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Ciccarone Articles

Ciccarone Center Research


Diabetes & Metabolic Syndrome

Landmark Articles

Long-term effects of the Diabetes Prevention Program interventions on cardiovascular risk factors: a report from the DPP Outcomes Study.
By: Orchard TJ, Temprosa M, Barrett-Connor E, Fowler SE, Goldberg RB, Golden SH, Mather KJ, Marcovina SM, Montez M, Ratner RE, Saudek CD, Sherif H, Watson KE; and the Diabetes Prevention Program Outcomes Study Research Group.
This study investigated the long-term differences in cardiovascular disease risk factors and the use of lipid and blood pressure medications by the original Diabetes Prevention Program intervention group.
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Statin therapy: impact on dyslipidemia and cardiovascular events in diabetic patients.
By: Martin SS, Joshi PH, Jones SP.

Diabetes mellitus is associated with high rates of atherosclerosis-related cardiovascular events. Rigorous randomized controlled trials have shown consistently beneficial effects with statin treatment in diabetic patients, reducing event rates. The beneficial effects are seen consistently regardless of pretreatment low-density lipoprotein cholesterol levels. Further reduction of risk with statins may be achieved with more aggressive treatment targeting metrics of atherogenic burden such as apolipoprotein B or LDL particle concentration, more accurately quantifying atherogenic and atherosclerosis-related event risk.

Metabolic Syndrome: understanding the epidemic in India and South Asia.
By: Blaha MJ, Tota-Maharaj R, McEvoy JW.
Reductions in glucose among postmenopausal women who use and do not use estrogen therapy.
By: Kim C, Kong S, Laughlin GA, Golden SH, Mather KJ, Nan B, Randolph JF Jr, Edelstein SL, Labrie F, Buschur E, Barrett-Connor E; for The Diabetes Prevention Program Research Group.
Among postmenopausal women who do not use estrogen therapy (ET), we have previously reported that intensive lifestyle modification (ILS) leads to increases in sex hormone-binding globulin (SHBG) and that such increases are associated with reductions in fasting plasma glucose (FPG) and 2-hour postchallenge glucose (2HG). Oral ET decreases FPG and increases 2HG while increasing both SHBG and estradiol (E2). It is unknown if ILS reduces glucose among ET users, if changes in SHBG and E2 might mediate any glucose decreases in ET users, and if these patterns differ from those in non-ET users. We conclude that among glucose-intolerant ET users, interventions to reduce glucose are effective but possibly mediated through different pathways than among women who do not use ET.
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Cardiovascular effects of noninsulin, glucose-lowering agents: Need for more outcomes data.
By: Joshi PH, Kalyani RR, Blumenthal RS, Donner TW.
This comprehensive review article provides recommendations, based on current data, for a therapeutic approach with noninsulin, glucose-lowering agents for the prevention of cardiovascular events in patients with type 2 diabetes.
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Endogenous sex hormone changes in postmenopausal women in the diabetes prevention program.
By: Kim C, Kong S, Laughlin GA, Golden SH, Mather KJ, Nan B, Edelstein SL, Randolph JF Jr, Labrie F, Buschur E, Barrett-Connor E.
Among postmenopausal glucose-intolerant women not using estrogen, intensive lifestyle modification increased SHBG levels and lower DHEA levels. These changes are associated with lower glucose independent of adiposity and insulin. Metformin effects upon endogenous sex hormones are not significant.
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Computed tomography scans in the evaluation of fatty liver disease in a population based study: the multi-ethnic study of atherosclerosis.
By: Zeb I, Li D, Nasir K, Katz R, Larijani VN, Budoff MJ.

Fatty liver disease is a common clinical entity in hepatology practice. This study evaluates the prevalence and reproducibility of computed tomography (CT) measures for diagnosis of fatty liver and compares commonly used CT criteria for the diagnosis of liver fat. Fatty liver can be reliably diagnosed using nonenhanced CT scans.

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Diurnal salivary cortisol and urinary catecholamines are associated with diabetes mellitus: the Multi-Ethnic Study of Atherosclerosis.
By: Champaneri S, Xu X, Carnethon MR, Bertoni AG, Seeman T, Diez Roux A, Golden SH.


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Comparative effectiveness and safety of methods of insulin delivery and glucose monitoring for diabetes mellitus: A systematic review and meta-analysis.
By: Yeh HC, Brown TT, Maruthur N, Ranasinghe P, Berger Z, Suh YD, Wilson LM, Haberl EB, Brick J, Bass EB, Golden SH.
Continuous subcutaneous insulin infusion and multiple daily injections have similar effects on glycemic control and hypoglycemia, except continuous subcutaneous insulin infusion has a favorable effect on glycemic control in adults with type 1 diabetes mellitus. For glycemic control, real-time continuous glucose monitoring is superior to self-monitoring of blood glucose, and sensor-augmented insulin pumps are superior to multiple daily injections and self-monitoring of blood glucose without increasing the risk for hypoglycemia.
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Metabolic Syndrome: from risk factors to management.
By: Blaha MJ, Tota-Maharaj R.