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- W128022079 abstract "Diabetes mellitus (DM) is a growing health problem in the USA, afflicting over 18.2 million Americans. Morbidity and mortality from DM most commonly result from the long-term complications of the disease. “Intensive therapy” reduces blood sugars to near normal and effective management of other associated risk factors such as lipid abnormalities and blood pressure (BP). New clinical trials are being carried out to determine whether goals for intensive therapy should be lower than current goals and to test various therapeutic strategies to determine the optimum methods to prevent diabetes complications. Cardiovascular disease (CVD) disproportionately affects people with diabetes and is a leading cause of death. So far, intensive glycemic control has not been conclusively shown to decrease cardiovascular events. The therapeutic agents used in treating glycemia have different effects on cardiovascular risks and therefore may have different effects on outcome. Metformin was the only oral anti-diabetic medication shown to decrease cardiovascular events independent of glycemic control. Thiazolidinediones improve insulin resistance and lower insulin concentrations, which may be beneficial because hyperinsulinemia is an independent predictor of CVD. In the recent PROACTIVE study, a pioglitazone treatment was associated with a significant reduction in myocardial infarction and cardiovascular mortality, although that was not the primary endpoint of the study. Insulin therapy acutely reduces mortality and morbidity in patients with hyperglycemia when critically ill, but the effect on cardiovascular events is unclear. In contrast, insulin secretagogues have very little effect on both cardiovascular risk factors and outcomes. Thus, the role of intensive glycemic control and the choice of therapeutic agents to reduce the macrovascular complications of diabetes are unclear." @default.
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- W128022079 date "2008-01-01" @default.
- W128022079 modified "2023-09-27" @default.
- W128022079 title "Intensive Treatment and Complications of Diabetes" @default.
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- W128022079 doi "https://doi.org/10.1007/978-1-59745-572-5_4" @default.
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