Glucose Control
Glucose Control
Understanding the basics of diabetes and its role in the cardiorenal syndrome
Diabetes and Metabolic Memory
Chronic and progressive hyperglycemia increases risk for microvascular and macrovascular complications.1,2 Landmark studies suggest development of complications may be influenced by a legacy of glycemic control established early in disease.3 Experimental evidence suggests that hyperglycemia-induced changes in gene expression, oxidative stress, and complications can persist even after the restoration of good glucose control.4,5 Both biochemical and epigenetic changes have been suggested to propagate the risk of complications following hyperglycemia despite potential improvements in glucose6.
Pharmacologic Management (Orals and Injectables)
Based on the American Diabetes Association 2020 (ADA 2020) publication7, pharmacologic management for diabetes comprises of 6 oral hypoglycemic agents and insulin, which is subdivided into either human insulin and analogue. This is summarized by the table presented in the presentation embedded.
References
- Gregg EW et al. N EnglJ Med. 2014;370:1514-1523.
- BergenstalRM et al. Am J Med. 2010;123(4):e9-e18.
- DCCT/EDIC StudyResearch Group. Diabetes Care. 2016;39:686-693.
- JayaramanS. CircRes. 2012;110:1039-1041.
- PasquierJ, et al. CurrDiabRep. 2015;15:108.
- Pirola, et al. Nat Rev Endocrinol. 2010;6:665–675.
- American Diabetes Association Diabetes Care 2020 Jan; 43(Supplement 1): S98-S110.https://doi.org/10.2337/dc20-S009
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