The effects of macronutrients composition on hormones and substrates during a meal tolerance test in drugnaive and sitagliptin-treated individuals with type 2 diabetes: a randomized crossover study.

Objective: To evaluate the effect of sitagliptin treatment in early type 2 diabetes mellitus (T2DM) and the impact of different macronutrient compositions on hormones and substrates during meal tolerance tests (MTT).

Methods: Half of the drug-naive patients with T2DM were randomly assigned for treatment with 100 mg of sitagliptin, q.d.

Development and internal validation of an adrenal cortical carcinoma prognostic score for predicting the risk of metastasis and local recurrence.

Objective: To develop and internally validate a prognostic score to predict the risk of metastases or recurrence in patients with adrenal cortical carcinomas (ACC).

Design: Clinical, laboratory and pathological data from 129 ACC patients, treated in a tertiary centre, were retrospectively reviewed.

Results: Using a multivariate binary logistic regression analysis, we developed a prognostic score with five covariates: a functional pattern other than isolated hyperandrogenism, a tumour size >7·5 cm, a primary tumour classified as T3/T4, the presence of microscopic venous invasion and a mitotic index >5/50 high-power fields.

Metformin, but not glimepiride, improves carotid artery diameter and blood flow in patients with type 2 diabetes mellitus.

Objective: To compare the effects of glimepiride and metformin on vascular reactivity, hemostatic factors and glucose and lipid profiles in patients with type 2 diabetes.

Methods: A prospective study was performed in 16 uncontrolled patients with diabetes previously treated with dietary intervention. The participants were randomized into metformin or glimepiride therapy groups.

Clinical approaches to preserve beta-cell function in diabetes.

In type 2 diabetes (DM2) there is progressive deterioration in beta-cell function and mass. It was found that islet function was about 50% of normal at the time of diagnosis and reduction in beta-cell mass of about 60% at necropsy (accelerated apoptosis). Among the interventions to preserve the beta-cells, those to lead to short-term improvement of beta-cell secretion are weight loss, metformin, sulfonylureas, and insulin.

Adipose tissue at the crossroads in the development of the metabolic syndrome, inflammation and atherosclerosis.

The authors analyze insulin resistance, the metabolic syndrome and endothelial dysfunction as consequence of a common antecedent, a low grade inflammation, indicating that in obesity there is a chronically activated inflammatory state of the adipose tissue. Furthermore, the inflammatory signaling is discussed according to the adipose tissue depot, visceral or subcutaneous.

[Lipid transfer to HDl in women with type 1 diabetes].

Introduction: People with type 1 diabetes mellitus (T1DM) have an increased risk of cardiovascular disease and may still have a normal lipid profile. In order to clarify whether normal HDL cholesterol levels may conceal defects in HDL function, we have studied the transfer of lipids to HDL in T1DM.

Methods: Twenty-one young women with T1DM were compared with 21 non-diabetic women.

Glycemia and cardiovascular disease in type 1 diabetes mellitus.

Objective: To evaluate the role of glycemic control in the development of cardiovascular disease (CVD) in type 1 diabetes mellitus (DM).

Methods: We review the literature regarding coronary atherosclerosis, coronary artery calcification, and the epidemiologic studies related to the role of glycemia and the classic risk factors for coronary artery disease (CAD) in type 1 DM.

Results: Four prospective studies (Wisconsin Epidemiologic Study of Diabetic Retinopathy, EURODIAB, Steno Diabetes Center Study of Adults With Type 1 DM, and Pittsburgh Epidemiology of Diabetes Complications study) do not show that glycemic control predicts CAD occurrence.

[The prevalence of diabetes and stress hyperglycemia in the acute myocardial infarction patients].

Objectives: To evaluate in our population the real prevalence of diabetes (DM) and stress hyperglycemia (HE) in patients with myocardial infarction (IAM) admitted in a cardiologic emergency unit.

Methods: A retrospective analysis of 2262 patients with AMI evaluating the prevalence of DM (referred and diagnosed) and stress hyperglycemia.

Results: Besides 12.

[Cardiovascular disease in type 1 diabetes mellitus].

The association between type 1 diabetes and coronary heart disease has become very clear since the late 1970. It has been demonstrated that there is an important increased risk in morbidity and mortality caused by coronary artery disease in young adults with type 1 diabetes compared with the non diabetic population. The underlying pathogeneses is still poorly understood.

Postprandial glycemia and cardiovascular disease in diabetes mellitus.

This article reviews the role of fasting and postprandial glycemia to the overall glycemic control of patients with type 2 diabetes and glucose intolerance, as well as their causal relationship upon micro and macrovascular complications. Recent studies have suggested that a third component of the glucose triad, the postprandial glucose excursions, might have a role in the overall glycemic load and might also reflect glycemic control. Epidemiological and intervention studies are presented in the article, supporting the conclusion that postprandial hyperglycemia in impaired glucose tolerance and diabetic subjects is a more powerful marker of cardiovascular disease risk than fasting hyperglycemia, then the treatment directed at specifically lowering postprandial glucose is crucial, as underlined by the American Diabetes Association.

Estrogen treatment improves arterial distensibility, fibrinolysis, and metabolic profile in postmenopausal women with type 2 diabetes mellitus.

The effects of isolated estrogen therapy on the hemostatic system and arterial distensibility were determined in postmenopausal females with type 2 diabetes mellitus. This was a prospective nonrandomized study of 19 subjects (age, 56.2 +/- 4.

Ambulatory blood pressure monitoring (ABPM) in normotensive adolescents with type 1 diabetes.

Objective: To evaluate 24-h ambulatory blood pressure monitoring (ABPM) for early detection of hypertension in adolescents with type 1 diabetes mellitus (DM1).

Design: Patients underwent fundoscopy, albuminuria determinations, two repeated autonomic cardiovascular tests, heart rate (HR) variation during deep breathing and blood pressure (BP) variation during sustained handgrip. Twenty-four hour BP measurements were taken automatically by an oscillometric portable monitor.

Intra-abdominal thickness by ultrasonography to predict risk factors for cardiovascular disease and its correlation with anthropometric measurements.

The aim of this study was to determine if intra-abdominal thickness measured by ultrasonography (IATU) in men and women had a correlation with cardiovascular risk factors, to compare it with anthropometric measures (waist circumference [WC] and abdominal sagittal diameter [SDi]), and to find a cut-off value for IATU to predict risk factors for cardiovascular disease (CVD). In a cross-validation study, intra-abdominal fat tissue measured by CT at L4-L5 was significantly correlated with ultrasonography (US) intra-abdominal thickness. A total of 191 and 231 healthy men and women, respectively, aged 20 to 60 years, were evaluated by anthropometric indexes (body mass index [BMI], WC, and SDi), and systolic blood pressure (SBP) and diastolic blood pressure (DBP), fasting total plasma cholesterol (Chol), high-density lipoprotein (HDL) cholesterol, triglyceride (TG), and glucose (Glu) levels.

Electrolyte and renal changes in severe potassium depletion.

This report describes electrolyte changes and some clinical aspects of the renal disease associated with the loss of potassium through the gastrointestinal tract in 2 patients with diarrhea. In one of them, the diarrhea resulted from non-tropical sprue, in the other, from non-beta islet-cell adenoma of pancreas. In both patients, some observations were repeated after potassium repletion.