Colesevelam lowers glucose and lipid levels in type 2 diabetes: The clinical evidence
Open accessAbstract
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 more than one risk factor is of therapeutic benefit. Clinical studies have shown that bile acid sequestrants have glucose‐lowering effects in addition to their low‐density lipoprotein cholesterol‐lowering effects in patients with T2DM. The bile acid sequestrant colesevelam hydrochloride is approved as an adjunct to antidiabetes therapy for improving glycaemic control in adults with T2DM. This review examines data from three phase III clinical trials that evaluated the glucose‐ and lipid‐lowering effects of colesevelam when added to the existing antidiabetes treatment regimen of patients with T2DM.
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Risk of diabetic ketoacidosis is increased in persons using SGLT2 inhibitors, especially those treated with insulin (particularly with recent insulin dose reduction) and/or those with acute illness and prolonged fasting.
“Risk of DKA is increased in persons using SGLT2is, especially in those being treated with insulin (especially if there has been a recent reduction in their insulin dose) and/or those with acute illnesses and prolonged fasting.1049,1050”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [1050]
The Safety of Colesevelam HCl in Combination with Existing Antidiabetes Therapy section discusses hypoglycaemia in trials that included insulin-treated patients, not ketoacidosis. Searches for SGLT2 inhibitors, DKA, insulin-dose reduction, acute illness and prolonged fasting found no passage in our copy addressing the claimed risk. The provided passages have no page numbers. (LLM, conf=0.78)
Experimental — accuracy not yet measuredColesevelam lowers LDL-C and improves glycated haemoglobin in patients with type 2 diabetes.
“The drug reduces LDL-C and also improves glycated haemoglobin (Hb A1C ) in patients with type 2 diabetes.109,110”
From ESC/EAS Guidelines for the management of dyslipidaemias (2011) · cites this paper as [110]
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- Authors
- Fonseca, V. A., Handelsman, Y., & Staels, B.
- Affiliations
- Tulane University (US)
- Inserm (FR)
- Corresponding author
- Fonseca, Vivian A.
- Venue
- Diabetes, Obesity and Metabolism
- Publisher
- Wiley
- Published
- 2010-03-30
- Volume
- 12
- Issue
- 5
- Pages
- 384-392
- ISSN
- 1462-8902 (ISSN-L)
- 1463-1326
- PMC
- PMC2871173
- OpenAlex
- W1963557257
- Cited by
- 130
- References
- 46
- Citations by year
- 2025: 1 · 2024: 4 · 2023: 3 · 2022: 6 · 2021: 4 · 2020: 10 · 2019: 6 · 2018: 9 · 2017: 5 · 2016: 11 · 2015: 13 · 2014: 11 · 2013: 12 · 2012: 16
- FWCI
- 1.53
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Obesity and Metabolism (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Daiichi Sankyo Europe
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- colesevelam, type 2 diabetes, bile acid sequestrants, glucose-lowering effect, hypolipidemic effect, LDL cholesterol, glycemic control, dyslipidemia, risk factor control
- MeSH terms
- Colesevelam Hydrochloride, Adult, Allylamine, Anticholesteremic Agents, Blood Glucose, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Female, Glycated Hemoglobin, Humans, Lipids, Male
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