[ Nutrition ]

Effects of pioglitazone and metformin on plasma adiponectin in newly detected type 2 diabetes mellitus.


Twenty general practices randomly invited 30 950 adults without diagnosed diabetes for screening (World Health Organization, 1999). RESEARCH DESIGN AND METHODS—In the Detection of Ischemia in Asymptomatic Diabetics (DIAD) study, 1,123 patients with type 2 diabetes, aged 50–75 years, with no known or suspected coronary artery disease, were randomly assigned to either stress testing and 5-year clinical follow-up or to follow-up only. We measured FFT, bound and total plasma L-tryptophan, neutral amino acids (NAAs), albumin, free fatty acids (FFAs), glucose, and HbA1c(A1C) and recorded IDAEPs with four intensities (40, 60, 90, and 103 dB). Compared with the first CGMS reading in each arm, the second had a longer mean duration of postprandial within-target glucose levels (P =.04), tendency for lower rate of diurnal hypoglycemic events (P =.1), shorter duration of nocturnal hypoglycemia (P =.05), and smaller 24-hour area under the curve for hypoglycemia (P =.04). Serum ferritin was tested in a univariate analysis against demographics, biochemical parameters, and histological features. CVD risk factors were measured at baseline and repeated at the follow-up examination. Baseline characteristics showed a significantly higher CVD risk, mainly depending on more prevalent CVD events in the screened compared with the clinically detected group (propensity score 0.59 vs.

This study confirmed that patients with CAD and known diabetes are at high risk for mortality and cardiovascular events and demonstrated that patients with newly diagnosed diabetes are at intermediate risk for adverse outcomes. But the process that has destroyed 90 percent of the insulin-producing cells will ultimately destroy the remaining insulin-producing cells. BMI has been inversely associated with GLP-1 response in a number of studies (7,11,14,15).

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