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- January 7, 2009 |
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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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PathophysiologyIn order to better understand the causes of Type 2 diabetes, certain fundamental studies are necessary. Many elements are presently being studied: production of insulin, method of hormonal action, signals produced by its production, chain reaction of cells when in contact with the hormone, receptors involved in the process of detection, causes of insulin insensitivity... The development of a better understanding of each of these factors may help prevent and treat Type 2 diabetes.
Presentations listing
Polyglandular Autoimmune Syndromes - Dr. Patricia Crock
Autoimmune Diseases: Impact on Diabetes - Dr. Trisha O'Moore-Sullivan
Relationship between hyperglycaemia and micro- and... - Prof. Timothy Davis
Relationship between underlying causes of insulin... - Prof. Christopher Nolan
Underlying Causes of Disease Progression: The Role of... - Prof. Nikolaus Marx
Women, CHD & Diabetes - Dr. Pat Phillips
« Is HDL Dysfunctional in Diabetes » ? - Prof. John Chapman
Nox, Nox, Knocking: The Emerging Roles of NADPH Oxidases in... - Dr. Grant Drummond
Mitochondria and the Pathogenesis of Type 2 Diabetes... - Prof. J.A. Maassen
Pathophysiology of Type 2 Diabetes - The Critical Role of... - Prof. Steven Kahn
The Clinical Implications of Advanced Glycation - Dr. Merlin C. Thomas
The Clinical Value of ApoB - Dr. Allan D. Sniderman
Diabetes Related Foot Complications - Dr. Paul Wraight
Diabetic Autonomic Neuropathy: GI Tract: DX and RX -... - Dr. Terry Moore
Quality of Life & Diabetes - Dr. Pat Phillips
Interaction of Metabolic with Haemodynamic Factors in... - Prof. Mark E. Cooper
Effects of fatty acids on glucose metabolism and the... - Dr. Meredith Hawkins
21 Years of Insulin Resistance - Targeted Drug Research:... - Dr. Stephen A. Smith
Introduction - Prof. Jean-Pierre Després
Natural History of ß-cell Decline in Type 2 Diabetes - Prof. Stefano Del Prato
Adipose Tissue as an Inflammatory Organ (Endocrine Tumor)... - Prof. John N. Fain
Muscle - Adipose Tissue "Crosstalk" :... - Prof. Edward W. Kraegen
Resistin and Fasting-Induced Adipose Factor (FIAF) in the... - Dr. Russell Brown
The ß-cell: Friend and Foe - Prof. Steven Kahn
Vascular Disease and Insulin Resistance - Prof. Giancarlo Viberti
Postprandial Hyperglycemia and Cardiovascular Disease - Prof. Antonio Ceriello
Increased Risk of Coronary Events in Dysglycemic Patients:... - Dr. Richard W. Nesto
Lessons from the UKPDS - Prof. Alastair Gray
Effect of Fructose Overfeeding and Fish Oil Administration... - Dr. David Faeh
Neural Control of Energy Balance - Prof. Stephen C. Woods
Markers of Inflammation and Hypercoagulation in CAD - Dr. Russell P. Tracy
Obesity, Dyslipidemia and Inflammation - Dr. Robert H. Eckel
Adiponectin - Prof. John Prins
Association of hsCRP with Later Stage ß-Cell Dysfunction... - Dr. A. Pfützner
CRP, Inflammation, and its Relationship to Cardiovascular... - Dr. Paul M. Ridker
What are the manifestations of beta-cell dysfunction and... - Dr. Steven V. Edelman
Type 2 Diabetes Mellitus and Heart Failure: Implications... - Dr. Richard W. Nesto
Impaired Microvascular Recruitment and Muscle Insulin... - Dr. Michael G. Clark
Ectopic fat and oxidative stress: common denominators in... - Dr. Robin Buckingham
Insulin Sensitivity in the Adiponectin Transgenic Mouse - Dr. Terry Combs
A PPAR gamma Mutation and the Lipodystrophic Phenotype - A... - Dr. Thomas Ransom
New Insights in Diabetic Retinopathy - Dr. Filiberto Altomare
The Wheres and Whats of Body Fat Distribution - Prof. Steven Kahn
Nuclear Receptor Diseases Mechanisms - Dr. Mitchell Lazar
Beta Cell Failure in type 2 Diabetes: A Paradigm Revisited - Dr. Minna Woo
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"Polyglandular Autoimmune Syndromes"Dr. Patricia Crock (biography)
English - 2008-05-22 - 49 minutes
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Summary :
Dr. Crock starts with a case presentation of a boy with Addison's disease, glucocorticoid and mineralocorticoid deficiency, and a family history of polyglandular autoimmune disease.
Autoimmune endocrinopathies cluster, for example patients with type 1 diabetes may have Hashimoto's disease or coeliac disease. Although Addison's disease is rare it may be indicated by falling insulin...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- Autoimmune diseases which cluster with type 1 diabetes
- A classical case presentation of polyglandular autoimmune disease
- Target autoantigens and autoantibody markers
- How to avoid some diagnostic pitfalls
- Monogenic Autoimmunity Syndromes
- Polyglandular Autoimmune syndromes
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"Autoimmune Diseases: Impact on Diabetes"Dr. Trisha O'Moore-Sullivan (biography)
English - 2007-11-21 - 36 minutes
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Summary :
Autoimmune diseases are found more commonly in people with Type 1 Diabetes (T1DM) than amongst the general population. Dr. O'Moore-Sullivan discusses the implications of a diagnosis of autoimmune disease accompanying T1DM, which relate to the management of both conditions, as well as to the screening for other autoimmune diseases in the patient and his family.
A common...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
-The association of Type 1 Diabetes with the following endocrine autoimmune diseases:
Autoimmune thyroid disease (AIT)
Autoimmune Addison's Disease (AD)
-The association of Type 1 Diabetes with a non-endocrine autoimmune disease, Coeliac Disease (CD)
-Autoimmune Polyendocrine Syndromes (APS)
Bibliographic references :
Jennifer M. Barker Type 1 Diabetes-Associated Autoimmunity: Natural History, Genetic Associations, and ScreeningThe Journal of Clinical Endocrinology & Metabolism Vol. 91, No. 4 1210-1217
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"Relationship between hyperglycaemia and micro- and macrovascular outcomes"Prof. Timothy Davis (biography)
English - 2007-11-10 - 34 minutes
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Summary :
Long-term randomised controlled trials have provided good evidence for the relationship between glycaemia and the risk of vascular complications of diabetes.
The DCCT study in type 1 diabetic patients showed that intensive treatment was associated with significant improvements in microvascular outcomes. There was a low number of cardiovascular events, however fewer events were seen...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- The relationship between glycaemia and vascular outcomes in type 1 and type 2 diabetes
- Evidence in support of a 'legacy' effect of good glycaemic control
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"Relationship between underlying causes of insulin resistance and beta-cell function"Prof. Christopher Nolan (biography)
English - 2007-11-10 - 34 minutes
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Summary :
Islet beta-cell failure is a key factor in type 2 diabetes pathogenesis. It is progressive, and occurs in the context of islets compensating for insulin resistance.
Beta-cell failure occurs in “susceptible” islets, and the mechanisms involved are of the initiation and progression types.
The factors that make islets susceptible to dysfunction need to be discovered,...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- GDM as an insulin resistant state
- Insulin secretion in women with previous GDM
- The influence of GDM on long-term control of glucose tolerance
- The islet beta-cell in T2DM
- Glucolipotoxicity as a proposed mechanism of beta-cell failure in T2DM
Bibliographic references :
Marc Prentki and Christopher J. NolanIslet β cell failure in type 2 diabetes J Clin Invest. 2006 July 3; 116(7): 1802–1812.
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"Underlying Causes of Disease Progression: The Role of PPAR-gamma and the Metabolic and Vascular Actions of the TZDs"Prof. Nikolaus Marx (biography)
English - 2006-12-04 - 28 minutes
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Summary :
Type 2 diabetes mellitus is a complex metabolic disorder associated with various risk factors like dyslipidaemia, inflammation and hypertension. Patients with insulin resistance and type 2 diabetes mellitus exhibit an increased propensity to develop arteriosclerosis with its sequelae acute myocardial infarction and stroke. Anti-diabetic, PARγ−activating, thiazolidinediones (TZDs,...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- Metabolic and vascular aspects of insulin resistance
- Mechanism of action of the insulin-sensitizing thiazolidinedione (TZD) drugs
- Metabolic effects of TZDs, including effects on HDL-C and LDL particle size
- Vascular action of TZDs: in vitro and in vivo evidence for anti-inflammatory and anti-atherogenic properties
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"Women, CHD & Diabetes"Dr. Pat Phillips (biography)
English - 2006-10-27 - 27 minutes
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Summary :
In this presentation Dr. Phillips talks about the importance of coronary heart disease (CHD) in diabetes, particularly in women.
Is diabetes a CHD risk equivalent? A well-known case-control study reported by Haffner et al. in 1998 suggested that diabetic patients without previous myocardial infarction have as high a risk of myocardial infarction as non-diabetic patients with...
Learning objectives :
After viewing this presentation, the participant will be able to discuss:
- Coronary heart disease is very common in those with type 2 diabetes and vice versa.
- In women the presence of diabetes increases coronary risk much more than in men and equalises coronary risk for men and women.
- Many women and their professionals do not appreciate the risk of coronary heart disease in women nor do they appreciate that diabetes increases a woman’s coronary risk as much as it does.
Bibliographic references :
1. Haffner SM, Lehto S, Ronnemaa T, Pyorala K, Laakso M.Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med. 1998 Jul 23;339(4):229-34.
2. S Lehto, T Ronnemaa, SM Haffner, K Pyorala, V Kallio and M LaaksoDyslipidemia and hyperglycemia predict coronary heart disease events in middle-aged patients with NIDDM Diabetes. 1997 Aug;46(8):1354-9.
3. Juutilainen A, Kortelainen S, Lehto S, Ronnemaa T, Pyorala K, Laakso M.Gender Difference in the Impact of Type 2 Diabetes on Coronary Heart Disease Risk Diabetes Care 27:2898-2904, 2004.
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"« Is HDL Dysfunctional in Diabetes » ?"Prof. John Chapman (biography)
English - 2006-10-04 - 62 minutes
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Summary :
In this presentation Prof. Chapman talks about high density lipoprotein (HDL) dysfunction in insulin-resistant states including type 2 diabetes. Not only HDL cholesterol (HDL-C) concentrations are reduced, but it has recently come to light that HDL particles themselves are dysfunctional in insulin-resistant states.
The atherogenic dyslipidemia of insulin-resistant states including...
Learning objectives :
After viewing this presentation, the participant will be able to discuss
- Epidemiological data supporting the concept that elevated levels of HDL-cholesterol are atheroprotective
- Epidemiological data that low levels of HDL-C are a major CV risk factor in diabetics and in non-diabetics
- Mechanisms underlying perturbed HDL metabolism in insulin-resistant states associated with hypertriglyceridemia
- Anti– atherogenic activities of HDL and defects in Type 2 diabetes
Bibliographic references :
1. Chieko Mineo, Hiroshi Deguchi, John H. Griffin, Philip W. Shaul Endothelial and Antithrombotic Actions of HDL Circulation Research. 2006;98:1352.
2. Barbara V. Howard; David C. Robbins; Maurice L. Sievers; Elisa T. Lee; Dorothy Rhoades; Richard B. Devereux; Linda D. Cowan; R. Stuart Gray; Thomas K. Welty; Oscar T. Go; Wm. James Howard. LDL Cholesterol as a Strong Predictor of Coronary Heart Disease in Diabetic Individuals With Insulin Resistance and Low LDL: The Strong Heart Study Arteriosclerosis, Thrombosis, and Vascular Biology. 2000;20:830.
3. Kontush A, Chapman MJ.Antiatherogenic small, dense HDL--guardian angel of the arterial wall? Nat Clin Pract Cardiovasc Med. 2006 Mar;3(3):144-53.
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"Nox, Nox, Knocking: The Emerging Roles of NADPH Oxidases in Vascular Physiology & Disease"Dr. Grant Drummond (biography)
English - 2006-09-16 - 48 minutes
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Summary :
"Despite the bad press about reactive oxygen species, they are not always that bad," says Dr. Drummond. "In fact they are critical for cell signaling processes." What happens when oxygen free radicals/reactive oxygen species are overproduced, and what are the potential implications for lowering oxidative stress in the vasculature?
All of the known cardiovascular risk factors are...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- What are reactive oxygen species?
- Effects of overproduction of reactive oxygen species in disease states
- Clinical trials with antioxidants
- NADPH oxidase isoforms and superoxide production
- Proposed mechanisms of vascular free radical production
Bibliographic references :
1. Young-Ah Suh, Rebecca S. Arnold, Bernard Lassegue, Jing Shi, Xiangxi Xu, Dan Sorescu, Andrew B. Chung, Kathy K. Griendling and J. David LambethCell transformation by the superoxide-generating oxidase Mox1 Nature 1999;401:79.
2. Bernard Lassègue, Dan Sorescu, Katalin Szöcs, QiQin Yin, Marjorie Akers, Yong Zhang, Sharon L. Grant, J. David Lambeth, Kathy K. Griendling Novel gp91phox Homologues in Vascular Smooth Muscle Cells: nox1 Mediates Angiotensin II–Induced Superoxide Formation and Redox-Sensitive Signaling Pathways Circulation Research. 2001;88:888.
3. Cornelius F.H. Mueller; Karine Laude; J. Scott McNally; David G. Harrison Redox Mechanisms in Blood Vessels Arteriosclerosis, Thrombosis, and Vascular Biology. 2005;25:274.
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"Mitochondria and the Pathogenesis of Type 2 Diabetes Mellitus"Prof. J.A. Maassen (biography)
English - 2006-09-15 - 57 minutes
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Summary :
In this presentation Prof. Maassen talks about the role of mitochondria in the development of glucose intolerance, in tissues such as adipose tissue, liver, muscle and pancreatic beta cells.
Mitochondria have their own DNA (mtDNA), which is about 16.5kb in length. This DNA is maternally inherited, and a number of clinical syndromes are associated with mtDNA mutations. One mutation...
Learning objectives :
After viewing this presentation, the participant will be able to discuss:
- The life style factors that contribute to the development of common type 2 diabetes
- Why triglycerides and in particular fatty acids are major players in the development of type 2 diabetes
- The role of mitochondria in the pathogenesis of the metabolic syndrome and the development of type 2 diabetes
- Why hyperglycemia is a late event in the metabolic syndrome and why thiazolidinediones (TZDs, glitazones) and physical exercise have a beneficial effect in slowing down the disease process
Bibliographic references :
1. van den Ouweland JM, Lemkes HH, Ruitenbeek W, Sandkuijl LA, de Vijlder MF,
Struyvenberg PA, van de Kamp JJ, Maassen JA.Mutation in mitochondrial tRNALeu(UUR) gene in a large pedigree with maternally transmitted type II diabetes mellitus and deafness Nature Genetics 1, 368 - 371 (1992).
2. Takashi Kadowaki, Hiroko Kadowaki, Yasumichi Mori, Kazuyuki Tobe, Ryoichi Sakuta, Yoshihiko Suzuki, Yuzo Tanabe, Hiroshi Sakura, Takuya Awata, Yu-ichi Goto, Takaki Hayakawa, Kenpei Matsuoka, Ryuzo Kawamori, Takenobu Kamada, Satoshi Horai, Ikuya Nonaka, Ryoko Hagura, Yasuo Akanuma, and Yoshio YazakiA Subtype of Diabetes Mellitus Associated with a Mutation of Mitochondrial DNA N Engl J Med. 1994 Apr 7;330(14):962-8.
3. Mootha VK, Lindgren CM, Eriksson KF, Subramanian A, Sihag S, Lehar J, Puigserver
P, Carlsson E, Ridderstrale M, Laurila E, Houstis N, Daly MJ, Patterson N,
Mesirov JP, Golub TR, Tamayo P, Spiegelman B, Lander ES, Hirschhorn JN,
Altshuler D, Groop LC.PGC-1alpha-responsive genes involved in oxidative phosphorylation are coordinately downregulated in human diabetes Nature Genetics 34, 267 - 273 (2003).
4. Petersen KF, Dufour S, Befroy D, Garcia R, Shulman GI.Impaired Mitochondrial Activity in the Insulin-Resistant Offspring of Patients with Type 2 Diabetes N Engl J Med. 2004 Feb 12;350(7):664-71.
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"Pathophysiology of Type 2 Diabetes - The Critical Role of the Beta-Cell"Prof. Steven Kahn (biography)
English - 2006-09-13 - 40 minutes
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Summary :
The beta-cell is critical in the maintenance of glucose tolerance and a marked decrease in beta-cell function is clearly associated with the development of hyperglycaemia in type 2 diabetes. Understanding the importance of insulin sensitivity in modulating beta-cell function has demonstrated that the beta-cell is capable of dramatically increasing insulin release in response to increased...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- Loss of the acute insulin response in T2DM
- Beta-cell adaptation to insulin sensitivity
- Beta-cell function in relation to fasting plasma glucose
- Beta-cell volume in IFG and T2DM
Bibliographic references :
1. Kahn SE.The relative contributions of insulin resistance and b-cell dysfunction to the pathophysiology of type 2 diabetes.Diabetologia 46:3-19, 2003
2. Utzschneider KM, Prigeon RL, Carr DB, Hull RL,Tong J, Shofer JB, Retzlaff BM, Knopp RH, Kahn SE. Impact of differences in fasting glucose and glucose tolerance on the hyperbolic relationship between insulin sensitivity and insulin responses.Diabetes Care 29:356-362, 2006
3. Holman RR. Assessing the potential for alpha-glucosidase inhibitors in prediabetic states. Diabetes Res Clin Pract 40 (Suppl):S21-S25, 1998
4. Leung N, Sakaue T, Carpentier A, Uffelman K, Giacca A, Lewis GF. Prolonged increase of plasma non-esterified fatty acids fully abolishes the stimulatory effect of 24 hours of moderate hyperglycaemia on insulin sensitivity and pancreatic b-cell function in obese men. Diabetologia 47:204-213, 2004
5. Kloppel G, Lohr M, Habich K,Oberholzer M, Heitz PU. Islet pathology and the pathogenesis of type 1 and type 2 diabetes mellitus revisited. Surv Synth Pathol Res 4:110-125, 1985
6. Butler AE, Janson J, Bonner-Weir S, Ritzel R, Rizza RA, Butler PC. b-cell deficit and increased b-cell apoptosis in humans with type 2 diabetes.Diabetes 52:102-110, 2003
7. Hull RL,Westermark GT,Westermark P, Kahn SE. Islet amyloid: a critical entity in the pathogenesis of type 2 diabetes. J Clin Endocrinol Metab 89:3629-3643, 2004
8. Barroso I.Genetics of type 2 diabetes.Diabet Med 22:517-535, 2005
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"The Clinical Implications of Advanced Glycation"Dr. Merlin C. Thomas (biography)
English - 2006-09-13 - 43 minutes
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Summary :
In this presentation Dr. Merlin Thomas of the Baker Heart Research Institute talks about the relevance of advanced glycation in diabetic patients. A number of haemodynamic and metabolic factors operate in chronic hyperglycemia, says Dr. Thomas, however, one pivotal pathway appears to be the formation and accumulation of advanced glycation end-products (AGEs).
AGEs are formed by ...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- What are AGEs?
- Experimental evidence for AGEs as downstream mediators of hyperglycemic injury
- Ten reasons why AGEs are important in the clinic
Bibliographic references :
1. Josephine M. Forbes, Mark E. Cooper, Matthew D. Oldfield and Merlin C. Thomas Role of Advanced Glycation End Products in Diabetic Nephropathy J Am Soc Nephrol 14:S254-S258, 2003.
2. Helen Vlassara. The AGE-receptor in the pathogenesis of diabetic complications Diabetes/Metabolism Research and Reviews. Volume 17, Issue 6 , Pages 436 - 443.
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"The Clinical Value of ApoB"Dr. Allan D. Sniderman (biography)
English - 2006-05-27 - 45 minutes
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Summary :
"Lowering the level of atherogenic lipoproteins in plasma is unquestionably the single most important step that can be taken to reduce the complications of vascular disease," says Dr. Sniderman. How should this be done and does measurement of LDL-C provide an accurate picture of risk in all cases?
The apoB value represents the total number of circulating atherogenic lipoproteins,...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- Limitations of LDL-C for risk assessment
- The value of apoB vs LDL-C for estimating cardiovascular risk and guiding therapy
- New data from CARDS: On-treatment apoB as a predictor of outcome in type 2 diabetic patients
- Approach to lowering apoB
Bibliographic references :
Barter PJ, Ballantyne CM, Carmena R, Castro Cabezas M, Chapman MJ, Couture P, de Graaf J, Durrington PN, Faergeman O, Frohlich J, Furberg CD, Gagne C, Haffner SM, Humphries SE, Jungner I, Krauss RM, Kwiterovich P, Marcovina S, Packard CJ, Pearson TA, Reddy KS, Rosenson R, Sarrafzadegan N, Sniderman AD, Stalenhoef AF, Stein E, Talmud PJ, Tonkin AM, Walldius G, Williams KM. Apo B versus cholesterol in estimating cardiovascular risk and in guiding therapy: report of the thirty-person/ten-country panel. J Intern Med. 2006 Mar;259(3):247-58.
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"Diabetes Related Foot Complications"Dr. Paul Wraight (biography)
English - 2006-05-06 - 33 minutes
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Summary :
Approximately 20 percent of the diabetic population will develop a foot complication during their lifetime, says Dr. Wraight. These complications come in different kinds, such as pressure lesions or burns in a neuropathic foot, neuropathic ulcers due to ill-fitting shoes and other more serious conditions. These conditions are usually precipitated by neuropathy, trauma or foot deformity, and the...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- Different kinds of diabetic foot complications
- The pathogenesis of diabetic foot complications
- Diabetic pedal osteomyelitis: diagnosis and treatment strategies
Bibliographic references :
1. Morrison WB, Schweitzer ME, Wapner KL, Hecht PJ, Gannon FH, Behm WR.Osteomyelitis in feet of diabetics: clinical accuracy, surgical utility, and cost-effectiveness of MR imaging. Radiology. 1995 Aug;196(2):557-64.
2. G Ha Van, H Siney, JP Danan, C Sachon and A GrimaldiTreatment of osteomyelitis in the diabetic foot. Contribution of conservative surgery Diabetes Care. 1996 Nov;19(11):1257-60.
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"Diabetic Autonomic Neuropathy: GI Tract: DX and RX - Conclusions of a Careful Clinician or Frustrations of an Impatient Patient"Dr. Terry Moore (biography)
English - 2006-04-28 - 38 minutes
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Summary :
Gastrointestinal (GI) complaints are common in diabetic patients, and in this presentation Dr. Moore discusses the more common GI symptoms in diabetes and their underlying mechanisms, as well as diagnostic and therapeutic approaches.
Diabetic patients may experience upper GI symptoms such as epigastric fullness, nausea and heartburn, and lower GI symptoms such as constipation,...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- The upper and lower gastrointestinal symptoms that are more common in diabetes
- The mechanisms especially the neuropathies, that promote these symptoms
- Based on these mechanisms, a diagnostic and therapeutic approach to GI symptoms in the diabetic patient
Bibliographic references :
1. J Arts, P Caenepeel, K Verbeke and J TackInfluence of erythromycin on gastric emptying and meal related symptoms in functional dyspepsia with delayed gastric emptying Gut 2005;54:455-460.
2. Prakash C, Lustman PJ, Freedland KE, Clouse RE.Tricyclic Antidepressants for Functional Nausea and Vomiting (Clinical Outcome in 37 Patients) Dig Dis Sci. 1998 Sep;43(9):1951-6.
3. Brian E. Lacy, PHD, MD, Michael D. Crowell, PHD, Ann Schettler-Duncan, RN, Carole Mathis, PHD and Pankaj J. Pasricha, MDThe Treatment of Diabetic Gastroparesis With Botulinum Toxin Injection of the Pylorus Diabetes Care 27:2341-2347, 2004.
4. Abell T, McCallum R, Hocking M, Koch K, Abrahamsson H, Leblanc I, Lindberg G, Konturek J, Nowak T, Quigley EM, Tougas G, Starkebaum W.Gastric electrical stimulation for medically refractory gastroparesis Gastroenterology. 2003 Aug;125(2):421-8.
5. Celik AF, Osar Z, Damci T, Pamuk ON, Pamuk GE, Ilkova H. "How important are the disturbances of lower gastrointestinal bowel habits in diabetic outpatients?" Am J Gastroenterol. 2001 Apr;96(4):1314-6.
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"Quality of Life & Diabetes"Dr. Pat Phillips (biography)
English - 2006-02-21 - 39 minutes
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Summary :
In this presentation Dr. Phillips talks about why it's important to understand quality of life (QoL) in diabetes, some of the measurements used, and the quality of life continuum in diabetes.
It is important to understand QoL in the context of individual choices of the patient, and to understand the health impact of QoL. QoL is also used in guiding public health choices and...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
QOL and Diabetes:
- Why bother?
- Measurement of QoL
- The QoL continuum in diabetes
Bibliographic references :
1. UK Prospective Diabetes Study Group.Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38 BMJ 1998;317:703-713.
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"Interaction of Metabolic with Haemodynamic Factors in Diabetic Nephropathy"Prof. Mark E. Cooper (biography)
English - 2006-02-16 - 40 minutes
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Summary :
In this presentation Prof. Cooper discusses the pathogenesis of diabetic nephropathy, current treatments, and future directions for the development of new and better treatments.
Elevated glucose and blood pressure levels are both associated with the development of diabetic complications, as seen in the UKPD study. With regards to the pathogenesis of diabetic nephropathy, there...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- A paradigm for the pathogenesis of diabetic nephropathy
- Efficacy of currently used antiproteinuric therapies and predictors of renal outcomes
- Potential therapeutic targets in diabetic nephropathy
Bibliographic references :
1. M. E. Cooper.Interaction of metabolic and haemodynamic factors in mediating experimental diabetic nephropathy Diabetologia, Volume 44, Issue 11, Nov 2001, Pages 1957 - 1972.
2. Barry M. Brenner, M.D., Mark E. Cooper, M.D., Ph.D., Dick de Zeeuw, M.D., Ph.D., William F. Keane, M.D., William E. Mitch, M.D., Hans-Henrik Parving, M.D., Giuseppe Remuzzi, M.D., Steven M. Snapinn, Ph.D., Zhonxin Zhang, Ph.D., Shahnaz Shahinfar, M.D., for the RENAAL Study Investigators. Effects of Losartan on Renal and Cardiovascular Outcomes in Patients with Type 2 Diabetes and Nephropathy N Engl J Med. 2001 Sep 20;345(12):861-9.
3. de Zeeuw D, Remuzzi G, Parving HH, Keane WF, Zhang Z, Shahinfar S, Snapinn S, Cooper ME, Mitch WE, Brenner BM.Proteinuria, a target for renoprotection in patients with type 2 diabetic nephropathy: Lessons from RENAAL Kidney International (2004) 65, 2309–2320.
4. Doublier S, Salvidio G, Lupia E, Ruotsalainen V, Verzola D, Deferrari G, Camussi G.Nephrin Expression Is Reduced in Human Diabetic Nephropathy: Evidence for a Distinct Role for Glycated Albumin and Angiotensin II Diabetes 52:1023-1030, 2003.
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"Effects of fatty acids on glucose metabolism and the metabolic syndrome"Dr. Meredith Hawkins (biography)
English - 2005-11-08 - 42 minutes
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Summary :
In this presentation Dr. Hawkins talks about the role of increased free fatty acids in various clinical manifestations of insulin resistance, including increased glucose production, the lack of its regulation by hyperglycemia, insulin resistance per se and a procoagulant state.
Beginning with the role of increased free fatty acids in increasing glucose production, elevated insulin...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
The role of increased free fatty acid levels in the following manifestations of insulin resistance:
- Increased glucose production and its lack of regulation by hyperglycemia
- Reduced insulin action
- Increased PAI-1 circulating levels and gene expression
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"21 Years of Insulin Resistance - Targeted Drug Research: Redefining the Pathophysiology of Type 2 Diabetes"Dr. Stephen A. Smith (biography)
English - 2005-11-08 - 36 minutes
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Summary :
Type 2 diabetes has been seen principally as a disorder of glucose metabolism resulting from insulin resistance and beta-cell dysfunction, but recent findings suggest there is a major lipid disorder component to the pathophysiology as well. In this talk Dr. Smith discusses how knowledge of the effects of thiazolidinediones have contributed to this changing view.
Thiazolidinedione...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- Development of the thiazolidinedione drugs
- Mechanisms of insulin sensitisation due to PPARγ activation by thiazolidinediones
Bibliographic references :
1. S. A. Smith. Central role of the adipocyte in the insulin-sensitising and cardiovascular risk modifying actions of the thiazolidinediones Biochimie 2003;85(12):1219-1230.
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"Introduction"Prof. Jean-Pierre Després (biography)
English - 2005-10-25 - 16 minutes
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Summary :
In this introduction, Prof. Després talks about the “toxic” environment in today's society which promotes obesity, the development of type 2 diabetes and an increased risk of cardiovascular disease.
Hyperglycemia management is only the tip of the iceberg when it comes to preventing first or recurrent myocardial infarction in diabetic patients. The underlying metabolic abnormalities...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- The contribution of modern lifestyle choices towards increased diabetes and heart disease risk
- The impact of metabolic syndrome on CHD risk in diabetic patients
Bibliographic references :
1. Alexander CM, Landsman PB, Teutsch SM, Haffner SM; Third National Health and Nutrition Examination Survey (NHANES III); National Cholesterol Education Program (NCEP).NCEP-Defined Metabolic Syndrome, Diabetes, and Prevalence of Coronary Heart Disease Among NHANES III Participants Age 50 Years and Older Diabetes 52:1210-1214, 2003.
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"Natural History of ß-cell Decline in Type 2 Diabetes"Prof. Stefano Del Prato (biography)
English - 2005-09-14 - 44 minutes
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| (42 slides) |
Summary :
In this presentation Prof. Del Prato answers Dr. Leiter's question on the role of beta-cell failure in the pathogenesis of type 2 diabetes.
In the natural history of type 2 diabetes, the notion has long been held of healthy beta-cells being challenged by insulin resistance to undergo compensatory hypersecretion of insulin till the point of exhaustion, and this would be followed by...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- The natural history of type 2 diabetes: traditional and emerging views
- The role of beta-cell dysfunction in the progression to diabetes
- Inherent and acquired factors promoting beta-cell dysfunction
Bibliographic references :
1. U.K. Prospective Diabetes Study GroupU.K. prospective diabetes study 16. Overview of 6 years' therapy of type II diabetes: a progressive disease.Diabetes 1995; Vol 44, Issue 11 1249-1258.
2. Stefano Del Prato, Piero Marchetti, and Riccardo C. BonadonnaPhasic Insulin Release and Metabolic Regulation in Type 2 Diabetes Diabetes 51:S109-S116, 2002.
3. Piero Marchetti, Roberto Lupi, Massimo Federici, Lorella Marselli, Matilde Masini, Ugo Boggi, Silvia Del Guerra, Giovanni Patanè, Salvatore Piro, Marcello Anello, Ettore Bergamini, Francesco Purrello, Renato Lauro, Franco Mosca, Giorgio Sesti, and Stefano Del PratoInsulin Secretory Function Is Impaired in Isolated Human Islets Carrying the Gly972->Arg IRS-1 Polymorphism Diabetes 51:1419-1424, 2002.
4. Anello M, Lupi R, Spampinato D, Piro S, Masini M, Boggi U, Del Prato S, Rabuazzo AM, Purrello F, Marchetti P.Functional and morphological alterations of mitochondria in pancreatic beta cells from type 2 diabetic patients Diabetologia. 2005 Feb;48(2):282-9. Epub 2005 Jan 15.
5. Sesti G, Cardellini M, Marini MA, Frontoni S, D'Adamo M, Del Guerra S, Lauro D, De Nicolais P, Sbraccia P, Del Prato S, Gambardella S, Federici M, Marchetti P, Lauro R.A Common Polymorphism in the Promoter of UCP2 Contributes to the Variation in Insulin Secretion in Glucose-Tolerant Subjects Diabetes 52:1280-1283, 2003.
6. Lupi R, Del Guerra S, Marselli L, Bugliani M, Boggi U, Mosca F, Marchetti P, Del Prato S.Rosiglitazone prevents the impairment of human islet function induced by fatty acids: evidence for a role of PPAR{gamma}2 in the modulation of insulin secretion Am J Physiol Endocrinol Metab 286: E560-E567, 2004.
7. D'Alessandris C, Andreozzi F, Federici M, Cardellini M, Brunetti A, Ranalli M, Del Guerra S, Lauro D, Del Prato S, Marchetti P, Lauro R, Sesti G.Increased O-glycosylation of insulin signaling proteins results in their impaired activation and enhanced susceptibility to apoptosis in pancreatic beta-cells FASEB J. 2004 Jun;18(9):959-61. Epub 2004 Apr 1.
8. Silvia Del Guerra, Roberto Lupi, Lorella Marselli, Matilde Masini, Marco Bugliani, Simone Sbrana, Scilla Torri, Maria Pollera, Ugo Boggi, Franco Mosca, Stefano Del Prato, and Piero MarchettiFunctional and Molecular Defects of Pancreatic Islets in Human Type 2 Diabetes Diabetes 54:727-735, 2005.
9. Lister CA et al. Diabetologia 1999;42(suppl 1):A150.
10. Loredana Farilla, Hongxiang Hui, Cristina Bertolotto, Elizabeth Kang, Angela Bulotta, Umberto Di Mario and Riccardo Perfetti Glucagon-Like Peptide-1 Promotes Islet Cell Growth and Inhibits Apoptosis in Zucker Diabetic Rats Endocrinology Vol. 143, No. 11 4397-4408.
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"Adipose Tissue as an Inflammatory Organ (Endocrine Tumor) in Human Obesity"Prof. John N. Fain (biography)
English - 2005-06-10 - 55 minutes
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| (28 slides) |
Summary :
We postulate that many of the deleterious effects of obesity in humans may involve enhanced formation of cytokines by the non-fat cells in adipose tissue. Cytokines are factors that are involved in the response to infections but also appear to promote heart disease as well as diabetes. We compared the release of cytokines by the adipose tissue of morbidly obese women with a body fat weight of 123...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- The specific parts of adipose tissue that inflammatory factors come from
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"Muscle - Adipose Tissue "Crosstalk" : Implications for Insulin Action"Prof. Edward W. Kraegen (biography)
English - 2005-06-10 - 53 minutes
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Summary :
In this presentation Prof. Kraegen discusses the link between muscle insulin resistance and free fatty acids (FFAs), buffering of the FFA supply by adipose tissue, and adipokine targets in muscle.
An overload of supply of fatty acids to muscle may be a major factor in the pathogenesis of muscle insulin resistance, says Prof. Kraegen. Cytosolic lipid accumulation leading to muscle...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- Muscle Insulin Resistance – Link to FFAs
- Buffering of FFA supply by adipose tissue
- Adipokines and targets in muscle
Bibliographic references :
1. K. Frayn. Adipose tissue as a buffer for daily lipid flux Diabetologia, Volume 45, Issue 9, Sep 2002, Pages 1201 - 1210.
2. D.R. Laybutt, D.J. Chisholm and E.W. Kraegen
Specific adaptations in muscle and adipose tissue in response to chronic systemic glucose oversupply in ratsAm J Physiol Endocrinol Metab 273: E1-E9, 1997.
3. 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.
4. Seng Khee Gan, Katherine Samaras, Campbell H. Thompson, Edward W. Kraegen, Andrew Carr, David A. Cooper, and Donald J. Chisholm Altered Myocellular and Abdominal Fat Partitioning Predict Disturbance in Insulin Action in HIV Protease Inhibitor-Related Lipodystrophy Diabetes 51:3163-3169, 2002.
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"Resistin and Fasting-Induced Adipose Factor (FIAF) in the Brain and Pituitary: Implications for Insulin Resistance and Obesity"Dr. Russell Brown (biography)
English - 2005-05-06 - 29 minutes
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| (20 slides) |
Summary :
In this presentation Russell Brown discusses experimental evidence for expression of the adipokines resistin and fasting-induced adipose factor (FIAF) in non-adipose tissues, and studies providing insights into the nature of expression of these genes.
Insulin and leptin are examples of hormones from the periphery that have been found to act in the brain, affecting food intake,...
Learning objectives :
Key Discussion Points:
- The brain and pituitary gland express adipokines including resistin and fasting-induced adipose factor (FIAF);
- RNA interference is an effective tool to study adipokines;
- These brain-derived adipokines may prove to be therapeutic targets for obesity and brain development, cell signaling and angiogenesis.
Bibliographic references :
1. Schwartz MW, Porte D Jr. Diabetes, obesity, and the brainScience. 2005 Jan 21;307(5708):375-9.
2. Schwartz MW and Morton GJ. “Keeping Hunger at Bay.” Nature 2002 Aug 8; 418:596-597.
3. Barbara A. Morash, Diane Willkinson, Ehud Ur and Michael Wilkinson. Resistin expression and regulation in mouse pituitary FEBS Lett. 2002; 526(1-3):26-30.
4. Michael Wilkinson, Diane Wilkinson, Glen Wiesner, Barbara Morash, Ehud UrHypothalamic Resistin Immunoreactivity Is Reduced b y Obesity in the Mouse: Co-Localization with (alpha)-Melanostimulating Hormone Neuroendocrinology 2005;81:19-30.
5. G Wiesner, BA Morash, E Ur, and M Wilkinson. Food restriction regulates adipose-specific cytokines in pituitary gland but not in hypothalamus Journal of Endocrinology, Vol 180, Issue 3, R1-R6.
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"The ß-cell: Friend and Foe"Prof. Steven Kahn (biography)
English - 2005-05-06 - 100 minutes
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Summary :
The islet ß-cell is a critical player in the maintenance of euglycemia and the development of the hyperglycemia of type 2 diabetes. When frank hyperglycemia is present, ß-cell function is markedly diminished. However, with the recognition that insulin sensitivity is an important modulator of the insulin response, it has become clear that individuals at high risk of developing type 2 diabetes...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- Assessment of beta-cell function in humans
- The role of islet amyloid in loss of beta-cell function
Bibliographic references :
1. Steven E. Kahn.The Importance of ß-Cell Failure in the Development and Progression of Type 2 Diabetes The Journal of Clinical Endocrinology & Metabolism Vol. 86, No. 9 4047-4058.
2. Christian Weyer, Clifton Bogardus, David M. Mott and Richard E. PratleyThe natural history of insulin secretory dysfunction and insulin resistance in the pathogenesis of type 2 diabetes mellitus J Clin Invest, September 1999, Volume 104, Number 6, 787-794.
3. Christine C. Jensen, Miriam Cnop, Rebecca L. Hull, Wilfred Y. Fujimoto, Steven E. Kahn, and the American Diabetes Association GENNID Study Groupß-Cell Function Is a Major Contributor to Oral Glucose Tolerance in High-Risk Relatives of Four Ethnic Groups in the U.S.Diabetes 51:2170-2178, 2002.
4.Kloppel G, Lohr M, Habich K, Oberholzer M, Heitz PU.Islet pathology and the pathogenesis of type 1 and type 2 diabetes mellitus revisited.Surv Synth Pathol Res. 1985;4(2):110-25.
5. Alexandra E. Butler, Juliette Janson, Susan Bonner-Weir, Robert Ritzel, Robert A. Rizza, and Peter C. Butlerß-Cell Deficit and Increased ß-Cell Apoptosis in Humans With Type 2 Diabetes Diabetes 52:102-110, 2003.
6. Rebecca L. Hull, Gunilla T. Westermark, Per Westermark and Steven E. Kahn Islet Amyloid: A Critical Entity in the Pathogenesis of Type 2 DiabetesThe Journal of Clinical Endocrinology & Metabolism 2004;Vol. 89, No. 8 3629-3643.
7. Rebecca L. Hull, Sofianos Andrikopoulos, C. Bruce Verchere, Josep Vidal, Feng Wang, Miriam Cnop, Ronald L. Prigeon, and Steven E. KahnIncreased Dietary Fat Promotes Islet Amyloid Formation and ß-Cell Secretory Dysfunction in a Transgenic Mouse Model of Islet Amyloid Diabetes 52:372-379, 2003.
8. Shen Z, Hull RL, Kodama K, et al. "Long term rosiglitazone and metformin treatment reduce the severity of islet amyloid but do not prevent its formation." Diabetes 2003; 52(Suppl 1):A338.
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"Vascular Disease and Insulin Resistance"Prof. Giancarlo Viberti (biography)
English - 2005-05-06 - 51 minutes
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Summary :
Insulin resistance increases the risk of cardiovascular disease, and Prof. Viberti describes data showing the relationships between traditional and non-traditional CVD risk factors and insulin resistance, as well as their associated risks.
PPAR gamma agonists affect the metabolic pathways of insulin signaling by improving insulin sensitivity, and also the trophic pathways mainly...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- CVD risk factors and insulin resistance
- The effects of PPAR gamma agonists
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"Postprandial Hyperglycemia and Cardiovascular Disease"Prof. Antonio Ceriello (biography)
English - 2005-04-16 - 31 minutes
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| (25 slides) |
Summary :
Increasing evidence suggests that the postprandial state is a contributing factor to the development of atherosclerosis. In diabetes, the postprandial phase is characterized by a rapid and large increase in blood glucose levels, and the possibility that the post-prandial hyperglycemic spikes may be relevant to the onset of cardiovascular complications has received recently much attention....
Learning objectives :
After viewing this presentation, participants will be able to discuss:
- The relevance of postprandial hyperglycemia and hypertriglyceridemia on oxidative stress generation and endothelial dysfunction.
- The relationship of postprandial and fasting glucose levels with HbA1c levels
Bibliographic references :
The DECODE study group on behalf of the Europe an Diabetes Epidemiology GroupGlucose tolerance and mortality: comparison of WHO and American Diabetic Association diagnostic criteria Lancet Volume 354, Issue 9179 , 21 August 1999, Pages 617-621
M Tominaga, H Eguchi, H Manaka, K Igarashi, T Kato, and A SekikawaImpaired glucose tolerance is a risk factor for cardiovascular disease, but not impaired fasting glucose. The Funagata Diabetes StudyDiabetes Care 22: 920-924.
B Balkau, M Shipley, RJ Jarrett, K Pyorala, M Pyorala, A Forhan, and E EschwegeHigh blood glucose concentration is a risk factor for mortality in middle-aged nondiabetic men. 20-year follow-up in the Whitehall Study, the Paris Prospective Study, and the Helsinki Policemen StudyDiabetes Care 21: 360-367
E Barrett-Connor and A FerraraIsolated postchallenge hyperglycemia and the risk of fatal cardiovascular disease in older women and men. The Rancho Bernardo StudyDiabetes Care 21: 1236-1239
Markolf Hanefeld, Jean Louis Chiasson, Carsta Koehler, Elena Henkel, Frank Schaper, and Theodora Temelkova-Kurktschiev Acarbose Slows Progression of Intima-Media Thickness of the Carotid Arteries in Subjects With Impaired Glucose Tolerance Stroke 2004 35: 1073 - 1078
M. Hanefeld, M. Cagatay, T. Petrowitsch, D. Neuser, D. Petzinna, and M. RuppAcarbose reduces the risk for myocardial infarction in type 2 diabetic patients: meta-analysis of seven long-term studiesEur. Heart J., January 2004; 25: 10 - 16.
Katherine Esposito, Dario Giugliano, Francesco Nappo, Raffaele Marfella for the Campanian Postprandial Hyperglycemia Study Group Regression of Carotid Atherosclerosis by Control of Postprandial Hyperglycemia in Type 2 Diabetes Mellitus Circulation 2004 110: 214 - 219
Francesco Perticone, Roberto Ceravolo, Arturo Pujia, Giorgio Ventura, Saverio Iacopino, Angela Scozzafava, Alessandro Ferraro, Massimo Chello, Pasquale Mastroroberto, Paolo Verdecchia, and Giuseppe SchillaciPrognostic Significance of Endothelial Dysfunction in Hypertensive PatientsCirculation, Jul 2001; 104: 191 - 196.
Antonio CerielloNew Insights on Oxidative Stress and Diabetic Complications May Lead to a "Causal" Antioxidant TherapyDiabetes Care 26: 1589-1596
Irene M Stratton, Amanda I Adler, H Andrew W Neil, David R Matthews, Susan E Manley, Carole A Cull, David Hadden, Robert C Turner, and Rury R HolmanAssociation of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational studyBMJ, Aug 2000; 321: 405 - 412.
Louis Monnier, Hélène Lapinski, and Claude ColetteContributions of Fasting and Postprandial Plasma Glucose Increments to the Overall Diurnal Hyperglycemia of Type 2 Diabetic Patients: Variations with increasing levels of HbA1c Diabetes Care 26: 881-885
Curt L. Rohlfing, Hsiao-Mei Wiedmeyer, Randie R. Little, Jack D. England, Alethea Tennill, and David E. GoldsteinDefining the Relationship Between Plasma Glucose and HbA1c: Analysis of glucose profiles and HbA1c in the Diabetes Control and Complications Trial Diabetes Care 25: 275-278.
EJ Bastyr, CA Stuart, RG Brodows, S Schwartz, CJ Graf, A Zagar, and KE RobertsonTherapy focused on lowering postprandial glucose, not fasting glucose, may be superior for lowering HbA1c. IOEZ Study GroupDiabetes Care 23: 1236-1241
Writing Team for the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research GroupSustained Effect of Intensive Treatment of Type 1 Diabetes Mellitus on Development and Progression of Diabetic Nephropathy: The Epidemiology of Diabetes Interventions and Complications (EDIC) StudyJAMA. 2003;290:2159-2167
The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group Intensive Diabetes Therapy and Carotid Intima–Media Thickness in Type 1 Diabetes MellitusNEJM 2003 (348):2294
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"Increased Risk of Coronary Events in Dysglycemic Patients: Mechanisms, and Reasons for Poor Outcomes"Dr. Richard W. Nesto (biography)
English - 2005-04-16 - 32 minutes
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Summary :
In recent years the early in-hospital mortality of diabetic patients after MI has been substantially reduced due to improvements in the medical management of these patients within the first 24 hours (1), however diabetes and hyperglycaemia itself still confer an increased risk of long-term mortality after MI which can be explained by a higher risk of congestive heart failure (2).
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- Studies relating admission blood glucose levels to in-hospital and long-term mortality after MI in diabetic and non-diabetic patients
- Mechanisms whereby hyperglycaemia in AMI leads to poor outcomes
- The role of metabolic modulators in AMI: GIK infusion therapy
- Remaining questions
Bibliographic references :
1. Oliver Schnell, MD, Oliver Schäfer, Sonja Kleybrink, Wittich Doering, MD, Eberhard Standl, MD and Wolfgang Otter, MDIntensification of Therapeutic Approaches Reduces Mortality in Diabetic Patients With Acute Myocardial Infarction: The Munich registryDiabetes Care 27:455-460, 2004.
2. Ischa Stranders, MD; Michaela Diamant, MD, PhD; Rogier E. van Gelder, MD; Hugo J. Spruijt, MSEE; Jos W. R. Twisk, PhD; Robert J. Heine, MD, PhD, FRCP; Frans C. Visser, MD, PhD. Admission Blood Glucose Level as Risk Indicator of Death After Myocardial Infarction in Patients With and Without Diabetes Mellitus Arch Intern Med. 2004;164:982-988.
3. Nazneem N. Wahab MD, Elizabeth A. Cowden MD, Neil J. Pearce MD, Martin J. Gardner MD, Heather Merry MSc, Jafna L. Cox MD and ICONS Investigators. Is blood glucose an independent predictor of mortality in acute myocardial infarction in the thrombolytic era? JACC.20 November 2002, Volume 40, Issue 10 Pages 1748-1754.
4. John A. Colwell, MD, PHD and Richard W. Nesto, MD.The Platelet in Diabetes: Focus on prevention of ischemic eventskjhkhkhDiabetes Care 26:2181-2188, 2003.
5. Jorik R. Timmer, Jan Paul Ottervanger, Menko-Jan de Boer, Jan-Henk E. Dambrink, Jan C.A. Hoorntje, A.T. Marcel Gosselink, Harry Suryapranata, Felix Zijlstra, Arnoud W.J. van't HofHyperglycemia is an important predictor of impaired coronary flow before reperfusion therapy in ST-segment elevation myocardial infarctionJACC.5 April 2005, Volume 45, Issue 7 Pages 999-1002.
6. Katsuomi Iwakura MD, Hiroshi Ito MD, FACC, Masashi Ikushima MD, Shigeo Kawano MD, Atsushi Okamura MD, Katsuaki Asano MD, Tadashi Kuroda MD, Koji Tanaka MD, Tohru Masuyama MD, Masatsugu Hori MD and Kenshi Fujii MDAssociation between hyperglycemia and the no-reflow phenomenon inpatients with acute myocardial infarctionJACC.1 January 2003, Volume 41, Issue 1 Pages 1-7.
7. Raffaele Marfella, MD, PHD, Mario Siniscalchi, MD, PHD, Katherine Esposito, MD, Ausilia Sellitto, MD, Umberto de Fanis, MD, Ciro Romano, MD, PHD, Michele Portoghese, MD, Silvio Siciliano, MD, Francesco Nappo, MD, PHD, Ferdinando Carlo Sasso, MD, PHD, Nicola Mininni, MD, Federico Cacciapuoti, MD, Giacomo Lucivero, MD, PHD, Riccardo Giunta, MD, Mario Verza, MD and Dario Giugliano, MD, PHDEffects of Stress Hyperglycemia on Acute Myocardial Infarction: Role of inflammatory immune process in functional cardiac outcome Diabetes Care 26:3129-3135, 2003.
8. Oliver MF, Opie LH. Effects of glucose and fatty acids on myocardial ischaemia and arrhythmiasLancet. 1994 Jan 15;343(8890):155-8.
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"Lessons from the UKPDS"Prof. Alastair Gray (biography)
English - 2005-04-15 - 33 minutes
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Summary :
In this presentation Prof. Gray descibes results from UKPDS 61 and 68, which looked at fasting plasma glucose (FPG) levels at diagnosis of diabetes in relation to clinical outcomes, and the UKPDS Outcomes Model, respectively.
UKPDS 61 found that those with lower FPG levels at diagnosis of diabetes had fewer complications but similar rates of deterioration in glycemic control...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- The relationship between FPG level at diagnosis of diabetes and clinical outcomes
- The UKPDS Outcomes Model
Bibliographic references :
Stephen Colagiuri, FRACP, Carole A. Cull, PHD and Rury R. Holman, FRCP For the UKPDS Group. Are Lower Fasting Plasma Glucose Levels at Diagnosis of Type 2 Diabetes Associated With Improved Outcomes? - U.K. Prospective Diabetes Study 61 Diabetes Care 25:1410-1417, 2002.
P. M. Clarke, A. M. Gray, A. Briggs, A. J. Farmer, P. Fenn, R. J. Stevens, D. R. Matthews, I. M. Stratton, R. R. Holman and on behalf of the UK Prospective Diabetes Study (UKPDS) Group. A model to estimate the lifetime health outcomes of patients with Type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model (UKPDS no. 68)Diabetologia. 2004; 47(10):1747 - 1759.
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"Effect of Fructose Overfeeding and Fish Oil Administration on De Novo Lipogenesis and Insulin Sensitivity in Healthy Males"Dr. David Faeh (biography)
English - 2005-04-15 - 23 minutes
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Summary :
High fructose diets (Hfr) may stimulate hepatic de novo lipogenesis (DNL), and cause hypertriglyceridemia and insulin resistance in rodents. It can therefore be hypothesized that fructose-induced insulin resistance is secondary to alterations of hepatic and extra-hepatic lipid metabolism. Since fish oil supplementation (FO) is known to suppress lipogenic enzymes and to decrease TG, it may improve...
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- Animal and human studies relating to the metabolic effects of fructose overfeeding and fish oil supplementation
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"Neural Control of Energy Balance"Prof. Stephen C. Woods (biography)
English - 2005-04-14 - 32 minutes
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