multiple articles

[Guest guest]

2.%% M Are Dietary Changes Helpful at Later Stages of T2DM Management?

8/23/10 Summary - this study, investigated the extent to which intensive

evidence-based

dietary advice improved glycemic control & risk factors for CV disease in

people with T2. [52 subjects randomly assigned to intensive dietary

intervention

& 52 controls]. emphasis was on food quantities, vegs, fruit, legumes,

whole-grain cereals, fish, nuts, low-fat dairy products, appropriate fats

and oils.

Each ptp had 2 individual sessions with the dietitian the first month then

monthly sessions for 5 months. At 6 months, levels of A1c in the

intervention

group declined from a mean of 8.9% to 8.4% but was unchanged at 8.6% in

the control grp. Though modest, the decrease in A1c levels (as well as

weight

and waist reductions) occurred after only 6 months of dietary changes. these

results suggest that lifestyle modification may be beneficial regardless

of when it is initiated.

3.%% M Higher Plasma Soluble Receptor for Advanced Glycation End Products

(sRAGE) Levels are Associated with Incident Cardio vascular Disease (CVD)

and

All-cause Mortality in T1DM 8/23/10; [169 pts with DM nephropathy and 170

controls;fup 12.3yr] Conclusions -Higher levels of sRAGE are associated

with

incident fatal and nonfatal CVD and all-cause mortality in individuals with

T1.. sRAGE- associated renal dysfunction may partially explain this

association.

4.%% SGLT2 Inhibitors: Glucuretic Treatment for T2DM 8/26/10; Brit Jour of

DM & Vasc Disease Sodium glucose co-transporter-2 (SGLT2) inhibitors offer a

novel approach to treat DM by reducing hyper- glycaemia [high blood sugar]

via increased glucosuria.[sugar in urine] The glucuretics are advanced in

clinical

development . Once daily dapaglifolozin for 12–24 wks in T2 pts ( HbA1C

8–9%) reduced HbA1C by about 0.5–1%, accompanied by weight loss [4.4-6.6

lb] and

without significant risk of hypoglycaemia...In conclusion, inhibition of

SGLT2 in the renal tubules provides a novel 'glucuretic' approach to assist

glycaemic

control by eliminating excess glucose in the urine.

5.%% M Therapeutic Potential of Aleglitazar, a New Dual PPAR-a/? Agonist:

Implications for CVD in Patients with DM 8/25/10; While microvascular

complications

such as nephropathy, retinopathy, and neuropathy are reduced with intensive

glycemic control, treatment of hyperglycemia has not been consistently shown

to have effects on macrovascular complications of DM such as coronary

artery, cerebro-vascular, and peripheral vascular disease. A phase II trial

examining

a novel dual PPAR agonist, aleglitazar, showed [it] reduced hyper-glycemia &

favorably modified levels of HDL-C and triglycerides with an acceptable

safety

profile. Aleglitazar is currently being studied in large-scale clinical

trials to assess whether it will reduce the risk of (death, MI, or stroke)

among

patients with DM and coronary artery disease.

6.%% ADA 8/24/10 New research indicates that unhealthy glucose levels in

people with DM may smother and block the mechanisms of the body's immune

system.

This may explain the higher risk of chronic bacterial and fungal infections

among diabetes patients. . Specialized receptors that recognize molecules

associated

with bacteria and fungi become " blind " when glucose levels are too high.

This may also help explain why DM complications include higher risks of

viral

infections and inflammatory conditions such as CVD. " It also helps to

emphasize the importance of good diet on preventing or controlling diseases

such

as diabetes. We will build on these ideas in order to..investigate new

routes to treatment and prevention. "

7.%% M 8/31/10 Symposium - Revolutionary Approaches in the Treatment of

Diabetes:.. The liver accounts for about 60% of gluconeogenesis [production

of

glucose]- the kidney normally accounts for about 40%. These gluconeogenesis

properties are stimulated by insulin and epinephrine. Conclusion, there are

changes that occur in kidney processes that are associated with hypertension

and hyperglycemia. . RAAS inhibitors will decrease the BP,and slow down rate

of development and progression of DM kidney disease. There clearly are renal

contributions to postprandial hyperglycemia as well: the abnormal rate of

gluconeogenesis as well as the increased glucose reabsorption that occurs

with up-regulation of SGLT2 transporters.. In diabetics, SGLT2s are

overexpressed.

Instead of actually letting glucose get out of the system, glucose gets

reabsorbed, and it causes more hyperglycemia, more glucose toxicity. These

drugs

are very new, but there is a lot of excitement. Dapagliflozin, or DAPA,

results in moderate glucosuria. [sugar in urine] current guidelines

recommend intensive

glucose control if it can be achieved safely. SGLT2 inhibitors prevent

reabsorption of glucose to the blood in an insulin- independent manner.

Several

agents are in development. Clinical trial data to date demonstrate improved

A1C, modest weight loss, good safety profile including low risk of

hypoglycemia,

and a mild decrease in BP.

8.%% JH Insulin: You’ve Got Choices 9/2/10 Approximately 40% of people with

T2DM eventually require some type of insulin treatment to control their

blood

glucose, either because their DM gets worse or it no longer responds to oral

drugs. Many people with T2 take insulin in combination with metformin, a

thiazolidinedione,

or a sulfonylurea.

Insulin was once obtained exclusively from pig or cow pancreas. Today,

regular and intermediate-acting insulins are referred to as human insulins,

because

they are manufactured to be identical to the insulin produced by the human

pancreas. There are 4 main types of insulin: Rapid-acting -Insulin aspart

(Novolog),

insulin lispro (Humalog), and insulin glulisine (Apidra) are called insulin

analogues, because their chemical structure is a modified form of human

insulin

that is designed to work more quickly and peak faster than regular insulin.

These manufactured insulins work with time-actions that are close to the

natural

insulin functions in the body. Consequently, they may be effective in

preventing high blood glucose (hyperglycemia) after meals and are less

likely to

produce hypoglycemia later on.

Regular or short-acting insulin.is manufactured to be the same as the

insulin produced in the human body. Popular brands have an " R " (for regular)

in their

names,( Humulin R.) Regular insulin is typically injected 30- 60 min before

meals and usually reaches the bloodstream within 30 min, in time to cover

the

rise in blood glucose that begins after food is eaten. Insulin action peaks

2-3 hours after injection and the effects generally last about 3-6 hrs.

Intermediate-acting

insulin. called NPH insulin contains protamine, which makes the solution

cloudy and slows the absorption of insulin. NPH insulins have an " N " in

their

names ( Novolin N) After injection, intermediate-acting insulins reach the

bloodstream within 2-4 hrs and show peak action in 4-10 hours. Duration of

action

is from 10- 16 hours. Intermediate- acting insulin is often used in

combination with regular or rapid- acting insulin. Long-acting insulin. -

Both insulin

glargine (Lantus) and insulin detemir (Levemir) are long-acting insulin

analogues. They are often used alone in people with T2, or in combination

with

a more quick- acting insulin. Lantus is a clear solution in the vial, but it

precipitates in the skin after injection, which greatly slows absorption and

makes it very long acting, usually 20 - 24 hours. Levemir also is absorbed

slowly, because it binds to the protein albumin in the skin. Its effects

last

about 14 -18 hours.

9.%% M Older Patients With Diabetes Remain Sexually Active, Study Finds

9/10/10 [2000 subjects both with and without DM] .. even though diabetes

impairs

libido, erectile function, and orgasm, older partnered adults with the

disease still engage in sexual activity about as often as people without the

disease:

Almost 70% of partnered men with DM and 62% of partnered women with DM

engage in sexual activity an average of 2- 3 times each month. Difficulties

achieving

orgasm were more common in those with DM, and were reported in both women

and men, regardless of whether they were aware they had diabetes. The

authors

say this suggests that orgasmic difficulties may tend to be predominantly

physiologic in etiology, rather than psychiatric.

10.%% M The New World of Biosimilars:.. 9/1/10 - Biosimilar pharmaceuticals

are emerging as patent protection on the original biopharmaceutical products

expires. However, [these] are particularly complex molecules - biosimilar

insulins present special challenges. Their therapeutic window is narrow and

the

accuracy of their dosing is highly dependent on the formulation and quality

of the administration device. Intro - Biopharmaceuticals are biological

medicinal

products derived from recombinant DNA and expressed by genetically

engineered organisms to produce therapeutic proteins in large quantities.

The first

biopharmaceutical introduced into clinical use was recombinant human insulin

(Humulin, Eli Lilly) in 1982..

11.%% Antigen-specific Immunotherapy for Type 1 Diabetes: 9/16/10; Diabetes.

2010;59(9) Studies in a variety of animal models, which act as replicas of

the major chronic inflammatory diseases that affect humans, have shown that

delivery of autoantigens, administered at different disease stages via a

variety

of routes, can provide robust, sustained health and protection from

inflammatory autoimmune disease. The most appealing element to this

approach, termed

antigen-specific immunotherapy (ASI), has been that it not only

provides an effective means of controlling the autoimmune response via

induction or restoration of ß-cell–specific tolerance, but that it may

achieve these

goals without major concerns over safety and certainly without the specter

of immune suppression. Yet significant questions remain. Are we doing enough

to realize the potential of

this sacred cow? How do we move from concept to reality? ..

12.%% 9/7/10 NIH News Study Shows How Insulin Stimulates Fat Cells to Take

in Glucose Using high-resolution microscopy, researchers at the National

Institutes

of Health have shown how insulin prompts fat cells to take in glucose in a

rat model. Next, they plan to observe the fat cells of people with varying

degrees

of insulin sensitivity, including insulin resistance-considered a precursor

to T2. These observations may help identify the interval when someone

becomes

at risk for developing DM. Glucose, a simple sugar, provides energy for cell

functions. After food is digested, glucose is released into the bloodstream.

In response, pancreas secretes insulin, which directs the muscle and fat

cells to take in glucose. Cells obtain energy from glucose or convert it to

fat

for long-term storage. Like a key fits into a lock, insulin binds to

receptors on the cell's surface, causing GLUT4 molecules to come to the

cell's surface

and act as vehicles to ferry glucose inside the cell...

13.%% M Breast-Feeding for Less Than 1 Month Linked to Increased Risk for

T2DM 9/10/10 " We have seen dramatic increases in the prevalence of T2 over

the

last century, " said lead author. " Diet and exercise are widely known to

impact the risk of T2, but few people realize that breastfeeding also

reduces mothers'

risk of developing the disease later in life by decreasing maternal belly

fat. " [2233 mothers].. women who consistently breast-fed all of their

children

for at least 1 m had a similar adjusted risk for T2 whereas mothers who had

never breast-fed an infant had greater risk.

14.%% Unique pathway in diabetes Nat Med Sep 2010 A team has identified a

proinflammatory pathway involving eukaryotic translation initiation factor

5A,(EIF5A) as a potential player in DM. [it] is in preclinical development.

..many proinflammatory pathways are at play in the pancreas in both T1 & T2,

the team thinks EIF5A might also contribute to pancreatic inflammation.

15.%% M Glucagon-like Peptide-1 Receptor Agonists in T2DM 9/01/10; Among the

newer treatments for T2DM are analogs of the incretin hormone glucagon-like

peptide (GLP)-1: drug class known as GLP-1 receptor agonists. Exenatide, a

synthetic analog of GLP-1, was the first in the class to be approved by FDA

as an adjunct to diet and exercise to improve glycemic control in adults

with T2. Liraglutide, was approved in Jan 2010. Conclusion - These agents

not

only effectively lower glucose, but they also have beneficial metabolic and

CV effects. clinical trials show consistent reductions in A1c and fasting

and

postprandial plasma glucose levels. In addition, weight loss, and beta-cell

function improvements have been observed. BP and lipids are also favorably

affected.. Longer- acting formulations are a promising development. GLP-1

agonists are generally well tolerated .. independent ed grant from

AMYLIN/Lilly.

16.%% Ophth vol117;10 Oct 2010 Optical Coherence Tomographic Evaluation of

Foveal Hard Exudates in Patients with Diabetic Maculopathy Accompanying

Macular

Detachment

Objective - To study morphologic changes of serous retinal detachment (SRD)

and hyperreflective dots, which have been reported to be precursors of hard

exudates, detectable in SRD using optical coherence tomography (OCT) to

assess whether or not the OCT findings are correlated with the subfoveal

deposition

of hard exudates in patients with diabetic macular edema (DME) accompanied

by SRD. [28pts]Conclusions In patients with DME accompanied by SRD, SD-OCT

revealed that hyperreflective dots

may be associated with the subfoveal deposition of hard exudates during

follow-up.

17.%% M Metformin Might Prevent Colorectal, Lung Cancers 9/3/10 It was

observed that DM patients taking metformin have a 40% reduced risk for

cancer.

Data from a small clinical trial and from an animal study suggest that

metformin might suppress the development of precancerous colorectal lesions

in humans

and prevent tobacco- induced lung cancers in mice. The drug appears to alter

cellular energy metabolism in a way that is particularly bad for cancers and

precancerous cells. It is also attractive because it is relatively nontoxic.

" Unlike chemotherapy or radiotherapy, which are intended to kill cancer

cells

in a directly toxic manner, metformin appears to target the cancer in a more

subtle way..It also may act in some patients, especially diabetic cancer

patients,

by reducing levels of hormones that can stimulate cell growth, including

insulin itself, "

18.%% Blood Pressure Control in Diabetes: How Low Should We Go?

9/7/10 Summary - The Internat Verapamil SR-Trandolapril study compared

clinical outcomes of patients with hypertension and coronary artery disease

(CAD).

[subset of 6400 pts with DM] .The team suggests there may be such a thing as

overly- aggressive BP control. In addition, adverse events were more common

in the aggressive group, Thus, it appears that lowering BP below 130 mm Hg

may do more harm than good.

19.%% MTD Diabetes Information In Twenty Languages 9/12/10

Ethnicity is a key factor in the risk of developing T2. In whites, T2

usually occurs above the age of 40, but Black and South Asian people can

develop

the condition from the age of 25. Diabetes UK Language Centre. We currently

have diabetes information in the following [includes] Albanian - Arabic-

Bengali – Chinese – Croatian – English - Farsi - French - Gujarati -

Hindi - Italian - Polish – Portuguese - Punjabi - Romanian - Serbian -

Somali

– Tamil – Turkish – Urdu – Welsh –

www.diabetes.org.uk/Other_languages/

20.%%Retina: Sep 2010; Vol 30; 8 Relationship Between Fasting Glucose and

Retinopathy for Diagnosis of Diabetes: purpose - to assess the relationship

between the fasting plasma glucose cutoff of 7 mmol/L and the presence of

retinopathy in a population in China. [3251 subjects] Conclusion: Confirming

a recent study from Australian and North Amer populations, the results

suggest that also for the Chinese population, a uniform glycemic threshold

for prevalent

retinopathy does not exist.

21.%% MedWatch Actos (pioglitazone): Ongoing Safety Review - Potential

Increased Risk of Bladder Cancer. The Agency is reviewing

data from an ongoing, 10-year epidemiological study designed to evaluate

whether Actos is associated with an increased risk of bladder cancer.

Findings

from studies in animals and humans suggest this is a potential safety risk

that needs further study. At this time. Patients should continue taking

Actos

unless told otherwise by their healthcare professional.

22.%% Diabetes and Thyroid Disorders 9/16/10; Brit Jour of DM and Vascular

Disease. 2010;10(4):Conclusions - The impact of thyroid alterations on

glucose

metabolism has been known for a long time. Recently, new pathways of thyroid

hormone action at the tissue level have been unveiled and may be of

relevance

to the understanding of insulin resistance present both in the hypothyroid

and hyperthyroid state. While thyroid disorders are more prevalent in people

with T1, due to common autoimmune origin, a similar prevalence of thyroid

disease has been reported in T2. The co-existence of both DM and thyroid

disorders

has been associated with increased long-term morbidity and mortality.. the

decision to treat should be taken on an individual approach.

..insulin-resistant,

dyslipidaemic or diabetic pts who are at higher risk of CV disease, might

be special cases for whom treatment of sub-clinical thyroid disease has to

be

seriously considered.

23.%%Hydroxychloroquine Lowers HbA1c in Rheumatic Patients With Diabetes

(Reuters Health) Sep 15 - When diabetics with rheumatic illnesses take

hydroxychloroquine,

their hemoglobin (Hb)A1c levels drop significantly, researchers report.

Methotrexate, however, doesn't have the same effect. " Hydroxychloroquine is

a weak

hypoglycemic agent compared with other typical oral anti-diabetic drugs, " he

added. " However, it is important to note that it can lower blood glucose.

Rheumatologists should be aware of this when starting [this drug] in

diabetics and non-diabetics. " [ 82 adults]

24.%% Breaking News Alert NYTimes 9/23/10 F.D.A. and European Regulators

Severely Restrict Avandia, Citing Heart Risks. In a highly unusual

coordinated

announcement, drug regulators in Europe and the US said that Avandia, the DM

medicine made by GlaxoKline, will no longer be widely available. The

drug's sales will be halted entirely in Europe, and patients in the US will

be allowed to receive it only if they have tried every other diabetes

medicine

and have been made aware of the drug's substantial risks to the heart.

25. %% JH Onglyza for Type 2 Diabetes 9/23/10 Diet and exercise may be

enough to control blood glucose levels in some people with T2DM

But if you’re still not meeting your A1c goal or if you’re having DM

symptoms, your doctor will start you on oral medications, either alone or in

combination with insulin injections. Now newly approved oral DM medication

called saxagliptin (Onglyza) has been shown to improve blood glucose control

without causing low blood sugar or weight gain in people with T2 [400 people

with T2; randomized to a placebo or Onglyza; Fup 6m] 34 to 41% of those in

the Onglyza group experienced reduced A1c levels below 7% (compared with 24%

of the placebo group.)The most common side effects are upper respiratory

tract infection, urinary tract infection, rash and headache.

26.%% ADDITION: No Significant Benefit of Intensive Therapy in Diabetes

9/22/10 Intensive multifactorial treatment was not significantly better than

routine

care in a study of 3000 patients with newly diagnosed T2 treated by general

practitioners. " In neither

group did body-mass index increase over 5 years, nor was there deterioration

in HbA. BP in both groups was remarkably improved, as

were LDL & HDL cholesterol, and smoking rates fell.. In conclusion,

said: " Stepwise screening for T2 in primary care is feasible, acceptable &

identifies individuals with high levels of modifiable risk factors.

27.%% M Overweight or Obese Men Without Metabolic Syndrome May Be at

Increased Risk for Diabetes 9/24/10 [1675 subjects ;normal wt at baseline]

" Based

on our observational data, overweight or obese persons without the MetS or

insulin resistance should be considered to have a substantially higher risk

for DM compared to normal weight persons without the MetS, " the authors

conclude. " The influence of weight loss on risk in such individuals needs to

be

determined...

28.%% EASD Implantable Device Promises Diabetics Continuous Exenatide

Therapy With 100% Compliance 9/27/10 Exenatide, a glucagon-like peptide-1

(GLP-1)

mimetic, was delivered with an implantable drug-dispensing .. osmotic pump.

As subcutaneous tissue fluid flows into the device through a semipermeable

membrane, it expands an osmotic " engine, " pumping the drug out at a constant

rate. The device can be inserted under the skin in just a few minutes. A key

aspect of the technology is a formulation that maintains the stability of

proteins and peptides at body temperature for an extended period of time,

[155

T2 pts;baseline HbA1c levels 7% - 10%] . a phase 3 trial of ITCA 650 is

planned. .

29.%% EASD Liraglutide and Sitagliptin Both Have Role to Play in Diabetes

9/28/10 - Two relatively new agents for T2 have a role to play in the

treatment

of this disorder because they have been shown to improve glycemia and induce

weight loss and could one day even replace the use of insulin in

insulin-dependent

T2. The LEAD series of trials compares liraglutide (Victoza)a glucagonlike

peptide-1 (GLP-1) agonist and with another incretin, the oral agent

sitagliptin

(Januvia)--a dipeptidyl-peptidase-4 (DPP-4) inhibitor; these show that

liraglutide is generally well tolerated and reduces (HbA1c) and body weight

to

a greater extent than sitagliptin when added to metformin.

treatment; also those on the higher dose of liraglutide reported greater

overall patient satisfaction, the presenter noted. This is the first oral

drug

for glycemia that also has weight loss. But the fact that liraglutide

induces greater weight loss than sitagliptin has to be balanced against the

fact

that it is an injectable agent with a high rate of nausea as a side effect,

...This compares with what was on offer from older drug classes, such as

sulfonylureas

and glitazones, which induce weight gain. In fact, these newer agents may

also allow a cautious reduction in dose of insulin or even withdrawal in

some

insulin-dependent diabetics ..

30.%% Intraocular Pressure and Aqueous Humor Flow During a [procedure] in

Patients with T1DM and Microvascular Complications 9/17/10; BMC Ophth.

2010;10(18)

Background: Microvascular complications, including retinopathy and

nephropathy are seen with T1. This study was designed to test the hypothesis

that clinical

markers of microvascular complications coexist with the alteration in

aqueous humor flow and IOP. [10pts] We conclude that compared to healthy

participants,

pts with T1 with microalbuminuria and retinopathy have higher IOPs

normalized by hyperinsulinemia; a reduction in aqueous flow was not

statistically significant.

31.%% ADA Fish Oils Work Against Inflammation in Diabetes 9/28/10 Fish oil

supplements may help work against the inflammation associated with DM and

enhance

insulin sensitivity, according to new research, while a chemical agonist of

omega-3 fatty acids produced similar results. " The receptor evolved to

respond

to a natural product omega-3 fatty acids--. Our work shows how fish oils

safely do this, and suggests a possible way to treating the serious problems

of

inflammation in obesity and in conditions like diabetes, cancer, and CVD

through simple dietary supplementation. " Part of the immune response

involves

macrophages, specialized white blood cells, secreting cytokines and other

proteins that cause inflammation. Fat tissue contains many macrophages that

produce

excessive cytokines, potentially causing chronic inflammation and increased

insulin resistance in neighboring cells overexposed to cytokines.

32.%% ADA Dental Caries in Diabetes Mellitus.. 9/28/10 A recent study

considered the possible protective role of salivary factors in patients with

T2 and

dental caries.. [398 pts]Decayed, missed, and filled teeth (DMFT) were

scored to indicate the severity of dental caries.. Blood glucose, HbA1c,and

DMFT

indices were significantly higher in those with DM compared to the controls.

Salivary flow rate, calcium, phosphate, and fluoride were all significantly

low.

33.%% ADA Endothelial Abnormalities in Adolescents With T1DM 9/28/10

Researchers investigated whether counts of circulating colony forming unit-

endothelial

cells (CFU-ECs), They conclude that in T1 endothelial progenitor cells

promote vascular health by facilitating endothelial integrity and function.

..

34.%% ADA Sleep Restriction for 1 Week Reduces Insulin Sensitivity in

Healthy Men - Short sleep duration is associated with impaired glucose

tolerance

and an increased risk of DM. This study tests the hypothesis that decreasing

nighttime sleep duration reduces insulin sensitivity ..[20 subjects]

Conclusions—Sleep

restriction (5 h/night) for 1 week significantly reduces insulin

sensitivity, raising concerns about effects of chronic insufficient sleep on

disease processes

associated with insulin resistance.

35.%% M Emergency Kits for Diabetics: notes from a video by Dr. Ann s

9/27/10 First Dr. P showed a book ‘Diabetes 911' available from ADA. Notes:

For those on insulin, a container such as a insulated child’s lunch box can

be used with freezer packs stored in the freezer to be inserted when needed.

Insulin should be stored in its unopened vial or pen; check the expiration

dates routinely. Add syringe, or pen needles. Remove battery from glucose

meter

before adding. Add lances and strips sealed in their vial. For hypoglycemia

add glucose tabs or gel since they take little space. Add 2 glucogen pens.

For oral meds: store in a central location - monitoring experation dates.

In your wallet etc keep a current medication list for replacing your meds if

necessary. She pointed out these supplies are in addition to storage of

water and food etc for emergencies

36.%% M Look AHEAD in Print: Lifestyle Intervention Improves CV Risk Factors

in T2DM 9/29/10 [2570 in intervention grp;2575 support and Ed grp;4yr]

Patients

with T2 who followed an intensive lifestyle- intervention program aimed at

achieving and maintaining weight loss & fitness achieved those goals and

showed

significant improvements in BP, glycemic control, and some lipid measures,

compared with a usual-care control group. Levels of LDL cholesterol went

down

more in the controls, who used statins to a greater extent. " Longer follow-

up will allow us to determine whether the differences between groups in CVD

risk factors can be maintained and whether the intensive lifestyle

intervention has positive effects on CV morbidity and mortality, " write the

authors,

Look AHEAD was sponsored by NIH.

37.%% EASD Progression of Diabetic Nephropathy Slowed With Early Detection

of Albuminuria 9/30/10 [11,000 adults with hypertension and T2] showed that

the lifetime risk for nephropathy & its progression might be greater than

previously thought. [and] that the use of angiotensin- converting-enzyme

(ACE)

inhibitors or angiotensin- receptor blockers (ARBs) was not optimal in this

population.. The presentor said because nephropathy is a major cause of CV

disease and end-stage renal disease, it is important to understand the

progression from normal levels of albumin excretion to micro- and

macroalbuminuria,

and to define the risk factors associated with nephropathy progression.

European Association for the Study of Diabetes (EASD) 46th Annual Meeting

Abbreviations:Fup-follow up; pt - patients; DM - diabetes Mellitus; T1DM

- type 1 diabetes mellitus T2DM - type 2; DME - diabetic macular edema; GDM

gestational diabetes;PDR - proliferative diabetic retinopathy; IVTA

intravitreal

triamcinolone acetonide; FPG - fasting plasma glucose; BP - blood pressure;

CVD - cardio-vascular disease; MI -myocardial infarction or heart attack

;HTN

- hypertension or high BP; OCT - optical coherence tomography; VA - visual

acuity -ADA - Am Diab Ass & ADA Professional.. Online; JH- s Hopkins

Alerts

; M- Medscape Web MD; NIH - Nat Institutes of Health; MTD- Medical News

Today Definitions via online Medical dictionaries. Disclaimer, I am a BSN

RN

but not a diabetic or diabetic educator. Reports are excerpted unless

otherwise noted. This project is done as a courtesy to the blind/visually

impaired

and diabetic communities. Dawn Wilcox BSN RN Coordinator The Health Library

at Vista Center; an affiliate of the Stanford Hospital Health Library.

contact

above e-mail or

thl@...