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At least 775 records · Page 43Linked to original sources
PubMed2004

In vivo bioequivalence of oral antidiabetic agents: pioglitazone tablets.

The study was designed to evaluate the bioequivalence of two pioglitazone (CAS 112529-15-4) formulations. The trial was performed in 26 healthy male volunteers with the aim of comparing a new generic product (tablets containing 30 mg pioglit-azone hydrochloride, test) with the originator product (reference). The trial was performed according to an open, crossover design in one study centre. In each of the two study periods (separated by a wash-out of 14 days) a single oral dose of 30 mg (test or reference) formulation was administered. Blood samples were taken up to 120 h post dose, the plasma was separated and the concentrations of pioglitazone and its principal active metabolite hydroxypioglitazone were determined by LC-MS-MS method. AUC0-inf, AUC0-t, Cmax, and Tmax were calculated for both formulations. The mean Cmax of pioglitazone ranged between 1.01 microg/mL and 1.05 microg/mL, while the mean AUC0-inf and AUC0-t ranged between 10.89 microg x h/mL and 10.98 microg x h/mL as well as between 10.56 microg x h/mL and 10.62 microg x h/mL for the test and reference formulations, respectively. The median Tmax for the test tablets was 1.50 h and for the reference was 1.75 h. The ratios test/reference formulation for AUC0-inf, AUC0-t and Cmax were 99.70%, 100.13% and 99.17%, respectively. Furthermore, the 90% geometric confidence intervals of the mean ratio of In-transformed AUC0-inf were narrow and symmetrical around 100%, i.e. 90.59% to 109.72%, for AUC0-t, 90.69% to 110.55%, whereas for Cmax they were 87.52% to 112.37%. As in the case of pioglitazone, mean values of the principal bioequivalence parameters of hydroxypioglitazone did not differ significantly after administration of the test and reference formulations. In the light of the present study it can be concluded that the two evaluated pioglitazone formulations, i.e. test formulation of pioglitazone hydrochloride and reference formulation, are bioequivalent in terms of the rate and extent of absorption.

Adolescent↗
PubMed2000

Effects of the oral antidiabetic repaglinide on the reproduction of rats.

Repaglinide (CAS 135062-02-1), a biguanide, is an orally available insulin secretagogue (beta-cell stimulant) and has been developed for the treatment of Type II diabetes. The developmental toxicity of the compound was investigated in rats. The effects on fertility, on embryo- and fetogenesis and on peri- and postnatal development were investigated. In a 'fertility study' 24 males were treated with 0, 1, 30, 300 mg/kg for 10 weeks prior to mating and during mating, and 24 females with 0, 1, 30, 80 mg/kg for 4 weeks prior to mating until gestation day 22 (hysterectomy group) or through gestation day 22 until postnatal day, i.e. lactation day 21 (littering group). In a 'teratogenicity study' with a hysterectomy group and a littering group included, 36 females were treated with 0, 0.5, 5 and 80 mg/kg from gestation day 7-16. In a 'peri-postnatal study' with a cross-foster group included 23 females were treated in the core study with 0, 0.5, 5, 30 and 80 mg/kg from gestation day 16 to lactation day 21 and in the cross-foster group 18 females with 0 and 80 mg/kg from gestation day 16 to lactation day 21. In a 'supplementary study' with five treatment windows 13 females each were treated with 80/30 mg/kg from gestation day 1-5 (W 1), gestation day 6-16 (W 2), gestation day 17-22 (W 3), lactation day 1-14 (W 4) and lactation day 15-21 (W 5). Effects of repaglinide on fertility, implantation, early and late embryogenesis, fetogenesis, birth and postnatal development including fertility of the offspring were investigated. In the 'fertility study' the NOTEL (no toxic effect level) for males was estimated to be 1 mg/kg and for females 30 mg/kg. In the 'teratogenicity study' the maternal NOTEL was 0.5 mg/kg as it was in the 'peri-postnatal study' 5 mg/kg. Food consumption and body weight gain of females were significantly reduced at the beginning of the respective treatment periods of the 'supplementary study' indicating a strong reaction of the dams to the treatment underlined by the death of individual animals (W 3, W 4 and W 5). Offspring survival during the last trimester of pregnancy and during lactation was affected in the 'fertility study' and in the 'peri-postnatal study' after 30 and 80 mg/kg and in the 'supplementary study' slightly in W 3 and more pronounced in W 4 and W 5. Changes of the skeleton in the extremities of the offspring were observed in all studies where the animals were exposed to repaglinide during late pregnancy (i.e. after completion of organogenesis) and/or lactation. At radiography the skeletal alterations comprised deformities of the coracoid process and acromion process, of the proximal humeral epiphysis, and of the epiphysis distalis and the condylus distalis of the femur. Deltoids of the humerus showed a slight increase of height and a length reduction. The radius and ulna were slightly bent. The most marked effects and the highest incidence were induced during the first half of lactation (W 4). As age of offspring increased the changes were more pronounced and occurred with a higher incidence. Correspondingly, ash weight, calcium, magnesium and phosphorus content of bones were reduced, but the proportions remained constant. Histopathological examination (supplementary study) showed that small fibrotic foci were formed in the area of dislocation of parts of the epiphyseal plate and that the remaining hyaline cartilage was thinner than normal (W 3, W 4 and W 5). Additionally, the longitudinal axis of the diaphysis juxtaposed to the growth zone was markedly bent, becoming convex to the lateral side. The studies clearly demonstrated that long bone development was not impaired during embryogenesis and early fetogenesis but after completition of organogenesis exclusively, indicating that repaglinide was not teratogenic. Effects of repaglinide were clearly effects on growth. The effects seen in all studies only occurred at excessively high plasma concentrations which will not be reached at human therapeutic dos

Animals↗
PubMed1999

Effect of oral antidiabetic agents on plasma amylin level in patients with non-insulin-dependent diabetes mellitus (type 2).

The purpose of the study was the comparison of the effect of the oral therapy of non-insulin-dependent diabetes mellitus (NIDDM) with either a sulphonylurea or biguanide derivative on plasma amylin level. In 10 healthy individuals the fasting plasma amylin level was 1.56 +/- 0.27 pmol/l (mean +/- SEM) and 6 min after i.v. injection of 1 mg glucagon a fourfold increase was observed. In 10 patients with NIDDM receiving glibenclamide (CAS 10238-21-8) the fasting plasma amylin level was twofold higher than in healthy control (2.72 +/- 0.38 pmol/l; p < 0.025) but following glucagon administration it increased only twofold. In 15 patients treated with metformin (CAS 657-24-9) the fasting plasma amylin level was similar to that in healthy individuals (1.64 +/- 0.25 pmol/l), but after glucagon stimulation the increment of plasma amylin was minimal and the relevant mean value was significantly lower when compared with those in healthy individuals and with NIDDM patients treated with glibenclamide. In 10 untreated obese patients with newly diagnosed NIDDM the administration of glibenclamide (14 days) resulted in the increase of basal (2.47 +/- 0.23 and 3.16 +/- 0.29 pmol/l; p < 0.1), and glucagon stimulated (3.34 +/- 0.39 and 4.56 +/- 0.38; p < 0.05) plasma amylin concentrations, whereas other 10 patients receiving metformin showed a decrease in fasting plasma level of this peptide before (2.64 +/- 0.59 and 1.28 +/- 0.38 pmol/l; p < 0.1), and after glucagon injection (5.02 +/- 0.55 and 2.83 +/- 0.65 pmol/l; p < 0.02). With the respect to the trophic effect of amyloid deposits in the pancreatic islets and to a hypothetic effect of amylin increasing insulin resistance, the present results emphasize the particular usefulness of metformin in the pharmacological treatment of NIDDM. All contraindications and side effects of metformin should be taken into account before drug administration.

Adult↗
PubMed2006

[Oral antidiabetic therapy].

Consistent antihyperglycaemic treatment for preventing vascular complications in type 2 diabetes mellitus (2DM) often require the application of several measures. The basis of such treatment should be dietary changes and increased physical exercise. The target of antiglycemic treatment is the reduction of HbA1c to below 6.5%. Regular monitoring of HbA1c every 2-6 months is reasonable in order to recognize therapeutic failure early and adapt treatment accordingly. Metformin is the drug of first choice for the oral treatment of 2DM, once possible contraindications having been excluded. The advantage of glinides, compared with sulfonylureas, is mainly in allowing greater dietary flexibility. Although not finally decided, there are ever fewer objections against combined metformin and sulphonylurea treatment. The current guidelines of the (British)National Institute for Clinical Excellence (NICE) specifically recommend this combination treatment. There are pointers to glitazone having protective effects in 2DM beyond its blood-sugar lowering action. However, the clinical significance of these effects requires confirmation. If adequate blood-sugar reduction cannot be achieved with oral medication it is important to initiate insulin administration as soon as possible.

Administration, Oral↗
PubMed1997

Antidiabetic effect of seishin-kanro-to in KK-Ay mice.

The hypoglycemic effect of Seishin-kanro-to (SK) was investigated in KK-Ay mice, one of the non-insulin dependent diabetic mellitus types. SK (1700 mg/kg) reduced the blood glucose of KK-Ay mice from 557 +/- 17 to 383 +/- 36 mg/100 ml 7 hours after single oral administration (P < 0.001). SK also decreased the blood glucose and improved glucose tolerance 5 weeks after repeated administration in KK-Ay mice. These results support, therefore, the use of SK in patients with diabetes and confirm its role as a traditional medicine. In addition, the active plants of SK were identified as the rhizome of Anemarrhena asphodeloides Bunge and the radix of Rehmannia glutinosa Liboschitz.

Animals↗
PubMed1987

The antidiabetic action of somatostatin-28 as assessed by the artificial endocrine pancreas: greater potency than somatostatin-14.

In order to investigate the action of somatostatin-28 (SS-28) on the metabolic homeostasis of insulin-dependent diabetics, we compared its effects to those of somatostatin-14 (SS-14) in terms of insulin sparing, changes in dextrose demands, glucose fluctuations and behavior of growth hormone and glucagon secretion. Eight insulin-dependent subjects were connected to Artificial Endocrine Pancreas (Biostator) for 84 hours during which they received intravenous infusions of either SS-14, SS-28 or isotonic saline in a randomized order, after a steady state of metabolism had been achieved. Five of the patients received SS-28 100 micrograms/h and SS-14 250 micrograms/h for 10 hours and three of them SS-28, 50 micrograms/h and SS-14 250 micrograms/h for 12 hours. Identical doses of both peptides were administered as bolus infusions prior to the continuous ones. Under SS-28 100 micrograms/h and SS-14 250 micrograms/h patients required 13.5 +/- 2.3 and 14.5 +/- 1.9 U of insulin respectively vs 40 +/- 5.6 U under isotonic saline infusion (mean +/- SEM, P less than 0.005 and P less than 0.01). At the same period the apparatus delivered 15 times more dextrose under SS-28 and 20 times more under SS-14. The magnitude of glucose fluctuations diminished from 64.6 +/- 2.47 mg% without to 41.4 +/- 2 mg% under SS-14 (P less than 0.01) and 46 +/- 3.8 mg% under SS-28 (P less than 0.02). Similar changes were observed in the remaining three patients who received SS-28 in the dose of 50 micrograms/h.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1996

Long-term treatment of type 2 diabetic patients with the new oral antidiabetic agent glimepiride (Amaryl): a double-blind comparison with glibenclamide.

An international, prospective, double-blind trial compared the long-term therapeutic value of glimepiride with glibenclamide in patients with Type 2 diabetes mellitus. Patients stabilised on glibenclamide were randomised to 1 mg glimepiride (524 patients) or 2.5 mg glibenclamide (520 patients). The treatment groups were comparable at baseline with respect to age (60.2 years), body mass index (26.5 kg/m2), duration of diabetes (5.0 years) and fasting blood glucose levels (163 mg/dl [9.0 mmol/l]). Doses were increased stepwise, up to 8 mg for glimepiride (once-daily) and 20 mg for glibenclamide (> 10 mg as divided dose), until metabolic control (fasting blood glucose < or = 150 mg/dl [8.3 mmol/l]), or maximum dose was achieved. After one year of treatment, patients entered a long-term follow-up study. Primary endpoints for evaluation of metabolic control, mean glycated haemoglobin and mean fasting blood glucose, were 8.4% and 174 mg/dl (9.7 mmol/l) for glimepiride and 8.3% and 168 mg/dl (9.3 mmol/l) for glibenclamide. Differences between treatment groups were not considered clinically relevant (95% confidence intervals (-0.05, 0.19%) for glycated haemoglobin and (2, 11 mg/dl) [0.1, 0.6 mmol/l] for fasting blood glucose). Statistically significant lower fasting insulin and C-peptide values were observed in glimepiride patients compared with glibenclamide (differences: insulin, -0.92 microU/ml [p = 0.04]; C-peptide, -0.14 ng/ml [p = 0.03]). Both treatment groups showed an equivalent safety profile. Adverse events were consistent with the nature of the diabetic patient population studied. Fewer hypoglycaemic reactions occurred with glimepiride than with glibenclamide (105 versus 150 episodes). The long-term follow-up (457 patients) confirmed that glimepiride (1-8 mg) once daily provides equivalent metabolic control to a higher dosage (2.5-20.0 mg) of glibenclamide. Both treatments were well tolerated.

Adult↗
PubMed1997

Direct antidiabetic effect of leptin through triglyceride depletion of tissues.

Leptin is currently believed to control body composition largely, if not entirely, via hypothalamic receptors that regulate food intake and thermogenesis. Here we demonstrate direct extraneural effects of leptin to deplete fat content of both adipocytes and nonadipocytes to levels far below those of pairfed controls. In cultured pancreatic islets, leptin lowered triglyceride (TG) content by preventing TG formation from free fatty acids (FFA) and by increasing FFA oxidation. In vivo hyperleptinemia, induced in normal rats by adenovirus gene transfer, depleted TG content in liver, skeletal muscle, and pancreas without increasing plasma FFA or ketones, suggesting intracellular oxidation. In islets of obese Zucker Diabetic Fatty rats with leptin receptor mutations, leptin had no effect in vivo or in vitro. The TG content was approximately 20 times normal, and esterification capacity was increased 3- to 4-fold. Thus, in rats with normal leptin receptors but not in Zucker Diabetic Fatty rats, nonadipocytes and adipocytes esterify FFA, store them as TG, and later oxidize them intracellularly via an "indirect pathway" of intracellular fatty acid metabolism controlled by leptin. By maintaining insulin sensitivity and preventing islet lipotoxicity, this activity of leptin may prevent adipogenic diabetes.

3-Hydroxybutyric Acid↗
PubMed1996

Down-regulation of the expression of the obese gene by an antidiabetic thiazolidinedione in Zucker diabetic fatty rats and db/db mice.

Obese (ob) is a recently identified gene involved in the regulation of energy balance in the mouse. We report here that AD-5075, a potent thiazolidinedione which lowered plasma glucose and triglyceride in Zucker diabetic fatty (ZDF) rats and db/db mice, decreased the expression of the ob gene in these animal models of obesity and non-insulin-dependent diabetes mellitus. The level of adipose ob mRNA in ZDF rats was 3-fold greater than that detected in the Zucker lean littermates. Chronic treatment with AD-5075 elicited a 67 and 70% reduction of ob mRNA in ZDF and control lean rats, respectively. Furthermore, the amount of adipose ob mRNA in db/db mice was 7 times higher than that detected in lean littermates. Treatment of db/db mice with AD-5075 resulted in a 78% reduction of the level of ob mRNA with parallel changes in circulating level of the ob gene product, leptin. The reduction of the ob mRNA in the Zucker lean rats was accompanied by significantly greater food intake and weight gain. However, in ZDF rats and db/db mice, there was profound increase in body weight without hyperphagia. The results demonstrate that the expression of the ob gene is up-regulated in these two rodent models of diabetes compared to their lean counterparts and that such overexpression is attenuated by treatment with an agent that improves insulin sensitivity and glucose homeostasis in vivo.

Adipose Tissue↗