Linked Life Data

20146161

Source:http://linkedlifedata.com/resource/pubmed/id/20146161

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
7
pubmed:dateCreated
2010-2-10
pubmed:abstractText
It is still a much debated question whether antidiabetic therapy to target normal glycated hemoglobin levels would reduce cardiovascular events in patients with advanced type 2 diabetes. New findings result from ACCORD, ADVANCE and VADT. These trials reveal that microvascular and macrovascular effects of intensive glucose lowering have to be considered separately: Glycemic control convincingly demonstrated to have a protective impact on microvascular complications, especially nephropathy. However, macrovascular benefits remain doubtful in these megatrials and have to be considered in connection with the individual global risk. On the other hand, the Diabetes Intervention Study (DIS) and UKPDS 10-year follow-up results yielded better cardiovascular outcomes for those patients who received intensive glucose-lowering therapy very early after diabetes diagnosis, but the favourable influences did not manifest until a time period of 1 - 2 decades. For the first time, the cardiovascular benefit of an antidiabetic substance (pioglitazone) could be verified in the large-scale outcome-trial PROactive for patients with advanced diabetes and multiple manifestations of macroangiopathy. The results provide strong support for a beneficial influence on macrovascular complications just under 3 years of treatment. Nevertheless, the positive findings did not result from better glycemic control, but from the complexity of effects of PPARgamma agonist pioglitazone on insulin resistance, lipoprotein spectrum, blood pressure, endothelial function and biomarkers of subclinical inflammation. It is obvious that we need to integrate such pleiotropic effects on metabolic syndrome and cardiovascular disease to improve the quality of drug-therapy decisions. This, in turn, requires a growing body of evidence from large, long-term outcome trials - but appropriate data are still unavailable for the vast majority of antidiabetic drugs.
pubmed:commentsCorrections
pubmed:language
ger
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Feb
pubmed:issn
1439-4413
pubmed:author
pubmed:copyrightInfo
Georg Thieme Verlag KG Stuttgart, New York.
pubmed:issnType
Electronic
pubmed:volume
135
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
301-7
pubmed:dateRevised
2011-6-20
pubmed:meshHeading
pubmed-meshheading:20146161-Blood Glucose, pubmed-meshheading:20146161-Blood Pressure, pubmed-meshheading:20146161-Cardiovascular Diseases, pubmed-meshheading:20146161-Diabetes Mellitus, Type 2, pubmed-meshheading:20146161-Diabetic Angiopathies, pubmed-meshheading:20146161-Endothelium, Vascular, pubmed-meshheading:20146161-Female, pubmed-meshheading:20146161-Hemoglobin A, Glycosylated, pubmed-meshheading:20146161-Humans, pubmed-meshheading:20146161-Hypoglycemic Agents, pubmed-meshheading:20146161-Inflammation Mediators, pubmed-meshheading:20146161-Insulin Resistance, pubmed-meshheading:20146161-Lipoproteins, pubmed-meshheading:20146161-Male, pubmed-meshheading:20146161-PPAR gamma, pubmed-meshheading:20146161-Randomized Controlled Trials as Topic, pubmed-meshheading:20146161-Survival Analysis, pubmed-meshheading:20146161-Thiazolidinediones
pubmed:year
2010
pubmed:articleTitle
[Glycemic control and cardiovascular benefit: What do we know today?].
pubmed:affiliation
Zentrum für Klinische Studien, GWT-TUD GmbH, Dresden. hanefeld@gwtonline-zks.de
pubmed:publicationType
Journal Article, Comparative Study, English Abstract, Review