13 results on '"Fadini G.P."'
Search Results
2. A Multinational Real-World Study on the Clinical Characteristics of Patients with Type 2 Diabetes Initiating Dapagliflozin in Southern Europe
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Fadini, G.P. Tentolouris, N. Caballero Mateos, I. Bellido Castañeda, V. Morales Portillo, C.
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Introduction: A real-world study was performed to describe the clinical characteristics of patients who received dapagliflozin to better understand differences when initiating dapagliflozin in various countries and different prescribing settings. Methods: We assessed pooled data from observational studies carried out in Italy (n = 2484), Spain (n = 564) and Greece (n = 87). The primary objective was to compare the clinical profile of patients initiating dapagliflozin in the three countries. We also evaluated the percentage of patients who received dapagliflozin in clinical practice who satisfied DECLARE-TIMI 58 enrolment criteria. Results: In Italy and Spain, around 90% of patients were receiving metformin vs. 66% in Greece (p < 0.0001). Patients in Greece had lower levels of estimated glomerular filtration rate and lower prevalence rates of retinopathy, prior stroke, acute myocardial infarction, peripheral arterial disease and atherosclerotic cardiovascular disease. Grouping the cohorts by prescribing setting (primary vs. specialist care), baseline HbA1c was lower in primary care (8.4 ± 1.7 vs. 8.7 ± 1.5, respectively; p < 0.0001). Significantly more patients were receiving other medications for concomitant conditions in specialist care. A total of 1416 patients (48%) did not meet DECLARE inclusion criteria, while 1561 (52%) patients met the criteria (Greece 41.05%, Italy 53.19%, Spain 51.35%). Conclusions: Significant differences were seen among patients initiating dapagliflozin in southern Europe. Our results suggest that dapagliflozin was being initiated at different stages of the disease according to the country and prescribing settings. Such geographic heterogeneity may have an impact upon effectiveness of dapagliflozin on glucose lowering, as well as cardiovascular and renal outcomes. © 2019, The Author(s).
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- 2020
3. Positioning sulphonylureas in a modern treatment algorithm for patients with type 2 diabetes: Expert opinion from a European consensus panel
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Consoli, A., Czupryniak, L., Duarte, R., Jermendy, G., Kautzky-Willer, A., Mathieu, C., Melo, M., Mosenzon, O., Nobels, F., Papanas, N., Roman, G., Schnell, O., Sotiropoulos, A., Stehouwer, C.D.A., Tack, C.J.J., Woo, V., Fadini, G.P., Raz, I., Consoli, A., Czupryniak, L., Duarte, R., Jermendy, G., Kautzky-Willer, A., Mathieu, C., Melo, M., Mosenzon, O., Nobels, F., Papanas, N., Roman, G., Schnell, O., Sotiropoulos, A., Stehouwer, C.D.A., Tack, C.J.J., Woo, V., Fadini, G.P., and Raz, I.
- Abstract
Contains fulltext : 229476.pdf (Publisher’s version ) (Closed access), The large number of pharmacological agents available to treat type 2 diabetes (T2D) makes choosing the optimal drug for any given patient a complex task. Because newer agents offer several advantages, whether and when sulphonylureas (SUs) should still be used to treat T2D is controversial. Published treatment guidelines and recommendations should govern the general approach to diabetes management. However, expert opinions can aid in better understanding local practices and in formulating individual choices. The current consensus paper aims to provide additional guidance on the use of SUs in T2D. We summarize current local treatment guidelines in European countries, showing that SUs are still widely proposed as second-line treatment after metformin and are often ranked at the same level as newer glucose-lowering medications. Strong evidence now shows that sodium-glucose co-transporter-2 inhibitors (SGLT-2is) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) are associated with low hypoglycaemia risk, promote weight loss, and exert a positive impact on vascular, cardiac and renal endpoints. Thus, using SUs in place of SGLT-2is and GLP-1RAs may deprive patients of key advantages and potentially important cardiorenal benefits. In subjects with ascertained cardiovascular disease or at very high cardiovascular risk, SGLT-2is and/or GLP-1RAs should be used as part of diabetes management, in the absence of contraindications. Routine utilization of SUs as second-line agents continues to be acceptable in resource-constrained settings.
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- 2020
4. Hypoglycaemia, irrespective of the definition used, is reduced when switching to insulin degludec from other basal insulins in routine clinical care : The ReFLeCT study
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Feher, M., Fadini, G.P., Krarup Hansen, T., Jendle, Johan, Merchante, A., Koefoed, M.M., Rizi, E.P., Zimmermann, E., de Valk, H.W., Feher, M., Fadini, G.P., Krarup Hansen, T., Jendle, Johan, Merchante, A., Koefoed, M.M., Rizi, E.P., Zimmermann, E., and de Valk, H.W.
- Abstract
Background and aims: ReFLeCT was a multicentre, prospective, observational study designed to investigate the safety and effectiveness of switching to insulin degludec (degludec) from other basal insulins in patients with type 1 (T1D) or type 2 diabetes (T2D). Few studies had prospectively collected hypoglycaemia data from patient diaries following a switch to degludec in everyday clinical practice. These additional analyses from the ReFLeCT study aimed to assess the effects of switching to degludec according to different hypoglycaemia definitions. Materials and methods: ReFLeCT comprised a 4-week baseline period (pre-switch basal insulin) and a 12-month follow-up period (degludec treatment). The primary endpoint of overall hypoglycaemia reported in patient diaries was reduced during follow-up vs baseline in T1D and T2D with improvement of glycaemic control, as previously reported. Here, hypoglycaemia data from ReFLeCT were analysed using pre-specified and updated (post hoc) American Diabetes Association (ADA) hypoglycaemia definitions. Definitions consisted of: documented asymptomatic and symptomatic, pseudo, probable symptomatic, and Level 1, 2 and 3 (severe) hypoglycaemia (Fig). Hypoglycaemic events were analysed using fully adjusted, negative binomial regression models. Results: In T1D (n=556) and T2D (n=611), estimated rate ratios across the previous and the updated ADA hypoglycaemia definitions were significantly lower during the 12-month follow-up vs the baseline period, except for asymptomatic hypoglycaemia in T1D and Level 3 hypoglycaemia in T2D (due to a low number of severe hypoglycaemic events, no comparable statistics were performed) (Fig). Event rates per patient year were also lower for all definitions during the 12-month follow-up vs the baseline period, except for Level 3 hypoglycaemia in T2D, which marginally increased, although this was likely due to the low number of events in this group. Conclusion: In patients with T1D and T2D, switching to degl
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- 2019
5. Switching to insulin degludec from other basal insulins reduces rates of hypoglycemia (according to different definitions) in routine clinical care : The ReFLeCT Study
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de Valk, H.W., Feher, M., Krarup Hansen, T., Jendle, Johan, Merchante, A., Koefoed, M.M., Rizi, E.P., Zimmermann, E., Fadini, G.P., de Valk, H.W., Feher, M., Krarup Hansen, T., Jendle, Johan, Merchante, A., Koefoed, M.M., Rizi, E.P., Zimmermann, E., and Fadini, G.P.
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- 2019
6. Switching to insulin degludec from other basal insulins reduces rates of hypoglycemia across patient subgroups in routine clinical care : The ReFleCT study
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de Valk, H.W., Feher, M., Krarup Hansen, T., Jendle, Johan, Merchante, A., Koefoed, M.M., Rizi, E.P., Zimmermann, E., Fadini, G.P., de Valk, H.W., Feher, M., Krarup Hansen, T., Jendle, Johan, Merchante, A., Koefoed, M.M., Rizi, E.P., Zimmermann, E., and Fadini, G.P.
- Abstract
ReFLeCT, a multicenter, prospective, observational study evaluated the safety and effectiveness of switching from other basal insulins to insulin degludec (degludec) in patients with type 1 (T1D) or type 2 diabetes (T2D) in routine clinical practice. ReFLeCT comprised a 4-week baseline period (pre-switch basal insulin) and 12-month follow-up period (degludec). The primary endpoint of overall hypoglycemia reported in patient diaries was reduced during the 12-month follow-up period vs. baseline, without compromising glycemic control. In pre-specified subgroup analyses of the primary endpoint, we assessed if the overall result was robust in different subgroups, characterized according to baseline A1C (<7.5, ≥7.5-<8.5, ≥8.5-<9.5, ≥9.5%), diabetes duration (quartiles) and physician’s reason for initiating degludec (hypoglycemia [Yes/No]). The estimated rate ratios of hypoglycemia were similar within subgroups (no significant interactions), and demonstrated overall lower rates (the majority significantly lower) during the 12-month follow-up periods vs. baseline in patients with T1D or T2D (Figure). Irrespective of baseline characteristics or physician’s reason for initiating degludec, switching to degludec from other basal insulins reduced rates of overall hypoglycemia in patients with T1D or T2D, in routine clinical practice.
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- 2019
7. Circulating endothelial progenitor cells are reduced in peripheral vascular complications of type 2 diabetes mellitus
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Fadini, G.P., Miorin, M., Facco, M., Bonamico, S., Baesso, I., Grego, F., Menegolo, M., de Kreutzenberg, S.V., Tiengo, A., Agostini, C., and Avogaro, A.
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Peripheral vascular diseases -- Diagnosis -- Care and treatment -- Research ,Type 2 diabetes -- Diagnosis -- Care and treatment -- Research ,Health ,Diagnosis ,Care and treatment ,Research - Abstract
Fadini GP, Miorin M, Facco M, Bonamico S, Baesso I, Grego F, Menegolo M, de Kreutzenberg SV, Tiengo A, Agostini C, Avogaro A: Circulating endothelial progenitor cells are reduced in [...]
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- 2005
8. Predictors of early discontinuation of dapagliflozin versus other glucose-lowering medications: a retrospective multicenter real-world study
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Fadini, G. P., Li Volsi, P., Devangelio, E., Poli, M., Cazzetta, G., Felace, G., Avogaro, A., Consoli, A., Formoso, G., Grossi, G., Pucci, A., Sesti, G., Andreozzi, F., Capobianco, G., Gatti, A., Bonadonna, R., Zavaroni, I., Cas, A. D., Buzzetti, R., Leto, G., Sorice, G. P., D'Angelo, P., Morano, S., Bossi, A. C., Duratorre, E., Franzetti, I., Morpurgo, P. S., Orsi, E., Querci, F., Boemi, M., D'Angelo, F., Petrelli, M., Aimaretti, G., Karamouzis, I., Cavalot, F., Saglietti, G., Cervone, S., Lamacchia, O., Arena, S., Di Benedetto, A., Frittitta, L., Giordano, C., Piro, S., Rizzo, M., Chianetta, R., Mannina, C., Anichini, R., Penno, G., Solini, A., Fattor, B., Bonora, E., Cigolini, M., Lapolla, A., Chilelli, N. C., Simioni, N., Frison, V., Vinci, C., Fadini G.P., Li Volsi P., Devangelio E., Poli M., Cazzetta G., Felace G., Avogaro A., Consoli A., Formoso G., Grossi G., Pucci A., Sesti G., Andreozzi F., Capobianco G., Gatti A., Bonadonna R., Zavaroni I., Cas A.D., Buzzetti R., Leto G., Sorice G.P., D'Angelo P., Morano S., Bossi A.C., Duratorre E., Franzetti I., Morpurgo P.S., Orsi E., Querci F., Boemi M., D'Angelo F., Petrelli M., Aimaretti G., Karamouzis I., Cavalot F., Saglietti G., Cervone S., Lamacchia O., Arena S., Di Benedetto A., Frittitta L., Giordano C., Piro S., Rizzo M., Chianetta R., Mannina C., Anichini R., Penno G., Solini A., Fattor B., Bonora E., Cigolini M., Lapolla A., Chilelli N.C., Simioni N., Frison V., and Vinci C.
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Blood Glucose ,Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,Type 2 diabetes ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Endocrinology ,Glucosides ,Diabetes mellitus ,Internal medicine ,Adherence ,Observational ,Pharmacotherapy ,Real-world ,Aged ,Benzhydryl Compounds ,Diabetes Mellitus, Type 2 ,Dipeptidyl-Peptidase IV Inhibitors ,Female ,Humans ,Hypoglycemic Agents ,Middle Aged ,Retrospective Studies ,Withholding Treatment ,Diabetes Mellitus ,medicine ,Outpatient clinic ,Dapagliflozin ,business.industry ,Retrospective cohort study ,medicine.disease ,Metformin ,Discontinuation ,chemistry ,Tolerability ,030220 oncology & carcinogenesis ,business ,Type 2 ,medicine.drug - Abstract
Background and aims: In routine clinical practice, early discontinuation of newly initiated glucose-lowering medications (GLM) is relatively common. We herein evaluated if the clinical characteristics associated with early discontinuation of dapagliflozin were different from those associated with early discontinuation of other GLM. Methods: The DARWIN-T2D was a multicenter retrospective study conducted at diabetes specialist outpatient clinics in Italy. We included 2484 patients who were initiated on dapagliflozin in 2015–2016 and 14,801 patients who were initiated on other GLM (DPP-4 inhibitors, GLP-1 receptor agonists, or gliclazide) in the same period. After excluding patients who had not (yet) returned to follow-up, we compared the characteristics of patients who persisted on drug versus those who were no longer on drug at the first available follow-up after at least 3months. Results: As compared to those who persisted on drug, patients who discontinued dapagliflozin (51.7%) were more often female, had higher baseline fasting plasma glucose (FPG), HbA1c, and eGFR, and less common use of metformin. Upon multiple regression, higher HbA1c, higher eGFR, and lower metformin use remained independently associated with early discontinuation. Among patients who had been initiated on other GLM, 41.7% discontinued. Variables independently associated with discontinuation were older age, longer diabetes duration, higher HbA1c, eGFR, and albumin excretion, more common use of insulin and less metformin. Conclusion: In routine clinical practice, all variables associated with dapagliflozin discontinuation were also associated with discontinuation of other GLM. Thus, despite a distinctive mechanism of action and a peculiar tolerability profile, no specific predictor of dapagliflozin discontinuation was detected.
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- 2019
9. SGLT-2 inhibitors and atrial fibrillation in the Food and Drug Administration adverse event reporting system
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Gian Paolo Fadini, Angelo Avogaro, Emanuel Raschi, Benedetta Maria Bonora, Bonora B.M., Raschi E., Avogaro A., and Fadini G.P.
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United State ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,Time Factors ,Complications ,Databases, Factual ,Time Factor ,Epidemiology ,Endocrinology, Diabetes and Metabolism ,Disease ,Type 2 diabetes ,Clinical practice ,Risk Assessment ,Type 2 diabete ,Pharmacovigilance ,Adverse Event Reporting System ,Risk Factors ,Diabetes mellitus ,Internal medicine ,Atrial Fibrillation ,Adverse Drug Reaction Reporting Systems ,Humans ,Observational ,Medicine ,Adverse effect ,Sodium-Glucose Transporter 2 Inhibitors ,Protective Factor ,Original Investigation ,United States Food and Drug Administration ,business.industry ,Risk Factor ,Sodium-Glucose Transporter 2 Inhibitor ,Atrial fibrillation ,Protective Factors ,medicine.disease ,United States ,Treatment Outcome ,Diabetes Mellitus, Type 2 ,lcsh:RC666-701 ,Concomitant ,Adverse Drug Reaction Reporting System ,Cardiology and Cardiovascular Medicine ,business ,Complication ,Human - Abstract
Background Sodium glucose cotransporter-2 inhibitors (SGLT2i) reduce the risk of heart failure and new data show they can prevent atrial fibrillation (AF). We examined the association between SGLT2i and AF in the Food and Drug Administration adverse event reporting system (FAERS). Methods We mined the FAERS from 2014q1 to 2019q4 to compare AF reporting for SGLT-2 i versus reports for other glucose lowering medications (ATC10 class). Several exclusions were sequentially applied for: concomitant medications; diabetes, cardiovascular or renal disease indication; reports for competing adverse events (genitourinary tract infections, ketoacidosis, Fournier’s gangrene, amputation). We provide descriptive statistics and calculated proportional reporting ratios (PRR). Results There were 62,098 adverse event reports for SGLT2i and 642,031 reports for other ATC10 drugs. The reporting of AF was significantly lower with SGLT2i than with other ATC10 drugs (4.8 versus 8.7/1000; p Conclusions In a large pharmacovigilance database, AF was robustly and consistently reported more frequently for diabetes medications other than SGLT2i. This finding complements available evidence from trials supporting a protective role of SGLT2i against the occurrence of AF.
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- 2021
10. A view on the quality of diabetes care in Italy and the role of Diabetes Clinics from the 2018 ARNO Diabetes Observatory
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Roberto Miccoli, Gian Paolo Fadini, Salvatore Cataudella, Olga Vaccaro, Nello Martini, Elisa Rossi, Giulio Marchesini, Enzo Bonora, Bonora, E., Cataudella, S., Marchesini, G., Miccoli, R., Vaccaro, O., Fadini, G. P., Martini, N., Rossi, E., Bonora E., Cataudella S., Marchesini G., Miccoli R., Vaccaro O., Fadini G.P., Martini N., and Rossi E.
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Blood Glucose ,Male ,Glycated Hemoglobin A ,Time Factors ,Endocrinology, Diabetes and Metabolism ,Medicine (miscellaneous) ,Practice Patterns ,Disease ,030204 cardiovascular system & hematology ,Ambulatory Care Facilities ,0302 clinical medicine ,Adherence ,Anti-hyperglycemic agents ,Diabetes mellitus ,Monitoring ,Quality of care ,Aged ,Aged, 80 and over ,Biomarkers ,Diabetes Mellitus ,Female ,Glycemic Control ,Guideline Adherence ,Humans ,Hypoglycemic Agents ,Italy ,Middle Aged ,Practice Guidelines as Topic ,Practice Patterns, Physicians' ,Prevalence ,Quality Indicators, Health Care ,Treatment Outcome ,Health care ,80 and over ,Nutrition and Dietetics ,medicine.diagnostic_test ,Carotid ultrasonography ,Eye examination ,Cardiology and Cardiovascular Medicine ,Human ,medicine.medical_specialty ,Diabetes mellitu ,Time Factor ,030209 endocrinology & metabolism ,Anti-hyperglycemic agent ,03 medical and health sciences ,medicine ,Medical prescription ,Glycated Hemoglobin ,Physicians' ,Hypoglycemic Agent ,business.industry ,Biomarker ,medicine.disease ,Health Care ,Ambulatory Care Facilitie ,Emergency medicine ,Quality Indicators ,Microalbuminuria ,business ,Lipid profile - Abstract
Backgrounds and aims To investigate relevant indicators of quality of care in a large population-based sample of people with diabetes representative of clinical practice in Italy in 2018. Methods and results We analyzed data from 11,300,750 subjects. All administrative healthcare claims collected in 2018 were scrutinized to identify subjects with diabetes and investigate several indicators of quality of care. Subjects with diabetes were identified by anti-hyperglycemic drug prescriptions, disease-specific co-payment exemption and hospital discharge codes. Indicators of quality of care pertained to monitoring (HbA1c, creatinine, lipid profile, microalbuminuria, eye examination, ECG, ultrasonography of carotid and lower limb arteries) and diabetes treatment (anti-hyperglycemic agents in subjects with cardiovascular disease, CVD). Subjects attending and nonattending Diabetes Clinics were compared. We identified 697,208 individuals with diabetes. HbA1c was assessed at least once in the year in 62.7%, creatinine in 62.3%, total cholesterol in 59.6%, microalbuminuria in 34.3%. Frequency of eye examination was 8.2%, ECG 23.5%, carotid ultrasonography 14.3%, lower limb ultrasonography 7.6%. Among anti-hyperglycemic drugs, SGLT-2 inhibitors were prescribed to ~5% and GLP-1 receptor agonists to ~5% although the proportion of subjects with CVD was ~45%. Subjects attending Diabetes Clinics had higher figures for all these monitoring and treatment indicators. Conclusions The implementation of national and international guidelines regarding disease monitoring and treatment is far from being satisfactory, especially among subjects nonattending Diabetes Clinics. Further efforts and investments are needed for better disseminating guidelines, more efficaciously engaging healthcare professionals and more strongly empowering the healthcare system to improve diabetes care.
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- 2020
11. Clinical burden of diabetes in Italy in 2018: A look at a systemic disease from the ARNO Diabetes Observatory
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Salvatore Cataudella, Nello Martini, Olga Vaccaro, Giulio Marchesini, Enzo Bonora, Elisa Rossi, Roberto Miccoli, Gian Paolo Fadini, Bonora, E., Cataudella, S., Marchesini, G., Miccoli, R., Vaccaro, O., Fadini, G. P., Martini, N., Rossi, E., Bonora E., Cataudella S., Marchesini G., Miccoli R., Vaccaro O., Fadini G.P., Martini N., and Rossi E.
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Research design ,Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Population ,Disease ,health care and epidemiology ,Diseases of the endocrine glands. Clinical endocrinology ,Ambulatory care ,administrative data ,Diabetes mellitus ,Health care ,medicine ,Diabetes Mellitus ,Humans ,Hypoglycemic Agents ,Medical prescription ,Epidemiology/Health Services Research ,education ,Copayment ,education.field_of_study ,business.industry ,Health Care Costs ,hospitalization ,resource use ,medicine.disease ,RC648-665 ,Italy ,Family medicine ,Female ,business - Abstract
IntroductionDiabetes is a highly prevalent disease worldwide and represents a challenge for patients and healthcare systems. This population-based study evaluated diabetes burden in Italy in 2018 by assessing all aspects of outpatient and hospital care.Research design and methodsWe investigated data of 11 300 750 residents in local health districts contributing to ARNO Diabetes Observatory (~20% of Italian inhabitants). All administrative healthcare claims were analyzed to gather information on access to medical resources. Subjects with diabetes, identified by antihyperglycemic drug prescriptions, disease-specific copayment exemption and hospital discharge codes, were compared with age, sex and residency-matched non-diabetic individuals.ResultsWe identified 697 208 subjects with ascertained diabetes, yielding a prevalence of 6.2% (6.5% in men vs 5.9% in women, p2-fold higher in subjects with diabetes, mainly driven by hospitalizations and outpatient care related to chronic complications rather than to glucose-lowering drugs, diabetes-specific devices, or metabolic monitoring.ConclusionsThe burden of diabetes in Italy is particularly heavy and, as a systemic disease, it includes all aspects of clinical medicine, with consequent high expenses in all areas of healthcare.
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- 2020
12. Similar effectiveness of dapagliflozin and GLP-1 receptor agonists concerning combined endpoints in routine clinical practice: A multicentre retrospective study
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Fadini, G. P., Sciannameo, V., Franzetti, I., Bottigliengo, D., D'Angelo, P., Vinci, C., Berchialla, P., Arena, S., Buzzetti, R., Avogaro, A., Consoli, A., Formoso, G., Grossi, G., Pucci, A., Sesti, G., Andreozzi, F., Capobianco, G., Gatti, A., Bonadonna, R., Zavaroni, I., Cas, A. D., Felace, G., Volsi, P. L., Leto, G., Sorice, G. P., Morano, S., Bossi, A. C., Duratorre, E., Morpurgo, P. S., Orsi, E., Querci, F., Boemi, M., D'Angelo, F., Petrelli, M., Aimaretti, G., Karamouzis, I., Cavalot, F., Saglietti, G., Cazzetta, G., Cervone, S., Devangelio, E., Lamacchia, O., Di Benedetto, A., Frittitta, L., Giordano, C., Piro, S., Rizzo, M., Chianetta, R., Mannina, C., Anichini, R., Penno, G., Solini, A., Fattor, B., Bonora, E., Cigolini, M., Lapolla, A., Chilelli, N. C., Poli, M., Simioni, N., Frison, V., Fadini G.P., Sciannameo V., Franzetti I., Bottigliengo D., D'Angelo P., Vinci C., Berchialla P., Arena S., Buzzetti R., Avogaro A., Consoli A., Formoso G., Grossi G., Pucci A., Sesti G., Andreozzi F., Capobianco G., Gatti A., Bonadonna R., Zavaroni I., Cas A.D., Felace G., Volsi P.L., Leto G., Sorice G.P., Morano S., Bossi A.C., Duratorre E., Morpurgo P.S., Orsi E., Querci F., Boemi M., D'Angelo F., Petrelli M., Aimaretti G., Karamouzis I., Cavalot F., Saglietti G., Cazzetta G., Cervone S., Devangelio E., Lamacchia O., Di Benedetto A., Frittitta L., Giordano C., Piro S., Rizzo M., Chianetta R., Mannina C., Anichini R., Penno G., Solini A., Fattor B., Bonora E., Cigolini M., Lapolla A., Chilelli N.C., Poli M., Simioni N., and Frison V.
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Blood Glucose ,Male ,Glycated Hemoglobin A ,Endocrinology, Diabetes and Metabolism ,Blood Pressure ,Type 2 diabetes ,030204 cardiovascular system & hematology ,Settore MED/13 - Endocrinologia ,chemistry.chemical_compound ,0302 clinical medicine ,Endocrinology ,Glucosides ,Clinical endpoint ,Medicine ,Dapagliflozin ,GLP-1 analogue ,Middle Aged ,Treatment Outcome ,glycaemic control ,antidiabetic drug ,dapagliflozin ,observational study ,Combination ,Original Article ,Drug Therapy, Combination ,Female ,Type 2 ,medicine.drug ,Adult ,medicine.medical_specialty ,030209 endocrinology & metabolism ,Glucagon-Like Peptide-1 Receptor ,03 medical and health sciences ,Drug Therapy ,GLP‐1 analogue ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,Diabetes Mellitus ,Humans ,Hypoglycemic Agents ,Benzhydryl Compounds ,Aged ,Retrospective Studies ,Glycated Hemoglobin ,Body Weight ,Diabetes Mellitus, Type 2 ,Diabetic Angiopathies ,Exenatide ,Liraglutide ,business.industry ,Retrospective cohort study ,Original Articles ,medicine.disease ,Blood pressure ,chemistry ,Propensity score matching ,business ,Antidiabetic drug, dapagliflozin, GLP-1 analogue, glycaemic control, observational study - Abstract
Aims According to cardiovascular outcome trials, some sodium‐glucose contransporter‐2 inhibitors (SGLT2i) and glucagon‐like peptide‐1 receptor agonists (GLP‐1RA) are recommended for secondary cardiovascular prevention in type 2 diabetes (T2D). In this real‐world study, we compared the simultaneous reductions in HbA1c, body weight and systolic blood pressure after initiation of dapagliflozin or GLP‐1RA as second or a more advanced line of therapy. Materials and methods DARWIN‐T2D was a retrospective multi‐centre study conducted at diabetes specialist clinics in Italy that compared T2D patients who initiated dapagliflozin or GLP‐1RA (exenatide once weekly or liraglutide). Data were collected at baseline and at the first follow‐up visit after 3 to 12 months. The primary endpoint was the proportion of patients achieving a simultaneous reduction in HbA1c, body weight and systolic blood pressure. To reduce confounding, we used multivariable adjustment (MVA) or propensity score matching (PSM). Results Totals of 473 patients initiating dapagliflozin and 336 patients initiating GLP‐1RA were included. The two groups differed in age, diabetes duration, HbA1c, weight and concomitant medications. The median follow‐up was 6 months in both groups. Using MVA or PSM, the primary endpoint was observed in 30% to 32% of patients, with no difference between groups. Simultaneous reduction of HbA1c, BP and SBP by specific threshold, as well as achievement of final goals, did not differ between groups. GLP‐1RA reduced HbA1c by 0.3% more than the reduction achieved with dapagliflozin. Conclusion In routine specialist care, initiation of dapagliflozin can be as effective as initiation of a GLP‐1RA for attainment of combined risk factor goals.
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- 2019
13. Comparative Effectiveness of DPP-4 Inhibitors Versus Sulfonylurea for the Treatment of Type 2 Diabetes in Routine Clinical Practice: A Retrospective Multicenter Real-World Study
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Fadini, Gian Paolo, Bottigliengo, Daniele, D'Angelo, Federica, Cavalot, Franco, Bossi, Antonio Carlo, Zatti, Giancarlo, Baldi, Ileana, Avogaro, A, Consoli, A, Formoso, G, Grossi, G, Pucci, A, Sesti, G, Andreozzi, F, Capobianco, G, Gatti, A, Bonadonna, R, Zavaroni, I, Cas, Ad, Felace, G, Volsi, Pl, Buzzetti, R, Leto, G, Sorice, Gp, D'Angelo, P, Morano, S, Bossi, Ac, Duratorre, E, Franzetti, I, Morpurgo, Ps, Orsi, E, Querci, F, Boemi, M, D'Angelo, F, Petrelli, M, Aimaretti, G, Karamouzis, I, Cavalot, F, Saglietti, G, Cazzetta, G, Cervone, S, Devangelio, E, Lamacchia, O, Arena, S, Benedetto, Di, A, Frittitta, L, Giordano, C, Piro, S, Rizzo, M, Chianetta, R, Mannina, C, Anichini, R, Penno, G, Solini, A, Fattor, B, Bonora, E, Cigolini, M, Lapolla, A, Chilelli, Nc, Poli, M, Simioni, N, Frison, V, Vinci, C, Fadini G.P., Bottigliengo D., D'Angelo F., Cavalot F., Bossi A.C., Zatti G., Baldi I., Avogaro A., Consoli A., Formoso G., Grossi G., Pucci A., Sesti G., Andreozzi F., Capobianco G., Gatti A., Bonadonna R., Zavaroni I., Cas A.D., Felace G., Volsi P.L., Buzzetti R., Leto G., Sorice G.P., D'Angelo P., Morano S., Duratorre E., Franzetti I., Morpurgo P.S., Orsi E., Querci F., Boemi M., Petrelli M., Aimaretti G., Karamouzis I., Saglietti G., Cazzetta G., Cervone S., Devangelio E., Lamacchia O., Arena S., Di Benedetto A., Frittitta L., Giordano C., Piro S., Rizzo M., Chianetta R., Mannina C., Anichini R., Penno G., Solini A., Fattor B., Bonora E., Cigolini M., Lapolla A., Chilelli N.C., Poli M., Simioni N., Frison V., and Vinci C.
- Subjects
endocrine system ,medicine.medical_specialty ,Epidemiology ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,Type 2 diabetes ,030204 cardiovascular system & hematology ,Database ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Diabetes mellitus ,Internal medicine ,medicine ,Clinical endpoint ,Pharmacotherapy ,Internal Medicine ,Outpatient clinic ,Gliclazide ,Original Research ,Glycemic ,business.industry ,nutritional and metabolic diseases ,Retrospective cohort study ,medicine.disease ,Metformin ,Diabetes and Metabolism ,business ,medicine.drug - Abstract
Introduction DPP-4 inhibitors (DPP4i) and sulfonylureas are popular second-line therapies for type 2 diabetes (T2D), but there is a paucity of real-world studies comparing their effectiveness in routine clinical practice. Methods This was a multicenter retrospective study on diabetes outpatient clinics comparing the effectiveness of DPP4i versus gliclazide extended release. The primary endpoint was change from baseline in HbA1c. Secondary endpoints were changes in fasting plasma glucose, body weight, and systolic blood pressure. Automated software extracted data from the same clinical electronic chart system at all centers. Propensity score matching (PSM) was used to generate comparable cohorts to perform outcome analysis. Results We included data on 2410 patients starting DPP4i and 1590 patients starting gliclazide (mainly 30–60 mg/day). At baseline, the two groups differed in disease duration, body weight, blood pressure, HbA1c, fasting glucose, HDL cholesterol, triglycerides, liver enzymes, eGFR, prevalence of microangiopathy, and use of metformin. Among DPP4i molecules, no difference in glycemic effectiveness was detected. In matched cohorts (n = 1316/group), patients starting DPP4i, as compared with patients starting gliclazide, experienced greater reductions in HbA1c (− 0.6% versus − 0.4%; p
- Published
- 2018
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