Two case studies illustrate how the IR2Dx TIGAR™ analytical system may be used to guide treatment and obtain superior results. The examples, showing a subset of the TIGAR™ markers, are shown in the diagrams below.
1. A Patient with Type 2 Diabetes
A patient on long-term metformin and glimepiride treatment is shown in this diagram. She had stable glucose levels as measured with HbA1c, but had slowly deteriorating overall health. After finding very abnormal levels with all panel markers, the physician discontinued glimepiride and added pioglitazone and liraglutide in order to get more effect on both insulin resistance and beta-cell function. This is an example of matching a currently treated patient with the right drug combination. As a result, all of the marker levels improved, leading to better control and reduction in potentially adverse clinical events.
2. A Prediabetes Patient
A patient with atherosclerosis, who is non-diabetic according to HbA1c levels, is shown in this diagram. This patient had significant underlying vascular inflammation, insulin resistance, and beta-cell stress. The addition of an oral diabetes drug to his cardiovascular therapy improved all of the underlying abnormalities. The C-reactive protein levels, which are associated with cardiovascular events like myocardial infarcts or strokes, normalized. The levels of proinsulin and adiponectin, which are associated with beta-cell stress, insulin resistance and adipose tissue dysfunction, improved as well. The patient’s underlying pathway function, and thus risk factors, all clearly improved by adding an oral anti-diabetic medication, as did his overall health.
Anti-diabetic Drug Effects: Arrow Charts
These charts represent the direction in which selected individual biomarkers, used in the TIGAR™ reports, will move when comparing a baseline level with a post administration level of an anti-diabetic drug. Continuation of therapy will generally increase the movement in the direction shown, provided that other factors remain constant.
1. Effects of anti-diabetic drugs on standard glucose related tests:
Arrows indicate change: Green is positive, yellow is neutral, red is negative. Parentheses around an arrow means there is a smaller change.