Pathophysiology

Focus on incretin-based therapies: targeting the core defects of type 2 diabetes

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Jellinger PS. Focus on incretin-based therapies: targeting the core defects of type 2 diabetes. Postgrad Med. 2011 Jan;123(1):53-65. Glucose homeostasis is regulated by a complex interaction of hormones, principally including insulin, glucagon, amylin, and the incretins. Glucagon, cortisol, catecholamines, and growth hormone serve as the classic glucose counterregulatory hormones.

Effects of intensive therapy and antecedent hypoglycemia on counterregulatory responses to hypoglycemia in type 2 diabetes

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Davis SN, Mann S, Briscoe VJ, Ertl AC, Tate DB. Effects of intensive therapy and antecedent hypoglycemia on counterregulatory responses to hypoglycemia in type 2 diabetes. Diabetes. 2009;58(3):701-709. The physiology of counterregulatory responses during hypoglycemia in intensively treated type 2 diabetic subjects is largely unknown.

Efficacy of glimepiride/metformin combination versus glibenclamide/metformin in patients with uncontrolled type 2 diabetes mellitus

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Gonzalez-Ortiz M, Guerrero-Romero JF, Violante-Ortiz R, et al. Efficacy of glimepiride/metformin combination versus glibenclamide/metformin in patients with uncontrolled type 2 diabetes mellitus. J Diabetes and Its Complications. 2008 Oct 10. [Epub ahead of print]. The aim of this study was to compare the efficacy of glimepiride/metformin combination versus glibenclamide/metformin for reaching glycemic control in patients with uncontrolled type 2 diabetes mellitus.

The role of incretins in cardiovascular control

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Mafong DD, Henry RR. The role of incretins in cardiovascular control. Curr Hypertens Rep. 2009;11(1):18-22. Glucagon-like peptide-1 (GLP-1) is an incretin secreted in response to nutrient ingestion. Understanding the incretin effect on diabetes pathophysiology has led to development of a new class of agents termed incretin mimetics. Exenatide is the first GLP-1 agonist approved to treat type 2 diabetes mellitus (T2DM).

Antihyperglycaemic therapy in elderly patients with type 2 diabetes: potential role of incretin mimetics and DPP-4 inhibitors

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Mathieu C, Bollaerts K. Antihyperglycaemic therapy in elderly patients with type 2 diabetes: potential role of incretin mimetics and DPP-4 inhibitors. Int J Clin Pract. 2007;(154):29-37. Management of elderly patients with type II diabetes is complicated by age-related changes in physiology, comorbidities, polypharmacy and heterogeneity of functional status.

Minireview: pharmacogenetics and beyond: the interaction of therapeutic response, beta-cell physiology, and genetics in diabetes

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Hattersley AT, Pearson ER. Minireview: pharmacogenetics and beyond: the interaction of therapeutic response, beta-cell physiology, and genetics in diabetes. Endocrinology. 2006;147:2657-2663. Defining the molecular genetics of diabetes gives new insight into the underlying etiology and so should help improve treatment. The genetic etiology is now known for most patients with beta-cell monogenic diabetes, allowing genetic classification. 

Incretin mimetics as emerging treatments for type 2 diabetes

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Joy SV, Rodgers PT, Scates AC. Incretin mimetics as emerging treatments for type 2 diabetes. Ann Pharmacother. 2005;39:110-118. To review the physiology, pharmacology, and clinical efficacy of glucagon-like peptide (GLP-1) and the incretin mimetics exenatide and liraglutide in clinical studies.

Effect of Moderate Alcohol Consumption on Adiponectin, Tumor Necrosis Factor-a, and Insulin Sensitivity

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Sierksma A, Patel H, Ouchi N, et al. Effect of Moderate Alcohol Consumption on Adiponectin, Tumor Necrosis Factor-a, and Insulin Sensitivity. Diabetes Care. 2004;27:184-189. Epidemiological studies suggest that moderate alcohol consumers have enhanced insulin sensitivity and a reduced risk of type 2 diabetes. Adiponectin, an adipocyte-derived plasma protein, has been found to be negatively associated with adiposity and positively associated with insulin sensitivity.

Mode of Onset of Type 2 Diabetes from Normal or Impaired Glucose Tolerance

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Ferrannini E, Nannipieri M, Williams K, et al. Mode of Onset of Type 2 Diabetes from Normal or Impaired Glucose Tolerance. Diabetes. 2004;53:160-165. Fasting plasma glucose concentrations (FPG) predict development of type 2 diabetes. Whether hyperglycemia evolves from normoglycemia gradually over time or as a step increase is not known.

Cardiovascular Risk Factors in Childhood and Carotid Artery Intimal-Media Thickness in Adulthood

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Raitakari OT, Juonala M, Kähönen M, et al. Cardiovascular Risk Factors in Childhood and Carotid Artery Intima-Media Thickness in Adulthood. JAMA. 2003;290:2277-2283. Exposure to cardiovascular risk factors during childhood and adolescence may be associated with the development of atherosclerosis later in life.

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