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- May 17, 2008 |
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| Presentation |
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"Type 2 Diabetes: A Multifactorial Syndrome"Dr. Stuart A Ross (biography)
English - 2002-04-24 - 49 minutes
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Summary :
In this presentation Dr Ross addresses the current-day notion of type 2 diabetes as a multifactorial syndrome. No longer is control of glycemia the sole goal of treatment, but we now must control dyslipidemia, hypertension, proteinuria, weight gain, insulin resistance and cardiovascular disease. Early in the talk, Dr Ross defines insulin resistance and it’s mechanisms. He then focuses on the treatment goals and stategies which address all the pathological factors of type 2 diabetes.
Learning objectives :
After viewing this presentation, the participant will be familiar with the mechanisms of insulin resistance and its role in type 2 diabetes. An idea of the treatment goals and strategies targeting all pathological aspects of the disease will also be gained.
Bibliographic references :
Multifactorial insulin resistance and clinical impact in hypertension
and cardiovascular diseases.
Harano Y, Suzuki M, Koyama Y, Kanda M, Yasuda S, Suzuki K, Takamizawa I.
Koshien University College of Nutrition, 10-1, Momijigaoka, Hyogo,
Takarazuka, Japan.
Insulin resistance and hyperinsulinemia have been observed in over 70% of the nonobese, nondiabetic subjects with essential hypertension (HT). Alpha-1 blockers, ACE-antagonists, long-acting Ca blockers including nifedipine CR, some form of beta-blockers, tilisolor, which is reported to increase blood flow, improve insulin sensitivity when blood pressure is better controlled. Decrease of serum potassium during insulin sensitivity test and intraplatelet free Ca2+ concentration is positively and negatively correlated with insulin sensitivity, respectively. Blood pressure is correlated with insulin resistance, which is also observed in secondary HT. The resistance is correlated with salt sensitivity as well as impaired nocturnal fall of blood pressure. These suggest the possible association of insulin resistance with altered intracellular cation metabolism. Insulin resistance and associated hyperinsulinemia have been observed in effort as well as vasospastic angina pectoris(VSAP), atherothrombotic cerebral infarction, and in ASO without obesity, HT, or diabetes, suggesting the resistance resulting from endothelial dysfunction. Insulin resistance has been observed in heart failure and is correlated with angiotensin II. Resistance is also observed in hypertrophic cardiomyopathy and is partially correlated with TNF-alpha. These results indicate that insulin resistance seem to be multifactorial. An effort to normalize insulin sensitivity is crucial to eliminate multiple risk factors as well as to prevent the progression of atherosclerotic vascular lesions.
J Diabetes Complications 2002 Jan-Feb;16(1):19-23
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