Diabetes, Heart, and Cardiovascular Diseases News Chronicle.      Article 204

The True Cause Of Respiratory Weakness (Or Dyspnea) In A Patient With Heart Failure

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A study at the University of Guelph, Guelph, Ontario, Canada and the Dalhousie University, Halifax, Nova Scotia, Canada shows the brain is the true cause of respiratory weakness (or dyspnea) in a patient with heart failure.


The true cause of respiratory weakness (or dyspnea) in a patient with heart failure.

The researchers have conducted a six-year-long experiment on the mice models to find out the mechanism behind the respiratory weakness, which is contributing to dyspnea in a patient with heart failure.


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The experiment has found a diaphragm (a large muscle) in the mice models, which helps them in the breathing function.

The study has found that the faulty signals from the brain may cause problems to the functioning of the diaphragm and the brain functionality is the root cause of the respiratory weakness (or dyspnea).

The experiment has found that the breathing problems (under certain conditions) in the mice models can be prevented with the first line therapy and with the blood pressure lowering drugs (medications).


The co-author of the study is Keith Brunt, assistant professor of pharmacology, Dalhousie Medical School, Dalhousie University, Saint John, Canada. The lead author of the study is Jeremy Simpson, professor of human health and nutritional sciences, University of Guelph, Guelph, Ontario, Canada. The study is published in May 2017 in the journal Science Translational Medicine.


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This study is funded by the following organizations.

  • The Canadian Institutes of Health Research.
  • The Ontario Thoracic Society.
  • The Natural Sciences and Engineering Research Council.



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A Black Box FDA Warning On The Label Of Type 2 Diabetes Drug Invokana

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The United States Food and Drug Administration (FDA) said that a new box amputation warning to the label must be added to the invokana (canagliflozin) drug, a type 2 diabetes (T2D) medication manufactured by Janssen Pharmaceuticals. A boxed label warning means the possibility of the most serious adverse events.


A black box FDA warning on the label of type 2 diabetes drug invokana.

Two large clinical trials (CANVAS and CANVAS-R) on the performance of type 2 diabetes (T2D) drug invokana, an SGLT-2 inhibitor shows the increased risk of amputation (leg and foot) in patients with diabetes when compared to placebo drug.


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The United States Food and Drug Administration (FDA) has requested healthcare professionals and patients using invokana medication to give feedback on the side effects.

Till now, the US FDA has received the following reports (leg amputations) with the use of invokana medication.


  • Below the knee level.
  • Above the knee level.
  • Single amputation.
  • Amputations to both limbs.


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Metformin Can Improve The Health Outcome In Diabetic Patients With HER2 And Breast Cancer

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The researchers say that health forecast of breast cancer patients with diabetes is poor when compared with breast cancer patients with no diabetes.


Metformin can improve the health outcome in diabetic patients with HER2 and breast cancer.

An analysis of the phase III ALTTO trial at the Jules Bordet Institute shows health improvements in diabetes patients with HER2 (human epidermal growth factor receptor 2) and positive primary breast cancer with the use of metformin.

In the analysis of pre-clinical and clinical data, the researchers have observed direct and indirect anti-tumor effects, particularly in patients of breast cancer with the use of metformin.


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The researchers have done an analytical study on 8,381 patients. Diabetic patients with metformin treatment are 186 and without metformin treatment are 260. 4.5 years of follow-up study shows the following.


  • 929 distant DFS (DDFS) events.
  • 1,205 disease-free survival (DFS) events.
  • 528 deaths.

A significant number of worse disease-free survival (DFS) events are found in those patients of diabetes who are not treated with metformin when compared with patients without diabetes. The similar health outcomes are found in patients with and without diabetes with the treatment of metformin.

Even though there is no level 1 evidence, the researchers say that healthcare professionals may recommend metformin treatment to avoid possible insulin use in those patients with HER2-positive and hormone receptor-positive disease and diabetes. Those patients using insulin may be at higher risk of recurrence.


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The lead author of the study is Evandro de Azambuja, MD, Ph.D., from the Jules Bordet Institute, Brussels and the study is published in May 2017 in the Journal of Clinical Oncology. Title of the article is "Impact of Diabetes, Insulin, and Metformin Use on the Outcome of Patients With Human Epidermal Growth Factor Receptor 2-Positive Primary Breast Cancer: Analysis From the ALTTO Phase III Randomized Trial."
DOI: doi.org/10.1200/JCO.2016.69.7722



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Published on June 14, 2017

 


The Diabetes News Chronicle does not provide medical advice, diagnosis or treatment. Information in Diabetes News Chronicle is to support and not to replace medical advice given by the surgeon or physician or doctor. The published article is not a medical advice by the OWNER of the "Diabetes News Chronicle" website or by the AUTHOR of the article.


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