BACKGROUND: Vildagliptin is believed to improve glucose variability by restoring the physiologic pattern of insulin secretion and improving beta and alpha cells' sensitivity to glucose but with less increase in insulin secretion compared to sulfonylureas resulting in similar glucose levels but with less risk of hypoglycemia.
OBJECTIVE: To compare the effect of vildagliptin and glimepiride on glucose variability among Type 2 diabetic patients not controlled on metformin alone.
METHODS: This investigation is a prospective, interventional, open-labeled, active control, parallel assignment, efficacy study that included patients with inadequate glycemic control on monotherapy with metformin, randomly assigned either to vildagliptin or glimeparide. For one month, one group took vildagliptin 50mg/tablet one tablet twice a day while the other group took glimepiride 1 mg/tablet one tablet once a day. Subjects were asked to monitor their capillary blood glucose at seven points throughout the day for 35 days.
RESULTS: A total of 18 patients were recruited for the study and randomly assigned to either of the two treatment arms. However, only 16 patients completed the study. The vildagliptin and glimepiride groups had comparable blood sugars at baseline and at the end of the study although the glimepiride group showed a steeper decline in the blood sugar levels. Subjects in both groups showed a downward trend in the blood glucose values from day one to the 35th day with comparable mean glucose values between treatments and across combinations of day and treatment. Likewise, mean postprandial incremental area under the curve (AUCpp)and mean amplitude of glycemic excursions (MAGE) were comparable across treatments and across combinations of day and treatment, although the Glimepiride group showed relatively higher MAGE values.
CONCLUSION: Vildaglipitin and glimepiride both improved glycemia of patients with uncontrolled blood sugar on monotherapy with metformin as both groups showed downward glucose trend, although vildagliptin showed relatively less abrupt glucose lowering effect suggesting lesser risk of hypoglycemia. Mean postprandial glucose excursions of the two groups were also comparable but the vildagliptin arm had lower MAGE and may suggest an improvement in both ?- and ?-cell function.

Human ; Male ; Female ; Aged 80 And Over ; Aged ; Middle Aged ; Adult ; Young Adult ; Adolescent ; Adamantane ; Blood Glucose ; Diabetes Mellitus, Type 2 ; Glucose ; Hypoglycemia ; Insulins ; Metformin ; Nitriles ; Prospective Studies ; Pyrrolidines ; Sulfonylurea Compounds

OBJECTIVE: To determine the relationship between hypothyroidism and color vision deficiency among Filipinos ages 20-60 years
DESIGN AND METHODS: A cross-sectional study was performed on 91 biochemically hypothyroid and euthyroid patients seen at the Makati Medical Center from July to December 2013. All subjects underwent the Ishihara color test, followed by the Farnsworth-Munsell D15 test if this was positive. The patient who tested positive in the Farnsworth-Munsell D15 test was referred to an ophthalmologist to rule out any anatomic problem, and was excluded from the study if found to have any. Fisher's exact test assessed the significant correlation between hypothyroidism and color vision deficiency. A p-value less than 0.05 was considered significant.
RESULTS: Of the 91 patients that were included in the study, the average age was 42 years, majority (87%) were females, and 41% were biochemically hypothyroid. All euthyroid patients (100%) had normal color vision, while one hypothyroid patient (3.0%) tested positive for color vision deficiency (p-value 0.407).
CONCLUSION: Based on this study, the hypothyroid state of the patients had no effect on their color vision, unlike those seen in rodents, probably because mature human cones are not as easily affected by changes in thyroid hormone levels.

Human ; Male ; Female ; Middle Aged ; Adult ; Color Vision Defects ; Color Vision ; Ophthalmologists ; Retinal Cone Photoreceptor Cells ; Thyroid Hormones ; Hypothyroidism

BACKGROUND: Total sialic acid determination has been show as an inflammatory marker for type 2 diabetes. No Local study has been done characterize the levels of TSA in gestational diabetes.

OBJECTIVES: To determine inflammatory markers predictive of gestational diabetes; to be able to describe the clinical profile of subjects enrolled in this study and determine the odds ratio for each inflammatory marker

STUDY DESIGN AND METHODOLOGY: Sixty two pregnant patients in their first trimester were included in this study. Inflammatory markers wre measured at 12 weeks and repeated at 24-28 weeks AOG together with screening glucose tets include random sugar at 12 weeks and 75-gram oral glucose tolerance test at 24-28 weeks. Factors independently associated with impaired glucose tolerance (IGT) and gestational diabetes mellitus(GDM) were determined using logistic regression stepwise model technique.

RESULTS: Of the 62 pregnant patients in their first trimester enrolled in study, five were diagnosed to have GDM based on the American Diabetes Association criteria(ADA), four with IGT and 53 with normal glucose tolerance. At 12 weeks gestation, total sialic acid (TSA) was higher among those with IGT and GDM compared to those with normal glucose tolerance (NGT) (mean=241.5 vs 175 vs 161. p=.030). However it was higher in GDM than those with IGT and NGT at 24-28 weeks (mean= 244.8 vs 229.7 vs 177, p = .025). Deranged total sialic acid performed at 24-28 weeks showed a trend for association with gestational diabetes (RR = 3.6, 95% CI 0-4.53, p=0.96). Other factors correlated, include a higher mean age (>26) and a family history of diabetes mellitus . Factors associated with impaired glucose tolerance, include a deranged TSA at 12 weeks, deranged CRP at 24-28 weeks , a deranged ESR both at 12 and 24-28 weeks gestation and a family history of diabetes mellitus.

CONCLUSION: Deranged levels of TSA at 24-28 weeks AOG seem to be associated wuth gestational diabetes. TSA determination at this gestational age can be utilized to screen gesttional diabetes.

Total Sialic Acid ; Gestational Diabetes ; Inflammatory Markers

OBJECTIVE: To evaluate the effects on healthy subjects of locally produced cane vinegar on the postprandial glucose surge after ingestion of a vinegar-containing meal. METHODOLOGY: A randomized controlled study on 37 healthy adult subjects with normal BMI. Subjects were randomized to a standard meal containing 28 mmols of acetic acid in the form of locally produced cane vinegar or to a meal without vinegar. The study was conducted for seven days, with all the volunteer subjects having the standard meals every morning. FBS and plasma insulin were determined on the first and last day of the study trial. Plasma glucose was also determined 30, 60 and 120 minutes after breakfast on all days of the trial. The postprandial plasma glucose results were compared between groups and across the seven days of observation using factorial analysis of variance (ANOVA). RESULTS: A total of 49 people were enrolled in the study but 12 were considered drop-outs. Volunteers who received vinegar had significantly lower blood glucose levels than those without vinegar, which was noted at 30 minutes postprandial (mean difference 16.68 mg/dl, p=0.005) and at 1 hour postprandial, (mean difference=12.2, p=0.02). Insulin levels did not statistically differ between the two groups. CONCLUSION: The mean drop in blood glucose values at 30 minutes and 1-hour postprandial were significantly higher in the vinegar meal group than in the control group.

Human ; Diabetes ; Obesity ; Insulin Resistance Syndrome ; Vinegar, Cane