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- September 5, 2010 |
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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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"Current treatments in type 2 diabetes"Dr. Neale Cohen (biography)
English - 2007-04-21 - 29 minutes
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Summary :
Type 2 diabetes develops due to insulin resistance as well as beta-cell dysfunction. There are various barriers to achieving good glycemic control in these patients, and one of them is inadequate targeting of the underlying pathophysiology.
Different factors are recognised to drive beta-cell failure, such as oversecretion of insulin to compensate for insulin resistance, glucotoxicity and lipotoxicity. As the United Kingdom Prospective Diabetes Study (UKPDS) showed, there was a progressive loss of glycemic control over 10 years regardless of the type of treatment (conventional or intensive) in newly diagnosed type 2 diabetic patients (1). The loss of glycemic control was associated with a progressive loss of beta-cell function (2).
Insulin resistance has been implicated in almost half of coronary heart disease events in type 2 diabetic individuals (3), and there is evidence from the UKPDS trial showing a significant reductions in myocardial infarction and all-cause mortality with metformin, an insulin sensitising agent (1).
Conservative management of glycaemia is based on the traditional step-wise approach which is not the most effective for achieving early glycaemic control. Dr. Cohen discusses the rationale for adding pharmacological therapy early on, as well as different oral antidiabetic agents - their mechanisms of action, safety, tolerability and efficacy.
Copyright © 2007 E-MedHosting.com Inc.
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- Core defects of type 2 diabetes: insulin resistance and beta-cell dysfunction
- The progressive nature of type 2 diabetes
- The link between insulin resistance and cardiovascular disease
- Evidence for decreased risk of macrovascular complications with decreasing insulin resistance
- Drawbacks of the traditional stepwise approach to management of glycaemia
- Antidiabetic medications: mechanisms of action, efficacy, tolerability and safety
Bibliographic references :
1. UK Prospective Diabetes Study (UKPDS) GroupEffect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34) 1: Lancet. 1998 Sep 12;352(9131):854-65.
2.U.K. prospective diabetes study 16. Overview of 6 years' therapy of type II diabetes: a progressive disease. U.K. Prospective Diabetes Study Group Diabetes, Vol 44, Issue 11 1249-1258.
3. Strutton DR, Stang PE, Erbey JR, Lydick E.
Estimated coronary heart disease attributable to insulin resistance in
populations with and without type 2 diabetes mellitus. Am J Manag Care. 2001 Aug;7(8):765-73.
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