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1

Tapas, Kumar Mohapatra* Akankshya Raul Soumyashree Dehury Rajesh Kumar Pothal. "Advancements in Osmotic Controlled Drug Delivery Systems and Their Role in Diabetes Management." International Journal of Pharmaceutical Sciences 3, no. 5 (2025): 1410–22. https://doi.org/10.5281/zenodo.15379161.

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A new and very successful method for improving the therapeutic results of oral drugs is Osmotic Controlled Drug Delivery Systems (OSMO) technology. This is especially true when it comes to the treatment of chronic conditions like Type 2 Diabetes Mellitus (T2DM). Regardless of the pH or motility of the gastrointestinal tract, these systems use osmotic pressure to distribute medications in a regulated and prolonged way. The fundamental benefit of OSMO technology is its capacity to keep plasma drug concentrations constant, reducing variations that may result in adverse effects or diminished effec
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Cheah, Zhen Fung, and Yueh Chien Kuan. "LBODP033 The Compliant Patient - When Adherence Hurts." Journal of the Endocrine Society 6, Supplement_1 (2022): A264—A265. http://dx.doi.org/10.1210/jendso/bvac150.543.

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Abstract Metformin is a biguanide oral antidiabetic agent which lowers blood glucose by decreasing hepatic gluconeogenesis. In the absence of contraindications, it is the initial treatment in most patients with type 2 diabetes along with lifestyle modifications. This drug however is commonly associated with gastrointestinal side effects especially diarrhoea which could be potentially life-threatening if prolonged. We report a case of chronic severe painless diarrhoea with weight loss over 8 months in a 40-year-old man after starting metformin for his newly diagnosed type 2 diabetes. Although t
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Mounazza Rehman, Qudsia Nawaz, Siddiqa Batool, Faiza Khanum, Sehrish Raja, and Munnaza Andleeb. "Efficacy of Metformin and Combination of Metformin and Myo-Inositol on Clinical and Hormonal Profile of Polycystic Ovarian Disease Patient." Indus Journal of Bioscience Research 3, no. 3 (2024): 713–17. https://doi.org/10.70749/ijbr.v3i3.933.

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Background: The widespread endocrine condition known as polycystic ovarian syndrome (PCOS) is typified by hyperandrogenism, insulin resistance, and reproductive failure. Metformin, a commonly used insulin sensitizer, has showed benefits in controlling PCOS but is often linked with gastrointestinal adverse effects. Another insulin-sensitizing drug that has drawn interest is myo-inositol because of its superior tolerability and comparable effectiveness. The purpose of this study is to compare the clinical and hormonal effects of metformin monotherapy against myo-inositol combination treatment in
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Ainan Arshad, Kashif Khan, and Muhammad Shoaib. "The synergy of linagliptin and empagliflozin in catering to diabetes mellitus in Pakistan." Journal of the Pakistan Medical Association 75, no. 02 (2025): 284–86. https://doi.org/10.47391/jpma.11145.

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Diabetes is rapidly increasing globally, especially in low- and middle-income countries, with Pakistan ranking third in prevalence, having 33 million people. The lack of adherence to the first-line treatment, metformin, mainly due to gastrointestinal side effects, is a significant concern. A novel approach for managing type 2 diabetes in Pakistan is to combine linagliptin and empagliflozin. Linagliptin is well-tolerated and suitable for those who cannot tolerate metformin, while empagliflozin reduces cardiovascular risks and nephropathy, showing promising results in controlling diabetes with m
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Chawla, Manoj, Purvi Chawla, Pratap Jethwani, Kiran Shah, and Sanjay Reddy. "Metformin Sustained-Release and Vildagliptin Fixed-Dose Combination for Optimizing Glycemic Control: A Review with Real-World Case Reports." Clinics and Practice 13, no. 2 (2023): 497–504. http://dx.doi.org/10.3390/clinpract13020045.

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(1) Background: There is a high burden of poor glycemic control in the Indian population with type 2 diabetes mellitus (T2DM). Currently, the use of metformin sustained-release (SR)–vildagliptin fixed-dose combination (FDC) is very low as compared to metformin immediate-release (IR)–vildagliptin FDC which is associated with higher adverse events (AEs). Here, we present real-world effectiveness of metformin SR–vildagliptin FDC treatment in patients with T2DM; (2) Methods: This retrospective analysis was carried out from the medical records of adult T2DM patients visiting a single study center i
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Shivaraj, Gurupadappa Sajjanshetty. "A Study on the Reduction of Type-2 Diabetes Incidence with Metformin and Lifestyle Modification." International Journal of Pharmaceutical and Clinical Research 15, no. 10 (2023): 1358–66. https://doi.org/10.5281/zenodo.11295886.

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<strong>Introduction:&nbsp;</strong>This study discusses how DM causes persistent hyperglycemia due to insulin resistance or decreased production. In 2015, there were 415 million cases of DM while by 2040, morethan&nbsp;&nbsp; 200 millions of DM patients will be added. Diabetes and hyperglycemia damage organs, raising coronary disease risk. The three primary kinds of DM are T1DM (autoimmune-driven insulin loss), T2DM (insulin resistance), and gestational DM. The main T2DM treatment is metformin.&nbsp;<strong>Aim and Objectives:</strong>&nbsp;This study aims to assess the effectiveness of metfo
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Eskin, Fatih, and Duygu Tutan. "Is there a relationship between metformin-related gastrointestinal symptoms and vitamin B12 deficiency in patients with type 2 diabetes mellitus?" Medicine Science | International Medical Journal 12, no. 1 (2023): 324. http://dx.doi.org/10.5455/medscience.2023.02.025.

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Metformin (MTF) associated gastrointestinal symptoms are fairly common side effects that adversely affect patients' treatment adherence. However, the variability of gastrointestinal symptoms in MTF-using patients has not been fully explained. In our study, we aimed to investigate the relationship between vitamin B12 deficiency with MTF-related gastrointestinal symptoms. Patients with type 2 diabetes mellitus (T2DM) using MTF were included in the study sequentially. Demographic characteristics of the patients, duration of diabetes, MTF dose and duration used, and gastrointestinal symptoms were
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Anderson, Jemma J. A., Jennifer J. Couper, Lynne C. Giles, et al. "Effect of Metformin on Vascular Function in Children With Type 1 Diabetes: A 12-Month Randomized Controlled Trial." Journal of Clinical Endocrinology & Metabolism 102, no. 12 (2017): 4448–56. http://dx.doi.org/10.1210/jc.2017-00781.

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Abstract Context Children with type 1 diabetes have vascular dysfunction preceding atherosclerosis. Early interventions are needed to reduce cardiovascular disease. Objective To evaluate the effect of metformin on vascular function in children with type 1 diabetes. Design Twelve-month double-blind, randomized, placebo-controlled trial. Setting Tertiary pediatric diabetes clinic. Participants Ninety children (8 to 18 years of age), &amp;gt;50th percentile body mass index (BMI), with type 1 diabetes. Intervention Metformin (up to 1 g twice a day) or placebo. Main Outcome Measure Vascular functio
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Florez, Hermes, Jiacong Luo, Sumaya Castillo-Florez, et al. "Impact of Metformin-Induced Gastrointestinal Symptoms on Quality of Life and Adherence in Patients with Type 2 Diabetes." Postgraduate Medicine 122, no. 2 (2010): 112–20. http://dx.doi.org/10.3810/pgm.2010.03.2128.

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Mario Alberto Ramírez-Camacho, Luis Alberto Soberanis-Monsreal, Abraham Arcos-Díaz, et al. "Adverse drug reactions and medication adherence to oral antidiabetic drugs in patients: A longitudinal study." International Journal of Biological and Pharmaceutical Sciences Archive 9, no. 1 (2025): 077–84. https://doi.org/10.53771/ijbpsa.2025.9.1.0033.

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The World Health Organization (WHO) has indicated that treatment adherence in most patients with type 2 diabetes (T2D) is low and may be affected by the presence of adverse drug reactions (ADRs) associated with hypoglycemic pharmacotherapy The aim of this study was to analyze the relationship between the degree of pharmacotherapeutic adherence and the appearance of ADRs in people with T2D. A three-month prospective study was conducted, in which pharmacotherapeutic adherence was assessed using an indirect method, while ADRs were identified and characterized through active pharmacovigilance in o
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11

Hernandez Crysthell, Perez, Valdez Vazquez Diana Isabel, and Ariza Ortega Jose Alberto. "EFFECT OF MYO-INOSITOL ON INSULIN RESISTANCE IN WOMEN WITH POLYCYSTIC OVARY SYNDROME EFECTO DEL MYO-INOSITOL EN LA RESISTENCIA A LA INSULIN." International Journal of Advanced Research 13, no. 04 (2025): 612–22. https://doi.org/10.21474/ijar01/20759.

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Polycystic ovary syndrome (PCOS) is an endocrine-metabolic disorder that affects women of reproductive age and is strongly associated with insulin resistance (IR) and hormonal imbalances. IR plays a critical role in the patohopysiology of PCOS, contributing to reproductive dysfunction, menstrual irregularities, and long-term cardiometabolic complications. Convemtional treatment such as metformin are effective but often poorly tolerated. In this context, myo-inositol has emerged as promising alternative due to its role in insulin signaling and its favorable safety profile. Objetive:To summarize
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12

Molteni, Laura, Giuseppe Marelli, Giona Castagna, et al. "Improving Type 2 Diabetes Care with Extended-Release Metformin: Real-Life Insights from a Physician Educational Program." Endocrine, Metabolic & Immune Disorders - Drug Targets 24 (February 28, 2024). http://dx.doi.org/10.2174/0118715303294909240221102552.

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Background: Compared to Immediate-Release (IR) metformin, Extended-Release (ER) metformin reduces side effects and pill burden while improving adherence; however, there is little real-life data on patient satisfaction with this innovative formulation to guide physicians toward a more holistic approach. Objective: Our goal is to train general practitioners on holistic patient management, with the aim of increasing patient satisfaction and treatment adherence, reducing side effects, and improving quality of life in patients with poor tolerance to metformin-IR. Design and Methods: We designed an
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13

Ito, Jumpei, Katsuhiko Hagi, Kenji Kochi, Kohjiro Ueki, Hirotaka Watada, and Kohei Kaku. "Gastrointestinal symptoms in patients receiving imeglimin in combination with metformin: A post‐hoc analysis of imeglimin clinical trial data." Journal of Diabetes Investigation, December 26, 2024. https://doi.org/10.1111/jdi.14396.

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ABSTRACTIntroductionAn increased rate of gastrointestinal (GI) symptoms is reported in patients with type 2 diabetes receiving imeglimin plus metformin vs monotherapy or in combination with other antidiabetic drugs. This post‐hoc analysis explored GI symptom incidence, risk factors for their occurrence, and the impact on therapeutic efficacy during imeglimin and metformin combination therapy.Materials and MethodsData were derived from the 52‐week, open‐label, phase 3 TIMES‐2 trial in Japanese type 2 diabetes patients. Patients in the imeglimin plus metformin group were divided into two subgrou
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Dixon, Sydney A., Sidharth Mishra, Katrina B. Dietsche, et al. "The effects of prebiotics on gastrointestinal side effects of metformin in youth: A pilot randomized control trial in youth-onset type 2 diabetes." Frontiers in Endocrinology 14 (February 23, 2023). http://dx.doi.org/10.3389/fendo.2023.1125187.

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Disclosure summaryDr. Yadav is Chief Scientific Officer and Co-Founder of Postbiotics Inc and has no conflict of interest with this work. All other authors have no conflicts of interest to disclose.BackgroundMetformin is the only approved first-line oral glucose lowering agent for youth with type 2 diabetes mellitus (Y-T2DM) but often causes gastrointestinal (GI) side effects, which may contribute to reduced treatment adherence and efficacy. Prebiotic intake may reduce metformin’s side effects by shifting microbiota composition and activity.ObjectiveThe aims of this study were to determine the
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Syed, Usheem, Natalia Elizabeth Fretes Oviedo, and Vivek Variar. "12621 Convergence Of Sglt2 Inhibitors And Glp1 Agonists: Unveiling The Recipe For Euglycemic Diabetic Ketoacidosis." Journal of the Endocrine Society 8, Supplement_1 (2024). http://dx.doi.org/10.1210/jendso/bvae163.720.

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Abstract Disclosure: U. Syed: None. N.E. Fretes Oviedo: None. V. Variar: None. Introduction: Euglycemic diabetic ketoacidosis (DKA) is a known adverse effect associated with the use of SGLT2 inhibitors. The concomitant initiation of GLP1 agonists with SGLT2 inhibitors presents a potential synergistic risk, precipitating metabolic acidosis without significant hyperglycemia. The individual propensity of both medication classes to contribute to metabolic disturbances highlights the necessity for heightened clinical awareness. Clinical Case: We present a case of a 34-year-old female with morbid ob
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DIXON, SYDNEY A., ABBY MEYERS, KUNANI TUTTLE, et al. "990-P: Prebiotics and Metformin: A Pilot Randomized Controlled Trial in Youth-Onset Type 2 Diabetes." Diabetes 71, Supplement_1 (2022). http://dx.doi.org/10.2337/db22-990-p.

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Metformin is the only first-line oral agent for youth with type 2 diabetes mellitus (Y-T2D) , but efficacy and adherence is complicated by gastrointestinal (GI) side effects. Prebiotic microbiome modulators (MM) may reduce side effects by shifting the microbial flora and promoting metabolism of short-chain fatty acid producing bacteria. The feasibility and tolerability of prebiotic use in Y-T2D is unknown. We hypothesized that a prebiotic MM would be safe, tolerable, and decrease GI symptoms in youth. We compared lower GI symptoms and glycemia in Y-T2D at initiation of daily metformin therapy
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"A Comparative Analysis of Bioavailability and Stability of Anti-Diabetic Drugs in Conventional vs. Nanoparticle-Based Formulations – A Review." Journal of Angiotherapy 9, no. 1 (2025): 1–8. https://doi.org/10.25163/biomedical.9110248.

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Introduction: Diabetes mellitus is a chronic metabolic condition marked by elevated blood glucose levels, often necessitating long-term pharmacological intervention. Conventional anti-diabetic drug formulations frequently suffer from low bioavailability and instability, which compromise therapeutic efficacy and patient compliance. Nanoparticle-based drug delivery systems have emerged as a novel strategy to overcome these limitations. Methodology: This comparative study analyzed the bioavailability and stability of selected anti-diabetic drugs (metformin, glibenclamide, and pioglitazone) in bot
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