1,721,432 research outputs found
To what extent is the new position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) 'personalised'?
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ADA/EASD position statement of the treatment of type 2 diabetes: Reply to Rodbard HW and Jellinger PS [letter], Scheen AJ [letter] and Ceriello A, Gallo M, Gentile S et al [letter]. [Diabetologia. 2012
Visualizing departures from symmetry. A study on cardiovascular risk among patients with diabetes.
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Influenza di uno stretto controllo metabolico sulla neuropatia autonomia in soggetti con diabete tipo I.
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Does personalized diabetology overcome clinical uncertainty and therapeutic inertia in type 2 diabetes?
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Glycemic Variability, Glycated Hemoglobin, and Cardiovascular Complications: Still a Dilemma in Clinical Practice
No full textDiabetes and kidney disease: emphasis on treatment with SGLT-2 inhibitors and GLP-1 receptor agonists
No full textKidney disease is a frequent microvascular complication of both type 1 and type 2 diabetes. Historic trials have demonstrated that a tight glycaemic control is the most powerful approach to decrease the chances of developing diabetic nephropathy. However, having an HbA1c < 7% does not completely suppress the risk of kidney disease. The observed residual risk is likely ascribable to two phenomena: 1- the presence of risk factors and alterations additive to and independent of glycaemia, and 2- the activation of long-lasting imbalances by periods of exposure to uncontrolled glycemia, a phenomenon referred to as metabolic memory or legacy effect. Long-lasting oxidative stress, epigenetic alterations, cellular senescence, and the resulting chronic low-grade inflammation are all candidate mechanisms explaining the development of nephropathy despite proper control of risk factors. Recently, two classes of drugs, i.e. glucagon-like peptide (GLP) 1 receptor agonists (RA) and sodium-glucose transporter 2 inhibitors (SGLT-i) have changed this scenario. Indeed, cardiovascular outcome and other trials have clearly shown a renoprotective effect for these drugs, well-beyond their glucose-lowering properties. In this review, we summarize: 1- selected key trials and mechanisms underlying the development of diabetic kidney disease and 2- the results relative to renal endpoints in clinical trials of GLP-1 RA and SGLT-2i. Then, we briefly discuss some of the hypotheses posited to explain the marked renoprotective properties of these two classes, evidencing the still existing gaps in knowledge and proposing future directions to further implement the use of these powerful, disease-modifying drugs
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