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Copyright of Saúde Coletiva is the property of MPM Comunicacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Saúde Coletiva is the property of MPM Comunicacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Diabetes is a public health problem with an estimated worldwide prevalence of 10% and a prevalence of 12% in Mexico. The costs resulting from this chronic-degenerative disease are significant. Treatment for diabetes involves different medication groups, some of which can cause significant gastrointestinal adverse effects, such as dyspepsia, nausea, vomiting, bloating, diarrhea, and constipation. The medications most frequently associated with said adverse effects are metformin, acarbose, and GLP-1 agonists. Gastrointestinal adverse effects negatively impact the quality of life and management of patients with diabetes. The factors of visceral neuropathy, acute dysglycemia, dysbiosis, and intestinal bacterial overgrowth contribute to the gastrointestinal symptoms in patients with diabetes, making it necessary to consider multiple etiologic factors in the presence of gastrointestinal symptoms, and not exclusively attribute them to the use of antidiabetics. Personalized treatment, considering gastrointestinal comorbidity and the type of drug utilized, is essential for mitigating the adverse effects and improving the quality of life in patients with diabetes. The aim of the present narrative review was to describe the gastrointestinal adverse effects of the antidiabetic drugs, their pathophysiologic mechanisms, and the corresponding therapeutic measures. Resumen: La diabetes es un problema de salud pública con prevalencias globales estimadas del 10% y en México del 12%. Esta enfermedad crónico-degenerativa genera costos significativos. El tratamiento para la diabetes involucra diversos grupos de medicamentos, algunos de los cuales pueden provocar efectos adversos gastrointestinales significativos, como dispepsia, náuseas, vómitos, distensión abdominal, diarrea y estreñimiento. Los medicamentos asociados con mayor frecuencia a dichos efectos adversos son la metformina, acarbosa y agonistas GLP-1. Los efectos adversos gastrointestinales impactan en la calidad de vida y en el manejo de los pacientes con diabetes. Factores como la neuropatía visceral, disglucemia aguda, disbiosis y el sobrecrecimiento bacteriano intestinal también contribuyen a los síntomas gastrointestinales en pacientes con diabetes por lo que se deben de considerar múltiples opciones etiológicas ante síntomas gastrointestinales y no atribuirlos exclusivamente al uso de antidiabéticos. La individualización del tratamiento, considerando la comorbilidad gastrointestinal y el tipo de fármaco utilizado, es crucial para mitigar los efectos adversos y mejorar la calidad de vida de los pacientes con diabetes. Esta revisión narrativa tiene como objetivo describir los efectos adversos gastrointestinales de los antidiabéticos, así como sus mecanismos fisiopatológicos y las medidas terapéuticas correspondientes.

Copyright of Conocimiento Enfermero is the property of Colegio Oficial de Enfermeria de Madrid and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Acne is a chronic, inflammatory, multifactorial disorder of the pilosebaceous unit, with no associated mortality but often accompanied by high physical and psychological morbidity. Metformin is an antihyperglycemic drug under investigation as a therapeutic option for acne in adults and adolescents. The authors performed an evidence-based review, according to the population, intervention, control, and outcomes methodology, to assess whether there is evidence for the use of metformin (monotherapy or adjuvant) in the treatment of acne in adolescents and adults in the absence of polycystic ovary syndrome (PCOS). At the end of the review method, five original studies were eligible for this review. All studies showed a statistically significant improvement in acne lesions in patients receiving metformin. Despite the small number of articles included in this review, results suggest that the use of metformin for the management of acne can be an option, although further investigation is required. According to the current evidence, metformin could be a therapeutic option in the treatment of acne without PCOS, with strength of recommendation taxonomy B level of evidence. This treatment has shown clinical benefits, particularly in acne resistant to other therapies or in more severe acne cases, improving the number and severity of the lesions. [ABSTRACT FROM AUTHOR]

Copyright of Revista Médica de Risaralda is the property of Universidad Tecnologica de Pereira and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Polycystic ovary syndrome involves oligomenorrhea and/ or anovulation due to excess testosterone or LH, in addition to metabolic disorders that may result in decreased levels of important vitamins and minerals, including Zinc and Magnesium levels. objetives: To show if metformin treatment for polycystic ovarian women can change zinc and magnesium levels in those women. Methods: this study involves 23 early-diagnosed polycystic ovarian women not on metformin and 16 polycystic ovarian women on metformin 850 mg twice daily for at least three months. FSH, LH, testosterone, estradiol, prolactin, SHBG, fasting insulin, fasting glucose, magnesium and zinc are measured on the second day of the cycle. Results: the patients without metformin showed significant increases in LH, LH: SH ratio, and free testosterone at P-values of 0.03, 0.037 and 0.009 respectively. Zinc showed a direct correlation with estradiol in patients not on metformin and an indirect correlation with body mass index in patients on metformin treatment. Conclusion: Zinc is an important element for female fertility as it may enhance estradiol level may be due to its antioxidant activity which decreases the inflammatory reaction in the pelvic region and enhance ovary function. The increase in zinc level has an inverse effect on body mass index. However, metformin treatment in this study showed no effect on the level of magnesium and zinc in polycystic ovarian women.

Objetivo. Determinar el efecto de un tratamiento con metformina (MET) sobre la predisposición adipogénica de células progenitoras de médula ósea (CPMO), adiposidad de la médula ósea y propiedades biomecánicas óseas. Materiales y métodos: 20 ratas Wistar machos adultos jóvenes fueron separados en cuatro grupos, recibiendo en agua de bebida: 100% agua (C); 20% de fructosa (F); metformina 100 mg/kg peso/día (M); o fructosa más metformina (FM). Tras cinco semanas se sacrificaron los animales, se diseccionaron ambos húmeros para obtener CPMO, y ambos fémures para evaluar adiposidad medular (histomorfometría) y propiedades biomecánicas (flexión a 3 puntos). Las CPMO se cultivaron in vitro en medio adipogénico para evaluar expresión de RUNX2, PPAR-γ y RAGE por RT-PCR, actividad de lipasa y acumulación de triglicéridos. Resultados. La dieta rica en fructosa (grupo F) produjo un aumento tanto de triglicéridos in vitro, como de la adiposidad medular in vivo; siendo parcial o totalmente prevenido por un co-tratamiento con metformina (grupo FM). No se observaron diferencias en las pruebas biomecánicas femorales in vivo, ni en actividad de lipasa y relación RUNX2/PPAR-γ in vitro. La DRF aumentó la expresión de RAGE en CPMO, siendo prevenido por co-tratamiento con MET. Conclusiones. El síndrome metabólico inducido por una dieta rica en fructosa aumenta la adiposidad medular femoral y, en parte, la predisposición adipogénica de las CPMO. A su vez, esto puede ser prevenido total o parcialmente por un co-tratamiento oral con MET.

Copyright of Médicas UIS is the property of Universidad Industrial de Santander and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: In adults with prediabetes, it is estimated that 51.2% have atherogenic dyslipidemia with low HDL cholesterol, not always diagnosed or treated. The present study evaluates a new intervention adding a class I-II histone deacetylase inhibitor (Trichosanthin A) to the standard management of metformin to treat prediabetes and increase HDL cholesterol. Objective: To evaluate the efficacy of Trichosanthin A and prolonged release metformin on the increase in HDL cholesterol in women with prediabetes. Material and methods: Double-blind randomized controlled trial with lifestyle management. Group 1 with histone I-II deacetylase inhibitor (Trichosanthin A) and extended-release metformin; group 2 with extended-release metformin and group 3 with placebo. The outcome variable HDL cholesterol evaluated at baseline and after 12 weeks. The study included women between 20-65 y.o., body mass index 25.0-34.9 with prediabetes. Results: The study sample was made up of 104 female patients, average age of 46 years (SD+8.6), average body mass index of 30.9 (SD + 4.14). In the Trichosanthin A and extended-release metformin group, an increase on HDL cholesterol was observed (2.92 mg/dL; p = 0.027). Conclusions: The histone I-II deacetylase inhibitor (Trichosanthin A) in addition to standard intensive lifestyle treatment and extended-release metformin significantly increases HDL cholesterol. [ABSTRACT FROM AUTHOR]

The response of the immune system to harmful stimuli leads to inflammation, and the adverse effects of the toxic hepatitis chemical, thioacetamide (TAA) on the human body are well documented. This article investigated the degree of protection provided by the combined pleotropic drug, metformin (Met) and the plant polyphenolic and the antiinflammatory compound, resveratrol (Res) on liver tissue exposed to TAA possibly via the inhibition of the inflammatory cytokine, tumor necrosis factor-α (TNF-α) / mammalian target of rapamycin (mTOR) axis-mediated liver fibrosis, as well as amelioration of profibrotic gene and protein expression. Rats were either given TAA (200 mg/kg via intraperitoneal injection) for 8 weeks beginning at the third week (experimental group) or received during the first two weeks of the experiment combined doses of metformin (200 mg/kg) and resveratrol (20 mg/kg) and continued receiving these agents and TAA until experiment completion at week 10 (treated group). A considerable damage to hepatic tissue in the experimental rats was observed as revealed by tissue collagen deposition in the portal area of the liver and a substantial increase (p<0.0001) in hepatic levels of the inflammatory marker, tumor necrosis factor-α (TNF-α), as well as blood levels of hepatocellular injury biomarkers, alanine aminotransferase (ALT) and aspartate aminotransferase (AST). TAA also augmented hepatic tissue levels of the signalling molecule that promotes liver fibrosis (mTOR), and profibrogenic markers; alpha-smooth muscle actin (α-SMA) protein, tissue inhibitor of metalloproteinases-1 (TIMP-1) mRNA, and matrix metalloproteinase-9 (MMP-9) mRNA. All these parameters were protected (p≤0.0016) by Met+Res. In addition, a significant correlation was detected between liver fibrosis score and inflammation, liver injury enzymes, mTOR, and profibrogenesis markers. Thus, these findings suggest that Met+Res effectively protect the liver against damage induced by thioacetamide in association with the downregulation of the TNF-α/mTOR/fibrosis axis. [ABSTRACT FROM AUTHOR]

Currently, the field of phytopharmacology has demonstrated the antidiabetic potential of several traditional plants, including Pseudoelephantopus spicatus (amargon); however, studies demonstrating the hypoglycemic effect of this plant are little known. Therefore, in the present study, its glycemia-regulating effect was evaluated in a Wistar rat model. The experiments were performed as a pilot test and were validated in a kinetic of 0, 1, 1, 2, 6 and 24 hours using five experimental groups (control, diabetics induced with alloxan, diabetics treated with metformin and diabetics treated with P. spicatus extract with doses of 250 and 500 mg/kg). The treatments were applied for 1, 5 and 21 days and the data obtained were validated by ANOVA/Neuman-Keuls (p< 0.05) using the GraphPad Prism V.5. statistical package. The results showed that alloxan at 120 mg/kg induced diabetes mellitus in 100 % of the rats. The extract at 250 and 500 mg/kg achieved a significant reduction in blood glucose levels compared to diabetic rats, showing no significant difference between doses. The reduction in blood glucose levels caused by metformin at 500 mg/kg p< 0,05, and the different doses of the extract showed no significant differences. According to the results of the study, the extract of P. spicatus induces a hypoglycemic effect in rats. [ABSTRACT FROM AUTHOR]

Copyright of Gaceta Médica Boliviana is the property of Universidad Mayor de San Simon, Facultad de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objetivo: Establecer la relación entre diabetes mellitus tipo 2 y el desarrollo de cáncer de tiroides en los pacientes que acuden a la consulta de cirugía oncológica de cabeza y cuello del CMDLT en el período comprendido entre enero 2018- enero 2023. Métodos: Estudio de tipo observacional, analítico, con casos controles, transversal, el cual incluyó 24 pacientes, obteniendo diagnóstico histopatológico de carcinoma de tiroides y previamente antecedente de diabetes. Se evaluó el comportamiento epidemiológico y desarrollo del carcinoma en presencia de diabetes mellitus tipo 2. Resultado: Más de la mitad de los pacientes (61%) pertenecieron al grupo con ambos diagnósticos, estimando una alta probabilidad comprendida entre 26,6 y 50,8% que el diagnóstico de diabetes mellitus tipo 2 previo sea un factor de riesgo para desarrollar cáncer de tiroides, con un IC del 95%. Además, se asocia que el diagnóstico de diabetes establecido en un tiempo mayor a 5 años pueda será el responsable del desarrollo de carcinogénesis; constatándose además que la histología más frecuente fue de carcinoma diferenciado, específicamente carcinoma papilar de tiroides (79%). Conclusión: La presencia de diabetes mellitus como factor de riesgo está relacionada con el cáncer de tiroides en pacientes jóvenes, menores de 50 años, asociado a un tiempo mayor de 5 años del diagnóstico endocrino patológico.

The toxic effects of thioacetamide (TAA) and carbon tetrachloride on the human body are well recognized. In this study, we examined whether TAA intoxication can induce kidney leukocyte infiltration (measured as leukocyte common antigen CD45) associated with the augmentation of the reactive oxygen species (ROS)/tumor necrosis factor-alpha (TNF-a) axis, as well as biomarkers of kidney injury with and without metformin treatment. Rats were either injected with TAA (200 mg/kg; twice a week for 8 weeks) before being sacrificed after 10 weeks (experimental group) or were pre-treated with metformin (200 mg/kg) daily for two weeks prior to TAA injections and continued receiving both agents until the end of the experiment, at week 10 (protective group). Using basic histology staining, immunohistochemistry methods, and blood chemistry analysis, we observed profound kidney tissue injury such as glomerular and tubular damage in the experimental group, which were substantially ameliorated by metformin. Metformin also significantly (p<0.05) inhibited TAA-induced ROS, TNF-a, urea, and creatinine in harvested kidney homogenates and blood samples. In addition, a significant (p<0.0001) positive correlation between kidney tubular epithelial cell injury and the serum levels of biomarkers of oxidative stress, inflammation, and kidney injury was observed. However, TAA caused no significant (p>0.05) increase in kidney expression of CD45 positive immunostaining cells. In conclusion, we found that TAA induces kidney injury in association with the augmentation of ROS/TNF-a axis, independent of leukocyte infiltration, which is protected by metformin. [ABSTRACT FROM AUTHOR]

Background: The control of diabetes mellitus is multifactorial, the different therapeutic options make it necessary to compare the effectiveness with previous therapeutic schemes. Objective: Analize the indicators of control of diabetes mellitus after incorporating liraglutide, sitagliptin/metformin, linagliptin, and sitagliptin. Material and methods: Observational, analytical, longitudinal study. Glucose, glycosylated hemoglobin, and blood pressure were compared after the inclusion of new cues in patients with diabetes mellitus; in addition to the control indicators reported in the unit in october, november, and december 2000, with those of 2021 in the same months. A descriptive analysis was performed, T for related samples and McNemar, a value of < .05 was considered significant, a confidence level of 95%, with the IBM-SPSS 24 software. Results: 352 files were analyzed, 59% women, aged 26 to 88 years, and the percentage of control decreased after the change of scheme (38.4% vs 35.8%) without a statistical difference (p .503). There was no statistical difference between the levels of glucose, glycated hemoglobin, weight, and blood pressure before and six months after the change. In the unit, the regimen glycemic control indicator improved in October, November, and December 2020 compared to the same months in 2021, it increased (from 17.2, 18.7, and 16.3, to 41.6, 47.2, and 46.5%). Blood pressure control went from 64.5, 66.7, and 67 to 82.4, 85.1, and 83.1%. Conclusions: The control indicators in the unit improved, however, the patients who used the new keys did not show any difference [ABSTRACT FROM AUTHOR]

Laryngeal cancer is the most common neck and head malignancy. Diabetic patients have an increased risk for developing cancer, including laryngeal and oral malignant lesions. Many factors have been involved in the relation between diabetes and carcinogenesis, such as hyperinsulinemia, hyperglycemia, increased oxidative stress, alterations in lipids levels and metabolism, and inflammation. The treatment options of oral cavity and laryngeal cancer include surgery, radiation therapy, chemotherapy, targeted therapy and immunotherapy. Metformin therapy is the most commonly used treatment in case of type 2 diabetes mellitus (T2DM). The impact of metformin use in diabetic patients with head and neck cancer is not currently fully understood. Several studies suggest that patients undergoing treatment with metformin had a lower incidence of head and neck squamous cell carcinoma and decreased rates of recurrence and metastasis. In contrast, other studies have not shown benefits of metformin therapy on the outcomes of head and neck cancer in patients with T2DM. Numerous other studies are needed to confirm the metformin benefit in oral cavity and laryngeal cancer. [ABSTRACT FROM AUTHOR]

Introduction: Polycystic Ovary Syndrome (PCOS) is a hormonal disorder that affects 5-10% of women who are their reproductive age. This meta-analysis aims to evaluate the efficacy of metformin and exenatide, respectively, and to compare the efficacy of both drugs using Body Mass Index (BMI), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and testosterone level. Method: Scopus, Science Direct, Oxford Journal, Wiley Online Library, and Medline (through the PubMed search engine) were used in this study. Statistical analysis of the included studies was done using the RevMan 5.4 software. Results: There were 6 studies included in the analysis of the study. There was a significant reduction in BMI of PCOS patients with exenatide versus metformin (mean difference = 0.51; 95% confidence interval (CI)= 0.07, 0.96, I 2= 52%; p=0.02). There was also a significant reduction in the testosterone level of PCOS patients with exenatide versus metformin (mean difference = 0.15; 95% confidence interval (CI)= 0.07, 0.22, I 2= 0%; p=0.0002). There was no effect on the mean of LDL-C and of HDL-C when compared between metformin and exenatide This meta-analysis shows that exenatide is effective in reducing BMI and testosterone levels in PCOS patients. Conclusions: There were a significant reduction in BMI and testosterone levels of PCOS patients when exenatide was used as compared to metformin. However, there was no effect on the mean of the LDL-C and HDL-C levels of the PCOS patients. [ABSTRACT FROM AUTHOR]

Metformin is the most widely used oral antidiabetic agent for the treatment of type 2 diabetes (T2D) and the association of the use of this drug with vitamin B12 deficiency has been described. A review of studies was carried out to find out the evidence of this association and the recommendations for its detection, prevention and treatment. The reported prevalence of vitamin B12 deficiency in patients treated with metformin ranged from 5.8% to 52% in the different series. Older patients, those who received metformin at high doses and for a longer time, and those who do not consume food of animal origin, are those who are at greater risk of suffering from this deficit.

Introduction: the prolonged use of metformin and the lack of consumption of vitamin B12 can cause its deficit, in T2D. Objectives: to analyze the frequency of insufficient consumption of vitamin B12 according to: personal characteristics, anthropometric and laboratory data, and use of metformin; associate serum cobalamin levels with metformin dose and time; establish a relationship between B12 intake and serum levels. Materials and methods: cross-sectional design. Through a survey of the frequency of consumption of food sources of B12 in 200 patients treated with metformin for more than 18 months. Clinical, anthropometric, laboratory data, time and dose of metformin were analyzed in 2 health centers in the Province of Buenos Aires. Results: the percentage of de cient consumption was 29%. 47.5% of unemployment was registered, which reached an in-take deficit of 32.6%. Serum B12 was measured in 65% of the sample where 53.8% of values were abnormal (0.8% in deficient levels) and 23% at levels normal lower cut-off point, with a significant association being observed at doses of metformin ≥1,500 mg. Deficiencies in B12 intake (

Objetivo: conocer el porcentaje de pacientes que tienen prescrito tratamiento para la diabetes mellitus, tipo de tratamiento y comparativa con el Plan Integral de Diabetes de Andalucía. Métodos: se incluyó en el estudio a todos aquellos pacientes que accedieron a la Farmacia Felisa Baena de Linares (Jaén) y quisieron facilitar su tratamiento completo (n=500). A través de un estudio observacional se comprobó el tipo de tratamiento y su coincidencia con el Plan Integral de Diabetes. Resultados: se comprobó que el 19,2 % de los pacientes objeto de estudio presentaban diabetes, de estos, el 75 % solo estaba en tratamiento por vía oral y el 9 % solo con insulina. De los resultados obtenidos se comprobó que un 80 % de los pacientes tenía prescrita metformina ya fuese en monoterapia, en combinación con otros antidiabéticos orales o con insulina. Del total de los pacientes con diabetes solo el 1 % tenía prescrito glucagón y un 16 % tiras reactivas, muy por debajo de lo establecido en el Plan Integral de Diabetes, que debería haberse encontrado en este caso en un 47 % de los pacientes. Conclusiones: en nuestro entorno existe un alto número de pacientes con diabetes, predominando la terapia con metformina. Hay un bajo porcentaje de pacientes que tiene prescrito glucagon y tiras reactivas, comparado con el Plan Integral de Diabetes, lo que supone un riesgo para la salud del paciente. De aquí la importancia de desarrollar programas de salud desde la farmacia para que los pacientes conozcan los controles de la diabetes.

Introdução: Diabetes Mellitus é doença metabólica, caracterizada pela deficiência absoluta ou relativa de insulina, que acomete cerca de 382 milhões de pessoas em todo mundo, tendo uma das complicações mais comuns a polineuropatia. A Metformina, medicamento amplamente utilizado como tratamento do Diabetes, foi descrita como responsável, em algumas literaturas, por causar ou agravar deficiência de vitamina B12, que está similarmente relacionada ao desenvolvimento de polineuropatia. Métodos: Nesse sentido, foi conduzido um estudo no município de Soledade – RS, com objetivo de verificar se essa relação é condizente com a realidade da localidade. Foram escolhidos 58 pacientes, dos quais 30 responderam questionários adaptados baseados na literatura e na Classificação de Neuropatia de Michigan (MNSS-Brasil), então colhidos 5 ml de sangue venoso da fossa antecubital, preparado soro do qual uma alíquota foi separada para determinação bioquímica da vitamina B12. Resultados: Analisando os resultados, a maioria dos pacientes analisados apresentou sintomas de polineuropatia, e 10% deste, deficiência vitamínica. Conclusão: nenhuma variável explicou a correlação do uso crônico da Metformina, dose e gênero com a deficiência da vitamina B12, o que indica que não há evidências fortes o suficiente que sustentem esse fato, de acordo com as particularidades da localidade analisada.

Introduction: Diabetes Mellitus is a metabolic disease, characterized by absolute or relative insulin deficiency, which affects about 382 million people, with polyneuropathy being one of the most common complications. Metformin, a drug widely used as a treatment for diabetes, has been described as responsible, in some literature, for causing or aggravating vitamin B12 deficiency, which is similarly related to the development of polyneuropathy. Methods: In this sense, a study was conducted in Soledade - RS, in order to verify whether this relationship is consistent with the reality of the locality. Fifty-eight patients were selected, of which 30 answered adapted questionnaires based on the literature and on the Michigan Neuropathy Classification (MNSS-Brazil), then 5 ml of venous blood was collected from the antecubital fossa, serum prepared from which an aliquot was separated for biochemical determination of the vitamin B12. Results: Analyzing the results, most of these patients presented symptoms of polyneuropathy and, 10% of them, vitamin deficiency. Conclusion: no variable explained the correlation of chronic use of Metformin, dose and gender with vitamin B12 deficiency, which indicates that there is not enough evidence to support this fact, according to the particularities of the analyzed locality. [ABSTRACT FROM AUTHOR]

BACKGROUND: Linear oral erythematous lesions are considered early signs of vitamin B12 deficiency; establishing an opportune diagnosis avoids neurological sequelae. CLINICAL CASE: A 60-year-old male patient with type 2 diabetes mellitus in control with metformin for 6 years, who presented burning and pain in the oral cavity of 6 months of evolution, multi-treated without improvement to the indicated therapies. Linear oral erythematous lesions were identified in different areas of the buccal mucosa, a diagnosis of vitamin B12 deficiency was established, without megaloblastic anemia. Two years after his follow-up, he was free of lesions and type 2 diabetes mellitus under control. CONCLUSIONS: Linear erythematous oral lesions on the buccal mucosa are an early sign of vitamin B12 deficiency in patients with diabetes mellitus 2 receiving metformin treatment for prolonged periods. [ABSTRACT FROM AUTHOR]

Copyright of Revista Mexicana de Endocrinología, Metabolismo y Nutrición is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Medicina Interna de Mexico is the property of Colegio de Medicina Interna de Mexico and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

De acordo com a Federação Internacional de Diabetes, estima-se 463 milhões de pessoas acometidas pela doença ao redor do mundo, sendo o Brasil líder de casos na América Latina. Esta revisão objetivou avaliar evidências do uso de vitamina B12 (cobalamina) na melhoria da qualidade de vida de pacientes com Neuropatia Diabética (ND), bem como na redução dos sintomas através da melhora da dor, aumento na percepção sensorial e da avaliação neurológica global. Produziu-se uma Revisão Sistemática de ensaios clínicos randomizados, partindo da seleção e análise de dados, preconizada pela Pubmed, Cochrane e Biblioteca Virtual de Saúde, na qual três revisores selecionaram e extraíram dados, chegando a um consenso entre a qualidade metodológica dos estudos, com objetivo de evitar vieses. Desenvolvido na Faculdade de Medicina Nova Esperança (FAMENE) em parceria da Universidade Federal do Triângulo Mineiro (UFTM), esta pesquisa abrange estudos duplo-cego, placebo controlado, prospectivos, com seguimento e avaliação de pacientes através de escalas e outras avaliações neurológicas. Nesses ensaios, foram avaliados pacientes entre todas as faixas etárias e gêneros, portadores de ND, devidamente diagnosticada, e aptos para realizar reposição oral de vitamina B12. Na primeira fase, foi verificado se cada estudo encontrado cumpria os critérios para inclusão: tipo de estudo, tipo de participantes e tipo de intervenções. Foi identificada a relação estabelecida entre uso de metformina e deficiência de vitamina B12. E, embora existam aumento nos parâmetros neurológicos e escalas avaliadas, não está constatada na literatura ainda a associação benéfica da reposição de cobalamina em pacientes com ND. Portanto, apesar do consenso acerca da deficiência de vitamina B12 causada pelo uso de metformina, ainda não existem evidências científicas referentes à eficiência terapêutica da reposição oral de vitamina B12 em pacientes com diabetes mellitus tipo 2 portadores de ND.

Copyright of Family Medicine Forum / Forum Medycyny Rodzinnej is the property of VM Medica-VM Group (Via Medica) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Diabetes mellitus is a metabolic disorder with a high incidence worldwide, however, treatment with conventional release tablets entails the presence of adverse effects, as well as high and repeated doses. Modified release dosage forms improve the performance of drugs and adherence to therapy by patients, which is why they are a useful alternative in the treatment of diabetes. Aim: To manufacture and to evaluate hydrophilic matrices of metformin hydrochloride using low proportions of HPMC with high viscosity, to obtain tablets that fulfill the prolonged release criteria of United States Pharmacopeia (USP). Methods: Tablets were manufactured by wet granulation and characterized by various pharmacopeial tests including in vitro release studies, with which the release mechanism was studied by fitting mathematical models of Higuchi, Korsmeyer-Peppas and Hixson-Crowell. Results: Formulation F2 complied with the pharmacopoeial quality tests and complied with the acceptance criteria for USP prolonged release criteria, by means of Fick-type diffusion. Conclusions: Hydrophilic matrices for modified release of Metformin were obtained, using low proportions of HPMC as a possible platform for new formulations in the treatment of diabetes. [ABSTRACT FROM AUTHOR]

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Diabetes and hypertension account for the majority of chronic kidney injury cases that can lead to renal failure. The link between the leukocytes common antigen (CD45) and diabetic kidney disease (DKD) with and without metformin incorporation in an animal model has not been investigated before. Therefore, we sought to assess the extent of leukocytes infiltration into kidney tissues 10 weeks following the induction of diabetes in rats treated with metformin. In addition, we monitored blood and urine parameters associated with diabetes. The model group of rats received streptozotocin (STZ; 50 mg/kg) injection after being fed for 14 days on a high-fat diet (HFD) and continuously fed a HFD until they were culled, at week 12. The protective group was treated in the same way except that these animals were put from day 1 on metformin (200 mg/kg) until being culled, on week 12. Kidneys were immunostained with CD45 as a marker of leukocytes infiltration and examined by light microscopy. Urine samples were tested for urine albumin and collected blood was analyzed for sugar, urea, creatinine, and oxidative stress and antioxidants biomarkers. Kidney injury secondary to diabetes was developed as demonstrated by (i) increased blood glucose, urea, and malondialdehyde (MDA) as a marker of lipid peroxidation; and (ii) kidney tissue damage and marked increase in kidney tissues expressing CD45 positive cells. The above markers were inhibited (p≤0.0006) by metformin. Also, a significant correlation was observed between CD45 score and glycemia, urea, MDA, and the antioxidant superoxide dismutase (SOD). Thus, our data demonstrate an association between the infiltration of CD45+ inflammatory cells into kidney tissues and biomarkers of kidney damage in a rat model of DKD, which was effectively protected by metformin. [ABSTRACT FROM AUTHOR]

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BACKGROUND: Most severe cases of metabolic acidosis are caused by lactic acid or ketones (diabetic ketoacidosis), and to a lesser extent by methanol, ethylene glycol, salicylates, and drugs such as metformin. CLINICAL CASES: This paper reports two clinical cases (a 70-year-old woman and a 63-year-old man) with lactic acidosis by metformin. CONCLUSIONS: Lactic acidosis by metformin is a complication of treatment in diabetic patients, highlighting the importance of replacement therapy as a treatment and that of an early diagnosis. [ABSTRACT FROM AUTHOR]

A metformina é um hipoglicemiante oral da classe das biguanidas muito utilizado no tratamento de diabetes mellitus tipo 2. Os estudos de equivalência farmacêutica destinam-se à avaliação de alguns parâmetros de qualidade dos medicamentos por meio de análise comparativa entre o(s) medicamento(s) teste e o medicamento de referência. Dessa maneira, o presente trabalho teve como objetivo avaliar a equivalência farmacêutica de comprimidos de duas marcas de medicamento genérico e duas marcas de similar frente ao medicamento referência de cloridrato de metformina 850 mg. Os testes realizados nas amostras foram peso médio, teor de substância ativa, friabilidade, desintegração e dissolução. As amostras testadas foram aprovadas em todos os testes, encontrando-se dentro dos limites preconizados pela farmacopeia brasileira 5ª edição. Assim pode-se afi rmar que todos os medicamentos testados são equivalentes farmacêuticos do medicamento referência.

Objetivos: Esclarecer o papel da metformina na prevenção da diabetes gestacional (DG) na grávida obesa não diabética. Fontes de dados: Bases de dados The Cochrane Library, Canadian Medical Association Infobase, Database of Abstracts of Reviews of Effects, NICE Guidelines Finder, National Guideline Clearinghouse, BMJ Clinical Evidence, PubMed e Índex de Revistas Médicas Portuguesas. Métodos: Em junho de 2020 foram pesquisadas meta-análises, revisões sistemáticas, ensaios clínicos controlados e randomizados e diretrizes clínicas publicados entre maio de 2010 e maio de 2020, nas línguas portuguesa e inglesa. Foram utilizados os termos MeSH Pregnancy, Obesity, Metformin, Diabetes Gestational e os termos Descritores em Ciências da Saúde “Gravidez”, “Obesidade”, “Metformina”, “Diabetes gestacional”. Para atribuição dos níveis de evidência e de força de recomendação utilizou-se a escala Strength Of Recommendation Taxonomy (SORT), da American Family Physician. Resultados: Foram encontrados 152 artigos, dos quais três cumpriam os critérios de inclusão e foram selecionados. A revisão da Cochrane de 2018, baseada em três ensaios clínicos aleatorizados e randomizados (ECAC) com um total de 1.099 grávidas, não encontrou diferenças significativas na taxa de DG nos grupos metformina vs. placebo (nível de evidência 1). A meta-análise de Chatzakis et al. Que avaliou quatro ECAC, incluindo 624 mulheres, concluiu que a metformina não diminui o risco de desenvolver DG (nível de evidência 1). O ECAC selecionado, Sales et al. incluiu 164 grávidas (82 metformina vs 82 controlo) e concluiu que o uso de metformina não é eficaz na prevenção de DG (nível de evidência 2). Conclusão: Não há evidência disponível para recomendar o uso de metformina na prevenção da DG em mulheres grávidas obesas (força de recomendação A).

Diabetes mellitus is represented worldwide as a healthcare challenge. Various treatments have been used in an attempt to improve glycemic control and decrease the disease's devastating complications. The present study aimed to assess the effect on diabetes-relevant parameters of the combination therapy with sitagliptin plus metformin in type 2 diabetic patients using adjuvant vitamin E or propolis as add-on therapy. For this purpose, three serum samples were collected from patients; first visit (baseline) and 8-week vitamin E added to their course of therapy, then serum sample collected at second visit followed by a washout period of one week and propolis added to the list of patients' therapy for additional 8-weeks and serum collected at the end of the 8-weeks (third visit). The collected samples were frozen until analysis. The baseline and post-therapy samples were analyzed for fasting blood sugar (FBS), glycated hemoglobin (HBA1c), C-peptide, and insulin; and the results were analyzed statistically. The results confirmed that vitamin E and propolis have both improved measured parameters through significant reduction of FBS and HBA1c together with improved insulin sensitivity through significant reduction of insulin level and C-peptide compared to baseline levels. Moreover, propolis has shown a higher effect over vitamin E shown by its increased positive effects on measured parameters. The study concluded that adjuvant addition of either propolis or vitamin E could improve glycemic control and associated parameters of insulin and relevant C-peptide level. [ABSTRACT FROM AUTHOR]

Induction of osteoarthritis (OA) following diabetes is characterized by a sever inflammation of the joints that can lead to disability. The cartilage content of proteoglycans can substantially be reduced, following the induction of diabetes mellitus associated with inflammation as well as knee joint injury, and the antidiabetic drug metformin combined with the antiinflammatory agent resveratrol can prevent these deleterious effects. Therefore, insulin-independent diabetes, type 2 diabetes mellitus (T2DM) was induced in Albino rats by streptozotocin (STZ) injection (50 mg/kg) after being fed on a high carbohydrate and fat diets for 2 weeks. The protective group of rats which also received a single injection of STZ was treated daily with metformin (Met; 200 mg/kg) and resveratrol (Res; 30 mg/kg) for 12 weeks. Harvested knee joint tissues were prepared for basic histology stain and for proteoglycans staining using light microscopy. Histology images showed in diabetic rats (T2DM) OA development as demonstrated by profound injury to the knee joint and severe decrease of articular cartilage proteoglycans content, which were substantialy protected by Met+Res. Met+Res also significantly (p< 0.0001) decreased diabetes induced glycemia, dyslipidemia, and the inflammatory biomarkers, tumor necrosis factor-alpha (TNF-a), interleukin-6 (IL-6), and high sensitivity C-reactive protein (hs-CRP). In addition, there was a significant correlation between OA and glycemia, dyslipidemia, and inflammation. Collectively, we demonstrate an association between knee joint damage and biomarkers of glycemia, dyslipidemia, and inflammation in diabetes-induced OA, with metformin plus resveratrol providing protective effects. [ABSTRACT FROM AUTHOR]

Objectives. Glycosylated hemoglobin could under-represent daily fluctuations in blood glucose. Multiple techniques have been proposed to study glycemic variability in order to better understand the metabolic control of the disease. The objective of this study is to compare the glycemic variability measured by MAGE and CONGA in the intervention and control group; In addition, compare the glycemic variability results obtained before and 12 weeks after the start of treatment in both groups. Methods. Phase IV, randomized, multicenter, open-label clinical trial. Forty subjects were randomized to receive vildagliptine plus metformin1 or glimepiride plus metformin for a period of 12 weeks. Continuous blood glucose monitoring was performed before and after the treatment period using iPro2 devices. The results of glycemic variability measured by MAGE, CONGA and DET were compared. The safety and tolerability profile of the interventions was compared. Results. The use of GalvusMet®? or glimepiride plus metformin for 12 weeks in diabetic patients with poor glycemic control was associated with a statistically significant reduction in glycemic variability (Wilcoxon p-value <0.005) and HbA1c (Wilcoxon p-value <0.005) in both groups; however, insufficient evidence was found to determine the superiority of the treatments. No differences were detected in the safety or tolerability profile of the drugs. Conclusions. The results of the study suggest that the evaluated treatment regimens are equivalent. Additional studies are required to determine the clinical significance of the results. [ABSTRACT FROM AUTHOR]

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Introducción: el consumo de metformina se asocia con déficit de vitamina B12. Objetivo: identificar las características clínicas predictoras del déficit en mayores de 18 años con diabetes mellitus tipo 2 (DM2) tratados con metformina. Materiales y métodos: estudio de corte transversal analítico en 100 pacientes entre 50 y 85 años con DM2 tratados con metformina por más de 3 meses, con registro de niveles de vitamina B12 en la historia clínica, atendidos en un programa de diabetes de medicina familiar en Bogotá DC, Colombia. Resultados: la media de duración de la enfermedad fue 9.6 años, el uso de metformina varió entre 1 y 5 años (32%), la dosis más utilizada estuvo entre 1001 y 2000 mg (65%), polifarmacia en 45% y la prevalencia del déficit en 27%. En el modelo de regresión logística se encontró que el tiempo de uso se comporta como factor predictor de déficit de vitamina B12 (OR=0,01 IC95% 0,01-0,03) (p

BACKGROUND: Metformin, in toxic doses, can cause resistant metabolic acidosis with hyperlactatemia, without hypoglycemia, contrary to what might be thought, considering it a hypoglycemic agent. CLINICAL CASE: A 52-year-old male patient, who was found with severe metabolic acidosis and hyperlactatemia secondary to the ingestion of 17 g of metformin, without repercussion in glycemia. Initially treated with life support, which consisted of advanced airway management, intravenous fluids, hemodynamic support with vasopressors and sodium bicarbonate as previous therapy to definitive treatment with hemodialysis. There is evidence of improvement of metabolic acidosis after the first session of hemodialysis with persistence of hyperlactatemia. Considering the redistribution of the agent, described in the literature, got into a second session of hemodialysis, reversing indicators of severity. CONCLUSIONS: The clinical manifestations of acute metformin intoxication usually begin late, so patients suspected of having ingested toxic doses should be closely monitored. [ABSTRACT FROM AUTHOR]

Diabetes prevention includes preventing or delaying the onset of diabetes, preserving beta cell function, preventing, or delaying microvascular and cardiovascular complications, and ultimately reducing the costs of diabetes care for institutions. In order to identify individuals who are suitable candidates for preventive interventions, many studies show that glycated hemoglobin or fasting plasma glucose is measured in adults over 45 years old; in women with a history of gestational diabetes; in adults of any age with a body mass index greater than 25 kg/m² with one or more additional risk factors for diabetes. Lifestyle modification, predominantly exercise and weight loss, successfully decreases the development of diabetes. Patients who are at high risk should be followed closely, with tests and repeated measurements of fasting blood glucose or A1C annually, for selected patients younger than 60 years or BMI greater than 35 kg/m² and women with a history of gestational diabetes, with impaired fasting glucose, impaired glucose tolerance, or 5.7 to 6.4% A1C, in whom lifestyle interventions fail to improve glycemic indices, studies conclude that medications can be used. [ABSTRACT FROM AUTHOR]

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RESUMEN Objetivo. Medir el precio, disponibilidad y asequibilidad de insulina y metformina, como comparador, en farmacias públicas y privadas en seis regiones del Perú. Métodos. Estudio transversal con uso de la metodología adaptada de la Organización Mundial de la Salud/Acción Internacional para la Salud (OMS/AIS). Se encuestaron farmacias públicas y privadas de seis regiones del Perú. Se recolectaron datos de disponibilidad y precio de insulina (todos los tipos) y metformina en presentación de 850 mg. La disponibilidad se expresa en porcentajes y los precios se reportan en medianas. La asequibilidad se define como el número de días que debe laborar una persona con el salario mínimo para cubrir el costo de un mes de tratamiento. Resultados. La disponibilidad en farmacias públicas es de 63,2% para insulina regular y 68,4% para isófana-NPH, pero se observaron diferencias de disponibilidad entre los niveles de atención y entre las regiones. En farmacias privadas, la variedad de insulina es mayor, pero la disponibilidad es menor del 11%. La mediana de precios para la insulina humana en farmacias privadas fue entre tres a cuatro veces mayor que en farmacias públicas. En comparación, la disponibilidad de metformina alcanza 89,5% en farmacias públicas y 77,7% en privadas. La asequibilidad en farmacias públicas para un mes de tratamiento con insulina humana o metformina genérica es menor a lo percibido por un día laborable. Conclusiones. El precio de insulinas humanas y de metformina genérica en farmacias públicas es asequible. Sin embargo, se necesitan esfuerzos para mejorar su disponibilidad en las regiones y los niveles de atención.

Objetivo: Analizar la actividad antiinflamatoria y antinociceptiva de la metformina en un evento agudo de inflamación-edema y dolor inducido en roedor. Materiales y métodos: Se utilizaron 198 ratones hembras. Se evaluó el efecto antiinflamatorio con la prueba de edema plantar inducido por carragenina en 64 ratones y, para evaluar el efecto sobre el dolor, se utilizó la prueba de placa caliente e inmersión de la cola, con 64 y 70 ratones, respectivamente. En ambos casos se tuvieron grupos controles, placebo y experimentales. Para el análisis se emplearon las pruebas de Shapiro-Wilk, de ANOVA de una cola, de Tukey y correlación de Pearson. Resultados: En el edema de la pata por carragenina, los grupos metformina 50 y 150 mg/kg presentaron efecto antiinflamatorio a la segunda y tercera hora. En la prueba de placa caliente, los grupos metformina 100, 200 y 250 mg/kg presentaron efecto analgésico en la segunda y cuarta hora. En la prueba de inmersión de cola, los grupos metformina 100, 150, 200 y 250 mg/kg presentaron efecto analgésico desde el minuto 15 hasta terminar el experimento; además, el grupo metformina 150 mg/kg tuvo efecto estadísticamente equivalente al grupo control de morfina 10 mg/kg. Conclusiones: Se demuestra la actividad antiinflamatoria y antinociceptiva aguda de metformina a diferentes dosis, en modelos experimentales con ratones.