【正文】 butable to elevated HbA1c levels. HLJ 業(yè)精于勤荒于嬉 行成于思?xì)в陔S →【醫(yī)學(xué)生物 PPT，歡迎收藏分享】網(wǎng)友 9 ? The authors concluded that HbA1c is associated with a progressive and continuous increase in risk for both CV disease and mortality across the entire range of HbA1c values. The study is unique because of the large number of study participants (including many women) and indicates that the threshold level between normal and abnormal HbA1c levels should be revised downward. ? These data are important because they demonstrate that HbA1c level can be considered an independent and progressive risk factor for CV disease in diabetic p39。ts. ? An increase in glycosylated HbA1c level of 1 percentage point predicts a 20% to 30% average relative increase in frequency of CV events across the range of HbA1c levels in the study sample. ? The metaanalysis performed by Selvin and coworkers confirmed these findings. Ann intern Med. 2022。141:41320. HLJ 業(yè)精于勤荒于嬉 行成于思?xì)в陔S →【醫(yī)學(xué)生物 PPT，歡迎收藏分享】網(wǎng)友 10 Liraglutide Effectively Improves Glycemic Control and Islet Cell Function in Type 2 DM (DM. 2022。53:118794. ) ? This study reports results with a new and novel approach to DM management. Glucagonlike peptide1 (GLP1), an incretin mimetic, is a naturally occurring insulin secretagogue that is released by the intestine in response to ingestion of food. Research has shown that GLP1 agonists that bind to the GLP1 receptors on 223。 cells improve glucose homeostasis by several mechanisms. ? Unique to the action of GLP1 is its relationship to serum glucose levels: It stops stimulating insulin secretion after glucose levels normalize, thereby avoiding hypoglycemia. The GLP1 agonists also inhibit glucagon release, which reduces glycemia after meals. After a person ingests food, the inhibition of glucagon ceases when glucose levels normalize, which reduces the risk for hypoglycemia. The GLP1 peptide is rapidly degraded, however, and its very short halflife has been a barrier to developing a therapeutic agent. ? The GLP1 derivative liraglutide is longer acting because of noncovalent coupling to albumin. This study explored the effects of liraglutide on glycemia, free fatty acids, insulin secretion, and gluconeogenesis. HLJ 業(yè)精于勤荒于嬉 行成于思?xì)в陔S →【醫(yī)學(xué)生物 PPT，歡迎收藏分享】網(wǎng)友 11 ? This study was a doubleblind, placebocontrolled crossover trial in 13 p39。ts with type 2 DM treated with SC liraglutide (6 181。g/kg of BW once daily). ? Liraglutide therapy significantly reduced 24hour plasma glucose and glucagon levels without altering free fatty acids or 24hour insulin secretion rates. ? This oute occurs because liraglutide stimulates insulin release primarily during intervals of hyperglycemia and not during the entire 24 hours. ? Arginine is a potent insulin secretagogue independent of plasma glucose and will also increase serum glucagon levels. In this study, insulin secretion increased in response to arginine without increasing glucagon secretion. Reduced glycogenolysis resulted in decreased glucose release from the liver. DM. 2022。53:118794. HLJ 業(yè)精于勤荒于嬉 行成于思?xì)в陔S →【醫(yī)學(xué)生物 PPT，歡迎收藏分享】網(wǎng)友 12 ? These very exciting (albeit preliminary) findings indicate that the GLP1 derivative liraglutide effectively improves glycemic control and islet cell function in type 2 DM. This peptide is arguably the most exciting therapeutic agent under consideration for the control of glycemia in type 2 diabetic p39。ts. The reduced plasma glucagon levels may lead to greater insulin sensitivity, which would account for the observed reduction in blood glucose level in the presence of unchanged insulin levels. ? To confirm both the safety and efficacy of these agents, we must await largescale clinical trials of longer duration that include a broad range of p39。ts with type 2 DM. ? Similar results were obtained by Ahren and colleagues, who evaluated a new inhibitor of dipeptidyl peptidase4, the enzyme that degrades GLP1 and thereby increases blood levels of GLP1. In this study, the drug reduced plasma glucagon, plasma glucose, and HbA1c levels. DM. 2022。53:118794. HLJ 業(yè)精于勤荒于嬉 行成于思?xì)в陔S →【醫(yī)學(xué)生物 PPT，歡迎收藏分享】網(wǎng)友 13 Rosiglitazone Reduces inStent Restenosis in Diabetic p39。ts with CAD (DM Care. 2022。27:265460. ) ? This study evaluated the effect of rosiglitazone on preventing instent restenosis in diabetic p39。ts with CAD and coronary stents. ? The rationale for the study hypothesis is that rosiglitazone, a thiazolidinedione used for therapy for DM, also reduces lipid levels, systemic inflammation, and vascular intima–media thickness. ? In this study, p39。ts were randomly assigned to a control group (n = 48) or a rosiglitazone therapy group (n = 47)。 both groups underwent quantitative coronary angiography at study entry and at 6 months. The rate of restenosis was the primary end point. HLJ 業(yè)精于勤荒于嬉 行成于思?xì)в陔S →【醫(yī)學(xué)生物 PPT，歡迎收藏分享】網(wǎng)友 14 ? Rosiglitazone therapy reduced serum levels of insulin and CRP and the rate of stent restenosis (% with rosiglitazone vs. % in the control group [P = ]). ? Rosiglitazone reduced serum CRP levels by mg/L (SD, ) pared with a mg/L reduction in the control group (P ). Both groups received adjunctive therapy with statins, exercise, and diet, and both had similar mean levels of HbA1c and serum lipids. ? The authors concluded that rosiglitazone therapy reduces instent restenosis in diabetic p39。ts with CAD. The mechanism of action is likely to be inhibition of the immunomodulators and cytokines associated with atherogenesis. ? The authors imply that rosiglitazone might represent a relatively safe and inexpensive alternative to brachytherapy or drugeluting stents. DM Care. 2022。27:265460. HLJ 業(yè)精于勤荒于嬉 行成于思?xì)в陔S →【醫(yī)學(xué)生物 PPT，歡迎收藏分享】網(wǎng)友 15 Telmisartan Is Comparable to Enala