Population-Based Strategy for Preventing Diabetes and its Complications
Journal Title: Diabetes Research – Open Journal - Year 2018, Vol 4, Issue 1
Abstract
A recent report from the American College of Physicians (ACP) should cause a paradigm change for the treatment of diabetic patients.1 The main purpose of diabetes therapy is the prevention of complications.2 The endpoint of many clinical trials is to lower blood glucose levels, but intensive treatments aimed at lowering the HbA1c to less than 6.5% are often accompanied by hypoglycemia as a side effect. At the same time, intensive regimens have not shown a reduction of cardiovascular complications in the longterm.3-7 For example, the action to control cardiovascular risk in diabetes (ACCORD) trial was prematurely discontinued, following the observation of an increase in overall mortality, cardiovascular-related deaths, and severe hypoglycemic events.3 The action in diabetes and vascular disease; preterAx and diamicroN-MR controlled evaluation (ADVANCE) study also failed to show a statistically significant clinical benefit, while more adverse effects were seen among those who achieved a median HbA1c level of 6.4%.4 More intensive treatments with tight glycemic control targets are more costly and associated with increased patient burdens. Only Hollan et al8 reported a long-term benefit with intensive therapy in the United Kingdom prospective diabetes study (UKPDS) after 10 years of intervention.
Authors and Affiliations
Shaw Watanabe
Keywords
Related Articles
- EP ID EP559053
- DOI 10.17140/DROJ-4-e011
- Views 135
- Downloads 0
Effect of Low Carbohydrate Diet on Type 2 Diabetic Patients and Usefulness of M-Value
Background: Debate between the Calorie Restriction (CR) and Low-Carbohydrate Diet (LCD) has been continued for several years. We have started LCD therapy for diabetic patients since 1999, and experienced good response to...
Ketone Body Production and Excretion During Wellness Fasting
Introduction: The importance of ketone body metabolism in diabetic patients has been known since the 1970s, but recently β-hydroxybutyrate (βHB) has been identified as a key component of a metabolic signaling pathway. Ho...
Sleep and Diabetes in Adolescents: A Battle between Physiology and Social Factors
About 200,000 of individuals under 20 years of age have been diagnosed with diabetes. Many of them have type 1 diabetes (T1D) but type 2 diabetes (T2D), a disease that used to be seen primarily in adults over age 45, is...
Basic Ketone Engine and Booster Glucose Engine for Energy Production
Recently, hyperketonemia induced by fasting or ketogenic diet calls attention because of the possibilities for various clinical applications. Animal species comparisons and biochemical data show that all fetuses can deve...
More Significant Life for Diabetic Patients in the Perspectives of Anti-Aging
For the patients with diabetes, basal daily lifestyle would be considered in the light of meal, exercise, rest, alcohol intake, smoking and oral health. These six factors are from the concept as a basic direction of “Hea...