By Francesco Paneni, Francesco Cosentino
This publication offers a pragmatic hands-on method of the administration of sufferers with diabetes and heart problems, with unique and updated insurance of quite a few facets of rising medical significance. functional recommendation is obtainable on prognosis, threat stratification, administration of cardiovascular possibility elements and on hand drug treatments. acceptable myocardial revascularization concepts are defined and the present nation of data is documented concerning target-led multifactorial remedy and the administration of acute coronary syndromes, middle failure, and cerebrovascular illness. New algorithms for analysis and therapy are provided and to make sure ease of reference every one bankruptcy contains a field with sensible strategies in addition to informative colour illustrations and tables. The guide should be of worth for all cardiologists and diabetologists and may be specially priceless for younger cardiologists, who're ever extra often faced by means of sufferers with diabetes and cardiovascular disease.
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Additional resources for Diabetes and Cardiovascular Disease: A Guide to Clinical Management
The V-Heft and, more recently, the ATLAS study showed that the proportion of DM patients with HF may reach 20 % [3, 4]. Interestingly, risk of HF already increases in non-DM patients with impaired glucose tolerance. This notion is supported by seminal studies showing that insulin resistance, detected by glycemic-hyperinsulinemic clamp, is strongly and independently associated with incidence of HF, with more than 20 persons/year affected in the lowest clamp quartile . In this study, fasting plasma glucose, OGTT 2 h glucose, and waist F.
2). Although IR has been attributed to adipocyte-derived inflammation, recent evidence is overturning the “adipocentric paradigm” . Indeed, inflammation and macrophage activation seem to primarily occur in nonadipose tissue in obesity. This concept is supported by the notion that suppression of inflammation in the vasculature prevents IR in other organs and prolongs lifespan . Transgenic mice with endothelium-specific overexpression of the inhibitory NF-kB subunit IkBα were protected against the development of IR.
32. 33. 34. 35. 36. 37. 38. 39. 40. 33 smooth muscle cell hypersensitivity to insulin in diabetic hypertensive rats. Cardiovasc Diabetol 10:48 Mammi C, Pastore D, Lombardo MF, Ferrelli F, Caprio M, Consoli C et al (2011) Sildenafil reduces insulin-resistance in human endothelial cells. PLoS One 6, e14542 Bohm F, Pernow J (2007) The importance of endothelin-1 for vascular dysfunction in cardiovascular disease. Cardiovasc Res 76:8–18 Ferri C, Bellini C, Desideri G, Di Francesco L, Baldoncini R, Santucci A et al (1995) Plasma endothelin-1 levels in obese hypertensive and normotensive men.