanied by numerous metabolic complications. No previous study has compared the effect of statin therapy on circulating levels of cardiometabolic risk factors in patients with elevated and normal prolactin levels. The study population consisted of 3 age‐, weight‐, and lipid‐matched groups of young women: 19 women with untreated hyperprolactinemia (group A), 20 normoprolactinemic women receiving bromocriptine treatment (because of previous hyperprolactinemia) (group B), and 20 untreated women with prolactin levels within the reference range (group C). Because of elevated total and low‐density lipoprotein cholesterol levels, all women were then treated with atorvastatin (40 mg daily). Apart from measuring plasma lipids, glucose homeostasis markers, and hormone levels at the beginning of the study and 12 weeks later, we measured circulating levels of uric acid, high‐sensitivity C‐reactive protein, homocysteine, and fibrinogen. Despite similar baseline levels of plasma lipids, levels of uric acid, high‐sensitivity C‐reactive protein, homocysteine, and fibrinogen as well as the degree of insulin resistance were higher in group A than in the remaining 2 groups. Atorvastatin reduced total and low‐density lipoprotein cholesterol levels in all study groups. However, only in normoprolactinemic women (groups B and C) did atorvastatin reduce circulating levels of nonlipid cardiometabolic risk factors, whereas only in group A did the drug slightly impair insulin sensitivity. The results of the study suggest that cardiometabolic effects of atorvastatin depend on the prolactin status of patients. [ABSTRACT FROM AUTHOR]

Oral pitavastatin (Livalo; Livazo) is a competitive HMG-CoA reductase inhibitor that is available in the EU for the reduction of elevated total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels in adults with primary hypercholesterolemia and combined (mixed) dyslipidemia. In short-term, phase III or IV studies in this patient population, pitavastatin 1-4 mg once daily was generally no less effective than presumed equipotent dosages of atorvastatin and simvastatin (including in patients with type 2 diabetes or ≥2 cardiovascular risk factors) and was superior to pravastatin (including in patients aged ≥65 years) in lowering LDL-C levels. Pitavastatin provided sustained LDL-C-lowering efficacy over up to 60 weeks' therapy in extension studies, and was associated with short- and longer-term improvements in several other lipid parameters. Short- and longer-term outcomes in studies in Asian patients were consistent with these findings. Pitavastatin was generally well tolerated and did not appear to adversely affect glucose metabolism parameters (e.g. fasting blood glucose, fasting plasma glucose, fasting plasma insulin, glycated hemoglobin) in short- and longer-term prospective and post-marketing surveillance studies in adults. Moreover, in combination with lifestyle modification advice, it was associated with a significant reduction in the risk of progression from impaired glucose tolerance to diabetes relative to lifestyle modification advice alone in a longer-term study in Japanese subjects. Thus, pitavastatin is an effective treatment option in adults with primary hypercholesterolemia and combined (mixed) dyslipidemia, including those at risk of developing type 2 diabetes. [ABSTRACT FROM AUTHOR]

Liraglutide is an acylated glucagon-like peptide-1 analogue with 97 % amino acid homology with native glucagon-like peptide-1 and greatly protracted action. It is widely used for the treatment of type 2 diabetes mellitus, and administered by subcutaneous injection once daily. The pharmacokinetic properties of liraglutide enable 24-h exposure coverage, a requirement for 24-h glycaemic control with once-daily dosing. The mechanism of protraction relates to slowed release from the injection site, and a reduced elimination rate owing to metabolic stabilisation and reduced renal filtration. Drug exposure is largely independent of injection site, as well as age, race and ethnicity. Increasing body weight and male sex are associated with reduced concentrations, but there is substantial overlap between subgroups; therefore, dose escalation should be based on individual treatment outcome. Exposure is reduced with mild, moderate or severe renal or hepatic impairment. There are no clinically relevant changes in overall concentrations of various drugs (e.g. paracetamol, atorvastatin, griseofulvin, digoxin, lisinopril and oral combination contraceptives) when co-administered with liraglutide. Pharmacodynamic studies show multiple beneficial actions with liraglutide, including improved fasting and postprandial glycaemic control (mediated by increased insulin and reduced glucagon levels and minor delays in gastric emptying), reduced appetite and energy intake, and effects on postprandial lipid profiles. The counter-regulatory hormone response to hypoglycaemia is largely unaltered. The effects of liraglutide on insulin and glucagon secretion are glucose dependent, and hence the risk of hypoglycaemia is low. The pharmacokinetic and pharmacodynamic properties of liraglutide make it an important treatment option for many patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]