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- March 10, 2010 |
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"Diabetes Treatments and Inflammatory Markers"Dr. Vivian A. Fonseca (biography)
English - 2004-09-30 - 46 minutes
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Summary :
It is by now well recognized that atherosclerosis is an inflammatory disease and diabetics appear to be disproportionately affected by both cardiovascular disease and inflammation. What is the effect of chronic inflammation on the pathophysiology of diabetes? What is the effect of diabetes on inflammatory processes?
Dr. Fonseca examines the evidence for the inter-relatedness of diabetes and inflammation in this review of the modulating effects of medications commonly used in the management of patients with diabetes on markers of inflammation, with particular reference to the effects on CRP.
What are the effects of insulin and different insulin sensitizers on CRP and other markers of inflammation? What are the effects of statins and are all statins created equal when it comes to reducing CRP levels? Are ACE-inhibitors just as good as ARBs for the modulation of inflammatory markers? What is the role of anti-inflammatory medications, such as ASA in diabetes?*
Dr. Fonseca addresses all of these questions and more in this very informative talk.
*Dr. Fonseca discusses the results of Hundal et al (J Clin Invest. 2002) in which a small series of diabetic patients received 7g of ASA per day for two weeks. It is important to recognize that such high-dose aspirin is not being recommended for clinical use, but rather has been used in order to elucidate the effect of ASA therapy on insulin resistance.
Copyright © 2004 E-MedHosting.com Inc
Learning objectives :
After viewing this presentation, participants will be able to discuss:
- The role of inflammation in diabetes
- The role of diabetes in inflammation
- The effect of insulin sensitizers on CRP and other markers of inflammation
- The effect of insulin on CRP and other markers of inflammation
- The effect of statins other cholesterol lowering medications on CRP and other markers of inflammation
- How ACE-inhibitors and ARBs impact on serum levels of markers of inflammation
- The role of anti-inflammatory medications, such as ASA, in diabetes
Bibliographic references :
Peter Libby, Paul M. Ridker, and Attilio Maseri Inflammation and Atherosclerosis Circulation 2002 105: 1135 - 1143
Grimble, Robert F.Inflammatory status and insulin resistance. Current Opinion in Clinical Nutrition & Metabolic Care. 5(5):551-559, September 2002.
Kaplan, Robert C. PhD; Frishman, William H. MDSystemic Inflammation as a Cardiovascular Disease Risk Factor and as a Potential Target for Drug Therapy. Heart Disease. 3(5):326-332, September/October 2001.
Steven M. Haffner, Andrew S. Greenberg, Wayde M. Weston, Hongzi Chen, Ken Williams, and Martin I. Freed Effect of Rosiglitazone Treatment on Nontraditional Markers of Cardiovascular Disease in Patients With Type 2 Diabetes Mellitus Circulation 2002 106: 679 - 684;
Neelima V. Chu, Alice P. S. Kong, Dennis D. Kim, Debra Armstrong, Sunita Baxi, Reena Deutsch, Michael Caulfield, Sunder R. Mudaliar, Richard Reitz, Robert R. Henry, and Peter D. ReavenDifferential Effects of Metformin and Troglitazone on Cardiovascular Risk Factors in Patients With Type 2 Diabetes Diabetes Care 25: 542-549
Burton E. Sobel, Janet Woodcock-Mitchell, David J. Schneider, Robert E. Holt, Kousuke Marutsuka, and Herman Gold Increased Plasminogen Activator Inhibitor Type 1 in Coronary Artery Atherectomy Specimens From Type 2 Diabetic Compared With Nondiabetic Patients : A Potential Factor Predisposing to Thrombosis and Its Persistence Circulation 1998 97: 2213 – 2221
Nakamura, Tsukasa; Ushiyama, Chifuyu; Shimada, Noriaki; Hayashi, Kayo; Ebihara, Isao; Koide, Hikaru Comparative effects of pioglitazone, glibenclamide, and voglibose on urinary endothelin-1 and albumin excretion in diabetes patients J Diabetes Complications Vol: 14, Issue: 5, September - October, 2000
Stefan Engeli, Mareike Feldpausch, Kerstin Gorzelniak, Frauke Hartwig, Ute Heintze, Jürgen Janke, Matthias Möhlig, Andreas F.H. Pfeiffer, Friedrich C. Luft, and Arya M. Sharma Association Between Adiponectin and Mediators of Inflammation in Obese Women Diabetes 2003; 52: 942-947
Paresh Dandona, Ahmad Aljada, Priya Mohanty, Husam Ghanim, Wael Hamouda, Ezzat Assian, and Shakeel AhmadInsulin Inhibits Intranuclear Nuclear Factor B and Stimulates I B in Mononuclear Cells in Obese Subjects: Evidence for an Anti-inflammatory Effect? J. Clin. Endocrinol. Metab., Jul 2001; 86: 3257 - 3265.
Troels Krarup Hansen, Steffen Thiel, Pieter Jozef Wouters, Jens Sandahl Christiansen, and Greet Van den BergheIntensive Insulin Therapy Exerts Antiinflammatory Effects in Critically Ill Patients and Counteracts the Adverse Effect of Low Mannose-Binding Lectin Levels J. Clin. Endocrinol. Metab., Mar 2003; 88: 1082 - 1088.
Van den Berghe G., Wouters P., Weekers F., Verwaest C., Bruyninckx F., Schetz M., Vlasselaers D., Ferdinande P., Lauwers P., Bouillon R.Intensive Insulin Therapy in Critically Ill Patients N Engl J Med 2001; 345:1359-1367, Nov 8, 2001.
Ajay Chaudhuri, David Janicke, Michael F. Wilson, Devjit Tripathy, Rajesh Garg, Arindam Bandyopadhyay, Janeen Calieri, Debbie Hoffmeyer, Tufail Syed, Husam Ghanim, Ahmad Aljada, and Paresh DandonaAnti-Inflammatory and Profibrinolytic Effect of Insulin in Acute ST-Segment–Elevation Myocardial Infarction Circulation 2004 109: 849 – 854
Hannes Gaenzer, Günther Neumayr, Peter Marschang, Wolfgang Sturm, Monika Lechleitner, Bernhard Föger, Rudolf Kirchmair and Josef PatschEffect of insulin therapy on endothelium-dependent dilation in type 2 diabetes mellitus The American Journal of Cardiology Volume 89, Issue 4 , 15 February 2002, Pages 431-434
JP Albertini, P Valensi, B Lormeau, MH Aurousseau, F Ferriere, JR Attali, and L GattegnoElevated concentrations of soluble E-selectin and vascular cell adhesion molecule-1 in NIDDM. Effect of intensive insulin treatment Diabetes Care 21: 1008-1013.
I. Jialal, D. Stein, D. Balis, S. M. Grundy, B. Adams-Huet, and S. Devaraj Effect of Hydroxymethyl Glutaryl Coenzyme A Reductase Inhibitor Therapy on High Sensitive C-Reactive Protein Levels Circulation 2001 103: 1933 - 1935
Steven E. Nissen; E. Murat Tuzcu; Paul Schoenhagen; B. Greg Brown; Peter Ganz; Robert A. Vogel; Tim Crowe; Gail Howard; Christopher J. Cooper; Bruce Brodie; Cindy L. Grines; Anthony N. DeMariaEffect of Intensive Compared With Moderate Lipid-Lowering Therapy on Progression of Coronary Atherosclerosis: A Randomized Controlled Trial JAMA. 2004;291:1071-1080
Christie M. Ballantyne, John Houri, Alberto Notarbartolo, Lorenzo Melani, Leslie J. Lipka, Ramachandran Suresh, Steven Sun, Alexandre P. LeBeaut, Philip T. Sager, and Enrico P. VeltriEffect of Ezetimibe Coadministered With Atorvastatin in 628 Patients With Primary Hypercholesterolemia: A Prospective, Randomized, Double-Blind Trial Circulation 2003 107: 2409 - 2415
Philip T. Sager, Lorenzo Melani, Leslie Lipka, John Strony, Bo Yang, Ramachandran Suresh, Enrico Veltri and Ezetimibe Study GroupEffect of coadministration of ezetimibe and simvastatin on high-sensitivity C-reactive protein The American Journal of Cardiology Volume 92, Issue 12 , 15 December 2003, Pages 1414-1418
Sushant Navalkar, Sampath Parthasarathy, Nalini Santanam and Bobby V. KhanIrbesartan, an angiotensin type 1 receptor inhibitor, regulates markers of inflammation in patients with premature atherosclerosis Journal of the American College of Cardiology Volume 37, Issue 2 , February 2001, Pages 440-444
Paul M. Ridker, M.D., Mary Cushman, M.D., Meir J. Stampfer, M.D., Russell P. Tracy, Ph.D., and Charles H. Hennekens, M.D. Inflammation, Aspirin, and the Risk of Cardiovascular Disease in Apparently Healthy Men NEJM 1997; Volume 336:973-979
Ripudaman S. Hundal, Kitt F. Petersen, Adam B. Mayerson, Pritpal S. Randhawa, Silvio Inzucchi, Steven E. Shoelson, and Gerald I. ShulmanMechanism by which high-dose aspirin improves glucose metabolism in type 2 diabetes J. Clin. Invest. 2002 109:1321-1326
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