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Hypoglycemia is a frequent occurrence in patients with diabetes who are treated with insulin and insulin secretagogues. Hypoglycemia is the limiting factor that prevents patients from achieving the glycemic control known to reduce the microvascular complications of diabetes. Recurrent episodes of hypoglycemia can lead to impaired awareness of hypoglycemia where the first symptom of a low blood sugar is unconsciousness. The fear of hypoglycemia has a significant effect on the quality of life of patients and their families. In the acute setting, hypoglycemia can kill, and clinical trials have demonstrated that a single episode of severe hypoglycemia increases the risk of subsequent mortality and cardiovascular events. Clinicians must make efforts to recognize and prevent hypoglycemia in order to prevent the adverse events associated with this event. Patient education is central to these efforts. Recent developments in glucose monitoring and drug development have provided more approaches that can be used to reduce the risk of hypoglycemia in patients with diabetes. 相似文献
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Revisiting multiple models of progression of β‐cell loss of function in type 1 diabetes: Significance for prevention and cure
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Type 1 diabetes (T1D) results from a chronic autoimmune process that leads to β‐cell destruction and exogenous insulin dependence. The natural history of T1D proposed by Eisenbarth suggested six relatively independent stages over the course of the entire disease process, which was considered to be linear and chronic. Based on this classical theory, immunotherapies aim to prevent or reverse all these periods of β‐cell loss. Over the past 30 years, much novel information about the pathogenesis of T1D proved that there are complex metabolic changes occurring throughout the entire disease process. Therefore, new possible models for the natural history of the disease have been proposed; these models, in turn, may help facilitate fresh avenues for the prevention and cure of T1D. Herein, we briefly review recent findings in this field of research, with the aim of providing a better theoretical basis for clinical practice. 相似文献
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Human herpesvirus 8 infection DNA positivity is associated with low insulin secretion: A case‐control study in a sub‐Saharan African population with diabetes
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Eric Lontchi‐Yimagou Jérôme Legoff Jean‐Louis Nguewa Philippe Boudou Eric V. Balti Jean J. Noubiap Vicky Kamwa Barbara Atogho‐Tiedeu Marcel Azabji‐Kenfack Eric N. Djahmeni Martine Etoa Gaelle Lemdjo Vanessa Balla Mesmin Y. Dehayem Fabienne Foufelle Jean‐Claude Mbanya Jean‐Francois Gautier Eugene Sobngwi 《Journal of Diabetes》2018,10(11):866-873
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Jihao Xu Rongrong Liang Wang Zhang Kuangyi Tian Jieyao Li Xianming Chen Tao Yu Qikui Chen 《Journal of Diabetes》2020,12(3):224-236
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Non‐high‐density lipoprotein cholesterol: High‐density lipoprotein cholesterol ratio is an independent risk factor for diabetes mellitus: Results from a population‐based cohort study
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Nan Zhang Xiang Hu Qiao Zhang Peng Bai Miao Cai Tian Shu Zeng Jiao‐Yue Zhang Sheng‐Hua Tian Jie Min Han‐Tao Huang Juan Zheng Miao‐Miao Peng Meng‐Jia Li Lu‐Lu Chen 《Journal of Diabetes》2018,10(9):708-714
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Lance A. Sloan 《Journal of Diabetes》2019,11(12):938-948
Type 2 diabetes mellitus (T2DM) is the most common cause of chronic kidney disease (CKD), and when it causes CKD it is collectively referred to as diabetic kidney disease. One of the newer therapies for managing hyperglycemia is the glucagon‐like peptide‐1 receptor agonist (GLP‐1RA) drug class. This review summarizes the effects of GLP‐1RAs in patients with T2DM with CKD and evidence for renoprotection with GLP‐1RAs using data from observational studies, prospective clinical trials, post hoc analyses, and meta‐analyses. Evidence from some preclinical studies was also reviewed. Taken together, subgroup analyses of patients with varying degrees of renal function demonstrated that glycemic control with GLP‐1RAs was not markedly less effective in patients with mild or moderate renal impairment vs that in patients with normal function. GLP‐1RAs were associated with improvements in some cardiorenal risk factors, including systolic blood pressure and body weight. Furthermore, several large cardiovascular outcome studies showed reduced risks of composite renal outcomes, mostly driven by a reduction in macroalbuminuria, suggesting potential renoprotective effects of GLP‐1RAs. In conclusion, GLP‐1RAs effectively reduced hyperglycemia in patients with mild or moderately impaired kidney function in the limited number of studies to date. GLP‐1RAs may be considered in combination with other glucose‐lowering medications because of their ability to lower glucose in a glucose‐dependent manner, lowering their risk for hypoglycemia, while improving some cardiorenal risk factors. Potential renoprotective effects of GLP‐1RAs, and their renal mechanisms of action, warrant further investigation. 相似文献