 |
|
 |
- May 17, 2008 |
|
|
Welcome to the #1 online source of information for Diabetes Specialists! An international online community of more than 10,000 Diabetes Specialists.
CME on Diabetes is a website built to transmit top-level CME conferences given by international experts in endocrinology, insulin resistance, prediabetes, metabolic syndrome and type 2 diabetes. More than 2.6 million slides have been viewed since the website launch. Thank you for your continued support and commitment!
|
|
|
| Presentation |
|
"Are We Making Progress With Slowing Disease Progression?"Prof. Peter J. Grant (biography)
English - 2006-12-04 - 17 minutes
|
 | (9 slides) |
Summary :
Our understanding of the pathophysiological relationship between diabetes and cardiovascular disease has been markedly increased over the last 15 years. The seminal ADA lecture by Reaven in 1989, which described the existence of cardiovascular risk clustering in the presence of underlying insulin resistance, has been followed by a wave of publications linking changes in classical and novel markers for cardiovascular disease to insulin resistance. In 1982, Stern proposed the common soil hypothesis, which stated that ‘diabetes and cardiovascular disease are the same condition underpinned by common genetic and environmental influences’ and insulin resistance and clustering of risk appear to comprise the common antecedent of these conditions. These observations, combined with a deeper understanding of the cellular and molecular mechanisms that underpin insulin resistance and vascular risk, have led to exciting developments in the prevention and management of type 2 diabetes. Interventional studies such as DPP, Da Qing and TRIPOD indicated that lifestyle changes and the use of insulin sensitizers (metformin, troglitazone) could defer the conversion of impaired glucose tolerance (IGT) to type 2 diabetes.
These results were recently confirmed by the DREAM study which reported a 62% reduction in conversion of IGT to type 2 diabetes over 4 years with rosiglitazone. UKPDS provided the first indication that the use of insulin sensitizers might be associated with a reduction in cardiovascular risk, with the observation that metformin decreased cardiovascular outcomes in obese subjects. The PROactive study using pioglitazone in high risk patients largely confirms this impression and the results of RECORD using rosiglitazone in primary prevention are eagerly awaited. The observation that interventions that prevent the development of diabetes also prevent cardiovascular disease indicates that we are getting near to the underlying cause of both conditions. This symposium will explore some of the biochemical, clinical and therapeutic issues associated with the pathophysiology of type 2 diabetes and its micro-and macrovascular complications.
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- Diabetes and cardiovascular disease: the "common soil" hypothesis
- Targeting of beta-cell dysfunction and increasing insulin resistance
- The DREAM trial: summary and conclusions
- The ADOPT trial: summary of glycaemic efficacy; outstanding questions
- Clinical trials across the diabetes continuum
|
|
|
|
|
|
| Search our website |
 |
| |
Would you like to know more about insulin resistance? Are you looking for information pertaining to Type 2 Diabetes? You can find what you are looking for in over 2000 references available on CMEonDiabetes. |
| |
|
|
| Social |
|
| |
Let others know about this presentation.
|
|
|
|
