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- July 20, 2008 |
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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!
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"Cardiovascular disease trials with implications for diabetes: Getting the evidence in the modern era"Prof. Timothy Davis (biography)
English - 2008-02-05 - 35 minutes
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Summary :
Professor Davis reviews several cardiovascular trials with implications for diabetes that have been conducted in recent years, with a focus on understanding the results. There are certain potential influences on clinical trials to keep in mind: the decrease in effect size due to the Hawthorn effect on the placebo group and due to more intensive management approaches, and the decrease in the...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
The reasons for recent negative results in CVD trials with implications for diabetes, specifically -
DIGAMI 2
PROACTIVE
FIELD
ASPEN
ASCOT-BPLA
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"The Indian diabetic diaspora: a cardiovascular time bomb"Dr. Soji Swaraj (biography)
English - 2007-11-16 - 21 minutes
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Summary :
In this presentation Dr. Swaraj discusses possible reasons for the high diabetes disease burden among people of East Indian origin, and prevention and treatment strategies.
Among countries, India has the highest number of people with diabetes. Among the Indian diaspora or Indians living outside of India, diabetes is more prevalent compared to their caucasian counterparts (1); they...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- Factors contributing to the high diabetes disease burden in people of East Indian origin
- Possible strategies to address this issue
Bibliographic references :
1. Raj Bhopal et al. Heterogeneity of coronary heart disease risk factors in Indian, Pakistani, Bangladeshi, and European origin populations: cross sectional study BMJ 1999;319:215-220.
2. C. J. K. Henry et al. Glycaemic index of common foods tested in the UK and India British Journal of Nutrition 2007.
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"CVD in Type 2 Diabetes: Who and How to Investigate"Dr. Trisha O'Moore-Sullivan (biography)
English - 2007-03-03 - 38 minutes
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Summary :
In this presentation Dr. O'Moore-Sullivan talks about investigations that can be done in type 2 diabetic patients who are symptomatic for coronary artery disease (CAD), and some potential means of identifying high-risk asymptomatic patients.
Coronary angiography is the "gold standard" for the detection of coronary artery disease (CAD), whereas multi-slice computed tomography,...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- Anatomical and functional tests for assessing CAD
- Imaging and prognosis in diabetic patients
- Data from the DIAD study: proportion of asymptomatic type 2 diabetic patients having an abnormal SPECT test
- The role of coronary artery calcium scoring in the identification of high-risk asymptomatic type 2 diabetic patients
Bibliographic references :
1. Bax JJ, Inzucchi SE, Bonow RO, Schuijf JD, Freeman MR, Barrett EJ; Global Dialogue Group for the Evaluation of Cardiovascular Risk in Patients with Diabetes.Cardiac Imaging for Risk Stratification in Diabetes Diabetes Care 30:1295-1304, 2007.
2. Wackers FJ, Young LH, Inzucchi SE, Chyun DA, Davey JA, Barrett EJ, Taillefer R, Wittlin SD, Heller GV, Filipchuk N, Engel S, Ratner RE, Iskandrian AE; Detection of Ischemia in Asymptomatic Diabetics Investigators.Detection of silent myocardial ischemia in asymptomatic diabetic subjects: the DIAD study. Diabetes Care 27:1954-1961, 2004.
3. Anand DV, Lim E, Hopkins D, Corder R, Shaw LJ, Sharp P, Lipkin D, Lahiri A. Risk stratification in uncomplicated type 2 diabetes: prospective evaluation of the combined use of coronary artery calcium imaging and selective myocardial perfusion scintigraphy Eur Heart J. 2006 Mar;27(6):713-21.
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"Hypertension: Where We Have Been and Where We Are Going"Prof. George L. Bakris (biography)
English - 2006-11-11 - 33 minutes
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Summary :
With the growing epidemic of obesity and the associated increase in the prevalence of diabetes and kidney disease comes an accompanying increase in the incidence of hypertension. Thus, the future portends more cardiovascular events associated with these conditions. This presentation is an overview of where we have been and where we are going with respect to control of hypertension.
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- Trends in the prevalence of hypertension
- Hypertension awareness, treatment and control
- JNC and HWG blood pressure classifications
- Prevalence of prehypertension
- Cardiovascular disease risk factors/markers
- Findings from the TROPHY trial
Bibliographic references :
Beeks, Esther; Kessels, Alfons GH; Kroon, Abraham A; van der Klauw, Melanie M; de Leeuw, Peter W Genetic predisposition to salt-sensitivity: a systematic review. Journal of Hypertension. 22(7):1243-1249, July 2004.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW,Materson BJ, Oparil S, Wright JT Jr, Roccella EJ; National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; National High Blood Pressure Education
Program Coordinating Committee. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003 May 21;289(19):2560-72.
European Society of Hypertension-European Society of Cardiology Guidelines Committee. 2003 European Society of Hypertension-European Society of Cardiology guidelines for the management of arterial hypertension [published corrections appear in J Hypertens. 2003;21:2203-2204 and J Hypertens.2004;22:435]. J Hypertens. 2003;21:1011-1053.
Kshirsagar AV, Carpenter M, Bang H, Wyatt SB, Colindres RE. Blood Pressure Usually Considered Normal Is Associated with an Elevated Risk of Cardiovascular Disease Am J Med. 2006 Feb;119(2):133-41.
Lewington S, Clarke R, Qizilbash N, Peto R, Collins R; Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies Lancet. 2002 Dec 14;360(9349):1903-13.
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"Progress in Heart Failure: Outcomes Trials Resulting in Evidence-Based Interventions"Dr. James Young (biography)
English - 2006-11-11 - 35 minutes
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Summary :
Progress in our understanding of heart failure can be defined by increasing insight into the enormous morbidity and mortality associated with this syndrome, as well as elucidation of its pathophysiology. Arguably, the “modern” day of heart failure awareness and therapy began in the mid-1960s when the syndrome was characterized more as a systemic cardiovascular disease than simply a problem...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- The facets of heart failure
- Historical perspectives on heart failure
- The emergence of clinical trials in heart failure
- Modern evolution of heart failure therapies
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"Role of Noninvasive Imaging in the Approach to Atherosclerotic Disease in Diabetes"Prof. Valentin Fuster (biography)
English - 2006-11-11 - 32 minutes
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Summary :
What are some strategic priorities concerning diabetes, atherothrombosis and imaging? In this presentation Prof. Fuster talks about the role of non-invasive imaging in the approach to atherosclerotic disease in diabetes.
Cardiovascular medicine is likely to focus more in the future on understanding and protecting health, and priorities may involve enhancing biological defense...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
Atherothrombosis, Diabetes and Imaging: Predicting 8 strategic priorities for 2006-2015:
- From treatment to protecting health
- Three molecular/cell processes to enhance
- Four clinical risk groups to identify and protect
Bibliographic references :
1. Boos CJ, Lip GY, Blann AD. Circulating Endothelial Cells in Cardiovascular Disease J Am Coll Cardiol. 2006 Oct 17;48(8):1538-47.
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"Type 2 Diabetes and Cardiovascular Disease: The Neel Hypothesis Revisited"Prof. Peter J. Grant (biography)
English - 2006-05-07 - 49 minutes
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Summary :
In this presentation Prof. Grant talks about the Common Soil and Thrifty Genotype hypotheses and how they can be interpreted in light of new information that became available since their conception.
According to the Common Soil Hypothesis put forth by Stern in the 1980s, diabetes and cardiovascular disease are the same condition, underpinned by common genetic and environmental...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- The primary function of inflammation and thrombosis;
- The physiological nature of the adipocyte response to fat loading;
- The inflammatory atherothrombotic insulin resistance syndrome underpinning diabetes and cardiovascular disease;
- The relationship of abnormal cyclical responses to diabetes and cardiovascular disease.
Bibliographic references :
Reaven, GM. Banting Lecture 1988. Role of Insulin Resistance in Human Disease Diabetes. 1988; 37(12): 1595-1607
Norhammar, A., Tenerz, A., Nilsson, G., Hamsten, A., Efendic, S., Ryden, L., Malmberg, K. Glucose Metabolism in Patients with Acute Myocardial Infarction and no Previous Diagnosis of Diabetes Mellitus: A Prospective Study The Lancet. June 2002; 359(9324): 2140-2144
Moreno, PR., Murcia, AM., Palacios, IF., Leon, MN., Bernardi, VH., Fuster, V., Fallon, JT. Coronary Composition and Macrophage Infiltration in Atherectomy Specimens From Patients With Diabetes Mellitus Circulation. 2000; 102: 2180
Vinik, AI., Erbas, T., Park, TS., Nolan, R., Pittenger, GL. Platelet Dysfunction in Type 2 Diabetes Diabetes Care. 2001; (24): 1476-1485
Freeman, MS., Mansfield, MW., Barrett, JH., Grant, PJ. Genetic Contribution to Circulating Levels of Hemostatic Factors in Healthy Families With Effects of Known Genetic Polymorphisms on Heritability Arteriosclerosis, Thrombosis, and Vascular Biology. 2002; 22: 506
Dunn, EJ., Ariens, RAS., Grant, PJ. The Influence of Type 2 Diabetes on Fibrin Structure and Function Diabetologia. 2005; 48(6): 1198-1206
Dunlap, JC. Molecular Bases for Circadian Clocks Cell. January 1999; 96(2): 271-290
Ando, H., Yanagihara, H., Hayashi, Y., Obi, Y., Tsuruoka, S., Takamura, T., Kaneko, S., Fujimura, A. Rhythmic Messenger Ribonucleic Acid Expression of Clock Genes and Adipocytokines in Mouse Visceral Adipose Tissue Endocrinology. 2005; 146(12): 5631-5636
Montagnani, M., Golovchenko, I., Kim, I., Koh, GY., Goalstone, ML., Mundhekar, AN., Johansen, M., Kucik, DF., Quon, MJ., Draznin, B. Inhibition of Phosphatidylinositol 3-Kinase Enhances Mitogenic Actions of Insulin in Endothelial Cells J. Biol. Chem. January 2002; 277(3): 1794-1799
Turek, FW., Joshu, C., Kohsaka, A., Lin, E., Ivanova, G., McDearmon, E., Laposky, A., Losee-Olson, S., Easton, A., Jensen, DR., Eckel, RH., Takahashi, JS., Bass, J. Obesity and Metabolic Syndrome in Circadian Clock Mutant Mice Science. May 2005; 308(5724): 1043-1045
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"Diabetes Mellitus: A Prothrombotic State"Dr. Richard W. Nesto (biography)
English - 2005-05-11 - 38 minutes
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Summary :
In this presentation Dr. Nesto talks about the mechanisms in diabetes that are responsible for the increased tendency to clot formation.
The higher risk of acute myocardial infarction in diabetes is hypothesized to be due to more extensive and progressive coronary artery disease, the proinflammatory and prothrombotic state of coronary plaques, as well as diabetes-specific...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- Diabetes-associated changes in coronary plaques and blood contributing to thrombosis risk
- Effects of different anti-platelet therapies in diabetes
Bibliographic references :
1. Pedro R. Moreno, MD and Valentin Fuster, MD, PhD. New aspects in the pathogenesis of diabetic atherothrombosis J Am Coll Cardiol. 2004 Dec 21;44(12):2293-300.
2. Frank D. Kolodgie, Ph.D., Herman K. Gold, M.D., Allen P. Burke, M.D., David R. Fowler, M.D., Howard S. Kruth, M.D., Deena K. Weber, M.S., Andrew Farb, M.D., L.J. Guerrero, B.S., Motoya Hayase, M.D., Robert Kutys, M.S., Jagat Narula, M.D., Ph.D., Aloke V. Finn, M.D., and Renu Virmani, M.D. Intraplaque Hemorrhage and Progression of Coronary Atheroma. N Engl J Med. 2003 Dec 11;349(24):2316-25.
3. Antonia Sambola, MD; Julio Osende, MD; James Hathcock, PhD; Michael Degen, BSc; Yale Nemerson, MD; Valentin Fuster, MD, PhD; Jill Crandall, MD; Juan Jose Badimon, PhD. Role of Risk Factors in the Modulation of Tissue Factor Activity and Blood Thrombogenicity. Circulation. 2003;107:973.
4. Nerea Varo, PhD; David Vicent, MD, PhD; Peter Libby, MD; Rebecca Nuzzo, BSc; Alfonso L. Calle-Pascual, MD, PhD; María Rosa Bernal, PhD; Arturo Fernández-Cruz, MD, PhD; Aristidis Veves, MD, DSc; Petr Jarolim, MD, PhD; Jose Javier Varo, MD, PhD; Allison Goldfine, MD; Edward Horton, MD; Uwe Schönbeck, PhD. Elevated Plasma Levels of the Atherogenic Mediator Soluble CD40 Ligand in Diabetic Patients: A Novel Target of Thiazolidinediones. Circulation. 2003;107:2664.
5. Burton E. Sobel, MD; Janet Woodcock-Mitchell, PhD; David J. Schneider, MD; Robert E. Holt, BA; Kousuke Marutsuka, MD; ; Herman Gold, MD. Increased Plasminogen Activator Inhibitor Type 1 in Coronary Artery Atherectomy Specimens From Type 2 Diabetic Compared With Nondiabetic Patients: A Potential Factor Predisposing to Thrombosis and Its Persistence. Circulation. 1998;97:2213-2221.
6. John A. Colwell, MD, PHD and Richard W. Nesto, MD. The Platelet in Diabetes: Focus on prevention of ischemic events. Diabetes Care 26:2181-2188, 2003.
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"Adiponectin - Novel 'Adipokine' with Metabolic and Vascular Effects"Dr. Barry Goldstein (biography)
English - 2005-04-27 - 54 minutes
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Summary :
A number of factors or adipocytokines are secreted from adipose tissue, many of which affect insulin sensitivity and vascular endothelial function. Central abdominal fat in particular has been found to be associated with insulin resistance (1), and ectopic fat deposition in liver and muscle also causes insulin resistance in those tissues. PPARγ agonists such as the thiazolidinediones, which...
Learning objectives :
Key discussion points:
- How does increased visceral adiposity lead to insulin resistance and vascular dysfunction?
- What is adiponectin and why is it apparently so important?
- What is the significance of these findings for the action of TZDs?
Bibliographic references :
1. Carey DG, Jenkins AB, Campbell LV, Freund J, Chisholm DJ.Abdominal fat and insulin resistance in normal and overweight women: Direct measurements reveal a strong relationship in subjects at both low and high risk of NIDDM.Diabetes. 1996 May;45(5):633-8.
2. Michio Shimabukuro, Namio Higa, Tomohiro Asahi, Yoshito Oshiro, Nobuyuki Takasu, Tatsuya Tagawa, Shinichiro Ueda, Iichiro Shimomura, Tohru Funahashi and Yuji Matsuzawa Hypoadiponectinemia Is Closely Linked to Endothelial Dysfunction in Man J Clin Endocrinol Metab. 2003 Jul;88(7):3236-40.
3. Barry J. Goldstein and Rosario Scalia Adiponectin: A Novel Adipokine Linking Adipocytes and Vascular Function J Clin Endocrinol Metab. 2004 Jun;89(6):2563-8.
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