Clinical practice and implications of recent diabetes trials

  title={Clinical practice and implications of recent diabetes trials},
  author={Mark Wi Webster},
  journal={Current Opinion in Cardiology},
  • M. Webster
  • Published 1 July 2011
  • Medicine
  • Current Opinion in Cardiology
Purpose of review Diabetes is an increasingly prevalent risk factor for coronary and other vascular disease. Recent trials in patients with diabetes have examined the effects of intensive glycemic control on cardiovascular outcomes, and treatment of common concomitant risk factors, in particular hypertension and dyslipidemia. Optimal revascularization strategies have also been examined. Recent findings Intensive glycemic control has a beneficial effect on microvascular but not macrovascular… 


The epidemiologic relationships of stroke in type 2 diabetes are shown and it is suggested that rigorous assessment and treatment of associated risk factors can substantially reduce the risk of strokes in patients with diabetes.

Vitamin E in the prevention of cardiovascular disease: the importance of proper patient selection

The scientific basis and clinical evidence related to the effect of vitamin E on CV outcomes, and the importance of proper patient selection in gaining therapeutic benefit from this intervention are detailed.

Glycemic Control Rate of T2DM Outpatients in China: A Multi-Center Survey

  • Rong ChenL. Ji D. Zou
  • Medicine
    Medical science monitor : international medical journal of experimental and clinical research
  • 2015
The T2DM glycemic control rate in China is currently low, especially in older obese patients with poor education and recent diagnosis, which is a cause for concern.

Is It Time to Screen for the Haptoglobin Genotype to Assess the Cardiovascular Risk Profile and Vitamin E Therapy Responsiveness in Patients with Diabetes?

The biological mechanisms underlying the interaction between the Hp genotype and DM on CVD are reviewed and the accumulating evidence in favor of Hpgenotyping all individuals with DM and providing antioxidant vitamin E supplementation specifically to Hp 2–2 DM individuals to reduce their CVD morbidity and mortality is reviewed.

Inhaled Insulin - Current Direction of Insulin Research.

Abrezza, inhaled insulin has been recently approved by Food and Drug Administration (FDA) and is a new, quicker acting inhalable insulin with a different and safer pharmacokinetic profile in comparison to previously failed inhaled form of insulin.

Meta-Analytic Assessment of Blood Lipid Response to Dietary Manipulation of Macronutrient Distribution

This chapter builds upon the concepts introduced in chapter one, and assesses the effect of manipulating macronutrient distribution on the lipid profile of adults, and compares these effects to recommendations regarding macronsutrients, such as the Acceptable Macronutrient Distribution Ranges (AMDRs).

Incidence and Molecular Characterization of Extended Spectrum of Beta Lactamase Producing Escherichia coli and Klebsiella pneumoniae isolated from Urinary Tract Infection in Patients with Type 2 Diabetes Mellitus

The high prevalence of ESBL production among E. coli and K. pneumoniae in the urinary tract infection among type 2 diabetic patients highlights the need of the hour for monitoring the significant ESBLs that can lead to treatment catastrophe in diabetic patients.

Islet amyloid polypeptide aggregation is a local trigger for pancreatic islet inflammation

......................................................................................................................................... ii Preface



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

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.

Tight blood pressure control and cardiovascular outcomes among hypertensive patients with diabetes and coronary artery disease.

Tight control of systolic BP among patients with diabetes and CAD was not associated with improved cardiovascular outcomes compared with usual control, and little difference existed between those withUsually control and those with tight control.

Health Status After Treatment for Coronary Artery Disease and Type 2 Diabetes Mellitus in the Bypass Angioplasty Revascularization Investigation 2 Diabetes Trial

Background— Health status is a key outcome for comparing treatments, particularly when mortality does not differ significantly. Methods and Results— Bypass Angioplasty Revascularization Investigation

Effect of Rosiglitazone on Progression of Coronary Atherosclerosis in Patients With Type 2 Diabetes Mellitus and Coronary Artery Disease: The Assessment on the Prevention of Progression by Rosiglitazone on Atherosclerosis in Diabetes Patients With Cardiovascular History Trial

Rosiglitazone did not significantly decrease the primary end point of progression of coronary atherosclerosis more than glipizide in patients with type 2 diabetes mellitus and coronary Atherosclerosis.

Aspirin for Primary Prevention of Cardiovascular Events in People With Diabetes: A Position Statement of the American Diabetes Association, a Scientific Statement of the American Heart Association, and an Expert Consensus Document of the American College of Cardiology Foundation

Aspirin has been shown to be effective in reducing cardiovascular morbidity and mortality in high-risk patients with myocardial infarction (MI) or stroke (secondary prevention), and its net benefit among patients with no previous cardiovascular events is more controversial.

Effects of combination lipid therapy in type 2 diabetes mellitus.

The routine use of combination therapy with fenofibrate and simvastatin to reduce cardiovascular risk in the majority of high-risk patients with type 2 diabetes does not support the routine use.

Long-term effects of intensive glucose lowering on cardiovascular outcomes.

The use of intensive therapy for 3.7 years to target a glycated hemoglobin level below 6% reduced 5-year nonfatal myocardial infarctions but increased 5- year mortality, and such a strategy cannot be recommended for high-risk patients with advanced type 2 diabetes.

Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes.

A strategy of intensive glucose control, involving gliclazide (modified release) and other drugs as required, that lowered the glycated hemoglobin value to 6.5% yielded a 10% relative reduction in the combined outcome of major macrovascular and microvascular events, primarily as a consequence of a 21%relative reduction in nephropathy.