Population-Based Strategy for Preventing Diabetes and its Complications
Journal Title: Diabetes Research – Open Journal - Year 2018, Vol 4, Issue 1
Abstract
A recent report from the American College of Physicians (ACP) should cause a paradigm change for the treatment of diabetic patients.1 The main purpose of diabetes therapy is the prevention of complications.2 The endpoint of many clinical trials is to lower blood glucose levels, but intensive treatments aimed at lowering the HbA1c to less than 6.5% are often accompanied by hypoglycemia as a side effect. At the same time, intensive regimens have not shown a reduction of cardiovascular complications in the longterm.3-7 For example, the action to control cardiovascular risk in diabetes (ACCORD) trial was prematurely discontinued, following the observation of an increase in overall mortality, cardiovascular-related deaths, and severe hypoglycemic events.3 The action in diabetes and vascular disease; preterAx and diamicroN-MR controlled evaluation (ADVANCE) study also failed to show a statistically significant clinical benefit, while more adverse effects were seen among those who achieved a median HbA1c level of 6.4%.4 More intensive treatments with tight glycemic control targets are more costly and associated with increased patient burdens. Only Hollan et al8 reported a long-term benefit with intensive therapy in the United Kingdom prospective diabetes study (UKPDS) after 10 years of intervention.
Authors and Affiliations
Shaw Watanabe
Keywords
Related Articles
- EP ID EP550244
- DOI 10.17140/DROJ-4-e011
- Views 135
- Downloads 0
Basic Ketone Engine and Booster Glucose Engine for Energy Production
Recently, hyperketonemia induced by fasting or ketogenic diet calls attention because of the possibilities for various clinical applications. Animal species comparisons and biochemical data show that all fetuses can deve...
Current Controversies around Carbohydrate Restriction and the Risk of High-Protein Diets
Recently, a Low carbohydrate (LCH) diet has been recommended by many doctors to control hyperglycemia and overweight. Unlike a traditional calorie-restricted diet, a carbohydrate-restricted diet typically contains less t...
Ocular Health Screening in a Type 1 Diabetes Mellitus Population
Background: Type 1 Diabetes Mellitus is among the most common conditions worldwide, affecting nearly 95 million children worldwide. One of the detrimental effects of this condition can be vision loss. Comprehensive annua...
Glycemic Variability: Clinical and Prognostic Significance
Minimizing development or progression of chronic diabetic micro and macro-vascular complications has been always the goal of glycemic control. In recent years, much attention has been focused on the possibility that glyc...
Publishing Research: From an Occupational Therapy Perspective
Two years ago, at the inception of this Diabetes Research – Open Journal, I wrote an opinion article for the inaugural issue about the need for articles targeting secondary prevention.1 The journal has grown to provide m...