Abstract:
:Metformin is a first-line pharmacological treatment for patients with type 2 diabetes mellitus because of its favorable overall profile, including its glucose-lowering ability, weight-neutral effects, and low risk of hypoglycemia; however, gastrointestinal (GI) intolerance may limit use in some patients. Extended-release metformin improves GI tolerability, allows once-daily dosing, and is currently available in multiple branded and generic formulations; however, it is more expensive than immediate-release metformin. Maximum plasma metformin concentrations are reached more slowly with the extended-release formulation compared with conventional immediate-release metformin, although both provide similar exposure at a given total daily dose. Extended-release metformin is as effective as immediate-release metformin in patients newly started on metformin and those switched from the immediate-release formulation, with similar weight-neutral effects. Tolerability is generally comparable, although patients switched from the immediate-release formulation--even those switched due to GI intolerance--are often better able to tolerate the extended-release formulation. Based on studies of extended-release formulations in other disease states, metformin extended-release formulation has the potential to improve patient adherence with a simpler dosing regimen and increased tolerability. Increased adherence may result in greater glycemic control, and in turn, improve outcomes and lower health care usage and costs. Extended-release metformin provides an appropriate option for patients with type 2 diabetes mellitus who require several medications to achieve glycemic control or manage comorbid conditions, and for those who have GI intolerance with the immediate-release formulation.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Jabbour S,Ziring Bdoi
10.3810/pgm.2011.01.2241subject
Has Abstractpub_date
2011-01-01 00:00:00pages
15-23issue
1eissn
0032-5481issn
1941-9260journal_volume
123pub_type
杂志文章,评审abstract:OBJECTIVE:To evaluate healthcare resource utilization (HCRU) by osteoarthritis (OA) pain severity. METHODS:Cross-sectional surveys of US physicians and their patients were conducted between February and May 2017. Using the Numeric Rating Scale, patients were classified by self-reported pain intensity in the last week ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2020.1841988
更新日期:2021-01-01 00:00:00
abstract::Self-assessment case studies illustrating prudent selection of antimicrobial agents in septic shock following urinary catheterization, bacteremia and skin lesions in an immunocompromised patient, and endocarditis in a patient with a prosthetic heart valve. ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1978.11714791
更新日期:1978-03-01 00:00:00
abstract::Inflammatory bowel disease (IBD) is difficult to diagnose, and differentiating between ulcerative colitis (UC) and Crohn's disease (CD) can be challenging. Overlapping symptoms of UC and CD often delay diagnosis, despite availability of endoscopic, radiologic, and histologic tools. This delay in diagnosis is quite com...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2010.07.2184
更新日期:2010-07-01 00:00:00
abstract::Nearly every healthcare reform plan introduced in Congress this year addresses medical malpractice. Although the tort reform goals in the plans may be similar, the methods of achieving them differ substantially. To highlight the areas that need to be resolved, we set up a dialogue between a physician and a plaintiff's...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1994.11945900
更新日期:1994-10-01 00:00:00
abstract::Prescription opioid analgesics are an important treatment option for patients with chronic pain; however, misuse, abuse and diversion of these medications are a major global public health concern. Prescription opioid analgesics can be abused via intended and non-intended routes of administration, both intact or after ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2016.1120642
更新日期:2016-01-01 00:00:00
abstract::Bulimia nervosa is a common eating disorder among women. Sociocultural and interpersonal pressures are thought to be highly influential in the development of the syndrome. An association with depression has also been suggested. Recognizing bulimia nervosa is usually difficult, because patients are hesitant to reveal t...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1988.11700368
更新日期:1988-08-01 00:00:00
abstract::Prompt, thorough evaluation is needed when patients present with symptoms of renal colic, acute urinary retention, prostatitis, pyelonephritis, and other urologic emergencies. Primary care physicians have an important role in initial workup and treatment. Once the diagnosis is determined, urologic consultation may be ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1996.10.100
更新日期:1996-10-01 00:00:00
abstract::The prevalence of chronic kidney disease (CKD) has increased markedly over past decades due to the aging of the worldwide population. Despite the progress in the prevention and treatment, the cardiovascular (CV) morbidity and mortality remain high among patients with CKD. Although CKD is a progressive and irreversible...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2018.1481714
更新日期:2018-06-01 00:00:00
abstract::Colonic cancer remains a major cause of death because diagnosis is usually delayed. Improved methods for earlier detection will maximize the patient's chances for survival. At present, surgery offers the greatest possibility of cure, but even in those instances where less than definitive resection is possible, there i...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1975.11714014
更新日期:1975-04-01 00:00:00
abstract::Many patients with significant carotid artery stenosis are candidates for endarterectomy, a procedure now proved to reduce the incidence of future stroke and death. In this article, Drs Jaigobin and Perry describe an approach to patients with both symptomatic and asymptomatic carotid stenosis and review current indica...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1994-10-01 00:00:00
abstract::Cataracts are the most common treatable form of reduced vision in older adults. Although the incidence of cataracts is high after age 65, careful history taking and clinical examination are essential to establish the diagnosis. Cataract surgery is medically indicated when the view to the retina is obscured or lens-ind...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1998.05.478
更新日期:1998-05-01 00:00:00
abstract::The many types of pigmentation disorders may present in diverse forms and distributions and have various causes. They can be inherited (eg, vitiligo, familial periorbital hyperpigmentation), acquired (eg, postinflammatory pityriasis alba, idiopathic guttate hypomelanosis, Becker's nevus, melasma), infectious (eg, tine...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1996-06-01 00:00:00
abstract::Autonomic neural impulses that accompany discharges during a seizure can cause a variety of cardiac manifestations, including cardiac arrhythmias, sudden death, anginal chest pain, neurogenic pulmonary edema, and symptoms of pheochromocytoma. Either generalized or focal seizures may generate such signs and symptoms. A...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1990.11716430
更新日期:1990-11-01 00:00:00
abstract::A carefully taken history and thorough physical examination remain the most crucial aspects of diagnosing rheumatic disorders. Non-rheumatologic conditions also need to be kept in mind. Laboratory tests should be looked on as mostly supportive or confirmatory, because many of the tests are relatively nonspecific and m...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1991.11700818
更新日期:1991-02-01 00:00:00
abstract::Although chronic hepatitis B is a relatively common disease that may have a serious outcome, the outlook is by no means uniformly poor. Alpha interferon therapy may be helpful in up to one third of patients who have hepatitis B e antigen in serum and elevated serum aminotransferase levels. New drugs that may have even...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-07-01 00:00:00
abstract::The fact that atopic dermatitis is such a common medical problem underlies the need for better understanding of the basic disease processes and the development of new therapeutic approaches. Infection is now recognized as an important exacerbating factor, and the role of inflammatory and immunologic mediators is recei...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1984.11698671
更新日期:1984-07-01 00:00:00
abstract::This case report describes prolongation of a patient's prothrombin time and partial thromboplastin time possibly due to coadministration of warfarin and an overdose of an acetaminophen-propoxyphene combination analgesic. Patients receive warfarin for many indications, and concomitant use of an analgesic agent is commo...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1988.11700233
更新日期:1988-04-01 00:00:00
abstract::Despite a plethora of clinical guidelines and evidence outlining the efficacy of inhaled corticosteroids, these medications continue to be underused in the treatment of asthma. This article reviews the justification for prescribing inhaled steroids as first-line therapy, discusses indications for their use, and compar...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2001.05.924
更新日期:2001-05-01 00:00:00
abstract::A study was undertaken to determine whether the platelet estimate included in the routine CBC is being utilized as a guide to ordering quantitative platelet counts. Requisition slips and results were reviewed for a one-month period. The data showed that platelet estimates were not being used properly. In fact, much of...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1980.11715507
更新日期:1980-08-01 00:00:00
abstract::Albuminuria has a strong, continuous, direct, linear relationship with adverse cardiovascular (CV) outcomes and chronic kidney disease progression. Even at levels below the accepted upper limit of what is considered "normal" daily albumin excretion (< 30 mg/24 h), a relationship between albumin excretion level and adv...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2009.07.2031
更新日期:2009-07-01 00:00:00
abstract::Hypertension increases the risk of reinfarction and sudden death in post-myocardial infarction (MI) patients. The same s true of coexisting left ventricular hypertrophy. Fortunately, these two risk factors may be modified by pharmacotherapy. In this article, Dr Boden describes the complementary use of beta blockers an...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1992.11701448
更新日期:1992-09-01 00:00:00
abstract::The maximal exercise stress test continues to be an important diagnostic and prognostic tool in the primary care office setting. But are you getting the most accurate information possible? Drs Driggers and Marchant discuss several factors that are crucial to the test's validity--and thus to its usefulness in your clin...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1999.05.1.737
更新日期:1999-05-01 00:00:00
abstract::Bronchiectasis belongs to the family of chronic obstructive lung diseases, even though it is much less common than asthma, chronic bronchitis, or emphysema. Clinical features of these entities overlap significantly. The triad of chronic cough, sputum production, and hemoptysis always should bring bronchiectasis to min...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1999.07.607
更新日期:1999-07-01 00:00:00
abstract::Type 2 diabetes, which is increasing in prevalence, is a multifaceted disease that presents a challenge to the primary care physician. In this article, Drs Flemmer and Vinik review the significant findings of several important clinical trials and present a method of comprehensive staged management to improve the quali...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2000.5.1.1064
更新日期:2000-05-01 00:00:00
abstract::Sleep is increasingly being recognized as an important factor in the homeostasis of multiple body functions, including blood glucose metabolism. One of the most common sleep disorders, obstructive sleep apnea, is not only highly prevalent in patients with type 2 diabetes mellitus, but may contribute to the development...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2012.07.2573
更新日期:2012-07-01 00:00:00
abstract::Gastroesophageal reflux disease is a very common condition that is usually manifested by heartburn or regurgitation. Reflux esophagitis, caused by mucosal exposure to the backflow of caustic gastric contents, is primarily a result of lower esophageal sphincter dysfunction. Diagnostic workup varies but commonly include...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1991.11700938
更新日期:1991-05-15 00:00:00
abstract::The diagnostic survey of the infertile couple usually takes about three months. After semen analysis, the husband is referred for general and urologic examination. The wife is given a general physical and pelvic examination and returns during the next two months for ovulation studies. Tubal patency tests are also perf...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1977.11714654
更新日期:1977-10-01 00:00:00
abstract::The hydroxyl-methyl-glutaryl-coenzyme-A (HMG-CoA) reductase inhibitors of statin action are very effective and safe drugs, and they are widely used for the treatment of hyperlipidemia and the prevention of primary and secondary cardiovascular diseases (CVDs). However, recent meta-analyses of previous studies done with...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2017.1292107
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:The mechanism of action of dipeptidyl peptidase-4 inhibitors, such as saxagliptin, makes them suitable for combination therapy in type 2 diabetes mellitus (T2DM). Genetic, cultural, and environmental differences in individuals from different regions of the world may result in differences in treatment respons...
journal_title:Postgraduate medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.3810/pgm.2011.07.2305
更新日期:2011-07-01 00:00:00
abstract::In clinical practice, atrial fibrillation (AF) is the most commonly encountered arrhythmia. With the aging of the US population, the number of patients with AF that physicians encounter will increase. Atrial fibrillation management involves a combination of rate- and rhythm-control strategies with thromboprophylaxis, ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2011.11.2491
更新日期:2011-11-01 00:00:00