Colesevelam lowers glucose and lipid levels in type 2 diabetes: the clinical evidence

@article{Fonseca2010ColesevelamLG,
  title={Colesevelam lowers glucose and lipid levels in type 2 diabetes: the clinical evidence},
  author={Vivian A. Fonseca and Yehuda Handelsman and Bart Staels},
  journal={Diabetes, Obesity \& Metabolism},
  year={2010},
  volume={12},
  pages={384 - 392}
}
Simultaneous control of blood glucose and other risk factors such as hypertension and dyslipidaemia is essential for reducing the risk of complications associated with type 2 diabetes mellitus (T2DM). As relatively few patients with T2DM have their risk factors managed to within the limits recommended by the American Diabetes Association, American College of Endocrinology or National Cholesterol Education Program Adult Treatment Panel III guidelines, treatment that can simultaneously control… 

Diabetic dyslipidaemia.

One unassailable truth is that statin therapy is beneficial and should rarely, if ever, be withheld.

Update on the Management of Diabetic Dyslipidaemia

The aim of this article is to review the pathophysiology of DD and discuss its role in cardiovascular event risk and treatment, as well as to study the effects of lipid-lowering therapy on glucose metabolism and the outcomes of antidiabetic treatment on dyslipidaemia.

Diabetes Dyslipidemia

The authors review the pathophysiology and implications of the alterations in lipoproteins observed in both type 1 and type 2 diabetes, the effect of medications commonly used in the management of diabetes on the lipid profile, the evidence for lifestyle and pharmaceutical interventions, and national and international recommendations for themanagement of dyslipidemia in patients with diabetes.

Glucose-lowering effect of colestimide is associated with baseline HbA1c in type 2 diabetic patients with hypercholesterolemia.

Since patients with type 2 diabetes often have hyperlipidemia as well, colestimide therapy may have a clinically useful dual action in such patients.

SGLT2 inhibitors.

Pharmacology and therapeutic implications of current drugs for type 2 diabetes mellitus

The pharmacokinetics, pharmacodynamics and safety profiles, including cardiovascular safety, of currently available therapies for management of hyperglycaemia in patients with T2DM are assessed within the context of disease pathogenesis and natural history.

Glucose Control and Cardiovascular Outcomes in Clinical Trials of Sodium Glucose Co-transporter 2 Inhibitor Treatments in Type 2 Diabetes.

While more long-term safety data are required to elucidate the benefit-risk profile of SGLT2 inhibitors, the rationale for their use in type 2 diabetes therapy is strong.

Glucose Control and Cardiovascular Outcomes in Clinical Trials of Sodium Glucose Co-transporter 2 Inhibitor Treatments in Type 2 Diabetes.

While more long-term safety data are required to elucidate the benefit–risk profile of SGLT2 inhibitors, the rationale for their use in type 2 diabetes therapy is strong.

Advances in Pharmacologic Therapies for Type 2 Diabetes

This review summarizes the updates on various established agents as well as the recent developments with regard to incretin-based therapies, inhibitors of the renal tubular sodium-glucose-linked-transporter-2 and ultra-long acting basal insulin formulations.

The Kidney as a Treatment Target for Type 2 Diabetes

Results from clinical trials show that these compounds decrease plasma glucose and body weight in treatment-naive patients and in patients receiving metformin or insulin and insulin sensitizers, and SGLT2 inhibition presents an additional option to promote glycemic control in patients with type 2 diabetes.
...

References

SHOWING 1-10 OF 59 REFERENCES

Colesevelam HCl Improves Glycemic Control and Reduces LDL Cholesterol in Patients With Inadequately Controlled Type 2 Diabetes on Sulfonylurea-Based Therapy

Colesevelam improved glycemic control and reduced LDL cholesterol levels in patients with type 2 diabetes receiving sulfonylurea-based therapy.

Colesevelam hydrochloride therapy in patients with type 2 diabetes mellitus treated with metformin: glucose and lipid effects.

Colesevelam improves glycemic and lipid parameters in patients with T2DM inadequately controlled with metformin-based therapy and improved other measures of glycemic response.

Efficacy and safety of colesevelam in patients with type 2 diabetes mellitus and inadequate glycemic control receiving insulin-based therapy.

Colesevelam treatment seems to be safe and effective for improving glycemic control and lipid management in patients with type 2 diabetes mellitus receiving insulin-based therapy, and it may provide a novel treatment for improving dual cardiovascular risk factors.

Cholestyramine Therapy for Dyslipidemia in NonInsulin-dependent Diabetes Mellitus: A Short-Term, Double-Blind, Crossover Trial

The purpose of this investigation was to study the efficacy and tolerability of cholestyramine therapy in patients with NIDDM who had high-risk LDL cholesterol levels and the effectiveness of bile acid sequestrant therapy to reduce cholesterol levels.

Effects of Intensive Glucose Lowering in Type 2 Diabetes

Lipoprotein Management in Patients With Cardiometabolic Risk

It is unclear whether lipoprotein parameters other than LDL or non-HDL cholesterol provide clinically significant additional prognostic information regarding CVD risk, yield more information about the effectiveness of therapy, or indicate more appropriate treatment targets.

Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes.

A target-driven, long-term, intensified intervention aimed at multiple risk factors in patients with type 2 diabetes and microalbuminuria reduces the risk of cardiovascular and microvascular events by about 50 percent.

Effectiveness of colesevelam hydrochloride in decreasing LDL cholesterol in patients with primary hypercholesterolemia: a 24-week randomized controlled trial.

Colesevelam was efficacious, decreasing mean LDL cholesterol levels by up to 18%, and well tolerated without serious adverse events, and compliance rates were between 88% and 92% for all groups.

Lower Baseline Glycemia Reduces Apparent Oral Agent Glucose-Lowering Efficacy

Expectations for the degree of reduction to be attained with a given agent may be excessively optimistic when a person’s initial A1C is already <7.5–8.0%, which may prevent acceptance of agents that are as effective as existing treatments at A 1C levels.
...