Diabetes research and clinical practice
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Diabetes Res. Clin. Pract. · Dec 2010
Case ReportsFulminant type 1 diabetes mellitus with rhabdomyolysis: have we overlooked the situation?
Fulminant type 1 diabetes mellitus (FT1DM) is characterized as remarkably abrupt onset and severe metabolic disorder. Prominent derangement of serum electrolytes was frequently observed, which could be associated with rhabdomyolysis. ⋯ Herein, we reported 2 cases. Since the clinical features of rhabdomyolysis vary, and creatine kinase levels are not routinely tested in young patients, the situation of rhabdomyolysis associated with FT1DM may be overlooked.
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Diabetes Res. Clin. Pract. · Nov 2010
ReviewDPP-4 inhibitors: what may be the clinical differentiators?
Attenuation of the prandial incretin effect, mediated by glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP), contributes to hyperglycemia in type 2 diabetes mellitus (T2DM). Since the launch of sitagliptin in 2006, a compelling body of evidence has accumulated showing that dipeptidyl peptidase-4 (DPP-4) inhibitors, which augment endogenous GLP-1 and GIP levels, represent an important advance in the management of T2DM. Currently, three DPP-4 inhibitors - sitagliptin, vildagliptin and saxagliptin - have been approved in various countries worldwide. ⋯ The expanding evidence base also suggests that certain differences between DPP-4 inhibitors may prove to be clinically significant. This therapeutic diversity should help clinicians tailor treatment to the individual patient, thereby increasing the proportion that safely attain target HbA(1c) levels, and reducing morbidity and mortality. This review offers an overview of DPP-4 inhibitors in T2DM and suggests some characteristics that may provide clinically relevant differentiators within this class.
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Diabetes Res. Clin. Pract. · Oct 2010
Acceleration of diabetic wound healing by collagen-binding vascular endothelial growth factor in diabetic rat model.
Vascular endothelial growth factor (VEGF) is an important active protein for the induction of angiogenesis and plays an important role in the tissue regeneration of diabetic wounds. In this study, we used collagen-binding VEGF in a diabetic rat model to investigate the effects of this new method. ⋯ Topical application of CBD-VEGF can promote diabetic wound healing in rat model, which could potentially provide a better therapeutic option for diabetic wounds.
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The cardiorenal syndrome in patients with diabetes mellitus represents a systemic condition that affects both the cardiovascular and renal systems. Diabetes is a well established risk factor for cardiovascular disease (CVD), and a significant proportion of diabetic patients go on to develop clinically significant nephropathy. In the diabetic state the kidney is involved by progressive sclerosis/fibrosis and proteinuria, due most likely to overactivity of the transforming growth factor-beta system and, to some extent, the vascular endothelial growth factor system, respectively. ⋯ Additionally, it has been suggested that endothelial dysfunction may lead to simultaneous development and progression of renal and cardiac pathology in diabetes. The risk of microvascular complications can be reduced by intensive glycemic control in patients with type 1 and type 2 diabetes mellitus whereas benefit to the cardiovascular system is less clear. However, intensified intervention involving other CVD risk factors like hypertension and dyslepidemia and interception of the rennin-angiotensin-aldosterone system in patients with type 2 diabetes have been shown to be associated with significant reduction in the risk for renal disease progression that was paralleled by a significant reduction in cardiovascular disease burden.