Current Diabetes Reviews - Volume 2, Issue 1, 2006

This issue of CDR contains a range of interesting, well-crafted and insightful reviews on diabetes mellitus and its complications by highly respected groups of investigators. At the level of the pancreatic acinar cells, Bouwens examines the ability of beta cells to regenerate, and considers recent data such as the use of combinations of growth factors to promote regeneration or replacement by precursor cell neogenesis, which m Read More

Beta cell replacement and regeneration therapies seem promising approaches to the treatment of insulindependent diabetes. The short supply in beta cells from cadaveric organ donors and the very low replication capacity of human beta cells have spurred efforts to find robust ways of (re-)generating beta cells in vitro and in vivo. In the pancreas, both the capacity of regeneration and the mechanism involved can differ Read More

Derangement of glucose metabolism is a key feature of T2DM, with the liver and pancreatic β-cells playing a key role in glucose homeostasis. In the postprandial state, glucose is transported into hepatocytes and either metabolized to fatty acids or CO2, or stored as glycogen. Glucose also acts as a key signal in pancreatic β-cells for regulating insulin secretion. Because GLUT2 and GK expressed in liver and β-cells are responsible fo Read More

Obesity is a well-known risk factor for the development of insulin resistance, type 2 diabetes, dyslipidemia, hypertension, and cardiovascular disease. Rather than the total amount of fat, central distribution of adipose tissue is very important in the pathophysiology of this constellation of abnormalities termed metabolic syndrome. Adipose tissue, regarded only as an energy storage organ until the last decade, is now know Read More

Chronic inflammation has been linked with an increased risk of type 2 diabetes and cardiovascular disease. As an endocrine and inflammatory organ, adipose tissue is an important source of circulating pro-inflammatory cytokines. Current evidence strongly supports that chronic inflammation is associated with enlarged body fat mass. Moreover, inflammation is independently linked with abdominal, especially visc Read More

The polycystic ovary syndrome (PCOS) and hyperandrogenism are some of the most common endocrine disorders in women of fertile age. Insulin resistance is present in a significant proportion of hyperandrogenic patients, yet also, impaired ß-cell function, even in absence of clinically evident glucose intolerance, is a frequent finding, especially in patients with familial history of type 2 diabetes mellitus. Therefore, it is not surpri Read More

A number of population studies have suggested that hyperinsulinaemia is an independent risk factor for the development of cardiovascular atherosclerosis. Furthermore, there is an emerging body of evidence supporting a role for insulin as both a vasoregulatory and glucoregulatory peptide. Principal amongst insulin's putative vascular effects is to stimulate release of the anti-atherosclerotic signalling molecule nitric o Read More

Insulin mediates its own access and that of glucose to muscle by capillary recruitment and an increase in bulk blood flow. In addition, insulin resistance of muscle may result in part from an impaired hemodynamic action of insulin. The present review examines some of the factors that influence the effects of insulin both at the level of hemodynamics and metabolism in muscle. Factors include fatty acids, the inflammato Read More

Diabetic retinopathy continues to be the leading cause of legal blindness among working-age individuals. The earliest histological features of diabetic retinopathy include neuroretinal damage, capillary basement membrane thickening, loss of pericytes and loss of endothelial cells. At advanced stages, neovascularization, the hallmark of proliferative diabetic retinopathy (PDR) occurs, and blindness can result from rele Read More

Diabetic macular edema is one of the leading causes of visual loss in first world countries and the first cause in diabetic retinopathy. The Early Treatment Diabetic Retinopathy Study showed a significant benefit in using focal laser photocoagulation for the treatment of macular edema, more specifically defined as clinically significant macular edema. Nevertheless, progressive visual loss is found in the 26% of patients with diab Read More

This review addresses the current concepts in our understanding of the epidemiology, mechanisms, symptoms, clinical consequences, diagnosis and treatment of delayed gastric emptying in patients with diabetes. Upper gastrointestinal symptoms, particularly postprandial fullness, nausea, vomiting and abdominal bloating, occur in 30-50% of patients with diabetes. The use of scintigraphic techniques, and more recently bre Read More