Its prevalence increases linearly with duration of diabetes. Outcome results of the Fosinopril Versus Amlodipine Cardiovascular Events Random- Hypertension, Diabetes, and the Heart 77. In particular, the role of an insulin sensitizer was evaluated in individuals felt to have impaired glucose tolerance and insulin resistance and who had attenuated brachial artery vasoactivity 97. Insulin resistance, compensatory hyperinsulinemia, and coronary heart disease: Syndrome X -- Ch. Overall, this study indicated that blood pressure reduction is more important than the antihypertensive agent used.
A subgroup analysis of the Scandanavian Simvastatin Survival Study. Chapter 3 addresses recognition, assessment, and management of insulin resistance. New insights into the role and mechanism of glycogen synthase activation by insulin. . Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in U. The combined primary outcome was myocardial infarction, stroke, or cardiovascular death.
Detection and diagnosis of heart disease in diabetic and prediabetic subjects -- Ch. Three recent epidemiological studies have provided data on such relationships. Overexpression of catalytic subunit p110alpha of phosphatidylinositol 3kinase increases glucose transport activity with translocation of glucose transporters in 3T3-L1 adipocytes. Effect of lisinopril on progression of retinopathy in normotensive people with type 1 diabetes. Control of blood pressure is shown to be effective in decreasing cardiovascular morbidity and mortality, which is the most common cause of death in diabetic patients. Therefore, the results of several clinical research studies strongly suggest that hyperinsulinemia does not explain the increased renal tubular NaCl reabsorption, shifts of pressure natriuesis, or the hypertension associated with obesity in both animals and humans 101. Moreover, hypertension has a greater impact on cardiovascular diseases in diabetic as compared with nondiabetic subjects 15.
Contents Detection and Diagnosis of Syndromes of Insulin Resistance and of Diabetes Mellitus Edward S. In most populations both fasting and postprandial plasma glucose levels are continuous variables that are skewed toward the higher range. Diabetes Care 1999; 22 suppl 2 :B35—B39. The 60-kDa phosphotyrosine protein in insulintreated adipocytes is a new member of the insulin receptor substrate family. J Biol Chem 1995; 270:26000—26005. Bile acid binding resins are not absorbed and, therefore, have no systemic toxicities.
Effects of aggressive blood pressure control in normotensive type 2 diabetic patients on albuminuria, retinopathy and strokes. Exercise should be considered a necessary adjunct to diet, as long-term exercise would result in little weight reduction unless caloric restriction is also part of the regimen. Reaven 105 117 v vi 8. Recognition and Assessment of Insulin Resistance 63 97. French, medical and graduate student, Dr. It is a reference for primary care, family practice, and internal medicine physicians, amongst others.
Proc Assoc Am Physicians 1999; 111:313—318. Multiple drug combinations are frequently necessary to reach the recommended target blood pressure levels in diabetic patients. Insulin therapy rapidly reverses this condition resulting in the clearance of chylomicron triglycerides from plasma. A particularly intriguing potential cause of insulin resistance in women with the polycystic ovarian syndrome is abnormal serine kinase activity resulting in serine phosphorylation as opposed as tyrosine phosphorylation of the insulin receptor with consequent lack of autophosphorylation and functional impairment. The prevalence of hypertension in these patients increases with age.
Hyperlipidemia, diabetes, and the heart -- Ch. Early captopril treatment reduces plasma endothelin concentrations in the acute and subacute phases of myocardial infarction: a pilot study. These include genetic factors, sodium retention, and hyperinsulinemia. However, until the ongoing prevention trials are completed and the results made available, a nonpharmacological approach is probably the most reasonable option the clinician can offer to the patient in order to achieve a reduction in insulin resistance and prevent the development of type 2 diabetes. You can be assured our editors closely monitor every feedback sent and will take appropriate actions.
The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The molecular and physiological basis of insulin resistance: Emerging implications for metabolic and cardiovascular diseases. Life without white fat: a transgenic mouse. Increased platelet aggregation may be associated with an altered balance of intracellular platelet cations. Diabetes 1996; 45 suppl 2 :52A. The impact of nephropathy and hyperglycemia on cardiovascular risk factors in type 1 diabetic patients can be partially dissected by comparing the metabolic consequences of kidney transplantation to those of kidney—pancreas transplantation.
J Biol Chem 1997; 272:21403— 21407. Such a strategy, if it can be implemented, should maintain atherosclerosis progression at the prediabetic level. Insulin resistance and its consequences, including hyperinsulinemia, have been directly and indirectly linked to the acceleration of coronary artery disease. J Clin Invest 2000; 106:163— 164. Detection and diagnosis of syndromes of insulin resistance and of diabetes mellitus --Ch. Ann Intern Med 1999; 131:281—303.
Signaling pathways in insulin action: Molecular targets of insulin resistance. Treatment of diabetes: implications for heart disease -- Ch. How to measure insulin sensitivity. A review with clinical implications. The apolipoproteins not only help to solubilize the core lipids, but also play critical roles in the regulation of plasma lipid and lipoprotein transport. J Clin Invest 1999; 103:931— 943. J Vasc Surg 1998; 28:1024—1031.