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- May 17, 2008 |
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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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"Managing Diabetes and Insulin Resistance in Patients with CVD"Dr. Vivian A. Fonseca (biography)
English - 2005-05-02 - 56 minutes
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Summary :
In this presentation Dr. Fonseca talks about the interaction between diabetes and cardiovascular disease, the effects of different diabetes therapies and their possible impact on CVD.
Insulin resistance is recognized as a core underlying defect in type 2 diabetes. Patients with diabetes or IGT are frequently encountered in cardiology practices, and many of these patients are insulin resistant. Apart from stimulating muscle glucose uptake and suppressing hepatic glucose production, insulin has other effects that are impaired in insulin resistance, such as its vasodilatory and anti-inflammatory effects. Insulin resistance is associated with factors that can promote the development of CVD, including dyslipidemia, hypertension, inflammation, coagulation abnormalities and endothelial dysfunction.
What are the known effects of diabetes treatments on surrogate cardiovascular risk factors? Dr. Fonseca discusses extra-glycemic effects of diet and exercise, metformin, sulfonylureas, TZDs, insulin, and angiotensin receptor blockers that might have an impact on cardiovascular outcomes. Statins have already been shown to reduce events in diabetic patients.
How can glycemic control be achieved in diabetic patients while possibly reducing their risk of CVD? The UKPDS showed that different monotherapies failed over time, and other studies have since shown significant reductions in A1c by combining different drug classes. Examples of such combinations are thiazolidinediones (TZDs) in combination with metformin or sulfonylureas or insulin.
Finally Dr. Fonseca talks about factors involved in diabetic cardiomyopathy and the management of diabetic patients with CHF, and recalls attention to the Steno-2 study and ongoing outcome studies.
Copyright © 2006 E-MedHosting.com Inc.
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- The role of insulin resistance in promoting CVD
- The effects of diabetes therapies on insulin-resistance related risk factors
- Combination therapies utilising insulin sensitizers
- Factors involved in diabetic cardiomyopathy
- Management of diabetic patients with CHF
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