Metformin-based single pill drug combinations for type 2 diabetes in primary care England: A time trend analysis

Optimization and Validation of the UPLC Method for Rapid, Facile, and Simultaneous Analysis of Sitagliptin and Metformin in Quality Control Samples

Many clinical trials have shown the effectiveness of combination therapy over monotherapy in diabetes management. Sitagliptin (SG) and metformin (MF) are the most common combinations for type II diabetes management. These drugs were combined into one tablet, called Janumet 50/850 (SG/MF). The pharmaceutical industry constantly demands a rapid, simple, sensitive, and valid analytical method for simultaneously determining drugs in pharmaceutical products. Therefore, this study aims to develop an ultraperformance liquid chromatography method for concurrently estimating metformin and sitagliptin in a short run time by applying the response surface methodology. A Box-Behnken design was implemented to study the influence of three independent factors: aqueous phase concentration in the mobile phase (A; 5-15%), mobile phase flow rate (B; 0.4-1 mL/min), and ammonium formate buffer strength (C; 5-20 mM). The data analysis showed a significant negative effect of the flow rate on the retention time and peak area. The optimized analytical condition was performed with 15% aqueous phase concentration, a flow rate of 0.52 mL/min, and a buffer strength of five mM. The analytical method was valid per the International Conference of Harmonization (ICH) guidelines. SG and MF were separated in a short time run of 2 min. The process was reliable in separating and extracting the drugs from the marketed Janumet tablets at a retention time of 0.73 and 1.36 min for SG and MF, respectively.

Theaflavin-3,3'-Digallate Protects Liver and Kidney Functions in Diabetic Rats by Up-Regulating Circ-ITCH and Nrf2 Signaling Pathway

Theaflavin-3,3'-digallate (TFDG) in black tea has a strong antioxidant capacity. However, its effect on diabetic liver and kidney injury and the underlying mechanisms remain unclear. In the present study, our findings indicated that TFDG administration effectively lowers the fasting blood glucose and serum lipid concentrations and enhances the functionality and cellular architecture of the liver and kidney in rats with diabetes. The data also showed that TFDG mitigates oxidative harm in the liver and kidney of rats afflicted with diabetes. Additionally, metformin combined with TFDG was significantly more effective in reducing blood glucose and oxidative stress. Further studies suggested that TFDG upregulates the Nrf2 signal pathway and circ-ITCH (hsa_circ_0001141) expression. Silencing of circ-ITCH by transfection of the interfering plasmid apparently reduces the effects of TFDG on the Nrf2 signal pathway and oxidative stress in high-glucose-treated hepatic and renal cells. In conclusion, the present study highlights the great potential of TFDG in ameliorating diabetic liver and kidney injury by up-regulating circ-ITCH to promote the Nrf2 signal pathway and provides a potential option for the prevention and treatment of diabetic complications.

Transitioning to GLP-1 RAs and SGLT2 Inhibitors as the First Choice for Managing Cardiometabolic Risk in Type 2 Diabetes

PURPOSE OF REVIEW

This forward-looking review summarizes existing evidence from cardiovascular outcome trials on cardiometabolic risk-reduction in type 2 diabetes (T2DM) management, with attention to updating and personalizing recommendations from recent diabetes practice guidelines issued by cardiology societies.

RECENT FINDINGS

T2DM management has shifted towards cardiometabolic outcome improvement rather than purely glycemic control. According to large clinical trials, sodium-glucose cotransporter-2 inhibitors showed robust results in reducing heart failure (HF) hospitalization and chronic kidney disease (CKD) progression, while glucagon-like peptide-1 receptor agonists demonstrated the largest effects on HbA1c reduction, weight loss, and atherosclerotic cardiovascular disease outcomes prevention, including stroke. Considering the distinct features of these new cardiometabolic agents, initial selection of therapy should be targeted to each individual patient, with consideration of combination therapy for the highest risk patients. Moreover, future studies should investigate the addition of obesity-predominant risk, in conjunction with coronary artery disease, stroke, CKD, and HF, as a new influential indicator for choosing the optimal cardiometabolic agent.