The lowest doses considered to have a physiological effect were used, 850 mg/day for metformin and 15 mg/day for pioglitazone. For the GLP-1 receptor agonist, medications were used based on insurance coverage: exenatide 10 μg twice daily (n = 26), liraglutide 1.2 mg daily (n = 49), exenatide extended-release 2 mg weekly (n = 3), or dulaglutide 1.5 mg weekly (n = 3). Doses of the GLP-1 receptor agonist were not modified during the study.This is Combo of medicine to stop pre-diabetes to progress to be full diabetes. So, what is on the table?
The block Box for Pioglitazone (Actos)
Pioglitazone and other similar medications for diabetes may cause or worsen heart failure (condition in which the heart is unable to pump enough blood to the other parts of the body). Before you start to take pioglitazone, tell your doctor if you have or have ever had heart failure, especially if your heart failure is so severe that you must limit your activity and are only comfortable when you are at rest or you must remain in a chair or bed. Also tell your doctor if you were born with a heart defect, and if you have or have ever had swelling of the arms, hands, feet, ankles, or lower legs; heart disease; high cholesterol or fats in the blood; high blood pressure; coronary artery disease (narrowing of the blood vessels that supply blood to the heart); a heart attack; an irregular heartbeat; or sleep apnea. Your doctor may tell you not to take pioglitazone or may monitor you carefully during your treatment.It is simple and easy to understand, three is better then one. So, not for those who are only on the start of long fatal way, let them be treated as soon as it is possible, to speed their way to the final end. It is the same as when one get flu. let them Rx ice bathing, and see if Flu never will be developed.
I do not see any reason to start this treatment. Why there are no studies in this trail just slow dose of Insulin, right after diagnose any elevation in blood sugar level? Really, why do not add to this medicine which was studies, well known and relabel medicine, Insulin? At least some of this medicine the same as Insulin, must be injected. So, add insulin, Lantus Solo Star, and see if blood sugar level will go down. There are no risk so fat. Dose of insulin is small, less then 20 units, not really very expensive. In every pen there are 300 units of Insulin. 2 pens for month is good to start. Then will see, if dose will dropping, and how fast sugar in blood will return back to normal.
"However, the complications of type 2 diabetes can be devastating and anything that can be done to avoid diabetes and therefore its complications is worthy of consideration."Why diabetes type 2 progress to so sever complications? Because treatment of diabetes type 2 is wrong. So it is treatment which leads to complications development. Without treatment diabetic type 2 will live longer, even still ill and weak. At least diabetic type 2 will be alive.With medicine to treat diabetes type 2 diabetic die less then within 10 years after being diagnosed with diabetes type 2. Looks like Medical Care progressed in own Greed, and now treatment started early, to prevent progression to diabetes. Nice try. At least Medical Pro never will be left without life stock.
A third group of 200 patients (76 high risk and 124 intermediate risk) who refused pharmacological therapy were assigned to lifestyle therapy only.What MD ask studies?
At a mean follow-up of 32 months, 28 of the 422 (7%) patients developed type 2 diabetes.
Family Medicine:Really, how it was determined that progress was stopped? level of sugar in blood is very manipulative. Just simple manipulation with time when sample was taken can give result researcher need to have and to show. Immidiate level of sugar in blood does not show if diabetes in progress or progress was stopped with combo medicine.
How long was the study?
Did they really stop the progression or just mask it for a while?
Another question is, for how long pre-diabetic must take this combo? If it is life long therapy then really how to see if it is wrong prediction or it is effect of medicine. In contrary, with Insulin most diabetic type 1 decreased dose of injected insulin. The matter of fact, many have "Honeymoon phase" when injection of insulin were stopped for awhile.
Lastly, how this combo therapy can be "personalized"? All patients got the same combo. If it will be in ADA guidance, then all American Diabetics type 2 and per-diabetics will have the same combo to prevent, to treat diabetes type 2, even when sugar in blood in fatal level. Only those who collected money from this studies can see overspecialization in this kind of therapy. They see all what customer ask them to see. Who Is Your Daddy?
Personalized Medicine, Combo Tx, Stops Progression to Diabetes
by Nancy A. Melville
https://www.medscape.com/viewarticle/902316?nlid=125212_381&src=WNL_mdplsnews_180928_mscpedit_wir&uac=164666HZ&spon=17&impID=1753252&faf=1#vp_2
via Ravenvoron
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