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  Français - August 16, 2011
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  Topic  

Pathophysiology

In order to better understand the causes of Type 2 diabetes, certain fundamental studies are necessary. Many elements are presently being studied: production of insulin, method of hormonal action, signals produced by its production, chain reaction of cells when in contact with the hormone, receptors involved in the process of detection, causes of insulin insensitivity... The development of a better understanding of each of these factors may help prevent and treat Type 2 diabetes.

Presentations listing

Polyglandular Autoimmune Syndromes - Dr. Patricia Crock
Diabetic Kidney Disease 2008 - Dr. Nicole Isbel
Autoimmune Diseases: Impact on Diabetes - Dr. Trisha O'Moore-Sullivan
Relationship between hyperglycaemia and micro- and... - Prof. Timothy Davis
Relationship between underlying causes of insulin... - Prof. Christopher Nolan
Relationship between hyperglycaemia and micro- and... - Prof. Timothy Davis
CVD in Type 2 Diabetes: Who and How to Investigate - Dr. Trisha O'Moore-Sullivan
Underlying Causes of Disease Progression: The Role of... - Prof. Nikolaus Marx
Women, CHD & Diabetes - Dr. Pat Phillips
Nox, Nox, Knocking: The Emerging Roles of NADPH Oxidases in... - Dr. Grant Drummond
Pathophysiology of Type 2 Diabetes - The Critical Role of... - Prof. Steven Kahn
The Clinical Implications of Advanced Glycation - Dr. Merlin C. Thomas
Renin-Angiotensin System: Beyond the Kidney - Prof. Mark E. Cooper
Type 2 Diabetes and Cardiovascular Disease: The Neel... - Prof. Peter J. Grant
New Developments in the Understanding of ß-cell Failure in... - Dr. Jenny Gunton
Gastric Motility and Glycaemic Control in Diabetes - The... - Prof. Michael Horowitz
Diabetes Related Foot Complications - Dr. Paul Wraight
The Erectile-Endothelial Dysfunction Nexus: Implications... - Prof. Gerald Watts
Management of Diabetic Retinopathy: What’s New? - Prof. Paul Mitchell
Quality of Life & Diabetes - Dr. Pat Phillips
Interaction of Metabolic with Haemodynamic Factors in... - Prof. Mark E. Cooper
Introduction - Prof. Jean-Pierre Després
Microvascular Complications of Type 2 Diabetes: New Insight... - Dr. Luigi Gnudi
Adiponectin: Conducting the Metabolic Orchestra - Prof. John Prins
Early Retinal Microvascular Changes in Diabetes: Insights... - Dr. Tien Y. Wong
Development of Atherosis in the Placental Bed of Diabetic... - Prof. Eileen Gallery
Adipose Tissue as an Inflammatory Organ (Endocrine Tumor)... - Prof. John N. Fain
Muscle - Adipose Tissue "Crosstalk" :... - Prof. Edward W. Kraegen
Resistin and Fasting-Induced Adipose Factor (FIAF) in the... - Dr. Russell Brown
Postprandial Hyperglycemia and Cardiovascular Disease - Prof. Antonio Ceriello
Increased Risk of Coronary Events in Dysglycemic Patients:... - Dr. Richard W. Nesto
Lessons from the UKPDS - Prof. Alastair Gray
Effect of Fructose Overfeeding and Fish Oil Administration... - Dr. David Faeh
Neural Control of Energy Balance - Prof. Stephen C. Woods
Advanced Glycation in Diabetic Complications - Dr. Stephen Twigg
Adiponectin - Prof. John Prins
The Role of Inflammation in Metabolic Disease - Prof. John Prins
Mechanism and Consequences of Fat-induced Gluconeogenesis - Prof. Joseph Proietto
CRP, Inflammation, and its Relationship to Cardiovascular... - Dr. Paul M. Ridker
Silent myocardial ischaemia and infarction in type II... - Prof. Timothy Davis
What are the manifestations of beta-cell dysfunction and... - Dr. Steven V. Edelman
Inflammation and Atherosclerosis - Dr. Peter Libby
ß-cell Failure in Type 2 Diabetes: The Case for Earlier... - Prof. Steven Kahn
Impaired Microvascular Recruitment and Muscle Insulin... - Dr. Michael G. Clark
New Insights in Diabetic Retinopathy - Dr. Filiberto Altomare
The Wheres and Whats of Body Fat Distribution - Prof. Steven Kahn
Nuclear Receptor Diseases Mechanisms - Dr. Mitchell Lazar
Beta Cell Failure in type 2 Diabetes: A Paradigm Revisited - Dr. Minna Woo
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 Presentation 

"Polyglandular Autoimmune Syndromes"

Dr. Patricia Crock (biography)
English - 2009-03-09 - 49 minutes
(46 slides)

Summary :
Dr. Crock starts with a case presentation of a boy with Addison's disease, glucocorticoid and mineralocorticoid deficiency, and a family history of polyglandular autoimmune disease.

Autoimmune endocrinopathies cluster, for example patients with type 1 diabetes may have Hashimoto's disease or coeliac disease. Although Addison's disease is rare it may be indicated by falling insulin...

Learning objectives :
After viewing this presentation the participant will be able to discuss:
- Autoimmune diseases which cluster with type 1 diabetes
- A classical case presentation of polyglandular autoimmune disease
- Target autoantigens and autoantibody markers
- How to avoid some diagnostic pitfalls
- Monogenic Autoimmunity Syndromes
- Polyglandular Autoimmune syndromes

   


 Presentation 

"Diabetic Kidney Disease 2008"

Dr. Nicole Isbel (biography)
English - 2008-05-17 - 48 minutes
(57 slides)

Summary :
Renal replacement requirements have increased almost entirely due to the increase in the incidence of type 2 diabetes (T2D). Chronic kidney disease (CKD) occurs in about 13% of patients with T2D (1).

However, loss of renal function is generally asymptomatic until the glomerular filtration rate (GFR) falls below 30 milliters per minute. Thus, it is important to monitor the GFR. ...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

-The prevalence of chronic kidney disease (CKD) among diabetic patients
-How CKD is diagnosed
-How to delay the loss of renal function
-CKD as an independent cardiovascular risk factor
-Who and when to refer to a nephrologist

Bibliographic references :
1) Kramer et al Renal Insufficiency in the Absence of Albuminuria and Retinopathy Among Adults With Type 2 Diabetes Mellitus JAMA. 2003;289:3273-3277

(2) PREVEND study group Macroalbuminuria Is a Better Risk Marker than Low Estimated GFR to Identify Individuals at Risk for Accelerated GFR Loss in Population Screening J Am Soc Nephrol 17: 2582-2590, 2006

(3) Bakris and Weir Angiotensin-Converting Enzyme Inhibitor–Associated Elevations in Serum Creatinine Arch Intern Med. 2000;160:685-693

   


 Presentation 

"Autoimmune Diseases: Impact on Diabetes"

Dr. Trisha O'Moore-Sullivan (biography)
English - 2007-11-21 - 36 minutes
(33 slides)

Summary :
Autoimmune diseases are found more commonly in people with Type 1 Diabetes (T1DM) than amongst the general population. Dr. O'Moore-Sullivan discusses the implications of a diagnosis of autoimmune disease accompanying T1DM, which relate to the management of both conditions, as well as to the screening for other autoimmune diseases in the patient and his family.

A common...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

-The association of Type 1 Diabetes with the following endocrine autoimmune diseases:
Autoimmune thyroid disease (AIT)
Autoimmune Addison's Disease (AD)

-The association of Type 1 Diabetes with a non-endocrine autoimmune disease, Coeliac Disease (CD)

-Autoimmune Polyendocrine Syndromes (APS)

Bibliographic references :
Jennifer M. Barker Type 1 Diabetes-Associated Autoimmunity: Natural History, Genetic Associations, and ScreeningThe Journal of Clinical Endocrinology & Metabolism Vol. 91, No. 4 1210-1217

   


 Presentation 

"Relationship between hyperglycaemia and micro- and macrovascular outcomes"

Prof. Timothy Davis (biography)
English - 2007-11-10 - 34 minutes
(29 slides)

Summary :
Long-term randomised controlled trials have provided good evidence for the relationship between glycaemia and the risk of vascular complications of diabetes.

The DCCT study in type 1 diabetic patients showed that intensive treatment was associated with significant improvements in microvascular outcomes. There was a low number of cardiovascular events, however fewer events were seen...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- The relationship between glycaemia and vascular outcomes in type 1 and type 2 diabetes
- Evidence in support of a 'legacy' effect of good glycaemic control

   


 Presentation 

"Relationship between underlying causes of insulin resistance and beta-cell function"

Prof. Christopher Nolan (biography)
English - 2007-11-10 - 34 minutes
(38 slides)

Summary :
Islet beta-cell failure is a key factor in type 2 diabetes pathogenesis. It is progressive, and occurs in the context of islets compensating for insulin resistance.

Beta-cell failure occurs in “susceptible” islets, and the mechanisms involved are of the initiation and progression types.

The factors that make islets susceptible to dysfunction need to be discovered,...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- GDM as an insulin resistant state
- Insulin secretion in women with previous GDM
- The influence of GDM on long-term control of glucose tolerance
- The islet beta-cell in T2DM
- Glucolipotoxicity as a proposed mechanism of beta-cell failure in T2DM

Bibliographic references :
Marc Prentki and Christopher J. NolanIslet β cell failure in type 2 diabetes J Clin Invest. 2006 July 3; 116(7): 1802–1812.

   


 Presentation 

"Relationship between hyperglycaemia and micro- and macrovascular outcomes"

Prof. Timothy Davis (biography)
English - 2007-11-10 - 34 minutes
(29 slides)

Summary :
Long-term randomised controlled trials have provided good evidence for the relationship between glycaemia and the risk of vascular complications of diabetes.

The DCCT study in type 1 diabetic patients showed that intensive treatment was associated with significant improvements in microvascular outcomes. There was a low number of cardiovascular events, however fewer events were seen...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- The relationship between glycaemia and vascular outcomes in type 1 and type 2 diabetes
- Evidence in support of a 'legacy' effect of good glycaemic control

   


 Presentation 

"CVD in Type 2 Diabetes: Who and How to Investigate"

Dr. Trisha O'Moore-Sullivan (biography)
English - 2007-03-03 - 39 minutes
(40 slides)

Summary :
In this presentation Dr. O'Moore-Sullivan talks about investigations that can be done in type 2 diabetic patients who are symptomatic for coronary artery disease (CAD), and some potential means of identifying high-risk asymptomatic patients.

Coronary angiography is the "gold standard" for the detection of coronary artery disease (CAD), whereas multi-slice computed tomography,...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- Anatomical and functional tests for assessing CAD
- Imaging and prognosis in diabetic patients
- Data from the DIAD study: proportion of asymptomatic type 2 diabetic patients having an abnormal SPECT test
- The role of coronary artery calcium scoring in the identification of high-risk asymptomatic type 2 diabetic patients

Bibliographic references :
1. Bax JJ, Inzucchi SE, Bonow RO, Schuijf JD, Freeman MR, Barrett EJ; Global Dialogue Group for the Evaluation of Cardiovascular Risk in Patients with Diabetes.Cardiac Imaging for Risk Stratification in Diabetes Diabetes Care 30:1295-1304, 2007.

2. Wackers FJ, Young LH, Inzucchi SE, Chyun DA, Davey JA, Barrett EJ, Taillefer R, Wittlin SD, Heller GV, Filipchuk N, Engel S, Ratner RE, Iskandrian AE; Detection of Ischemia in Asymptomatic Diabetics Investigators.Detection of silent myocardial ischemia in asymptomatic diabetic subjects: the DIAD study. Diabetes Care 27:1954-1961, 2004.

3. Anand DV, Lim E, Hopkins D, Corder R, Shaw LJ, Sharp P, Lipkin D, Lahiri A. Risk stratification in uncomplicated type 2 diabetes: prospective evaluation of the combined use of coronary artery calcium imaging and selective myocardial perfusion scintigraphy Eur Heart J. 2006 Mar;27(6):713-21.

   


 Presentation 

"Underlying Causes of Disease Progression: The Role of PPAR-gamma and the Metabolic and Vascular Actions of the TZDs"

Prof. Nikolaus Marx (biography)
English - 2006-12-04 - 28 minutes
(51 slides)

Summary :
Type 2 diabetes mellitus is a complex metabolic disorder associated with various risk factors like dyslipidaemia, inflammation and hypertension. Patients with insulin resistance and type 2 diabetes mellitus exhibit an increased propensity to develop arteriosclerosis with its sequelae acute myocardial infarction and stroke. Anti-diabetic, PARγ−activating, thiazolidinediones (TZDs,...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- Metabolic and vascular aspects of insulin resistance
- Mechanism of action of the insulin-sensitizing thiazolidinedione (TZD) drugs
- Metabolic effects of TZDs, including effects on HDL-C and LDL particle size
- Vascular action of TZDs: in vitro and in vivo evidence for anti-inflammatory and anti-atherogenic properties

   


 Presentation 

"Women, CHD & Diabetes"

Dr. Pat Phillips (biography)
English - 2006-10-27 - 27 minutes
(29 slides)

Summary :
In this presentation Dr. Phillips talks about the importance of coronary heart disease (CHD) in diabetes, particularly in women.

Is diabetes a CHD risk equivalent? A well-known case-control study reported by Haffner et al. in 1998 suggested that diabetic patients without previous myocardial infarction have as high a risk of myocardial infarction as non-diabetic patients with...

Learning objectives :
After viewing this presentation, the participant will be able to discuss:

- Coronary heart disease is very common in those with type 2 diabetes and vice versa.
- In women the presence of diabetes increases coronary risk much more than in men and equalises coronary risk for men and women.
- Many women and their professionals do not appreciate the risk of coronary heart disease in women nor do they appreciate that diabetes increases a woman’s coronary risk as much as it does.

Bibliographic references :
1. Haffner SM, Lehto S, Ronnemaa T, Pyorala K, Laakso M.Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med. 1998 Jul 23;339(4):229-34.

2. S Lehto, T Ronnemaa, SM Haffner, K Pyorala, V Kallio and M LaaksoDyslipidemia and hyperglycemia predict coronary heart disease events in middle-aged patients with NIDDM Diabetes. 1997 Aug;46(8):1354-9.

3. Juutilainen A, Kortelainen S, Lehto S, Ronnemaa T, Pyorala K, Laakso M.Gender Difference in the Impact of Type 2 Diabetes on Coronary Heart Disease Risk Diabetes Care 27:2898-2904, 2004.

   


 Presentation 

"Nox, Nox, Knocking: The Emerging Roles of NADPH Oxidases in Vascular Physiology & Disease"

Dr. Grant Drummond (biography)
English - 2006-09-16 - 49 minutes
(41 slides)

Summary :
"Despite the bad press about reactive oxygen species, they are not always that bad," says Dr. Drummond. "In fact they are critical for cell signaling processes." What happens when oxygen free radicals/reactive oxygen species are overproduced, and what are the potential implications for lowering oxidative stress in the vasculature?

All of the known cardiovascular risk factors are...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- What are reactive oxygen species?
- Effects of overproduction of reactive oxygen species in disease states
- Clinical trials with antioxidants
- NADPH oxidase isoforms and superoxide production
- Proposed mechanisms of vascular free radical production

Bibliographic references :
1. Young-Ah Suh, Rebecca S. Arnold, Bernard Lassegue, Jing Shi, Xiangxi Xu, Dan Sorescu, Andrew B. Chung, Kathy K. Griendling and J. David LambethCell transformation by the superoxide-generating oxidase Mox1 Nature 1999;401:79.

2. Bernard Lassègue, Dan Sorescu, Katalin Szöcs, QiQin Yin, Marjorie Akers, Yong Zhang, Sharon L. Grant, J. David Lambeth, Kathy K. Griendling Novel gp91phox Homologues in Vascular Smooth Muscle Cells: nox1 Mediates Angiotensin II–Induced Superoxide Formation and Redox-Sensitive Signaling Pathways Circulation Research. 2001;88:888.

3. Cornelius F.H. Mueller; Karine Laude; J. Scott McNally; David G. Harrison Redox Mechanisms in Blood Vessels Arteriosclerosis, Thrombosis, and Vascular Biology. 2005;25:274.

   


 Presentation 

"Pathophysiology of Type 2 Diabetes - The Critical Role of the Beta-Cell"

Prof. Steven Kahn (biography)
English - 2006-09-13 - 40 minutes
(17 slides)

Summary :
The beta-cell is critical in the maintenance of glucose tolerance and a marked decrease in beta-cell function is clearly associated with the development of hyperglycaemia in type 2 diabetes. Understanding the importance of insulin sensitivity in modulating beta-cell function has demonstrated that the beta-cell is capable of dramatically increasing insulin release in response to increased...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- Loss of the acute insulin response in T2DM
- Beta-cell adaptation to insulin sensitivity
- Beta-cell function in relation to fasting plasma glucose
- Beta-cell volume in IFG and T2DM

Bibliographic references :
1. Kahn SE.The relative contributions of insulin resistance and b-cell dysfunction to the pathophysiology of type 2 diabetes.Diabetologia 46:3-19, 2003

2. Utzschneider KM, Prigeon RL, Carr DB, Hull RL,Tong J, Shofer JB, Retzlaff BM, Knopp RH, Kahn SE. Impact of differences in fasting glucose and glucose tolerance on the hyperbolic relationship between insulin sensitivity and insulin responses.Diabetes Care 29:356-362, 2006

3. Holman RR. Assessing the potential for alpha-glucosidase inhibitors in prediabetic states. Diabetes Res Clin Pract 40 (Suppl):S21-S25, 1998

4. Leung N, Sakaue T, Carpentier A, Uffelman K, Giacca A, Lewis GF. Prolonged increase of plasma non-esterified fatty acids fully abolishes the stimulatory effect of 24 hours of moderate hyperglycaemia on insulin sensitivity and pancreatic b-cell function in obese men. Diabetologia 47:204-213, 2004

5. Kloppel G, Lohr M, Habich K,Oberholzer M, Heitz PU. Islet pathology and the pathogenesis of type 1 and type 2 diabetes mellitus revisited. Surv Synth Pathol Res 4:110-125, 1985

6. Butler AE, Janson J, Bonner-Weir S, Ritzel R, Rizza RA, Butler PC. b-cell deficit and increased b-cell apoptosis in humans with type 2 diabetes.Diabetes 52:102-110, 2003

7. Hull RL,Westermark GT,Westermark P, Kahn SE. Islet amyloid: a critical entity in the pathogenesis of type 2 diabetes. J Clin Endocrinol Metab 89:3629-3643, 2004

8. Barroso I.Genetics of type 2 diabetes.Diabet Med 22:517-535, 2005

   


 Presentation 

"The Clinical Implications of Advanced Glycation"

Dr. Merlin C. Thomas (biography)
English - 2006-09-13 - 43 minutes
(62 slides)

Summary :
In this presentation Dr. Merlin Thomas of the Baker Heart Research Institute talks about the relevance of advanced glycation in diabetic patients. A number of haemodynamic and metabolic factors operate in chronic hyperglycemia, says Dr. Thomas, however, one pivotal pathway appears to be the formation and accumulation of advanced glycation end-products (AGEs).

AGEs are formed by ...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- What are AGEs?
- Experimental evidence for AGEs as downstream mediators of hyperglycemic injury
- Ten reasons why AGEs are important in the clinic

Bibliographic references :
1. Josephine M. Forbes, Mark E. Cooper, Matthew D. Oldfield and Merlin C. Thomas Role of Advanced Glycation End Products in Diabetic Nephropathy J Am Soc Nephrol 14:S254-S258, 2003.

2. Helen Vlassara. The AGE-receptor in the pathogenesis of diabetic complications Diabetes/Metabolism Research and Reviews. Volume 17, Issue 6 , Pages 436 - 443.

   


 Presentation 

"Renin-Angiotensin System: Beyond the Kidney"

Prof. Mark E. Cooper (biography)
English - 2006-09-01 - 28 minutes
(45 slides)

Summary :
In this presentation Prof. Cooper talks about effects of the renin-angiotensin system in the vasculature, the retina and the pancreatic beta cell.

Diabetes is associated with accelerated atherosclerosis, for which elevated blood pressure is one risk factor. How would the renin-angiotensin system be implicated in this increased risk? Angiotensin II raises blood pressure by acting as...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

Clinical and experimental evidence for extra-renal benefits of renin-angiotensin system (RAS) blockade in the:
- Vasculature
- Retina
- Pancreas

Bibliographic references :
1. Riccardo Candido, MD; Karin A. Jandeleit-Dahm, MD, PhD; Zemin Cao, MD; Stefan P. Nesteroff;; Wendy C. Burns, BSc, (Hons), BEd; Stephen M. Twigg, MBBS, FRACP, PhD; Rodney J. Dilley, PhD; Mark E. Cooper, MBBS, FRACP, PhD; Terri J. Allen, PhDPrevention of Accelerated Atherosclerosis by Angiotensin-Converting Enzyme Inhibition in Diabetic Apolipoprotein E–Deficient Mice Circulation. 2002;106:246.

2. Riccardo Candido, MD; Terri J. Allen, PhD; Markus Lassila, PhD; Zemin Cao, MD; Vicki Thallas, BSc; Mark E. Cooper, MBBS, FRACP, PhD; Karin A. Jandeleit-Dahm, MD, PhDIrbesartan but Not Amlodipine Suppresses Diabetes-Associated Atherosclerosis Circulation. 2004;109:1536-1542.

3. Christina J. Moravski; Darren J. Kelly; Mark E. Cooper; Richard E. Gilbert; John F. Bertram; Shahnaz Shahinfar; Sandford L. Skinner; Jennifer L. Wilkinson-Berka Retinal Neovascularization Is Prevented by Blockade of the Renin-Angiotensin System Hypertension. 2000;36:1099.

4. Sarlos et al. Am J Pathol 2004.

5. Jandeleit-Dahm, Karin AM; Tikellis, Christos; Reid, Christopher M; Johnston, Colin I; Cooper, Mark EWhy blockade of the renin-angiotensin system reduces the incidence of new-onset diabetes. Journal of Hypertension. 23(3):463-473, March 2005.

6. Tikellis C, Wookey PJ, Candido R, Andrikopoulos S, Thomas MC, Cooper ME.Improved Islet Morphology after Blockade of the Renin- Angiotensin System in the ZDF Rat Diabetes 53:989-997, 2004.

   


 Presentation 

"Type 2 Diabetes and Cardiovascular Disease: The Neel Hypothesis Revisited"

Prof. Peter J. Grant (biography)
English - 2006-05-07 - 50 minutes
(47 slides)

Summary :
In this presentation Prof. Grant talks about the Common Soil and Thrifty Genotype hypotheses and how they can be interpreted in light of new information that became available since their conception.

According to the Common Soil Hypothesis put forth by Stern in the 1980s, diabetes and cardiovascular disease are the same condition, underpinned by common genetic and environmental...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- The primary function of inflammation and thrombosis;
- The physiological nature of the adipocyte response to fat loading;

- The inflammatory atherothrombotic insulin resistance syndrome underpinning diabetes and cardiovascular disease;
- The relationship of abnormal cyclical responses to diabetes and cardiovascular disease.

Bibliographic references :
Reaven, GM. Banting Lecture 1988. Role of Insulin Resistance in Human Disease Diabetes. 1988; 37(12): 1595-1607

Norhammar, A., Tenerz, A., Nilsson, G., Hamsten, A., Efendic, S., Ryden, L., Malmberg, K. Glucose Metabolism in Patients with Acute Myocardial Infarction and no Previous Diagnosis of Diabetes Mellitus: A Prospective Study The Lancet. June 2002; 359(9324): 2140-2144

Moreno, PR., Murcia, AM., Palacios, IF., Leon, MN., Bernardi, VH., Fuster, V., Fallon, JT. Coronary Composition and Macrophage Infiltration in Atherectomy Specimens From Patients With Diabetes Mellitus Circulation. 2000; 102: 2180

Vinik, AI., Erbas, T., Park, TS., Nolan, R., Pittenger, GL. Platelet Dysfunction in Type 2 Diabetes Diabetes Care. 2001; (24): 1476-1485

Freeman, MS., Mansfield, MW., Barrett, JH., Grant, PJ. Genetic Contribution to Circulating Levels of Hemostatic Factors in Healthy Families With Effects of Known Genetic Polymorphisms on Heritability Arteriosclerosis, Thrombosis, and Vascular Biology. 2002; 22: 506

Dunn, EJ., Ariens, RAS., Grant, PJ. The Influence of Type 2 Diabetes on Fibrin Structure and Function Diabetologia. 2005; 48(6): 1198-1206

Dunlap, JC. Molecular Bases for Circadian Clocks Cell. January 1999; 96(2): 271-290

Ando, H., Yanagihara, H., Hayashi, Y., Obi, Y., Tsuruoka, S., Takamura, T., Kaneko, S., Fujimura, A. Rhythmic Messenger Ribonucleic Acid Expression of Clock Genes and Adipocytokines in Mouse Visceral Adipose Tissue Endocrinology. 2005; 146(12): 5631-5636

Montagnani, M., Golovchenko, I., Kim, I., Koh, GY., Goalstone, ML., Mundhekar, AN., Johansen, M., Kucik, DF., Quon, MJ., Draznin, B. Inhibition of Phosphatidylinositol 3-Kinase Enhances Mitogenic Actions of Insulin in Endothelial Cells J. Biol. Chem. January 2002; 277(3): 1794-1799

Turek, FW., Joshu, C., Kohsaka, A., Lin, E., Ivanova, G., McDearmon, E., Laposky, A., Losee-Olson, S., Easton, A., Jensen, DR., Eckel, RH., Takahashi, JS., Bass, J. Obesity and Metabolic Syndrome in Circadian Clock Mutant Mice Science. May 2005; 308(5724): 1043-1045

   


 Presentation 

"New Developments in the Understanding of ß-cell Failure in Humans"

Dr. Jenny Gunton (biography)
English - 2006-05-06 - 25 minutes
(21 slides)

Summary :
In this presentation, Dr. Gunton talks about the importance of beta-cell dysfunction in the pathogenesis of type 2 diabetes, and genetic causes of diabetes.

Maturity-onset diabetes of the young (MODY) is thought to make up 5-10% of type 2 diabetes. MODY 2 is the commonest form, related to a mutation in the glucokinase gene. Dr. Gunton reviews the different types of MODY mutations...

Learning objectives :
After viewing this presentation, the participant will be able to discuss:

- The importance of beta-cell dysfunction in the pathogenesis of type 2 diabetes;
- Genetic causes of diabetes;
- Expression levels of various genes in type 2 diabetic islets;
- A novel candidate gene: ARNT.

   


 Presentation 

"Gastric Motility and Glycaemic Control in Diabetes - The Chicken and the Egg Revisited"

Prof. Michael Horowitz (biography)
English - 2006-05-06 - 38 minutes
(65 slides)

Summary :
In this presentation Prof. Horowitz talks about delayed gastric emptying in diabetes and strategies for its management.

Delayed gastric emptying is fairly common in type 1 and type 2 diabetic patients, though gastroparesis may not be associated with a poor prognosis. Prof. Horowitz talks about the natural history of disordered gastric emptying in diabetes and reviews some evidence...

Learning objectives :
After viewing this presentation, the participant will be able to discuss:

- The prevalence and natural history of disordered gastric emptying in diabetes
- The effect of acute hyperglycaemia and hypoglycaemia on gastric emptying
- The importance of gastric emptying in postprandial glycaemia
- Strategies for the management of symptomatic gastroparesis

Bibliographic references :
Schvarcz E, Palmer M, Ingberg CM, Aman J, Berne C.
Increased prevalence of upper gastrointestinal symptoms in long-term type 1 diabetes mellitus.
Diabet Med. 1996 May;13(5):478-81.

Ceriello A, Hanefeld M, Leiter L, Monnier L, Moses A, Owens D, Tajima N, Tuomilehto J.
Postprandial glucose regulation and diabetic complications. Arch Intern Med. 2004 Oct 25;164(19):2090-5.

Jones KL, Horowitz M, Carney BI, Wishart JM, Guha S, Green L. Gastric emptying in early noninsulin-dependent diabetes mellitus. J Nucl Med. 1996 Oct;37(10):1643-8.

Sutep Gonlachanvit, Chia-Wen Hsu, Guenther H. Boden, Linda C. Knight, Alan H. Maurer, Robert S. Fisher and Henry P. ParkmanEffect of Altering Gastric Emptying on Postprandial Plasma Glucose Concentrations Following a Physiologic Meal in Type-II Diabetic Patients Dig Dis Sci. 2003 Mar;48(3):488-97.

Diana Gentilcore, Reawika Chaikomin, Karen L. Jones, Antonietta Russo, Christine Feinle-Bisset, Judith M. Wishart, Christopher K. Rayner and Michael HorowitzEffects of Fat on Gastric Emptying of and the Glycemic, Insulin, and Incretin Responses to a Carbohydrate Meal in Type 2 Diabetes J Clin Endocrinol Metab. 2006 Jun;91(6):2062-7.

Juris J. Meier, Guido Kemmeries, Jens J. Holst, and Michael A. NauckErythromycin Antagonizes the Deceleration of Gastric Emptying by Glucagon-Like Peptide 1 and Unmasks Its Insulinotropic Effect in Healthy Subjects Diabetes 54:2212-2218, 2005.

Little TJ, Pilichiewicz AN, Russo A, Phillips L, Jones KL, Nauck MA, Wishart J, Horowitz M, Feinle-Bisset C.Effects of Intravenous Glucagon-Like Peptide-1 on Gastric Emptying and Intragastric Distribution in Healthy Subjects: Relationships with Postprandial Glycemic and Insulinemic Responses J Clin Endocrinol Metab. 2006 May;91(5):1916-23.

   


 Presentation 

"Diabetes Related Foot Complications"

Dr. Paul Wraight (biography)
English - 2006-05-06 - 34 minutes
(18 slides)

Summary :
Approximately 20 percent of the diabetic population will develop a foot complication during their lifetime, says Dr. Wraight. These complications come in different kinds, such as pressure lesions or burns in a neuropathic foot, neuropathic ulcers due to ill-fitting shoes and other more serious conditions. These conditions are usually precipitated by neuropathy, trauma or foot deformity, and the...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- Different kinds of diabetic foot complications
- The pathogenesis of diabetic foot complications
- Diabetic pedal osteomyelitis: diagnosis and treatment strategies

Bibliographic references :
1. Morrison WB, Schweitzer ME, Wapner KL, Hecht PJ, Gannon FH, Behm WR.Osteomyelitis in feet of diabetics: clinical accuracy, surgical utility, and cost-effectiveness of MR imaging. Radiology. 1995 Aug;196(2):557-64.

2. G Ha Van, H Siney, JP Danan, C Sachon and A GrimaldiTreatment of osteomyelitis in the diabetic foot. Contribution of conservative surgery Diabetes Care. 1996 Nov;19(11):1257-60.

   


 Presentation 

"The Erectile-Endothelial Dysfunction Nexus: Implications for Cardiovascular Disease"

Prof. Gerald Watts (biography)
English - 2006-05-06 - 35 minutes
(24 slides)

Summary :
In this presentation Prof. Watts talks about the association between endothelial dysfunction and erectile dysfunction.

A number of studies have shown that worsening endothelial dysfunction is predictive of cardiac events (1), and both endothelial dysfunction and erectile dysfunction have been associated with cardiovascular risk factors (2,3). Also of interest is a study published...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- Endothelial dysfunction as a predictor of cardiac events
- Mechanisms of induction of endothelial dysfunction by conventional risk factors
- The association of endothelial dysfunction with cardiovascular risk factors
- The association of erectile dysfunction with cardiovascular risk factors
- Evidence for vascular endothelial dysfunction in type 2 diabetic men with erectile dysfunction
- Evidence to suggest erectile dysfunction as an independent predictor of cardiovascular disease
- Effects of treatment therapies for erectile dysfunction

Bibliographic references :
1. Volker Schächinger, MD; Martina B. Britten, MD; Andreas M. Zeiher, MDPrognostic Impact of Coronary Vasodilator Dysfunction on Adverse Long-Term Outcome of Coronary Heart Disease Circulation. 2000;101:1899.

2. Celermajer DS, Sorensen KE, Bull C, Robinson J, Deanfield JE.Endothelium-dependent dilation in the systemic arteries of asymptomatic subjects relates to coronary risk factors and their interaction. J Am Coll Cardiol. 1994 Nov 15;24(6):1468-74.

3. Virag R, Bouilly P, Frydman D."About arterial risk factors and impotence." Lancet. 1985 May 11;1(8437):1109-10.

4. L. De Angelis, M. A. Marfella, M. Siniscalchi, L. Marino, F. Nappo, F. Giugliano, D. De Lucia, D. Giugliano. Erectile and endothelial dysfunction in Type II diabetes: a possible link Diabetologia. 2001 Sep;44(9):1155-60.

5. Yavuzgil O, Altay B, Zoghi M, Gurgun C, Kayikcioglu M, Kultursay H.Endothelial function in patients with vasculogenic erectile dysfunction Int J Cardiol. 2005 Aug 3;103(1):19-26.

6. Chiurlia E, D'Amico R, Ratti C, Granata AR, Romagnoli R, Modena MG.Subclinical Coronary Artery Atherosclerosis in Patients With Erectile Dysfunction J Am Coll Cardiol. 2005 Oct 18;46(8):1503-6.

7. Carmine Gazzaruso, MD; Stefano Giordanetti, MD; Emanuela De Amici, MD; Gianandrea Bertone, MD; Colomba Falcone, MD; Diego Geroldi, MD; Pietro Fratino, MD; Sebastiano B. Solerte, MD; Adriana Garzaniti, MD. Relationship Between Erectile Dysfunction and Silent Myocardial Ischemia in Apparently Uncomplicated Type 2 Diabetic Patients Circulation. 2004;110:22-26.

   


 Presentation 

"Management of Diabetic Retinopathy: What’s New?"

Prof. Paul Mitchell (biography)
English - 2006-04-06 - 50 minutes
(58 slides)

Summary :
In this presentation Prof. Mitchell gives an evidence-based review of the current literature on the management of diabetic retinopathy up to the present time.

The pathogenesis of diabetic retinopathy is multifactorial, involving many pathways linked to glycaemia, and about 25 to 45 percent of diabetic patients currently have some signs of diabetic retinopathy - about 300,000...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- The underlying pathogenesis of diabetic retinopathy
- The risk factors for diabetic retinopathy
- What's new in the medical management of diabetic retinopathy

Bibliographic references :
The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group. Retinopathy and Nephropathy in Patients with Type 1 Diabetes Four Years after a Trial of Intensive Therapy NEJM 2000; 342:381-389.

UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33) The Lancet, Volume 352, Issue 9131, 12 September 1998, Pages 837-853.

UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38 BMJ 1998;317:703-713.

   


 Presentation 

"Quality of Life & Diabetes"

Dr. Pat Phillips (biography)
English - 2006-02-21 - 39 minutes
(37 slides)

Summary :
In this presentation Dr. Phillips talks about why it's important to understand quality of life (QoL) in diabetes, some of the measurements used, and the quality of life continuum in diabetes.

It is important to understand QoL in the context of individual choices of the patient, and to understand the health impact of QoL. QoL is also used in guiding public health choices and...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

QOL and Diabetes:

- Why bother?
- Measurement of QoL
- The QoL continuum in diabetes

Bibliographic references :
1. UK Prospective Diabetes Study Group.Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38 BMJ 1998;317:703-713.

   


 Presentation 

"Interaction of Metabolic with Haemodynamic Factors in Diabetic Nephropathy"

Prof. Mark E. Cooper (biography)
English - 2006-02-16 - 40 minutes
(46 slides)

Summary :
In this presentation Prof. Cooper discusses the pathogenesis of diabetic nephropathy, current treatments, and future directions for the development of new and better treatments.

Elevated glucose and blood pressure levels are both associated with the development of diabetic complications, as seen in the UKPD study. With regards to the pathogenesis of diabetic nephropathy, there...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- A paradigm for the pathogenesis of diabetic nephropathy
- Efficacy of currently used antiproteinuric therapies and predictors of renal outcomes
- Potential therapeutic targets in diabetic nephropathy

Bibliographic references :
1. M. E. Cooper.Interaction of metabolic and haemodynamic factors in mediating experimental diabetic nephropathy Diabetologia, Volume 44, Issue 11, Nov 2001, Pages 1957 - 1972.

2. Barry M. Brenner, M.D., Mark E. Cooper, M.D., Ph.D., Dick de Zeeuw, M.D., Ph.D., William F. Keane, M.D., William E. Mitch, M.D., Hans-Henrik Parving, M.D., Giuseppe Remuzzi, M.D., Steven M. Snapinn, Ph.D., Zhonxin Zhang, Ph.D., Shahnaz Shahinfar, M.D., for the RENAAL Study Investigators. Effects of Losartan on Renal and Cardiovascular Outcomes in Patients with Type 2 Diabetes and Nephropathy N Engl J Med. 2001 Sep 20;345(12):861-9.

3. de Zeeuw D, Remuzzi G, Parving HH, Keane WF, Zhang Z, Shahinfar S, Snapinn S, Cooper ME, Mitch WE, Brenner BM.Proteinuria, a target for renoprotection in patients with type 2 diabetic nephropathy: Lessons from RENAAL Kidney International (2004) 65, 2309–2320.

4. Doublier S, Salvidio G, Lupia E, Ruotsalainen V, Verzola D, Deferrari G, Camussi G.Nephrin Expression Is Reduced in Human Diabetic Nephropathy: Evidence for a Distinct Role for Glycated Albumin and Angiotensin II Diabetes 52:1023-1030, 2003.

   


 Presentation 

"Introduction"

Prof. Jean-Pierre Després (biography)
English - 2005-10-25 - 16 minutes
(7 slides)

Summary :
In this introduction, Prof. Després talks about the “toxic” environment in today's society which promotes obesity, the development of type 2 diabetes and an increased risk of cardiovascular disease.

Hyperglycemia management is only the tip of the iceberg when it comes to preventing first or recurrent myocardial infarction in diabetic patients. The underlying metabolic abnormalities...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- The contribution of modern lifestyle choices towards increased diabetes and heart disease risk
- The impact of metabolic syndrome on CHD risk in diabetic patients

Bibliographic references :
1. Alexander CM, Landsman PB, Teutsch SM, Haffner SM; Third National Health and Nutrition Examination Survey (NHANES III); National Cholesterol Education Program (NCEP).NCEP-Defined Metabolic Syndrome, Diabetes, and Prevalence of Coronary Heart Disease Among NHANES III Participants Age 50 Years and Older Diabetes 52:1210-1214, 2003.

   


 Presentation 

"Microvascular Complications of Type 2 Diabetes: New Insight into Pathogenesis and Risk Reduction"

Dr. Luigi Gnudi (biography)
English - 2005-06-18 - 44 minutes
(55 slides)
(3 questions)

Summary :
In this presentation Dr. Gnudi discusses experimental evidence providing new insight into the pathogenesis of microvascular complications of diabetes, with a focus on kidney disease, and new therapeutic opportunities addressing root causes.

In the UKPDS, a trend was observed for increasing risk of CV death with increasing diabetic nephropathy (1), and excess mortality has been...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- Experimental evidence suggesting a mechanism of interaction between haemodynamic and metabolic factors in the pathogenesis of glomerular injury
- Classic and modern therapeutic approaches to reduce the risk of microvascular complications in diabetes
- New therapeutic opportunities addressing the root causes of microvascular complications

Bibliographic references :
1. Amanda I. Adler, Richard J. Stevens, Sue E. Manley, Rudy W. Bilous, Carole A. Cull, and Rury R. Holman, on behalf of the UKPDS GROUP Development and progression of nephropathy in type 2 diabetes: The United Kingdom Prospective Diabetes Study (UKPDS 64)Kidney International. Volume 63 Issue 1 Page 225 - January 2003.

2. SL Wang, J Head, L Stevens and JH Fuller. Excess mortality and its relation to hypertension and proteinuria in diabetic patients. The world health organization multinational study of vascular disease in diabetes Diabetes Care. 1996;19(4):305-312.

3. Andrew Smith, Janaka Karalliedde, Lorenita De Angelis, David Goldsmith and Giancarlo Viberti Aortic Pulse Wave Velocity and Albuminuria in Patients with Type 2 Diabetes J Am Soc Nephrol 16: 1069-1075, 2005.

4. Luigi Gnudi; GianCarlo Viberti; Leopoldo Raij; Veronica Rodriguez; Davina Burt; Pedro Cortes; Barry Hartley; Stephen Thomas; Sabrina Maestrini; Gabriella Gruden GLUT-1 Overexpression: Link Between Hemodynamic and Metabolic Factors in Glomerular Injury? Hypertension. 2003;42:19.

5. Gabriella Gruden, Giorgia Setti, Anthea Hayward, David Sugden, Sara Duggan, Davina Burt, Robin E. Buckingham, Luigi Gnudi and Giancarlo VibertiMechanical Stretch Induces Monocyte Chemoattractant Activity via an NF-B-Dependent Monocyte Chemoattractant Protein-1-Mediated Pathway in Human Mesangial Cells: Inhibition by Rosiglitazone J Am Soc Nephrol 16: 688-696, 2005.

6. Dick de Zeeuw, Giuseppe Remuzzi, Hans-Henrik Parving, William F. Keane, Zhongxin Zhang, Shahnaz Shahinfar, Steve Snapinn, Mark E. Cooper, William E. Mitch, and Barry M. Brenner
Proteinuria, a target for renoprotection in patients with type 2 diabetic nephropathy: Lessons from RENAAL Kidney International.Volume 65 Issue 6 Page 2309 - June 2004.

7. Palla R, Panichi V, Finato V, Parrini M, Andreini B, Bianchi AM, Giovannini L, Migliori M, Bertelli AA Effect of increasing doses of lisinopril on proteinuria of normotensive patients with IgA nephropathy and normal renal function. Int J Clin Pharmacol Res. 1994;14(1):35-43.

   


 Presentation 

"Adiponectin: Conducting the Metabolic Orchestra"

Prof. John Prins (biography)
English - 2005-06-18 - 38 minutes
(28 slides)
(2 questions)

Summary :
Adipose tissue has come to be known as an important endocrine organ making different kinds of molecules including adiponectin, collectively known as adipokines.

Adiponectin is produced exclusively by fat cells and its secretion is decreased in obesity and the metabolic syndrome. Adiponectin promotes insulin sensitivity, is a potent anti-inflammatory molecule, a potent activator of...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

Adiponectin structure and circulating isoforms
Adiponectin analysis
Adiponectin and insulin sensitivity
Adiponectin and inflammation
Adiponectin regulation
Adiponectin in the metabolic syndrome
Clinical implications
Adiponectin – what we don't yet know

   


 Presentation 

"Early Retinal Microvascular Changes in Diabetes: Insights into Pathogenesis and Prediction"

Dr. Tien Y. Wong (biography)
English - 2005-06-18 - 57 minutes
(43 slides)
(5 questions)

Summary :
Early retinal microvascular changes are poorly understood yet important to be studied, as early stages of the disease may be reversible, and further, studies suggest that individuals with classical signs of diabetic retinopathy may already have diabetes for several years.

Do changes in retinal vascular caliber predict the development of diabetes, and in people with diabetes does it...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- Changes in retinal vascular caliber as a predictor of diabetes and diabetic complications
- Retinopathy and the risk of diabetes, stroke and CHF

   


 Presentation 

"Development of Atherosis in the Placental Bed of Diabetic Pregnancy"

Prof. Eileen Gallery (biography)
English - 2005-06-18 - 27 minutes
(37 slides)

Summary :
Type 1 diabetes is associated with poor pregnancy outcomes many of which are related to abnormalities in placental function and fetal growth (1). Of importance in diabetic pregnancy is an increased and more rapid development of a disorder called “atherosis” in the maternal blood vessels of the placental bed, which is similar to atheroma in the vessels of a non-pregnant individual. Atherosis leads...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- The significance and consequences of atherosis in diabetic pregnancy
- Mechanisms promoting atherosis in diabetic pregnancy

Bibliographic references :
1. Dorte M. Jensen, PHD, Peter Damm, DMSC, Lars Moelsted-Pedersen, DMSC, Per Ovesen, DMSC, Jes G. Westergaard, DMSC, Margrethe Moeller, MD and Henning Beck-Nielsen, DMSC.Outcomes in Type 1 Diabetic Pregnancies: A nationwide, population-based study Diabetes Care 27:2819-2823, 2004.

2. Anoula Galettis, BSC, Suzanne Campbell, BSC, PHD, Jonathan M. Morris, MBBS, MMED, PHD, FRACOG, Christopher J. Jackson, BSC, PHD, Steven M. Twigg, MBBS, PHD, FRACP and Eileen D.M. Gallery, MD(SYD), FRACP. Monocyte Adhesion to Decidual Endothelial Cells Is Increased in Pregnancies Complicated by Type 1 Diabetes but not by Gestational Diabetes Diabetes Care 27:2514-2515, 2004.

   


 Presentation 

"Adipose Tissue as an Inflammatory Organ (Endocrine Tumor) in Human Obesity"

Prof. John N. Fain (biography)
English - 2005-06-10 - 55 minutes
(28 slides)

Summary :
We postulate that many of the deleterious effects of obesity in humans may involve enhanced formation of cytokines by the non-fat cells in adipose tissue. Cytokines are factors that are involved in the response to infections but also appear to promote heart disease as well as diabetes. We compared the release of cytokines by the adipose tissue of morbidly obese women with a body fat weight of 123...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- The specific parts of adipose tissue that inflammatory factors come from

   


 Presentation 

"Muscle - Adipose Tissue "Crosstalk" : Implications for Insulin Action"

Prof. Edward W. Kraegen (biography)
English - 2005-06-10 - 53 minutes
(40 slides)

Summary :
In this presentation Prof. Kraegen discusses the link between muscle insulin resistance and free fatty acids (FFAs), buffering of the FFA supply by adipose tissue, and adipokine targets in muscle.

An overload of supply of fatty acids to muscle may be a major factor in the pathogenesis of muscle insulin resistance, says Prof. Kraegen. Cytosolic lipid accumulation leading to muscle...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- Muscle Insulin Resistance – Link to FFAs
- Buffering of FFA supply by adipose tissue
- Adipokines and targets in muscle

Bibliographic references :
1. K. Frayn. Adipose tissue as a buffer for daily lipid flux Diabetologia, Volume 45, Issue 9, Sep 2002, Pages 1201 - 1210.

2. D.R. Laybutt, D.J. Chisholm and E.W. Kraegen
Specific adaptations in muscle and adipose tissue in response to chronic systemic glucose oversupply in ratsAm J Physiol Endocrinol Metab 273: E1-E9, 1997.

3. Carey DG, Jenkins AB, Campbell LV, Freund J, Chisholm DJ.Abdominal fat and insulin resistance in normal and overweight women: Direct measurements reveal a strong relationship in subjects at both low and high risk of NIDDM.Diabetes. 1996 May;45(5):633-8.

4. Seng Khee Gan, Katherine Samaras, Campbell H. Thompson, Edward W. Kraegen, Andrew Carr, David A. Cooper, and Donald J. Chisholm Altered Myocellular and Abdominal Fat Partitioning Predict Disturbance in Insulin Action in HIV Protease Inhibitor-Related Lipodystrophy Diabetes 51:3163-3169, 2002.

   


 Presentation 

"Resistin and Fasting-Induced Adipose Factor (FIAF) in the Brain and Pituitary: Implications for Insulin Resistance and Obesity"

Dr. Russell Brown (biography)
English - 2005-05-06 - 29 minutes
(20 slides)
(2 questions)

Summary :
In this presentation Russell Brown discusses experimental evidence for expression of the adipokines resistin and fasting-induced adipose factor (FIAF) in non-adipose tissues, and studies providing insights into the nature of expression of these genes.

Insulin and leptin are examples of hormones from the periphery that have been found to act in the brain, affecting food intake,...

Learning objectives :
Key Discussion Points:

- The brain and pituitary gland express adipokines including resistin and fasting-induced adipose factor (FIAF);
- RNA interference is an effective tool to study adipokines;
- These brain-derived adipokines may prove to be therapeutic targets for obesity and brain development, cell signaling and angiogenesis.

Bibliographic references :
1. Schwartz MW, Porte D Jr. Diabetes, obesity, and the brainScience. 2005 Jan 21;307(5708):375-9.

2. Schwartz MW and Morton GJ. “Keeping Hunger at Bay.” Nature 2002 Aug 8; 418:596-597.

3. Barbara A. Morash, Diane Willkinson, Ehud Ur and Michael Wilkinson. Resistin expression and regulation in mouse pituitary FEBS Lett. 2002; 526(1-3):26-30.

4. Michael Wilkinson, Diane Wilkinson, Glen Wiesner, Barbara Morash, Ehud UrHypothalamic Resistin Immunoreactivity Is Reduced b y Obesity in the Mouse: Co-Localization with (alpha)-Melanostimulating Hormone Neuroendocrinology 2005;81:19-30.

5. G Wiesner, BA Morash, E Ur, and M Wilkinson. Food restriction regulates adipose-specific cytokines in pituitary gland but not in hypothalamus Journal of Endocrinology, Vol 180, Issue 3, R1-R6.

   


 Presentation 

"Postprandial Hyperglycemia and Cardiovascular Disease"

Prof. Antonio Ceriello (biography)
English - 2005-04-16 - 31 minutes
(25 slides)

Summary :
Increasing evidence suggests that the postprandial state is a contributing factor to the development of atherosclerosis. In diabetes, the postprandial phase is characterized by a rapid and large increase in blood glucose levels, and the possibility that the post-prandial hyperglycemic spikes may be relevant to the onset of cardiovascular complications has received recently much attention....

Learning objectives :
After viewing this presentation, participants will be able to discuss:

- The relevance of postprandial hyperglycemia and hypertriglyceridemia on oxidative stress generation and endothelial dysfunction.
- The relationship of postprandial and fasting glucose levels with HbA1c levels

Bibliographic references :
The DECODE study group on behalf of the Europe an Diabetes Epidemiology GroupGlucose tolerance and mortality: comparison of WHO and American Diabetic Association diagnostic criteria Lancet Volume 354, Issue 9179 , 21 August 1999, Pages 617-621

M Tominaga, H Eguchi, H Manaka, K Igarashi, T Kato, and A SekikawaImpaired glucose tolerance is a risk factor for cardiovascular disease, but not impaired fasting glucose. The Funagata Diabetes StudyDiabetes Care 22: 920-924.


B Balkau, M Shipley, RJ Jarrett, K Pyorala, M Pyorala, A Forhan, and E EschwegeHigh blood glucose concentration is a risk factor for mortality in middle-aged nondiabetic men. 20-year follow-up in the Whitehall Study, the Paris Prospective Study, and the Helsinki Policemen StudyDiabetes Care 21: 360-367


E Barrett-Connor and A FerraraIsolated postchallenge hyperglycemia and the risk of fatal cardiovascular disease in older women and men. The Rancho Bernardo StudyDiabetes Care 21: 1236-1239

Markolf Hanefeld, Jean Louis Chiasson, Carsta Koehler, Elena Henkel, Frank Schaper, and Theodora Temelkova-Kurktschiev Acarbose Slows Progression of Intima-Media Thickness of the Carotid Arteries in Subjects With Impaired Glucose Tolerance Stroke 2004 35: 1073 - 1078

M. Hanefeld, M. Cagatay, T. Petrowitsch, D. Neuser, D. Petzinna, and M. RuppAcarbose reduces the risk for myocardial infarction in type 2 diabetic patients: meta-analysis of seven long-term studiesEur. Heart J., January 2004; 25: 10 - 16.

Katherine Esposito, Dario Giugliano, Francesco Nappo, Raffaele Marfella for the Campanian Postprandial Hyperglycemia Study Group Regression of Carotid Atherosclerosis by Control of Postprandial Hyperglycemia in Type 2 Diabetes Mellitus Circulation 2004 110: 214 - 219

Francesco Perticone, Roberto Ceravolo, Arturo Pujia, Giorgio Ventura, Saverio Iacopino, Angela Scozzafava, Alessandro Ferraro, Massimo Chello, Pasquale Mastroroberto, Paolo Verdecchia, and Giuseppe SchillaciPrognostic Significance of Endothelial Dysfunction in Hypertensive PatientsCirculation, Jul 2001; 104: 191 - 196.

Antonio CerielloNew Insights on Oxidative Stress and Diabetic Complications May Lead to a "Causal" Antioxidant TherapyDiabetes Care 26: 1589-1596


Irene M Stratton, Amanda I Adler, H Andrew W Neil, David R Matthews, Susan E Manley, Carole A Cull, David Hadden, Robert C Turner, and Rury R HolmanAssociation of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational studyBMJ, Aug 2000; 321: 405 - 412.

Louis Monnier, Hélène Lapinski, and Claude ColetteContributions of Fasting and Postprandial Plasma Glucose Increments to the Overall Diurnal Hyperglycemia of Type 2 Diabetic Patients: Variations with increasing levels of HbA1c Diabetes Care 26: 881-885

Curt L. Rohlfing, Hsiao-Mei Wiedmeyer, Randie R. Little, Jack D. England, Alethea Tennill, and David E. GoldsteinDefining the Relationship Between Plasma Glucose and HbA1c: Analysis of glucose profiles and HbA1c in the Diabetes Control and Complications Trial Diabetes Care 25: 275-278.

EJ Bastyr, CA Stuart, RG Brodows, S Schwartz, CJ Graf, A Zagar, and KE RobertsonTherapy focused on lowering postprandial glucose, not fasting glucose, may be superior for lowering HbA1c. IOEZ Study GroupDiabetes Care 23: 1236-1241

Writing Team for the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research GroupSustained Effect of Intensive Treatment of Type 1 Diabetes Mellitus on Development and Progression of Diabetic Nephropathy: The Epidemiology of Diabetes Interventions and Complications (EDIC) StudyJAMA. 2003;290:2159-2167

The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group Intensive Diabetes Therapy and Carotid Intima–Media Thickness in Type 1 Diabetes MellitusNEJM 2003 (348):2294

   


 Presentation 

"Increased Risk of Coronary Events in Dysglycemic Patients: Mechanisms, and Reasons for Poor Outcomes"

Dr. Richard W. Nesto (biography)
English - 2005-04-16 - 32 minutes
(25 slides)

Summary :
In recent years the early in-hospital mortality of diabetic patients after MI has been substantially reduced due to improvements in the medical management of these patients within the first 24 hours (1), however diabetes and hyperglycaemia itself still confer an increased risk of long-term mortality after MI which can be explained by a higher risk of congestive heart failure (2).

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- Studies relating admission blood glucose levels to in-hospital and long-term mortality after MI in diabetic and non-diabetic patients
- Mechanisms whereby hyperglycaemia in AMI leads to poor outcomes
- The role of metabolic modulators in AMI: GIK infusion therapy
- Remaining questions

Bibliographic references :
1. Oliver Schnell, MD, Oliver Schäfer, Sonja Kleybrink, Wittich Doering, MD, Eberhard Standl, MD and Wolfgang Otter, MDIntensification of Therapeutic Approaches Reduces Mortality in Diabetic Patients With Acute Myocardial Infarction: The Munich registryDiabetes Care 27:455-460, 2004.

2. Ischa Stranders, MD; Michaela Diamant, MD, PhD; Rogier E. van Gelder, MD; Hugo J. Spruijt, MSEE; Jos W. R. Twisk, PhD; Robert J. Heine, MD, PhD, FRCP; Frans C. Visser, MD, PhD. Admission Blood Glucose Level as Risk Indicator of Death After Myocardial Infarction in Patients With and Without Diabetes Mellitus Arch Intern Med. 2004;164:982-988.

3. Nazneem N. Wahab MD, Elizabeth A. Cowden MD, Neil J. Pearce MD, Martin J. Gardner MD, Heather Merry MSc, Jafna L. Cox MD and ICONS Investigators. Is blood glucose an independent predictor of mortality in acute myocardial infarction in the thrombolytic era? JACC.20 November 2002, Volume 40, Issue 10 Pages 1748-1754.

4. John A. Colwell, MD, PHD and Richard W. Nesto, MD.The Platelet in Diabetes: Focus on prevention of ischemic eventskjhkhkhDiabetes Care 26:2181-2188, 2003.

5. Jorik R. Timmer, Jan Paul Ottervanger, Menko-Jan de Boer, Jan-Henk E. Dambrink, Jan C.A. Hoorntje, A.T. Marcel Gosselink, Harry Suryapranata, Felix Zijlstra, Arnoud W.J. van't HofHyperglycemia is an important predictor of impaired coronary flow before reperfusion therapy in ST-segment elevation myocardial infarctionJACC.5 April 2005, Volume 45, Issue 7 Pages 999-1002.

6. Katsuomi Iwakura MD, Hiroshi Ito MD, FACC, Masashi Ikushima MD, Shigeo Kawano MD, Atsushi Okamura MD, Katsuaki Asano MD, Tadashi Kuroda MD, Koji Tanaka MD, Tohru Masuyama MD, Masatsugu Hori MD and Kenshi Fujii MDAssociation between hyperglycemia and the no-reflow phenomenon inpatients with acute myocardial infarctionJACC.1 January 2003, Volume 41, Issue 1 Pages 1-7.

7. Raffaele Marfella, MD, PHD, Mario Siniscalchi, MD, PHD, Katherine Esposito, MD, Ausilia Sellitto, MD, Umberto de Fanis, MD, Ciro Romano, MD, PHD, Michele Portoghese, MD, Silvio Siciliano, MD, Francesco Nappo, MD, PHD, Ferdinando Carlo Sasso, MD, PHD, Nicola Mininni, MD, Federico Cacciapuoti, MD, Giacomo Lucivero, MD, PHD, Riccardo Giunta, MD, Mario Verza, MD and Dario Giugliano, MD, PHDEffects of Stress Hyperglycemia on Acute Myocardial Infarction: Role of inflammatory immune process in functional cardiac outcome Diabetes Care 26:3129-3135, 2003.

8. Oliver MF, Opie LH. Effects of glucose and fatty acids on myocardial ischaemia and arrhythmiasLancet. 1994 Jan 15;343(8890):155-8.

   


 Presentation 

"Lessons from the UKPDS"

Prof. Alastair Gray (biography)
English - 2005-04-15 - 33 minutes
(25 slides)

Summary :
In this presentation Prof. Gray descibes results from UKPDS 61 and 68, which looked at fasting plasma glucose (FPG) levels at diagnosis of diabetes in relation to clinical outcomes, and the UKPDS Outcomes Model, respectively.

UKPDS 61 found that those with lower FPG levels at diagnosis of diabetes had fewer complications but similar rates of deterioration in glycemic control...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- The relationship between FPG level at diagnosis of diabetes and clinical outcomes
- The UKPDS Outcomes Model

Bibliographic references :
Stephen Colagiuri, FRACP, Carole A. Cull, PHD and Rury R. Holman, FRCP For the UKPDS Group. Are Lower Fasting Plasma Glucose Levels at Diagnosis of Type 2 Diabetes Associated With Improved Outcomes? - U.K. Prospective Diabetes Study 61 Diabetes Care 25:1410-1417, 2002.

P. M. Clarke, A. M. Gray, A. Briggs, A. J. Farmer, P. Fenn, R. J. Stevens, D. R. Matthews, I. M. Stratton, R. R. Holman and on behalf of the UK Prospective Diabetes Study (UKPDS) Group. A model to estimate the lifetime health outcomes of patients with Type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model (UKPDS no. 68)Diabetologia. 2004; 47(10):1747 - 1759.

   


 Presentation 

"Effect of Fructose Overfeeding and Fish Oil Administration on De Novo Lipogenesis and Insulin Sensitivity in Healthy Males"

Dr. David Faeh (biography)
English - 2005-04-15 - 23 minutes
(24 slides)

Summary :
High fructose diets (Hfr) may stimulate hepatic de novo lipogenesis (DNL), and cause hypertriglyceridemia and insulin resistance in rodents. It can therefore be hypothesized that fructose-induced insulin resistance is secondary to alterations of hepatic and extra-hepatic lipid metabolism. Since fish oil supplementation (FO) is known to suppress lipogenic enzymes and to decrease TG, it may improve...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- Animal and human studies relating to the metabolic effects of fructose overfeeding and fish oil supplementation

   


 Presentation 

"Neural Control of Energy Balance"

Prof. Stephen C. Woods (biography)
English - 2005-04-14 - 32 minutes
(68 slides)

Summary :
Knowledge of the hormones, neurotransmitters and neural pathways that regulate energy homeostasis is increasing at a rapid pace. Food intake was historically thought to occur in response to acute energy demands; however, current evidence suggests that meals occur based on habit and convenience rather than on metabolic need. Most individuals maintain stable body weights over long intervals by...

Learning objectives :
After viewing this presentation, participants will be able to discuss:
• The satiety system of energy balance
• The adiposity system of energy balance
• The central integrators of energy balance

   


 Presentation 

"Advanced Glycation in Diabetic Complications"

Dr. Stephen Twigg (biography)
English - 2005-03-15 - 47 minutes
(34 slides)

Summary :
Advanced glycation end-products (AGEs) are increased in diabetes and can be formed endogenously or be derived from dietary sources or cigarette tar. The AGE pathway is one of several mechanisms that have been implicated in glucose-mediated vascular damage (1).

AGEs can exert their pathological effects for example through covalent cross-linking with proteins and lipids or by...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- The formation and pathological effects of advanced glycation end-products (AGEs);
- Effects of the inhibition of AGE formation and cleavage of pre-formed AGE crosslinks in animal models of diabetes;
- Preliminary data in human diabetic subjects on the effects of dietary AGEs.

Bibliographic references :
1. MICHAEL BROWNLEE. Biochemistry and molecular cell biology of diabetic complicationsNature. 2001;414:813-820.

2. Stephen M. Twigg, Zemin Cao, Sue V. MCLennan, Wendy C. Burns, Gail Brammar, Josephine M. Forbes and Mark E. Cooper. Renal Connective Tissue Growth Factor Induction in Experimental Diabetes Is Prevented by Aminoguanidine Endocrinology. 2002; 143(12):4907-4915.

3. Riccardo Candido, Josephine M. Forbes, Merlin C. Thomas, Vicki Thallas, Rachael G. Dean, Wendy C. Burns, Christos Tikellis, Rebecca H. Ritchie, Stephen M. Twigg, Mark E. Cooper, Louise M. Burrell
A Breaker of Advanced Glycation End Products Attenuates Diabetes-Induced Myocardial Structural Changes Circulation Research. 2003;92:785.

4. Reigh-Yi Lin, Robin P. Choudhury, Weijing Cai, Min Lu, John T. Fallon, Edward A. Fisher and Helen Vlassara. Dietary glycotoxins promote diabetic atherosclerosis in apolipoprotein E-deficient mice Atherosclerosis. Volume 168, Issue 2 , June 2003, Pages 213-220.

5. Vlassara H, Cai W, Crandall J, Goldberg T, Oberstein R, Dardaine V, Peppa M, Rayfield EJ. Inflammatory mediators are induced by dietary glycotoxins, a major risk factor for diabetic angiopathy.
Proc Natl Acad Sci U S A. 2002 Nov 26;99(24):15596-601.

   


 Presentation 

"Adiponectin"

Prof. John Prins (biography)
English - 2004-09-23 - 22 minutes
(24 slides)

Summary :
Adiponectin is an important adipokine having endocrine effects in the liver, muscle and vasculature.

Most adipokines are secreted at higher than normal levels in obesity and the metabolic syndrome, but adiponectin is an exception as its secretion is decreased in these states. Adiponectin promotes insulin sensitivity and has anti-inflammatory effects. Prof. Prins describes these...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- The characteristics and regulation of adiponectin;
- Improvement of insulin sensitivity via adiponectin action in muscle and the liver;
- Anti-inflammatory effects of adiponectin in the vasculature;
- The clinical implications of adiponectin deficiency in obesity and the metabolic syndrome.

   


 Presentation 

"The Role of Inflammation in Metabolic Disease"

Prof. John Prins (biography)
English - 2004-06-26 - 31 minutes
(30 slides)
(3 questions)

Summary :
Obesity is an important contributing factor in the metabolic syndrome, and can lead to the development of localized and systemic inflammation in different ways.

Dysregulation of adipokine secretion, elevated free fatty acid levels and fat distribution all play a part in the development of inflammation in the setting of obesity. In this presentation Dr. Prins talks about all these...

Learning objectives :
The participant will learn how the following factors affect the development of inflammation in metabolic disease:

- dysregulation of adipokines
- elevated free fatty acid levels
- body fat distribution

   


 Presentation 

"Mechanism and Consequences of Fat-induced Gluconeogenesis"

Prof. Joseph Proietto (biography)
English - 2004-06-26 - 28 minutes
(35 slides)

Summary :
In this presentation Prof. Proietto presents data from experimental studies showing the mechanism of fat-induced gluconeogenesis, and the consequences of chronically elevated gluconeogenesis.

Studies done by Prof. Proietto's group showed that rats who were fed a high fat diet exhibited increases in endogenous glucose production, alanine gluconeogenesis and...

Learning objectives :
After viewing this presentation, the participant will be able to discuss:

- The mechanism of fat-induced gluconeogenesis involving the up-regulation of fructose-1,6-bisphosphatase protein levels
- The development of specific metabolic abnormalities in an animal model of chronically increased gluconeogenesis

Bibliographic references :
Shaoming Song, Sofianos Andrikopoulos, Christine Filippis, Anne W. Thorburn, David Khan, and Joseph Proietto. Mechanism of fat-induced hepatic gluconeogenesis: effect of metformin Am J Physiol Endocrinol Metab 2001; 281: E275-E282.

A. W. Thorburn, M. E. Baldwin, G. Rosella, J. D. Zajac, S. Fabris, S. Song, J. Proietto. Features of syndrome X develop in transgenic rats expressing a non-insulin responsive phosphoenolpyruvate carboxykinase gene
Diabetologia 1999; 42(4):419 - 426.

   


 Presentation 

"CRP, Inflammation, and its Relationship to Cardiovascular Disease, Metabolic Syndrome and Type 2 Diabetes"

Dr. Paul M. Ridker (biography)
English - 2004-06-25 - 45 minutes
(42 slides)

Summary :
In this presentation Dr Ridker reviews the use of high-sensitivity C-Reactive Protein (hs-CRP) as a prognostic indicator of myocardial infarction, stroke and type 2 diabetes; the added prognostic information CRP provides in patients with the metabolic syndrome, the role of CRP in atherothrombosis, and how some antidiabetic agents have been shown to lower levels of inflammatory markers including...

Learning objectives :
The participant will learn about CRP in relation to CVD, metabolic syndrome and type 2 diabetes.

Bibliographic references :
1. Paul M. Ridker, M.D., Mary Cushman, M.D., Meir J. Stampfer, M.D., Russell P.Tracy, Ph.D., and Charles H. Hennekens, M.D. Inflammation, Aspirin, and the Risk of Cardiovascular Disease in Apparently Healthy Men. NEJM 1997;336:973-79.

2. Paul M. Ridker, M.D., Charles H. Hennekens, M.D., Julie E. Buring, Sc.D., and Nader Rifai, Ph.D. C-Reactive Protein and Other Markers of Inflammation in the Prediction of Cardiovascular Disease in Women NEJM 2000;342:836-43.

3. Paul M. Ridker, M.D., Nader Rifai, Ph.D., Lynda Rose, M.S., Julie E. Buring, Sc.D., and Nancy R. Cook, Sc.D. Comparison of C-Reactive Protein and Low-Density Lipoprotein Cholesterol Levels in the Prediction of First Cardiovascular Events NEJM 2002;347: 1557-65.

4. Paul M Ridker, MD; Julie E. Buring, ScD; Nancy R. Cook, ScD; Nader Rifai, PhD C-Reactive Protein, the Metabolic Syndrome, and Risk of Incident Cardiovascular Events Circulation 2003;107: 391-7.

5. John S. Yudkin; C. D. A. Stehouwer; J. J. Emeis; S. W. Coppack C-Reactive Protein in Healthy Subjects: Associations With Obesity, Insulin Resistance, and Endothelial Dysfunction ATVG 1999;19:972-978 .

6. Aruna D. Pradhan, MD,MPH; JoAnn E. Manson, MD,DrPH; Nader Rifai, PhD; Julie E. Buring, ScD; Paul M. Ridker, MD,MPH C-Reactive Protein, Interleukin 6, and Risk of Developing Type 2 Diabetes Mellitus JAMA. 2001;286:327-334.

7. Frank B. Hu, James B. Meigs, Tricia Y. Li1, Nader Rifai, and JoAnn E. Manson Inflammatory Markers and Risk of Developing Type 2 Diabetes in Women Diabetes 53:693-700,2004.

8. Steven M. Haffner, MD; Andrew S. Greenberg, MD; Wayde M. Weston, PhD; Hongzi Chen, PhD; Ken Williams, MS; Martin I. Freed, MD Effect of Rosiglitazone Treatment on Nontraditional Markers of Cardiovascular Disease in Patients With Type 2 Diabetes Mellitus Circulation.2002;106:679.

9. Nikolaus Marx, MD; Armin Imhof, MD; Johannes Froehlich, MS; Laila Siam, MS; Jochen Ittner, MD; Gerhard Wierse, MD; Arnold Schmidt, MD; Winfried Maerz, MD; Vinzenz Hombach, MD; Wolfgang Koenig, MD Effect of Rosiglitazone Treatment on Soluble CD40L in Patients With Type 2 Diabetes and Coronary Artery Disease Circulation. 2003;107:1954.

10. Noriko Satoh, MD, PHD, Yoshihiro Ogawa, MD, PHD, Takeshi Usui, MD, PHD, Tetsuya Tagami, MD, PHD, Shigeo Kono, MD, PHD, Hiroko Uesugi, MD, PHD, Hiroyuki Sugiyama, MD, PHD, Akira Sugawara, MD, PHD, Kazunori Yamada, MD, PHD, Akira Shimatsu, MD, PHD, Hideshi Kuzuya, MD, PHD and Kazuwa Nakao, MD, PHD. Antiatherogenic Effect of Pioglitazone in Type 2 Diabetic Patients Irrespective of the Responsiveness to Its Antidiabetic Effect Diabetes Care 26:2493-2499, 2003.

11. BART STAELS, WOLFGANG KOENIG, AÏDA HABIB, RÉGINE MERVAL, MARILYNE LEBRET, INÉS PINEDA TORRA, PHILIPPE DELERIVE, ABDESSAMAD FADEL, GIULIA CHINETTI, JEAN-CHARLES FRUCHART, JAMILA NAJIB, JACQUES MACLOUF & ALAIN TEDGUIActivation of human aortic smooth-muscle cells is inhibited by PPAR (alpha) but not by PPAR (gamma) activatorsNature 393, 790 - 793 (25 June 1998).

12. Howard D. Sesso, ScD, MPH; Julie E. Buring, ScD; Nader Rifai, PhD; Gavin J.Blake, MD, MPH; J. Michael Gaziano, MD, MPH; Paul M. Ridker, MD, MPH C-Reactive Protein and the Risk of Developing Hypertension JAMA. 2003;290:2945-2951.

13. Ridker PM; JUPITER Study Group. Rosuvastatin in the primary prevention of cardiovascular disease among patients with low levels of low-density lipoprotein cholesterol and elevated high-sensitivity C-reactive protein: rationale and design of the JUPITER trial
Circulation. 2003 Nov 11;108(19):2292-7.

14. Paul A, Ko KW, Li L, Yechoor V, McCrory MA, Szalai AJ, Chan L. C-reactive protein accelerates the progression of atherosclerosis in apolipoprotein E-deficient mice. Circulation. 2004 Feb 10;109(5):647-55. Epub 2004 Jan 26.

15. Danenberg HD, Szalai AJ, Swaminathan RV, Peng L, Chen Z, Seifert P, Fay WP, Simon DI, Edelman ER. Increased thrombosis after arterial injury in human C-reactive protein-transgenic mice. Circulation. 2003 Aug 5;108(5):512-5. Epub 2003 Jul 21.

   


 Presentation 

"Silent myocardial ischaemia and infarction in type II diabetes"

Prof. Timothy Davis (biography)
English - 2004-06-04 - 40 minutes
(27 slides)

Summary :
In this presentation Dr. Davis provides an update on silent myocardial ischaemia in diabetes based on 2 presentations given at the 64th ADA meeting in Orlando in June of 2004, as well as results from the Fremantle Diabetes Study which investigated the prevalence, risk factors and prognosis of silent myocardial infarction in a community cohort of diabetic patients.

Preliminary data...

Learning objectives :
The participant will learn about the following in type 2 diabetes:

- Silent myocardial ischaemia (data from the 64th ADA meeting in Orlando)
- Silent myocardial infarction (Fremantle Diabetes Study)

Bibliographic references :
T.M.E. Davis, P. Fortun, J.Mulder, W.A. Davis and D.G. Bruce. Silent myocardial infarction and its prognosis in a community-based cohort of Type 2 diabetic patients: the Fremantle Diabetes Study Diabetologia 2004; 47(3): 395 - 399.

   


 Presentation 

"What are the manifestations of beta-cell dysfunction and insulin resistance?"

Dr. Steven V. Edelman (biography)
English - 2004-06-04 - 12 minutes
(3 slides)

Summary :
In the natural history of type 2 diabetes, the development of insulin resistance, impaired glucose tolerance and finally type 2 diabetes occurs over several years, with no apparent symptoms. This period is significant as insulin resistance is associated with cardiovascular abnormalities. Compensatory hyperinsulinemia maintains blood glucose levels until the point of beta cell exhaustion, when...

Learning objectives :
After viewing these slides the participant will be able to discuss:

- The natural history of type 2 diabetes
- UKPDS data showing the decline in beta cell function over time

Bibliographic references :
UKPDS Group (UKPDS 16).U.K. prospective diabetes study 16. Overview of 6 years' therapy of type II diabetes: a progressive disease. U.K. Prospective Diabetes Study Group Diabetes 1995;44(11):1249-1258.

   


 Presentation 

"Inflammation and Atherosclerosis"

Dr. Peter Libby (biography)
English - 2004-06-04 - 42 minutes
(56 slides)
(49 slides)

Summary :
In this presentation Dr. Libby presents scientific data illustrating the role of inflammation in atherosclerosis, as well as evidence for the use of biomarkers in the assessment of cardiovascular risk.

Moving away from the "rust in a pipe" analogy of atherosclerosis based on the buildup of cholesterol-containing debris in the artery, it is now understood that the artery wall is...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- Basic science data illustrating the role of inflammation in the initiation, progression and thrombotic complications of atherosclerosis
- Studies demonstrating the predictive value of biomarkers of cardiovascular risk: soluble CD40 ligand and high-sensitivity C-reactive protein (hs-CRP)
- Recommendations for hs-CRP testing from the AHA/CDC scientific statement on Markers of Inflammation and Cardiovascular Disease

Bibliographic references :
Gu L, Okada Y, Clinton SK, Gerard C, Sukhova GK, Libby P, Rollins BJ.Absence of monocyte chemoattractant protein-1 reduces atherosclerosis in low density lipoprotein receptor-deficient mice.Mol Cell. 1998 Aug;2(2):275-81.

Li H, Cybulsky MI, Gimbrone MA Jr, Libby P.An atherogenic diet rapidly induces VCAM-1, a cytokine-regulatable mononuclear leukocyte adhesion molecule, in rabbit aortic endothelium.Arterioscler Thromb. 1993 Feb;13(2):197-204.

Peter Libby, MD.Molecular Bases of the Acute Coronary Syndromes Circulation. 1995;91:2844-2850.

Peter Libby, MD; Paul M. Ridker, MD, MPH.Novel Inflammatory Markers of Coronary Risk: Theory Versus Practice Circulation. 1999;100:1148-1150.

Peter Libby, MD.Current Concepts of the Pathogenesis of the Acute Coronary Syndromes Circulation. 2001;104:365.

Libby P."Atherosclerosis: the new view."Sci Am. 2002 May;286(5):46-55.

PETER LIBBY.Inflammation in atherosclerosis Nature 2002;420:868 - 874.

Peter Libby, MD; Paul M. Ridker, MD; Attilio Maseri, MD.Inflammation and Atherosclerosis Circulation. 2002;105:1135.

François Mach, MD; Uwe Schönbeck, PhD; Jean-Yves Bonnefoy, PhD; Jordan S. Pober, MD, PhD; ; Peter Libby, MD.Activation of Monocyte/Macrophage Functions Related to Acute Atheroma Complication by Ligation of CD40-Induction of Collagenase, Stromelysin, and Tissue FactorCirculation. 1997;96:396-399.

François Mach, Uwe Schönbeck, Galina K. Sukhova, Todd Bourcier, Jean-Yves Bonnefoy, Jordan S. Pober, and Peter Libby.Functional CD40 ligand is expressed on human vascular endothelial cells, smooth muscle cells, and macrophages: Implications for CD40-CD40 ligand signaling in atherosclerosis Proc. Natl. Acad. Sci. USA. 1997;94:1931-1936.

FRANÇOIS MACH, UWE SCHÖNBECK, GALINA K. SUKHOVA, ELIZABETH ATKINSON & PETER LIBBY.Reduction of atherosclerosis in mice by inhibition of CD40 signallingNature.1998;394:200 - 203.

Thomas A. Pearson, MD, PhD (Co-Chair); George A. Mensah, MD (Co-Chair); R. Wayne Alexander, MD, PhD; Jeffrey L. Anderson, MD; Richard O. Cannon, III, MD; Michael Criqui, MD; Yazid Y. Fadl, MD; Stephen P. Fortmann, MD; Yuling Hong, MD, PhD; Gary L. Myers, PhD; Nader Rifai, PhD; Sidney C. Smith, Jr, MD; Kathryn Taubert, PhD; Russell P. Tracy, PhD; Frank Vinicor, MD Markers of Inflammation and Cardiovascular Disease Circulation. 2003;107:499.

Aruna D. Pradhan, MD,MPH; JoAnn E. Manson, MD,DrPH; Nader Rifai, PhD; Julie E. Buring, ScD; Paul M. Ridker, MD,MPH. C-Reactive Protein, Interleukin 6, and Risk of Developing Type 2 Diabetes Mellitus JAMA. 2001;286:327-334.

Tripathi Rajavashisth, Jian-Hua Qiao, Sangeetika Tripathi, Jagannath Tripathi, Nikhilesh Mishra, Michael Hua, Xu-Ping Wang, Arthur Loussararian, Steven Clinton, Peter Libby, and Aldons Lusis.Heterozygous Osteopetrotic (op) Mutation Reduces Atherosclerosis in LDL Receptor- deficient Mice JCI 1998;101(12):2702-2710.

Paul M. Ridker, MD; Robert J. Glynn, ScD; ; Charles H. Hennekens, MD C-Reactive Protein Adds to the Predictive Value of Total and HDL Cholesterol in Determining Risk of First Myocardial Infarction Circulation. 1998;97:2007-2011.

Paul M Ridker, MD; Julie E. Buring, ScD; Nancy R. Cook, ScD; Nader Rifai, PhD.C-Reactive Protein, the Metabolic Syndrome, and Risk of Incident Cardiovascular Events: An 8-Year Follow-Up of 14 719 Initially Healthy American Women Circulation. 2003;107:391.

Paul M Ridker, MD, MPH; Nancy Cook, ScD.Clinical Usefulness of Very High and Very Low Levels of C-Reactive Protein Across the Full Range of Framingham Risk Scores Circulation. 2004;109:1955-1959.

U. Schönbeck, G. K. Sukhova, K. Shimizu, F. Mach, and P. Libby.Inhibition of CD40 signaling limits evolution of established atherosclerosis in mice PNAS 2000;97(13):7458-7463.

Uwe Schönbeck, PhD*; Nerea Varo, PhD*; Peter Libby, MD; Julie Buring, ScD; Paul M. Ridker, MD.Soluble CD40L and Cardiovascular Risk in Women Circulation. 2001;104:2266.

Howard D. Sesso, ScD, MPH; Julie E. Buring, ScD; Nader Rifai, PhD; Gavin J. Blake, MD, MPH; J. Michael Gaziano, MD, MPH; Paul M. Ridker, MD, MPH. C-Reactive Protein and the Risk of Developing Hypertension JAMA. 2003;290:2945-2951.

Galina K. Sukhova, PhD; Uwe Schönbeck, PhD; Elena Rabkin, MD, PhD; Frederick J. Schoen, MD, PhD; A. Robin Poole, PhD, DSc; R. Clark Billinghurst, DVM, PhD; Peter Libby, MD.Evidence for Increased Collagenolysis by Interstitial Collagenases-1 and -3 in Vulnerable Human Atheromatous Plaques Circulation. 1999;99:2503-2509.

Nerea Varo, PhD; David Vicent, MD, PhD; Peter Libby, MD; Rebecca Nuzzo, BSc; Alfonso L. Calle-Pascual, MD, PhD; María Rosa Bernal, PhD; Arturo Fernández-Cruz, MD, PhD; Aristidis Veves, MD, DSc; Petr Jarolim, MD, PhD; Jose Javier Varo, MD, PhD; Allison Goldfine, MD; Edward Horton, MD; Uwe Schönbeck, PhD.Elevated Plasma Levels of the Atherogenic Mediator Soluble CD40 Ligand in Diabetic Patients: A Novel Target of Thiazolidinediones Circulation. 2003;107:2664.

Nerea Varo, PhD; James A. de Lemos, MD; Peter Libby, MD; David A. Morrow, MD, MPH; Sabina A. Murphy, MPH; Rebecca Nuzzo, BSc; C. Michael Gibson, MD; Christopher P. Cannon, MD; Eugene Braunwald, MD; Uwe Schönbeck, PhD.Soluble CD40L: Risk Prediction After Acute Coronary SyndromesCirculation. 2003;108:1049.

Marjolein Visser, PhD; Lex M. Bouter, PhD; Geraldine M. McQuillan, PhD; Mark H. Wener, MD; Tamara B. Harris, MD, MS. Elevated C-Reactive Protein Levels in Overweight and Obese Adults JAMA. 1999;282:2131-2135.

   


 Presentation 

"ß-cell Failure in Type 2 Diabetes: The Case for Earlier Intervention"

Prof. Steven Kahn (biography)
English - 2004-05-24 - 78 minutes
(46 slides)
(5 questions)

Summary :
It has been known for some time that both insulin resistance and beta cell dysfunction are important contributors in the pathogenesis of type 2 diabetes. The relative contribution of each of these defects at different stages in the deterioration of glucose tolerance can be assessed by observing a plot of insulin sensitivity versus acute insulin response to glucose. The product of these two...

Learning objectives :
The participant will learn about the following:

- Relationship between insulin sensitivity and the acute insulin response to glucose in different groups of individuals at risk for type 2 diabetes
- Deterioration in insulin secretion and insulin sensitivity during the conversion from normal to impaired glucose tolerance
- Islet amyloid deposition and its impact on beta cell mass
- Intervention at the IGT stage (TRIPOD and DPP Studies)

Bibliographic references :
Alexandra E. Butler, Juliette Janson, Susan Bonner-Weir, Robert Ritzel, Robert A. Rizza, and Peter C. Butler. ß-Cell Deficit and Increased ß-Cell Apoptosis in Humans With Type 2 Diabetes Diabetes 52:102-110, 2003

SE Kahn, RL Prigeon, DK McCulloch, EJ Boyko, RN Bergman, MW Schwartz, JL Neifing, WK Ward, JC Beard, JP Palmer. Quantification of the relationship between insulin sensitivity and beta-cell function in human subjects. Evidence for a hyperbolic function Diabetes 1993; 42(11):1663-1672

Christian Weyer, Clifton Bogardus, David M. Mott and Richard E. Pratley. The natural history of insulin secretory dysfunction and insulin resistance in the pathogenesis of type 2 diabetes mellitus J Clin Invest, September 1999, Volume 104, Number 6, 787-794

   


 Presentation 

"Impaired Microvascular Recruitment and Muscle Insulin Resistance"

Dr. Michael G. Clark (biography)
English - 2004-05-15 - 53 minutes
(48 slides)

Summary :
Apart from increasing glucose uptake into muscle, in vivo insulin induces nitric oxide-dependent recruitment of muscle capillaries. In this presentation Dr. Clark speaks about insulin-mediated capillary recruitment, how it is affected by insulin resistant states, and how it affects glucose uptake in muscle.

Copyright © 2004 MULTIWEBCAST...

Learning objectives :
The participant will learn about the following:

- Rate-limiting steps in muscle glucose uptake in vivo
- Status of capillary flow in muscle at rest
- Measurement of capillary recruitment
- Effects of insulin and exercise on capillary recruitment
- Insulin resistance

Bibliographic references :
Poulin RA, Steil GM, Moore DM, Ader M, Bergman RN. Dynamics of glucose production and uptake are more closely related to insulin in hindlimb lymph than in thoracic duct lymph. PMID: 8288041 [PubMed - indexed for MEDLINE]

Sjostrand M, Gudbjornsdottir S, Holmang A, Lonn L, Strindberg L, Lonnroth P. Delayed transcapillary transport of insulin to muscle interstitial fluid in obese subjects. Diabetes. 2002 Sep;51(9):2742-8.

Halseth AE, Bracy DP, Wasserman DH. Limitations to basal and insulin-stimulated skeletal muscle glucose uptake in the high-fat-fed rat. Am J Physiol Endocrinol Metab. 2000 Nov;279(5):E1064-71.

Rattigan S, Clark MG, Barrett EJ. Hemodynamic actions of insulin in rat skeletal muscle: evidence for capillary recruitment. PMID: 9287035 [PubMed - indexed for MEDLINE]

Vincent MA, Clerk LH, Lindner JR, Klibanov AL, Clark MG, Rattigan S, Barrett EJ. Microvascular recruitment is an early insulin effect that regulates skeletal muscle glucose uptake in vivo. Diabetes. 2004 Jun;53(6):1418-23.

Zhang N, Richter A, Suriawinata J, Harbaran S, Altomonte J, Cong L, Zhang H, Song K, Meseck M, Bromberg J, Dong H. Elevated vascular endothelial growth factor production in islets improves islet graft vascularization. Diabetes. 2004 Apr;53(4):963-70.

Vincent MA, Barrett EJ, Lindner JR, Clark MG, Rattigan S. Inhibiting NOS blocks microvascular recruitment and blunts muscle glucose uptake in response to insulin. Am J Physiol Endocrinol Metab. 2003 Jul;285(1):E123-9.

Youd JM, Rattigan S, Clark MG. Acute impairment of insulin-mediated capillary recruitment and glucose uptake in rat skeletal muscle in vivo by TNF-alpha. Diabetes. 2000 Nov;49(11):1904-9.

S Rattigan, MG Clark, and EJ Barrett Acute vasoconstriction-induced insulin resistance in rat muscle in vivo Diabetes 48: 564-569.

Lucy H. Clerk, Stephen Rattigan, and Michael G. Clark Lipid Infusion Impairs Physiologic Insulin-Mediated Capillary Recruitment and Muscle Glucose Uptake In Vivo Diabetes 51: 1138-1145.

Michelle G. Wallis, Catherine M. Wheatley, Stephen Rattigan, Eugene J. Barrett, Andrew D.H. Clark, and Michael G. Clark Insulin-Mediated Hemodynamic Changes Are Impaired in Muscle of Zucker Obese Rats Diabetes 2002 51: 3492-3498.

   


 Presentation 

"New Insights in Diabetic Retinopathy"

Dr. Filiberto Altomare (biography)
English - 2003-10-31 - 40 minutes
(31 slides)

Summary :
The underlying pathogenesis of diabetic retinopathy has long been thought of as being primarily vascular in nature, but there is growing evidence that there are not only vascular but neuronal changes (1, 2) involved.

A better understanding of the molecular biology of the ocular angiogenesis pathway has led to the development of new therapeutic targets. For example, inhibition of ...

Learning objectives :
The participant will get a new understanding of the pathogenesis of diabetic retinopathy and learn about advances in its treatment.

Conclusion:

- Diabetic retinopathy is a disease that includes neurodegenerative as well as vascular pathologies. Therefore, vision loss can be attributed to neuronal dysfunction and vascular abnormalities.

- Great acheivements in the understanding of the molecular biology of angiogenesis have occurred. This has permitted the identification of novel targets in the management of diabetic retinopathy.

- A number of clinical trials are underway, the outcome of which will initiate a new era whereby diabetic retinopathy is managed pharmacologically, rather than with laser photocoagulation.

Bibliographic references :
1. Scott TM, Foote J, Peat B, Galway G. “Vascular and neural changes in the rat optic nerve following induction of diabetes with streptozotocin.” J Anat. 1986 Feb;144:145-52.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2961719&dopt=Abstract

2. Barber AJ, Lieth E, Khin SA, Antonetti DA, Buchanan AG, Gardner TW. “Neural apoptosis in the retina during experimental and human diabetes. Early onset and effect of insulin.” J Clin Invest. 1998 Aug 15;102(4):783-91.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9710447&dopt=Abstract

3. Ozaki H, Seo MS, Ozaki K, Yamada H, Yamada E, Okamoto N, Hofmann F, Wood JM, Campochiaro PA. “Blockade of vascular endothelial cell growth factor receptor signaling is sufficient to completely prevent retinal neovascularization.” Am J Pathol. 2000 Feb;156(2):697-707.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10666398&dopt=Abstract

4. Gilbert RE, Kelly DJ, Cox AJ, Wilkinson-Berka JL, Rumble JR, Osicka T, Panagiotopoulos S, Lee V, Hendrich EC, Jerums G, Cooper ME. “Angiotensin converting enzyme inhibition reduces retinal overexpression of vascular endothelial growth factor and hyperpermeability in experimental diabetes.” Diabetologia. 2000 Nov;43(11):1360-7.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11126403&dopt=Abstract

   


 Presentation 

"The Wheres and Whats of Body Fat Distribution"

Prof. Steven Kahn (biography)
English - 2003-07-14 - 37 minutes
(30 slides)
(4 questions)

Summary :
We have been focusing a lot lately on the roles of adipocytokines, although the distribution of body fat also plays an important part in insulin resistance. We now know that there are lean as well as obese insulin resistant patients, and about 47% of the variance in insulin sensitivity among healthy (non-diabetic) subjects can be explained by intra-abdominal fat area (Cnop M et al. Diabetes 51:...

Learning objectives :
The participant will learn about the importance of body fat distribution in insulin resistance, and receive new information about the adipokines leptin and adiponectin in relation to body fat distribution:

- There are lean as well as obese insulin resistant patients, and about 47% of the variance in insulin sensitivity among healthy (non-diabetic) subjects can be explained by intra-abdominal fat area (Cnop M et al. Diabetes 51: 1005-15; 2002).

- Central adiposity contributes to an atherogenic lipid profile (Nieves DJ et al. Diabetes 52: 172-79; 2003).

- Leptin levels increase with increasing subcutaneous fat and this phenomenon is more pronounced in women (Cnop M et al. Diabetes 51: 1005-15; 2002).

- Adiponectin levels, which are associated with insulin sensitivity, decrease with increasing intra-abdominal fat, increase with age and are higher in women than in men; also adiponectin and leptin levels are not related (Cnop M et al. Diabetologia. 46: 459-69; 2003).

- Adiponectin levels are inversely related to triglyceride levels, and tightly correlated with HDL cholesterol levels (Cnop M et al. Diabetologia. 46: 459-69; 2003).


Bibliographic references :
Cnop M, Havel PJ, Utzschneider KM, Carr DB, Sinha MK, Boyko EJ, Retzlaff BM, Knopp RH, Brunzell JD, Kahn SE. Relationship of adiponectin to body fat distribution, insulin sensitivity and plasma lipoproteins: evidence for independent roles of age and sex. Diabetologia. 2003 Apr;46(4):459-69.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi

Nieves DJ, Cnop M, Retzlaff B, Walden CE, Brunzell JD, Knopp RH, Kahn SE. The atherogenic lipoprotein profile associated with obesity and insulin resistance is largely attributable to intra-abdominal fat. Diabetes. 2003 Jan;52(1):172-9.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi

Cnop M, Landchild MJ, Vidal J, Havel PJ, Knowles NG, Carr DR, Wang F, Hull RL, Boyko EJ, Retzlaff BM, Walden CE, Knopp RH, Kahn SE. The concurrent accumulation of intra-abdominal and subcutaneous fat explains the association between insulin resistance and plasma leptin concentrations : distinct metabolic effects of two fat compartments. Diabetes. 2002 Apr;51(4):1005-15.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi


   


 Presentation 

"Nuclear Receptor Diseases Mechanisms"

Dr. Mitchell Lazar (biography)
English - 2002-10-28 - 47 minutes
(36 slides)

Summary :
Nuclear receptors are important mediators of disease in general. In this talk Dr Lazar focuses on two mechanistic aspects, showing how these receptors may be targeted for disease. Nuclear hormone receptors are transcription factors that are found in the nucleus of cells, and bind to ligands. Classical members of the nuclear receptor family are thyroid hormone, the steroid hormones, and vitamins A...

Learning objectives :
Nuclear recptors are ligand-activated transcription factors, and their mechanisms of action can be understood to develop ways to treat some diseases, for example type 2 diabetes.
The drugs called thiazolidinediones (TZDs) act as ligands to the PPARγ nuclear recptors, thereby downregulating the insulin resistance molecule resistin, and upregulating adiponectin which increases insulin action. These produce clinically antidiabetic effects, thus making TZDs a treatment option for type 2 diabetes.
TZDs also promote fat uptake and storage, and have recently been found to affect the enzyme glycerol kinase in this process.


Bibliographic references :
Thiazolidinedione activation of peroxisome proliferator-activated receptor gamma can enhance mitochondrial potential and promote cell survival.

Wang YL, Frauwirth KA, Rangwala SM, Lazar MA, Thompson CB.


Abramson Family Cancer Research Institute, Department of Cancer Biology, University of Pennsylvania, Philadelphia, Pennsylvania 19104-6160, USA.

Thiazolidinediones (TZDs) are widely used for treatment of type 2 diabetes mellitus. Peroxisome proliferator-activated receptor gamma (PPAR gamma) is the molecular target of TZDs and is believed to mediate the apoptotic effects of this class of drugs in a variety of cell types, including B and T lymphocytes. The finding that TZDs induce lymphocyte death has raised concerns regarding whether TZDs might further impair immune functions in diabetics. To address this issue, we investigated the roles of PPAR gamma and TZDs in lymphocyte survival. PPAR gamma was up-regulated upon T cell activation. As previously reported, PPAR gamma agonists induced T cell death in a dose-dependent manner. However, the concentrations of TZD needed to cause T cell death were above those needed to induce PPAR gamma-dependent transcription. Surprisingly, at concentrations that induce optimal transcriptional activation, TZD activation of PPAR gamma protected cells from apoptosis following growth factor withdrawal. The survival-enhancing effects depended on both the presence and activation of PPAR gamma. Measurements of mitochondrial potential revealed that PPAR gamma activation enhanced the ability of cells to maintain their mitochondrial potential. These data indicate that activation of PPAR gamma with TZDs can promote cell survival and suggest that PPAR gamma activation may potentially augment the immune responses of diabetic patients.

J Biol Chem 2002 Aug 30;277(35):31781-8


   


 Presentation 

"Beta Cell Failure in type 2 Diabetes: A Paradigm Revisited"

Dr. Minna Woo (biography)
English - 2002-01-19 - 20 minutes
(20 slides)

Summary :
Pathology of type 2 diabetes is a combination of insulin resistance and defective beta-cells. Overview of the impact of b cells in this pathology and a conclusion that demonstrates that a change in the cellular function and mass of beta-cells are both involved in the development of type 2 diabetes.

Learning objectives :
Upon completion of this presentation, participants should be able to understand the:
1.Importance of b cell failure in the development and progression of Type 2 DM.
2.Potential causes of b cell failure.
3.Mechanisms of b cell failure.

Bibliographic references :
Executionary pathway for apoptosis: lessons from mutant mice.

Woo M, Hakem R, Mak TW.

Amgen Institute and Ontario Cancer Institute, Department of Immunology, University of Toronto, Canada. mwoo@oci.utoronto.ca

Apoptosis or programmed cell death (PCD) is an evolutionarily conserved cellular process that is essential for normal development and homeostasis of multicellular organisms. Defects in the apoptosis signaling result in many diseases including autoimmune diseases and cancer. The apoptosis signaling pathway was first described genetically in the nematode Caenorhabditis elegans which serves as a framework for the more complex apoptotic pathways that exist in mammals. In this review, we will discuss the apoptotic pathways that are emerging in mammals as elucidated by studies of gene-targeted mutant mice.

Cell Res 2000 Dec;10(4):267-78

   


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