SSCI 2005 Meeting HighlightsA Lethal Tetrad in Diabetes: Hyperglycemia, Dyslipidemia, Oxidative Stress, and Endothelial Dysfunction
Section snippets
Epidemiology of Diabetes and Its Complications
After the discovery of insulin by Frederick Banting and Charles Best in Toronto in 1921, there was much optimism that the major problems associated with diabetes had been solved. Patients with type 1 diabetes, most of whom were children or teenagers, no longer faced certain death within a matter of months and instead could hope for a normal life expectancy. Unfortunately, although the availability of insulin was indeed a revolution for diabetic patients, it became clear over the ensuing decades
Hyperglycemia and Oxidative Stress
The most extensive study addressing the role of hyperglycemia and the complications of type 1 diabetes is the DCCT.14 In this study, 1441 type 1 diabetic subjects were randomized to “intensive” or “standard” glycemic control between 1984 and 1987. The primary endpoint was new appearance (primary prevention group) or progression (secondary prevention group) of diabetic retinopathy. This study was prematurely terminated in 1993 because of a salutatory effect on retinopathy and secondary
Treating Risk Factors for the Complications of Diabetes: The Treatment Gap
There is now widespread concern in the diabetes community about the failure of diabetes specialists, health care providers, and the health care “industry” to apply existing knowledge for the prevention of complications in the systematic community-based manner that is essential to address an epidemic disease. Pearson et al. showed that although 95% of physicians are aware of national cholesterol education panel guidelines, only 18% of patients are treated to goal.43 This problem exists not only
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