Diabetes Research Today is a free monthly online journal that collates and summarizes the latest research about Diabetes, including details on insulin, type i, type ii, diet, treatment, prevention.

A randomized trial of therapies for type 2 diabetes and coronary artery disease.

, Frye RL, August P, Brooks MM, Hardison RM, Kelsey SF, MacGregor JM, Orchard TJ, Chaitman BR, Genuth SM, Goldberg SH, Hlatky MA, Jones TL, Molitch ME, Nesto RW, Sako EY, Sobel BE

BACKGROUND: Optimal treatment for patients with both type 2 diabetes mellitus and stable ischemic heart disease has not been established. METHODS: We randomly assigned 2368 patients with both type 2 diabetes and heart disease to undergo either prompt revascularization with intensive medical therapy or intensive medical therapy alone and to undergo either insulin-sensitization or insulin-provision therapy. Primary end points were the rate of death and a composite of death, myocardial infarction, or stroke (major cardiovascular events). Randomization was stratified according to the choice of percutaneous coronary intervention (PCI) or coronary-artery bypass grafting (CABG) as the more appropriate intervention. RESULTS: At 5 years, rates of survival did not differ significantly between the revascularization group (88.3%) and the medical-therapy group (87.8%, P=0.97) or between the insulin-sensitization group (88.2%) and the insulin-provision group (87.9%, P=0.89). The rates of freedom from major cardiovascular events also did not differ significantly among the groups: 77.2% in the revascularization group and 75.9% in the medical-treatment group (P=0.70) and 77.7% in the insulin-sensitization group and 75.4% in the insulin-provision group (P=0.13). In the PCI stratum, there was no significant difference in primary end points between the revascularization group and the medical-therapy group. In the CABG stratum, the rate of major cardiovascular events was significantly lower in the revascularization group (22.4%) than in the medical-therapy group (30.5%, P=0.01; P=0.002 for interaction between stratum and study group). Adverse events and serious adverse events were generally similar among the groups, although severe hypoglycemia was more frequent in the insulin-provision group (9.2%) than in the insulin-sensitization group (5.9%, P=0.003). CONCLUSIONS: Overall, there was no significant difference in the rates of death and major cardiovascular events between patients undergoing prompt revascularization and those undergoing medical therapy or between strategies of insulin sensitization and insulin provision. (ClinicalTrials.gov number, NCT00006305.)

Published 11 June 2009 in N Engl J Med, 360(24): 2503-15.
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Articles on Diabetes published 8 June 2009:

Developmental origins of adult disease.   Pediatr Clin North Am, 56(3): 449-66, Table of Contents.

Intrauterine growth retardation (IUGR) has been linked to development of type 2 diabetes in adulthood. Using a rat model, we tested the hypothesis that uteroplacental insufficiency disrupts the function of the electron transport chain in the fetal beta-cell and leads to a debilitating cascade of events. The net result is progressive loss of beta-cell function and eventual development of type 2 diabetes in the adult. Studies in the IUGR rat demonstrate that an abnormal intrauterine environment ... [Abstract] [Full-text]

Is there a clear threshold for fasting plasma glucose that differentiates between those with and without neuropathy and chronic kidney disease?: the Singapore Prospective Study Program.   Am J Epidemiol, 169(12): 1454-62.

Recent studies suggest that no distinct glycemic threshold consistently differentiates individuals with or without retinopathy. The authors sought to determine whether the same was true for other microvascular complications. They studied 5,094 participants with fasting plasma glucose values and concurrent microvascular complications from 4 previous cross-sectional surveys carried out in Singapore (1982-1998) who attended a follow-up examination in 2004-2007. Peripheral neuropathy was diagnosed ... [Abstract] [Full-text]

Birth weight, early weight gain, and subsequent risk of type 1 diabetes: systematic review and meta-analysis.   Am J Epidemiol, 169(12): 1428-36.

Previous studies suggest that birth weight and weight gain during the first year of life are related to later risk of type 1 diabetes. The authors performed a systematic review and meta-analysis on these associations. Twelve studies involving 2,398,150 persons of whom 7,491 had type 1 diabetes provided odds ratios and 95% confidence intervals of type 1 diabetes associated with birth weight. Four studies provided data on weight and/or weight gain during the first year of life. High birth weight ... [Abstract] [Full-text]

Articles on Diabetes published 5 June 2009:

Abnormal skeletal muscle capillary recruitment during exercise in patients with type 2 diabetes mellitus and microvascular complications.   J Am Coll Cardiol, 53(23): 2175-83.

OBJECTIVES: We sought to determine whether skeletal muscle capillary recruitment is impaired in type 2 diabetes mellitus (DM) with and without microvascular complications (MC). BACKGROUND: Insulin and exercise each stimulate recruitment of skeletal muscle capillaries. Insulin-mediated recruitment is impaired in insulin-resistant humans and animals, but exercise-mediated recruitment has not been studied. METHODS: We studied 20 control subjects, 22 patients with DM, and 8 patients with DM + MC. ... [Abstract] [Full-text]

A prospective Swedish study on body size, body composition, diabetes, and prostate cancer risk.   Br J Cancer, 100(11): 1799-805.

Obesity may be associated with increased risk of prostate cancer (PCa). According to one hypothesis, obesity could lower the risk of non-aggressive tumours, while simultaneously increasing the risk of aggressive cancer. Furthermore, central adiposity may be independently associated with PCa risk; it is also associated with diabetes, which itself may influence risk of PCa. We studied the associations between height, body composition, and fat distribution, diabetes prevalence and risk of total, ... [Abstract] [Full-text]

Articles on Diabetes published 4 June 2009:

Selective autoantibody production against CCL3 is associated with human type 1 diabetes mellitus and serves as a novel biomarker for its diagnosis.   J Immunol, 182(12): 8104-9.

We have recently demonstrated that patients suffering from chronic autoimmune diseases develop an autoantibody response against key mediators that participate in the initiation and progression of these diseases. In this paper, we show that patients with type 1 diabetes mellitus (T1DM), but not those suffering from several other inflammatory autoimmune diseases, display a selective autoantibody titer to a single CC chemokine named CCL3. From the diagnostic point we show that this response could ... [Abstract] [Full-text]

Articles on Diabetes published 3 June 2009:

Timing and tempo of first-year rapid growth in relation to cardiovascular and metabolic risk profile in early adulthood.   JAMA, 301(21): 2234-42.

CONTEXT: Growth during infancy appears to be an important determinant of cardiovascular disease and type 2 diabetes later in life. OBJECTIVES: To specify which period in the first year of life is related to determinants of cardiovascular disease and type 2 diabetes in early adulthood and to investigate the association between tempo of first-year weight gain (>0.67 SDs) and these determinants. DESIGN, SETTING, AND PARTICIPANTS: Observational study using longitudinal data collected in the ... [Abstract] [Full-text]

False aneurysm of a hepatic artery branch complicating intrahepatic islet transplantation.   Transpl Int, 22(6): 663-6.

Islet transplantation, an innovative treatment strategy for type 1 diabetes mellitus, is a relatively safe procedure, with less morbidity than pancreas transplantation. Vascular injuries have not been reported to date. We report a percutaneous transhepatic intraportal islet transplant infusion that was followed by bleeding from a false aneurysm of an intrahepatic branch of the hepatic artery. The bleeding was controlled by selective embolization. Despite the complication and its treatment, the ... [Abstract] [Full-text]

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