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Ciccarone Articles
Ciccarone Center Research
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Diabetes & Metabolic Syndrome
Landmark Articles
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To facilitate the guideline-based implementation of treatment recommendations in the ambulatory setting and to encourage participation in the multiple preventive health efforts that exist, we have organized several recent guideline updates into a simple ABCDEF approach. We would remind clinicians that evidence-based medicine is meant to inform recommendations but that synthesis of patient-specific data and use of appropriate clinical judgment in each individual situation is ultimately preferred.
Published in: Journal of the American Heart AssociationRead on Pubmed -
We conclude that CAC can help risk stratify individuals with diabetes and may aid in selection of patients who may benefit from therapies such as low-dose aspirin for primary prevention of CVD. Published in: Diabetes CareRead on Pubmed -
The goal of this study was to assess the independent and collective associations of hepatic steatosis, obesity, and the metabolic syndrome with elevated hsCRP levels. We evaluated 2,388 individuals without clinical cardiovascular disease between December 2004 and December 2006. Hepatic steatosis was diagnosed by ultrasound, and the metabolic syndrome was defined using National Heart, Lung, and Blood Institute criteria. We concluded that hepatic steatosis, obesity, and the metabolic syndrome are independently and additively associated with increased odds of high hsCRP levels. Published in: Arteriosclerosis, Thrombosis & Vascular BiologyRead on Pubmed
Long-term effects of the Diabetes Prevention Program interventions on cardiovascular risk factors: a report from the DPP Outcomes Study.
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.
- Year: 2013
- Topics: Diabetes & Metabolic Syndrome
- Read more articles by: Sherita Golden, MD, MHS
Statin therapy: impact on dyslipidemia and cardiovascular events in diabetic patients.
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.
- Year: 2013
- Topics: Cholesterol / Lipids / Statins, Diabetes & Metabolic Syndrome
- Read more articles by: Seth Martin, MD, MHS, Steven Jones, MD
Metabolic Syndrome: understanding the epidemic in India and South Asia.
- Year: 2013
- Topics: Diabetes & Metabolic Syndrome
- Read more articles by: Michael Blaha, MD, MPH, J. Bill McEvoy, MB BCh, MHS
Reductions in glucose among postmenopausal women who use and do not use estrogen therapy.
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.
- Year: 2012
- Topics: Diabetes & Metabolic Syndrome, Gender / Cardiovascular Disease in Women, Hormones
- Read more articles by: Sherita Golden, MD, MHS
Cardiovascular effects of noninsulin, glucose-lowering agents: Need for more outcomes data.
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.
- Journal: American Journal of Cardiology
- Year: 2012
- Topics: Diabetes & Metabolic Syndrome
- Read more articles by: Roger S. Blumenthal, MD
Endogenous sex hormone changes in postmenopausal women in the diabetes prevention program.
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.
- Year: 2012
- Topics: Diabetes & Metabolic Syndrome, Gender / Cardiovascular Disease in Women
- Read more articles by: Sherita Golden, MD, MHS
Computed tomography scans in the evaluation of fatty liver disease in a population based study: the multi-ethnic study of atherosclerosis.
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.
- Year: 2012
- Topics: Cardiac CT, Diabetes & Metabolic Syndrome
- Read more articles by: Khurram Nasir, MD, MPH
Diurnal salivary cortisol and urinary catecholamines are associated with diabetes mellitus: the Multi-Ethnic Study of Atherosclerosis.
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- Year: 2012
- Topics: Diabetes & Metabolic Syndrome, Hormones
- Read more articles by: Sherita Golden, MD, MHS
Comparative effectiveness and safety of methods of insulin delivery and glucose monitoring for diabetes mellitus: A systematic review and meta-analysis.
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.
- Journal: Annals of Internal Medicine
- Year: 2012
- Topics: Diabetes & Metabolic Syndrome, Quality of Care
- Read more articles by: Sherita Golden, MD, MHS
Metabolic Syndrome: from risk factors to management.
- Year: 2012
- Topics: Diabetes & Metabolic Syndrome
- Read more articles by: Michael Blaha, MD, MPH