Abstract:
:Most patients with type 2 diabetes present with comorbid overweight or obesity. Reaching and maintaining acceptable glycemic control is more difficult in overweight and obese patients, and these conditions are associated with increased risk for cardiovascular and other diseases. Glycemic management for these patients is complicated by the fact that insulin and many of the oral medications available to treat type 2 diabetes produce additional weight gain. However, an increasing number of therapeutic options are available that are weight neutral or lead to weight loss in addition to their glycemic benefits. This article evaluates the evidence from clinical trials regarding the relative glycemic benefits, measured in terms of glycated hemoglobin change, versus the impact on body weight of each medication currently approved for type 2 diabetes. In general, the sulfonylureas, thiazolidinediones, and D-phenylalanine derivatives have been shown to promote weight gain. The dipeptidyl peptidase-4 inhibitors are weight neutral, while the biguanides, incretin mimetics, and amylin mimetics promote weight loss. Trials examining the glycemic benefits of the weight loss agents orlistat and sibutramine are also examined. Awareness of this evidence base can be used to inform medication selection in support of weight management goals for patients with type 2 diabetes.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Mavian AA,Miller S,Henry RRdoi
10.3810/pgm.2010.05.2148subject
Has Abstractpub_date
2010-05-01 00:00:00pages
106-17issue
3eissn
0032-5481issn
1941-9260journal_volume
122pub_type
杂志文章,评审abstract::In the face of deficiencies in our present system of introducing new drugs, clinicians must be committed to monitoring patients carefully. They must not be caught up in the hyperbole and excitement of the latest new drug, but instead should allow the crucible of time to teach them and the rest of the medical community...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1983.11697799
更新日期:1983-03-01 00:00:00
abstract::Many patients who present with acute or chronic diarrhea do not have an important organic disease. Most have functional diarrhea. The history, clinical examination, and initial laboratory studies should lead to a provisional diagnosis with respect to organic or functional origin and help define whether the disease aff...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1989.11704504
更新日期:1989-12-01 00:00:00
abstract::Preview Back pain can be a symptom of any number of problems, most commonly mechanical, or structural, in nature. Among the nonmechanical causes is ankylosing spondylitis, an inflammatory disease that involves the spine and sometimes other joints and extra-articular organs. Dr Escalante explains how to differentiate t...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1993.11945685
更新日期:1993-07-01 00:00:00
abstract::Preview Although no one theory on aging explains satisfactorily why or how this process occurs, we know that aging causes physiologic changes and a progressive decline of functional organ reserve. The implications of these changes are increasingly important as the elderly segment of the population grows. In this artic...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1996.11946121
更新日期:1996-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy and safety of colesevelam in Hispanic subjects with primary hyperlipidemia and prediabetes. MATERIALS AND METHODS:A 16-week, randomized, double-blind, placebo-controlled, multinational study evaluating colesevelam in participants with primary hyperlipidemia (low-density lipoprotein c...
journal_title:Postgraduate medicine
pub_type: 杂志文章,随机对照试验
doi:10.3810/pgm.2012.07.2564
更新日期:2012-07-01 00:00:00
abstract::Looking back at the long history of cancer, we can still relate to that POSTGRADUATE MEDICINE editorial written 50 years ago: "None of the basic problems of cancer has been solved. The death rate is constantly mounting. Small wonder that many doctors face cancer with a pessimism bordering on resignation." The temptati...
journal_title:Postgraduate medicine
pub_type: 历史文章,杂志文章
doi:10.3810/pgm.1997.09.307
更新日期:1997-09-01 00:00:00
abstract::Although fairly common, syncope is a frightening symptom that can signal a serious underlying disease. The varying causes present a diagnostic challenge to the examining physician, who needs to assess whether referral for more specialized or invasive study is appropriate. The authors review common cases of syncope and...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1992.11701298
更新日期:1992-04-01 00:00:00
abstract::Venous thromboembolism is a serious and, often, asymptomatic complication of hip surgery. A reliable screening test is needed to detect thrombi early to prevent death from pulmonary emboli. Noninvasive screening tests were ineffective in our study of 453 patients. We recommend early use of ventilation/perfusion lung s...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1986.11699529
更新日期:1986-09-15 00:00:00
abstract:INTRODUCTION:The American Academy of Pediatrics and the American Academy of Family Physicians believe that infants, children, and adolescents benefit from having a medical home, characterized by accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective care. Several st...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2010.03.2126
更新日期:2010-03-01 00:00:00
abstract::Most changes that occur in the aging face are related to gravity working on skin that is becoming progressively thinner, drier, and less elastic. Exposure to sunlight hastens these changes, and protection from the sun is the only proved way to delay them. Dermabrasion, chemabrasion, and collagen implant (Zyderm) injec...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1984.11698794
更新日期:1984-11-15 00:00:00
abstract::Aspirin-induced hypersensitivity affects a substantial number of people, including 20% or more of asthmatic patients. A dramatic flare of symptoms occurs after indigestion of aspirin or a nonsteroidal anti-inflammatory drug, and symptoms can persist even after the agent is discontinued. Fortunately, aspirin desensitiz...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1991.11701086
更新日期:1991-10-01 00:00:00
abstract::Systolic hypertension, especially isolated systolic hypertension (ISH) is very common in older subjects aged ≥ 65 years and is a major risk factor for cardiovascular disease (CVD), strokes, heart failure (HF) and chronic kidney disease (CKD). It is also, directly and linearly related with these complications irrespect...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2018.1433434
更新日期:2018-03-01 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::Two cases of subclavian steal syndrome are reported. Symptoms included light-headedness or syncope, reflecting vertebrobasilar insufficiency, and in one case, numbness and tingling in the left upper extremity, reflecting ischemia. Many persons with this syndrome are asymptomatic. Key findings include unilaterally decr...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1988.11700138
更新日期:1988-02-01 00:00:00
abstract:BACKGROUND:Point-of-care testing (POCT) is widely used to measure blood glucose levels in people with diabetes, although its use in measuring glycated hemoglobin (HbA1c) levels is less common, perhaps due to perceived performance issues and access to the technology. METHODS:Forty blood samples were analyzed in duplica...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2013.05.2664
更新日期:2013-05-01 00:00:00
abstract:OBJECTIVES:We aimed to determine the prevalence of chronic diseases and unhealthy lifestyle behaviors of Turkish doctors as compared with the general population and the frequency of compliance with preventive clinical practices among doctors. METHODS:This was an observational, prospective cohort study that enrolled gr...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2017.1272399
更新日期:2017-04-01 00:00:00
abstract::A 29-year-old man had a febrile illness accompanied by chest pain and tachycardia. The ECG suggested either myocarditis or acute ischemia. Heart muscle enzymes were normal, the peripheral blood count showed absolute and relative lymphocytosis, and an echocardiogram disclosed a small pericardial effusion. After deferve...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1989.11700655
更新日期:1989-04-01 00:00:00
abstract::Cervical spondylotic myelopathy remains a diagnostic and therapeutic challenge to physicians in a number of specialties. The diagnostic evaluation consists of a comprehensive neurologic and orthopedic examination supplemented by appropriate neurophysiologic and neuroradiologic studies. Currently, magnetic resonance im...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1990.11704741
更新日期:1990-09-01 00:00:00
abstract::Oculoglandular syndrome and swelling of the parotid gland are unusual manifestations of cat-scratch disease. Although exposure to cats is considered an important part of the patient history, an actual cat scratch is not required to establish the diagnosis. Oral fluoroquinolones show promise in the treatment of the inf...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1992.11701289
更新日期:1992-04-01 00:00:00
abstract::Scleroderma is no longer the diagnostic or therapeutic dilemma it previously was. New diagnostic techniques facilitate earlier diagnosis, and many symptoms are amenable to treatment. ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1981.11715861
更新日期:1981-09-01 00:00:00
abstract::Inhaled corticosteroids (ICSs) belong to the armament for treatment of chronic obstructive pulmonary disease (COPD) and as such, they are widely used in real life. This is a narrative review on evidence-based papers published in the English language listed in Medline between 1990 and March 2016 discussing ICS applicat...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2016.1186487
更新日期:2016-06-01 00:00:00
abstract::Solitary pulmonary nodules are usually identified on routine chest radiographs in asymptomatic patients. Most nodules have a benign cause, but bronchogenic carcinoma, metastases, and other malignant processes are important causes as well and must be excluded in differential diagnosis. Plain chest radiography, computed...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1996-02-01 00:00:00
abstract:OBJECTIVE:Among a random sample of emergency department (ED) patients, we sought to determine the extent to which reported risk for human immunodeficiency virus (HIV) is related to ever having been tested for HIV. METHODS:A random sample of patients (aged 18-64 years) from an adult, urban, northeastern United States, ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2010.01.2100
更新日期:2010-01-01 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::Exercise-induced bronchospasm is a common complication of asthma. Aggressive treatment of this conditions permits patients to maintain full activity despite their illness. Since most asthmatic patients are healthy except for an intermittent respiratory problem, providing them the opportunity to exercise in all weather...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1992.11701232
更新日期:1992-02-15 00:00:00
abstract::Drug-induced aseptic meningitis is a syndrome that should be considered in the differential diagnosis of acute and recurrent aseptic meningitis. It has been observed in all age-groups and can occur following the use of a wide spectrum of pharmaceutical agents. Presumptive diagnosis is made by demonstrating the resolut...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1991.11701123
更新日期:1991-11-15 00:00:00
abstract::With the US population aging steadily, herpes zoster represents a growing contributor to diminished quality of life. Dermatologic manifestations appear as immunity declines with age but rarely pose a significant threat, except in instances when ocular structures are involved. Pain is of more concern, because it usuall...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2000.06.1114
更新日期:2000-06-01 00:00:00
abstract::Primary care physicians have an important role in diagnosing and treating eye disorders--including dacryocystitis, blepharitis, and conjunctivitis--and in determining when ophthalmologic referral is needed. Fundus examination for diagnosis of glaucoma and diabetic eye complications should be a part of the routine exam...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:
更新日期:1996-04-01 00:00:00
abstract::Currently, surveillance or risk-oriented follow-up of patients in the individual practice setting may be the most efficacious means of reducing the morbidity and mortality associated with selected types of cancer. Intervention into carcinogenesis or alteration of the natural history of cancer requires a clear understa...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1985.11699112
更新日期:1985-09-01 00:00:00
abstract::An exploratory subgroup analysis of a prospective, randomized, double-blind, forced-titration study comparing the efficacy and safety of once-daily olmesartan medoxomil (OM) and losartan potassium (LOS) in patients with stage 1 or stage 2 hypertension is reported. After a 3- to 4-week placebo run-in period, eligible p...
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.2012.05.2549
更新日期:2012-05-01 00:00:00