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- December 1, 2008 |
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"Glycaemic Control and Diabetes Complications"Dr. Stephen Twigg (biography)
English - 2004-06-26 - 44 minutes
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Summary :
In this presentation, Dr. Stephen Twigg examines the evidence in the literature for better glycemic control.
Dr. Twigg presents the available evidence for the prevention of end-organ damage through better glycemic control, citing the UKPDS, DDCT, and EDIC trials in particular. He discusses proposed mechanisms for the effects of hyperglycmemia on end-organs and presents some of his own research to this effect. Some of the controversies that surround certain theories are also briefly discussed.
Dr. Twigg subsequently examines the potential for the reversal of end-organ damage with improved glycemic control, concluding with a discourse on possible prospective methods to minimise diabetes complications.
Copyright © 2004 E-MedHosting.com Inc
Learning objectives :
After viewing this presentation, participants will be able to discuss:
• The evidence for the prevention of end-organ complications by better glycemic control (eg. UKPDS, DCCT, EDIC)
• Proposed mechanisms for the effects of glycemia on end-organs
• The role of advanced glycosylation end-products in end-organ damage
• The evidence for the reversal of end-organ complications with improved glycemic control
• Prospective methods to minimise diabetes complications
Bibliographic references :
The Diabetes Control and Complications Trial Research Group The Effect of Intensive Treatment of Diabetes on the Development and Progression of Long-Term Complications in Insulin-Dependent Diabetes Mellitus
New Engl J Med. 329(14):977-986.
Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, Hadden D, Turner RC, Holman RR. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000 Aug 12;321(7258):405-12.
Writing Team for the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group. Sustained effect of intensive treatment of type 1 diabetes mellitus on development and progression of diabetic nephropathy: the Epidemiology of Diabetes Interventions and Complications (EDIC) study. JAMA. 2003 Oct 22;290(16):2159-67.
Brownlee M. Biochemistry and molecular cell biology of diabetic complications. Nature. 2001 Dec 13;414(6865):813-20.
Twigg SM, Cao Z, MCLennan SV, Burns WC, Brammar G, Forbes JM, Cooper ME. Renal connective tissue growth factor induction in experimental diabetes is prevented by aminoguanidine. Endocrinology. 2002 Dec;143(12):4907-15.
Twigg SM, Chen MM, Joly AH, Chakrapani SD, Tsubaki J, Kim HS, Oh Y, Rosenfeld RG. Advanced glycosylation end products up-regulate connective tissue growth factor (insulin-like growth factor-binding protein-related protein 2) in human fibroblasts: a potential mechanism for expansion of extracellular matrix in diabetes mellitus. Endocrinology. 2001 May;142(5):1760-9.
McLennan SV, Wang XY, Moreno V, Yue DK, Twigg SM. Connective tissue growth factor mediates high glucose effects on matrix degradation through tissue inhibitor of matrix metalloproteinase type 1: implications for diabetic nephropathy. Endocrinology. 2004 Sep 2 [Epub ahead of print]
McCarter RJ, Hempe JM, Gomez R, Chalew SA. Biological variation in HbA1c predicts risk of retinopathy and nephropathy in type 1 diabetes. Diabetes Care. 2004 Jun;27(6):1259-64.
Additional References of Interest
The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group Retinopathy and Nephropathy in Patients with Type 1 Diabetes Four Years after a Trial of Intensive Therapy New Engl J Med. 342(6):381-389
Writing Team for the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group. Effect of intensive therapy on the microvascular complications of type 1 diabetes mellitus. JAMA. 2002 May 15;287(19):2563-9.
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