metformin/glipizide / Generic mfg. - LARVOL DELTA

Outpatient Discharge Therapy With Saxagliptin+MetforminXR vs GlipizideXL for Type 2 Diabetes With Severe Hyperglycemia (clinicaltrials.gov) - P4 | N=100 | Completed | Sponsor: Cook County Health | Unknown status ➔ Completed

Trial completion • Diabetes • Hypoglycemia • Metabolic Disorders • Type 2 Diabetes Mellitus

7 Common Medications That Can Contribute to Weight Gain (The Healthy) - "Still, weight gain can add other health woes such as metabolic syndrome and type 2 diabetes, so you do want to minimize it as much as possible, says Louis Aronne, MD...Older beta-blockers that are given to lower blood pressure-including Tenormin (atenolol), Lopressor (metoprolol), and Inderal (propranolol)-have the potential to cause extra pounds to creep on, Dr. Aronne says."

Media quote

Evaluating the stability of prescription drugs in municipal wastewater and sewers based on wastewater-based epidemiology. (PubMed, Sci Total Environ) - "Within 72 h, eleven of these 14 drugs, such as metformin, metoprolol, bezafibrate, etc., have decay percentages below 20% in wastewater, which are considered as stable drugs; and the decay percentages of the other three, monluster, paroxetine, and sertraline, are greater than 20%, which are the most unstable drugs. In lab-scale aerobic and anaerobic sewers, the decay percentages of metformin, glipizide, metoprolol, gemfibrozil, and atorvastatin are less than 20% within 24 h. The decay percentages of venlafaxine, citalopram, fluoxetine, salmeterol, and salbutamol within 24 h are 20%-60% and paroxetine and sertraline are close to or even exceed 80% within 6 h. Biodegradation of drugs in sewers with aerobic or anaerobic biofilms is higher than that in wastewater systems without biofilms. The results showed that when the per capita consumption of drugs is estimated by using the WBE method, the stability of drugs in wastewater and different types of sewers..."

Clinical • Journal • Asthma • Cardiovascular • CNS Disorders • Depression • Diabetes • Metabolic Disorders • Psychiatry • Respiratory Diseases

[VIRTUAL] A Rare Presentation of Asymptomatic Eosinophilic Colitis (ACG 2020) - "His medications included amlodipine, lisinopril, aspirin, simvastatin, metformin, glipizide, repaglinide and tadalafil. This case highlights the importance of considering eosinophilic colitis when encountering the endoscopic finding of whitish mucosal exudates even in asymptomatic patients. Perhaps, these patients need to be followed to monitor for development of symptoms later in life."

Allergy • Colonic Polyps • Colorectal Cancer • Constipation • Diabetes • Eosinophilia • Food Hypersensitivity • Gastroenterology • Gastrointestinal Cancer • Gastrointestinal Disorder • Hypertension • Immunology • Metabolic Disorders • Oncology • Pain • Solid Tumor • Type 2 Diabetes Mellitus

[VIRTUAL] Diabetes Mellitus Is Associated With Higher Rates of Pancreatic Cysts: A U.S. Population-Based Study (ACG 2020) - "When compared to DM patients without PC, patients with PC were more likely to use both subcutaneous antihyperglycemics (insulin) and oral antihyperglycemics (metformin and glipizide) (Table 1). Out of 39,398,710 patients in the database (2015-2020), we identified 25,840 (0.07%) with PC and 3,727,990 (9.46%) with DM. Amongst patients with DM, 6,050 (0.16%) were found to have a new diagnosis of PC after at least 30 days of DM diagnosis. Patients with DM were more likely to have a diagnosis of PC when compared to those without DM [OR: 3.47; 95% CI: 3.37-3.57]."

Clinical • Cardiovascular • Coronary Artery Disease • Diabetes • Dyslipidemia • Gastrointestinal Cancer • Genetic Disorders • Hepatology • Hypertension • Immunology • Inflammation • Metabolic Disorders • Obesity • Oncology • Pancreatic Cancer • Pancreatitis • Solid Tumor

A Polygenic Score for Type 2 Diabetes Risk is Associated with Both the Acute and Sustained Response to Sulfonylureas. (PubMed, Diabetes) - "In the Study to Understand the Genetics of the Acute Response to Metformin and Glipizide in Humans (SUGAR-MGH), we constructed weighted polygenic scores using known genome-wide significant associations for T2D, fasting glucose (FG), and fasting insulin (FI), comprised of 65, 43, and 13 single nucleotide polymorphisms, respectively. In replication, a higher T2D score was associated with a greater 1-year HbA1c reduction to sulfonylureas in the Genetics of Diabetes Audit and Research, Tayside and Scotland (GoDARTS) study (p=0.02). Our findings suggest that individuals with a higher genetic burden for T2D experience a greater acute and sustained response to sulfonylureas."

Journal • Diabetes • Metabolic Disorders • Type 2 Diabetes Mellitus

[VIRTUAL] Triple therapy with pioglitazone/exenatide/metformin prevents hepatic fibrosis and steatosis in type 2 diabetes (EASD 2020) - P4 | "Both Triple (6.0%) and Conventional Therapy (6.7%) markedly reduced the HbA1c after 2 years, but only Triple Therapy (Pioglitazone/Exenetide/Metformin) reduced the AST and ALT. Liver fibrosis scores did not change in either group and were not useful in predicting response to therapy. Triple Therapy completely prevented fibrosis and reduced steatosis by >50 % vs Conventional Therapy."

Diabetes • Metabolic Disorders • Non-alcoholic Fatty Liver Disease • Type 2 Diabetes Mellitus

[VIRTUAL] Treatment of Hepatitis C Has Time-Dependent Relationship with Type 2 Diabetes Progress (ENDO-I 2020) - "Case Presentation 52 y/o white male nursing home patient history of hepatitis C and type 2 diabetes mellitus was treated with ledipasvir/sofosbuvir (90 mg - 400 mg) for 12 weeks. Prior to HCV treatment patient DM control was treated with oral medications (metformin and glipizide) with fast glucose level fluctuating 143±44 mg/dl; 2 hours postprandial level 205±57mg/dl; HbA1c 7.0%...Oral DM medications were doubled dosages and maximum dosage of pioglitazone was added on...Discussion Based on our observation there are four phases of DM development related to the HCV treatment: phase I silence stage (during 3 month HCV treatment) DM is stable; phase II deterioration stage (First 3 month after HCV treatment) DM is progressively getting worse; phase III recovery stage (4 to 6 month after HCV treatment) DM is gradually improving; phase IV stabilization stage (6 month after HCV treatment) DM is stabilized and improved. Conclusion Anti-viral treatment of HCV has..."

Diabetes • Hepatitis C Virus • Infectious Disease • Metabolic Disorders • Type 2 Diabetes Mellitus

"Blink Health Launches Free Type 2 Diabetes Drug Program for metformin, glipizide, pioglitazone in USnhttps://t.co/NVAITwSRAT via @medscape" (@ferguriffic)

Biosimilar • Diabetes

[VIRTUAL] Pancreatic Cancer in Longstanding Diabetes (ENDO-I 2020) - "Regarding her T2DM, she was diagnosed 15 years ago and prior to the last month, her glucose had been well controlled on Metformin and Glipizide, never requiring Insulin...During her admission, her glucose continued to range from 178-315 even though she was on Lantus 12 units nightly and an Insulin Sliding Scale before meals...Conclusion Unexplained elevation in HA1C should prompt clinicians to run a differential diagnosis of factors that can induced hyperglycemia. This case highlights the importance of recognizing pancreatic malignancy as a possible cause of worsening hyperglycemia in T2DM."

Diabetes • Gastrointestinal Cancer • Immunology • Metabolic Disorders • Oncology • Ophthalmology • Pancreatic Adenocarcinoma • Pancreatic Cancer • Solid Tumor • Type 2 Diabetes Mellitus

[VIRTUAL] Relapsing Diabetic Ketoacidosis During Stepdown from Intensive Care Unit (ENDO-I 2020) - "Home medications: metformin, glipizide and glargine. Recurrent DKA due to abrupt cessation of IV insulin prolonged these patients’ hospitalization. The practice of overlapping IV insulin with SQ insulin for >30 min prevents dissipation of insulin action during resolution of DKA. Half-life of IV insulin is 3 min, so SQ insulin must be given before cessation of the insulin drip to prevent the relapse."

Diabetes • Metabolic Disorders

Treatment of Hepatitis C Has Time-Dependent Relationship with Type 2 Diabetes Progress (ENDO 2020) - "Case Presentation 52 y/o white male nursing home patient history of hepatitis C and type 2 diabetes mellitus was treated with ledipasvir/sofosbuvir (90 mg - 400 mg) for 12 weeks. Prior to HCV treatment patient DM control was treated with oral medications (metformin and glipizide) with fast glucose level fluctuating 143±44 mg/dl; 2 hours postprandial level 205±57mg/dl; HbA1c 7.0%...Oral DM medications were doubled dosages and maximum dosage of pioglitazone was added on...Discussion Based on our observation there are four phases of DM development related to the HCV treatment: phase I silence stage (during 3 month HCV treatment) DM is stable; phase II deterioration stage (First 3 month after HCV treatment) DM is progressively getting worse; phase III recovery stage (4 to 6 month after HCV treatment) DM is gradually improving; phase IV stabilization stage (6 month after HCV treatment) DM is stabilized and improved. Conclusion Anti-viral treatment of HCV has..."

Pancreatic Cancer in Longstanding Diabetes (ENDO 2020) - "Regarding her T2DM, she was diagnosed 15 years ago and prior to the last month, her glucose had been well controlled on Metformin and Glipizide, never requiring Insulin...During her admission, her glucose continued to range from 178-315 even though she was on Lantus 12 units nightly and an Insulin Sliding Scale before meals...Conclusion Unexplained elevation in HA1C should prompt clinicians to run a differential diagnosis of factors that can induced hyperglycemia. This case highlights the importance of recognizing pancreatic malignancy as a possible cause of worsening hyperglycemia in T2DM."

Relapsing Diabetic Ketoacidosis During Stepdown from Intensive Care Unit (ENDO 2020) - "Home medications: metformin, glipizide and glargine. Recurrent DKA due to abrupt cessation of IV insulin prolonged these patients' hospitalization. The practice of overlapping IV insulin with SQ insulin for >30 min prevents dissipation of insulin action during resolution of DKA. Half-life of IV insulin is 3 min, so SQ insulin must be given before cessation of the insulin drip to prevent the relapse."

Advanced and multifaceted stability profiling of the first-line antidiabetic drugs metformin, gliclazide and glipizide under various controlled stress conditions. (PubMed, Saudi Pharm J) - "All drug peaks were sharp and well separated. Stress degradation revealed that metformin has a remarkable sensitivity to alkaline stress, glipizide was more sensitive to thermal degradation while gliclazide exhibited almost full degradation in acidic, alkaline and oxidative stress conditions."

Clinical • Journal

Access to and price trends of antidiabetic, antihypertensive, and antilipidemic drugs in outpatient settings of the Universal Coverage Scheme in Thailand. (PubMed, PLoS One) - "Due to generic market competition, metformin, glipizide, amlodipine, losartan, simvastatin, atorvastatin, and fenofibrate prices decreased by 6-22%. Antiretrovirals and risperidone prices decreased by more than 10% due to price negotiation by the UCS...A decline in the PPI could contain essential drug expenditure when the demand for the drugs increased. Generic market competition and price negotiation by the UCS led to price reduction."

Clinical • Journal

The presence of two reduced function variants in CYP2C9 influences the acute response to glipizide. (PubMed, Diabet Med) - "Carriers of two reduced function alleles in CYP2C9 may experience an increased insulin response to glipizide and be predisposed to a higher risk of hypoglycaemia, although no effect of genotype was seen in glucose-based measurements. Further studies are needed to clarify the utility of CYP2C9 genotyping to guide sulfonylurea treatment."

Journal • CYP2C9

Hospital Admissions Associated With Medication-Related Problems in Thai Older Patients: A Multicenter Prospective Observational Study. (PubMed, J Patient Saf) - "Hospital admissions associated with MRPs in Thai older patients continue to burden the Thai healthcare system of which nearly half were preventable. Further studies should consider analysis of costs and include hepatic and renal function status of participants."

Clinical • Journal • Observational data

HYPERGLYCEMIA-ASSOCIATED LACTIC ACIDOSIS IN SEPSIS (CHEST 2019) - "In the ED she was treated with 30cc/kg IV fluids, ceftriaxone, azithromycin, and IV solumedrol...Metformin and glipizide had been held prior to admission...Lactate is a nonspecific marker used in management of septic patients. Due to the numerous processes that can cause elevated lactic acid, it should be used judiciously in septic patients to avoid unnecessary testing and administration of IV fluids."

Genetic Risk Scores Predict Glycemic Traits and Response to Glipizide Treatment in the Study to Understand the Genetics of the Acute Response to Metformin and Glipizide in Humans (SUGAR-MGH) (ADA 2019) - "When we set a more stringent P-value of 0.008 to correct for multiple comparisons, the FG GRS remained associated with FG and the T2D GRS remained associated with the insulin-based endpoint. We conclude that established genetic determinants of glycemic traits predict FG and FI in our cohort of individuals free of overt diabetes; moreover, T2D risk alleles may predispose individuals to a greater insulin response to glipizide treatment."

Discontinuation of Metformin among Patients with Reduced Renal Function (ADA 2019) - "Probability of discontinuing metformin with reduced renal function decreased over time but was more likely than glipizide discontinuation. The decrease in discontinuation over time was similar in both treatments."

Clinical

Severe Euglycemic Diabetic Ketoacidosis Associated with Use of Canagliflozin (ATS 2019) - "His past medical history was significant for type 2 diabetes mellitus treated with canagliflozin, metformin and glipizide; hypertension and hyperlipidemia. EuDKA remains a diagnostic challenge to clinicians since hyperglycemia is one of the prominent criteria for DKA. In addition, there are multiple causes of metabolic acidosis that makes it challenging to establish the etiology. This report contributes to a growing body of evidence highlighting the association between SGLT2 inhibitors and EuDKA."

ADRENAL MYELOLIPOMA: IS IT ALL NON-FUNCTIONAL FAT? (AACE 2019) - "...Biochemical evaluation:Abnormal dexamethasone test, with a cortisol 8.32 μg/dl and elevated 24 hr urine free cortisol level of 51.7 mcg/24 hrs (4 – 50 mcg/24 hrs).Baseline ACTH was 10 pg/ml (6 – 50 pg/ml), Cortisol: 11.37 μg/dl (6 – 18.4 μg/dl) and DHEAs: 33 mcg/dl (24 – 244 mcg/dl).Plasma metanephrines, aldosterone and renin were normal...Due to worsening type 2 diabetes, Empagliflozin was recently added to his regimen of Metformin, Glipizide, and Pioglitazone...Although functionality of myelolipomas is rare, endocrine dysfunction associated with myelolipomas is underestimated. If functionality is found to be present, such as in our case with hypercortisolism, it may affect surgical management."

Euglycemic DKA triggered by Ketogenic diet- A theoretical concern or actual risk? (AACE 2019) - "Methods : n/a Results : n/a Discussion : Case Presentation: 35 years old male with 12 years history of DM-2 managed on metformin, glipizide and empagliflozin developed severe nausea, vomiting and fatigue. These may precipitate DKA even in the absence of other risk factors. This message should be an integral part of ongoing patient education during use of these medications."

Euglycemic ketoacidosis in a post-operative patient taking empagliflozin (NKF-CSM 2019) - "Her home oral antihyperglycemics including metformin, glipizide, and empagliflozin were held on admission. CONCLUSION Unfortunately, the patient continued to clinically deteriorate, and her family made the decision to withdraw care after she was declared brain dead. This case emphasizes a grave outcome in a post-operative patient taking an SGLT2 inhibitor."

Clinical