Current Diabetes Reviews - Volume 1, Issue 3, 2005

Genetic and environmental determinants play critical roles in insulin resistance and b-cell function. A model of the complex feedback system for maintenance of glucose tolerance has been developed that reflects the constraint of glycemia within narrow physiologic limits. The "glucose homeostasis" model is described by insulin sensitivity, glucose effectiveness, acute insulin response to glucose, and disposition index (DI) Read More

The prevalence of obesity continues to increase throughout the world in an analogous way to that of type 2 diabetes mellitus (T2DM). Excess adiposity and accompanying insulin resistance is frequently associated to the development of cardiovascular disease. The circulating hormone resistin, which is produced mainly by adipocytes and appears to be increased in obesity and inflammation, seems to play a role in this as Read More

Diabetes is a highly prevalent chronic and debilitating condition that is associated with significant morbidity, mortality, and increased health care costs. Depression is also highly prevalent and is a leading cause of disability, work place absenteeism, lost productivity, and increased use of health care resources. There is evidence that persons with diabetes are twice as likely to have depression as persons without diabetes and that Read More

Chronic complications of diabetes mellitus represent a major cause of morbidity and mortality among those affected and have an enormous impact on society as a whole. Although these complications manifest as a number of clinically distinct syndromes, the pathology underlying them may be very similar, if not identical. Endothelial dysfunction leading to microcirculatory insufficiency and functional ischemia of tissues are propo Read More

The aim of this project was to develop evidence-based guidelines regarding psychosocial aspects of diabetes mellitus in an effort to help the clinician bridge the gap between research and practice. Recommendations address the following topics: patient education, behavioural medicine, and psychiatric disorders of particular relevance to diabetes: depression, anxiety disorders, eating disorders, and dependence on alcoho Read More

This paper reviews emerging interventions from the recent clinical literature that demonstrate the potential for effectiveness in the therapy of the diverse forms of diabetic neuropathy. Diabetic sensorimotor polyneuropathy is the primary focus of this review given that it is the most common form of diabetic neuropathy. For this condition, several promising disease-modifying drugs - including inhibitors of the aldose reductase Read More

Diabetic nephropathy is a major cause of end-stage renal failure (ESRF) in patients with both type 1 and type 2 diabetes. Many factors such as genetic and non-genetic promoters, hypertension, hyperglycemia, accumulation of advanced glycation end products (AGEs), dyslipidemia, albuminuria and proteinuria influence the progression of this desease. It is important to determine pathogenesis and treatment of this di Read More

Accumulation of triosephosphates arising from high cytosolic glucose concentrations in hyperglycemia is one likely or potential trigger for biochemical dysfunction leading to the development of diabetic complications. This may be prevented by disposal of excess triosephosphates via the reductive pentosephosphate pathway. This pathway is impaired in experimental and clinical diabetes by mild thiamine deficiency. Th Read More

Only a limited number of treatment options are available for insulin resistance, a major cause of type 2 diabetes (T2D) and the metabolic syndrome. None adequately address the simultaneous defects in lipid and carbohydrate metabolism. Peroxisome proliferator-activated receptors (PPARs) are members of the superfamily of nuclear hormone receptors that function as ligand-activated transcription factors. The PPAR Read More

Diabetes is on the increase worldwide and greater than 90% are type 2. There are two features to type 2 diabetes: muscle, fat and liver tissues are insulin resistant and β cells lose the ability to secrete insulin. Prior to developing diabetes, however, insulin resistant individuals lose the first-phase insulin secretion response. Transgenic mice lacking insulin receptors in their β cells have no first-phase response. Primary cultures of mo Read More

Triglyceride accumulation in skeletal muscle is increased in subjects with insulin resistance. Increased intracellular lipolysis from stored triglyceride may induce insulin resistance in skeletal muscle by activating the glucosefatty acid cycle. However, inconsistent with this hypothesis, intracellular lipolysis from skeletal muscle is decreased in high fat-fed, insulin resistant rats. Therefore, it is suggested that an increase in triglyceride Read More

Diagnosis of Gestational Diabetes Mellitus (GDM) requires at least two or more values to be abnormal on the 3 h - 100 g oral glucose tolerance test: but how to care for pregnant women with only one abnormal glucose value remains a point of discussion. In fact, although a large number of studies on this argument exist, the clinical significance of "one abnormal value" has yet to be clarified. Our review of previous studies an Read More

Helicobacter pylori [H. pylori], one of the most common chronic infections worldwide, is the main etiologic agent of gastritis, peptic ulcer and gastric cancer. Patients with diabetes mellitus are often affected by chronic infections. Many studies have evaluated the prevalence of H. pylori infection in diabetic patients and the possible role of this condition in their metabolic control. Some studies found a higher prevalence of Read More