Diabetes type interventions

Diabetes Atherosclerosis Intervention Study Investigators. Effect of fenofibrate on progression of coronary-artery disease in type 2 diabetes the Diabetes Atherosclerosis Intervention Study, a randomised study. Lancet 2001 357(9260) 905-910. 

The nurse in the medical department is preparing to administer Humalog, a rapidacting insulin, to a client diagnosed with Type 1 diabetes. Which intervention should the nurse implement ... 

In a 10-year follow-up, among 32,826 women in the Nurses Health Study, Lopez-Garcia et al. [129] demonstrated that elevated plasma levels of inflammatory markers, especially C-reactive protein (CRP), were independent predictors of type-2 diabetes. Dietary intervention concurrent with healthy lifestyle strategies to increase exercise and encourage weight loss was effective in lowering CRP and other inflammatory markers. 

It has been proposed that the development of the complications of diabetes mellitus may be linked to oxidative stress and therefore might be attenuated by antioxidants such as vitamin E. Furthermore, it is discussed that glucose-induced vascular dysfunction in diabetes can be reduced by vitamin E treatment due to the inactivation of PKC. Cardiovascular complications are among the leading causes of death in diabetics. In addition, a postulated protective effect of vitamin E (antioxidants) on fasting plasma glucose in type 2 diabetic patients is also mentioned but could not be confirmed in a recently published triple-blind, placebo-controlled clinical trial [3]. To our knowledge, up to now no clinical intervention trials have tested directly whether vitamin E can ameliorate the complication of diabetes. 

Enzymes involved in TG synthesis continue to represent challenging and intriguing targets for small-molecule intervention against the worldwide epidemic of obesity, metabolic syndrome, and type 2 diabetes, as well as smaller market indications from rare familial diseases to veterinary use. There is also intriguing evidence that inhibition of these enzymes may be beneficial for diseases unrelated to the area of metabolic disorders, such... 

Purpose T1D-RAID is a cooperative program of the NIDDK and NCI that is designed to facilitate translation to the clinic of novel, scientifically meritorious, therapeutic interventions for the treatment of Type-1 diabetes. The goal of T1D-RAID is to support the pre-clinical tasks needed for the clinical "proof of principle" to determine if a new molecule merits... 

The STOP-NIDDM trial demonstrated that -glucosidase therapy in prediabetic persons successfully prevented a significant number of new cases of type 2 diabetes and helped restore beta-cell function, in addition to reducing cardiovascular disease and hypertension. Intervention with acarbose also reduced cardiovascular events in persons with diabetes. Diabetes and cardiovascular disease prevention may become a further indication for this class of medications. 

Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group Intensive diabetes therapy and carotid intima-media thickness in type 1 diabetes mellitus. N Engl 3 Med 2003 348 2294. 

Diabetes Prevention Program Research Group Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl 3 Med 2002 346 393. 

Gaede P et al Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl 3 Med 2008 358 580. [PMID 18256393]... 

Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002 346(6) 393 103. 

In an 8-week, non-interventional cohort study in 22 045 patients with type 2 diabetes, of whom 4.9% discontinued therapy, adverse advents occurred in 2.3% (52). There were attacks of hypoglycemia in 0.3%. Of the 6547 patients taking glimepiride, 2.5% had adverse reactions and 0.4% had hypoglycemic reactions. 

Insulin may also be administered in some cases of type 2 diabetes to complement other drugs (oral antidiabetic agents) and to supplement endogenous insulin release.64,70 In type 2 diabetes (NIDDM), exogenous insulin basically makes up the difference between the patient s endogenous hormone production and his or her specific insulin requirement. In addition, many patients with advanced cases of type 2 diabetes ultimately require supplemental insulin because other interventions (diet, exercise, other drugs) are not able to adequately control this disease.35... 

Bertera S, Alexander A, Giannoukakis N, et al. Immunology of type 1 diabetes. Intervention and prevention strategies. Endocrinol Metab Clin North Am. 1999 28 841-864. 

For the first time in history there was clear, unambiguous clinical evidence, in humans, that symptoms of diabetes mellitus could be controlled with the exogenous administration of the active factor of the pancreas—insulin. Thus, replacement therapy with the newly discovered hormone, insulin, had arrested what was clearly an otherwise fatal metabolic disorder. From that point forward, diabetes mellitus (type 1) became a manageable disease by pharmacological intervention. 

Individuals with type 1 diabetes are also at risk of subsequent ketoacidotic crises. One common cause of DKA is noncompliance with insulin therapy. Infections, (including subclinical infections) and physiological stressors (such as myocardial infarction) can also precipitate DKA. Since the mortality rate associated with DKA can be as high as 10%, successfully educating patients about the early warning signs of the condition and providing a plan for early intervention is crucial to its effective prevention. 

Schatz DA and Bingley PJ (2001) Update on major trials for the prevention of type 1 diabetes mellitus the American Diabetes Prevention Trial (DPT-1) and the European Nicotinamide Diabetes Intervention Trial (ENDIT). Journal of Pediatrics Endocrinology and Metabolism 14(Suppl 1), 619-22. 

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