Triglyceride High-Density Lipoprotein Ratios Predict Glycemia-Lowering in Response to Insulin Sensitizing Drugs in Type 2 Diabetes: A Post Hoc Analysis of the BARI 2D
Glycemic management is central in prevention of small vessel and cardiovascular complications in type 2 diabetes. With the plethora of newer medications and recommendations for a patient centered approach, more information is necessary to match the proper drug to each patient. We showed that BARI 2D...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Journal of Diabetes Research |
| Online Access: | http://dx.doi.org/10.1155/2015/129891 |
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| author | Joel Zonszein Manuel Lombardero Faramarz Ismail-Beigi Pasquale Palumbo Suzy Foucher Yolanda Groenewoud Gary Cushing Bernardo Wajchenberg Saul Genuth BARI 2D Study Group |
| author_facet | Joel Zonszein Manuel Lombardero Faramarz Ismail-Beigi Pasquale Palumbo Suzy Foucher Yolanda Groenewoud Gary Cushing Bernardo Wajchenberg Saul Genuth BARI 2D Study Group |
| author_sort | Joel Zonszein |
| collection | DOAJ |
| description | Glycemic management is central in prevention of small vessel and cardiovascular complications in type 2 diabetes. With the plethora of newer medications and recommendations for a patient centered approach, more information is necessary to match the proper drug to each patient. We showed that BARI 2D, a five-year trial designed to compare two different glycemic treatment strategies, was suitable for assessing different responses according to different phenotypic characteristics. Treatment with insulin sensitizing medications such as thiazolidinediones and metformin was more effective in improving glycemic control, particularly in the more insulin resistant patient, when compared to the insulin provision strategy using insulin and or sulfonylureas. Triglyceride and high density lipoprotein ratio (TG/HDL-cholesterol ratio) was found to be a readily available and practical biomarker that helps to identify the insulin resistant patient. These results support the concept that not all medications for glycemic control work the same in all patients. Thus, tailored therapy can be done using phenotypic characteristics rather than a “one-size-fits-all approach.” |
| format | Article |
| id | doaj-art-3ae2a3ebcf83428b81d7aaab6754fb82 |
| institution | Kabale University |
| issn | 2314-6745 2314-6753 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Research |
| spelling | doaj-art-3ae2a3ebcf83428b81d7aaab6754fb822025-08-20T03:55:36ZengWileyJournal of Diabetes Research2314-67452314-67532015-01-01201510.1155/2015/129891129891Triglyceride High-Density Lipoprotein Ratios Predict Glycemia-Lowering in Response to Insulin Sensitizing Drugs in Type 2 Diabetes: A Post Hoc Analysis of the BARI 2DJoel Zonszein0Manuel Lombardero1Faramarz Ismail-Beigi2Pasquale Palumbo3Suzy Foucher4Yolanda Groenewoud5Gary Cushing6Bernardo Wajchenberg7Saul Genuth8BARI 2D Study Group9Albert Einstein College of Medicine, Montefiore Clinical Diabetes Center, Bronx, NY 10461, USADepartment of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15260, USACase Western Reserve University and Cleveland VA Medical Center, Cleveland, OH 44106, USAMayo Clinic, Scottsdale, AZ 85259, USAMontreal Heart Institute, Hotel-Dieu CHUM (Centre Hospitalier de l’Université de Montréal), Montreal, QC, H2W 1T8, CanadaToronto General Hospital, Toronto, ON, M5G 2C4, CanadaLahey Clinic Medical Center, Burlington, MA 01805, USAUniversity of Sao Paulo Heart Institute, 01246903 São Paulo, SP, BrazilCase Western Reserve University, Cleveland, OH 44106, USAUniversity of Pittsburgh, Pittsburgh, PA 15260, USAGlycemic management is central in prevention of small vessel and cardiovascular complications in type 2 diabetes. With the plethora of newer medications and recommendations for a patient centered approach, more information is necessary to match the proper drug to each patient. We showed that BARI 2D, a five-year trial designed to compare two different glycemic treatment strategies, was suitable for assessing different responses according to different phenotypic characteristics. Treatment with insulin sensitizing medications such as thiazolidinediones and metformin was more effective in improving glycemic control, particularly in the more insulin resistant patient, when compared to the insulin provision strategy using insulin and or sulfonylureas. Triglyceride and high density lipoprotein ratio (TG/HDL-cholesterol ratio) was found to be a readily available and practical biomarker that helps to identify the insulin resistant patient. These results support the concept that not all medications for glycemic control work the same in all patients. Thus, tailored therapy can be done using phenotypic characteristics rather than a “one-size-fits-all approach.”http://dx.doi.org/10.1155/2015/129891 |
| spellingShingle | Joel Zonszein Manuel Lombardero Faramarz Ismail-Beigi Pasquale Palumbo Suzy Foucher Yolanda Groenewoud Gary Cushing Bernardo Wajchenberg Saul Genuth BARI 2D Study Group Triglyceride High-Density Lipoprotein Ratios Predict Glycemia-Lowering in Response to Insulin Sensitizing Drugs in Type 2 Diabetes: A Post Hoc Analysis of the BARI 2D Journal of Diabetes Research |
| title | Triglyceride High-Density Lipoprotein Ratios Predict Glycemia-Lowering in Response to Insulin Sensitizing Drugs in Type 2 Diabetes: A Post Hoc Analysis of the BARI 2D |
| title_full | Triglyceride High-Density Lipoprotein Ratios Predict Glycemia-Lowering in Response to Insulin Sensitizing Drugs in Type 2 Diabetes: A Post Hoc Analysis of the BARI 2D |
| title_fullStr | Triglyceride High-Density Lipoprotein Ratios Predict Glycemia-Lowering in Response to Insulin Sensitizing Drugs in Type 2 Diabetes: A Post Hoc Analysis of the BARI 2D |
| title_full_unstemmed | Triglyceride High-Density Lipoprotein Ratios Predict Glycemia-Lowering in Response to Insulin Sensitizing Drugs in Type 2 Diabetes: A Post Hoc Analysis of the BARI 2D |
| title_short | Triglyceride High-Density Lipoprotein Ratios Predict Glycemia-Lowering in Response to Insulin Sensitizing Drugs in Type 2 Diabetes: A Post Hoc Analysis of the BARI 2D |
| title_sort | triglyceride high density lipoprotein ratios predict glycemia lowering in response to insulin sensitizing drugs in type 2 diabetes a post hoc analysis of the bari 2d |
| url | http://dx.doi.org/10.1155/2015/129891 |
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