Abstract：
PURPOSE OF REVIEW:Diabetes is the leading cause of kidney disease globally. Diabetic kidney disease (DKD) is a heterogeneous disorder manifested as albuminuria and/or decreasing GFR. Hyperglycemic burden is the major contributor to the development of DKD. In this article, we review the evidence for the contribution of glycemic variability and the pitfalls associated with use of hemoglobin A1c (A1C), the gold standard for assessment of glucose control, in the setting of DKD. RECENT FINDINGS:Glycemic variability, characterized by swings in blood glucose levels, can result in generation of mitochondrial reactive oxygen species, a putative inciting factor for hyperglycemia-induced alterations in intracellular metabolic pathways. While there is indirect evidence supporting the role of glycemic variability in the pathogenesis of DKD, definitive data are lacking. A1C has many limitations and is a particularly suboptimal measure in patients with kidney disease, because its accuracy is compromised by variables affecting RBC survival and other factors. Continuous glucose monitoring (CGM) technology has the potential to enable us to use glucose as a more important clinical tool, for a more definitive understanding of glucose variability and its role in DKD. Glycemic variability may be a factor in the development of DKD, but definitive evidence is lacking. Currently, all available glycemic biomarkers, including A1C, have limitations and in the setting of DKD and should be used cautiously. Emerging data suggest that personal and professional CGM will play an important role in managing diabetes in patients with DKD, where risk of hypoglycemia is high.
journal_name
Curr Diab Repjournal_title
Current diabetes reportsauthors
Subramanian S,Hirsch IBdoi
10.1007/s11892-018-0979-3subject
Has Abstractpub_date
2018-02-15 00:00:00pages
13issue
3eissn
1534-4827issn
1539-0829pii
10.1007/s11892-018-0979-3journal_volume
18pub_type
杂志文章,评审abstract：:Type 1 and type 2 diabetes both accelerate cardiovascular disease, yet the triggers are likely different for the two types of diabetes. Results from large-scale clinical trials suggest that intense blood glucose control can reduce cardiovascular events many years later in patients with type 1 diabetes. In type 2 diabe...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-009-0005-x
更新日期：2009-02-01 00:00:00
abstract：PURPOSE OF REVIEW:Our review provides a brief summary of the most recent advances towards the identification of the genetic basis of specific aspects of obesity and the quantification of their consequences on health. We also highlight the most promising avenues to be explored in the future. RECENT FINDINGS:While obesi...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-020-1285-4
更新日期：2020-01-22 00:00:00
abstract：:Cell therapy has enormous potential for the treatment of conditions of unmet medical need. Cell therapy may be applied to diabetes mellitus in the context of beta cell replacement or for the treatment of diabetic complications. A large number of cell types including hematopoietic stem cells, mesenchymal stem cells, um...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-013-0469-6
更新日期：2014-03-01 00:00:00
abstract：:Beta cell replacement therapy has been proposed as a novel therapy for the treatment of type 1 diabetes. The proof of concept has been demonstrated with successful islet allotransplantation. Islet xenotransplantation has been proposed as an alternative, more reliable, and infinite source of beta cells. The advantages ...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-013-0413-9
更新日期：2013-10-01 00:00:00
abstract：:The term prediabetes refers to subjects with impaired fasting glucose and/or impaired glucose tolerance who are at increased risk for type 2 diabetes mellitus. Although both types of patients are at increased risk for developing type 2 diabetes mellitus and cardiovascular disease, they manifest distinct metabolic abno...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-009-0032-7
更新日期：2009-06-01 00:00:00
abstract：PURPOSE OF REVIEW:Therapies that target beta-cell antigen-specific T cells subsets have not been as successful in patients with type 1 diabetes as in mice. This might be explained by complexities in the repertoire of beta-cell antigen-specific T cells and the variety of T cell subsets involved in type 1 diabetes develo...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-017-0889-9
更新日期：2017-08-01 00:00:00
abstract：PURPOSE OF REVIEW:To introduce recent advances in the understanding of diabetic retinopathy and to summarize current and emerging strategies to treat this common and complex cause of vision loss. RECENT FINDINGS:Advances in retinal imaging and functional analysis indicate that retinal vascular and neural pathologies e...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-019-1218-2
更新日期：2019-09-10 00:00:00
abstract：:Proliferative diabetic retinopathy (PDR), characterized by pathologic retinal angiogenesis, is a major cause of blindness in the USA and globally. Treatments targeting vascular endothelial growth factor (VEGF) have emerged as a beneficial part of the therapeutic armamentarium for this condition, highlighting the utili...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-012-0289-0
更新日期：2012-08-01 00:00:00
abstract：:Diabetes self-management education (DSME) has been shown to improve health outcomes. Yet, relatively little is known about how DSME has its effects. Literature reviewed from the past 3 years indicates that if DSME is to become more effective interventions need to be theory-based, to increase patient involvement in the...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-002-0074-6
更新日期：2002-04-01 00:00:00
abstract：:Unfortunately, the only approved medical treatment for type 1 diabetes mellitus (DM) is insulin, despite the fact that tight control cannot be reached without some serious side effects such as hypoglycemia and weight gain. More and more importance is now shifted towards developing new drugs that can reach a better gly...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-012-0291-6
更新日期：2012-10-01 00:00:00
abstract：:In the general population, breast-feeding is associated with a reduced risk of the offspring being overweight later in life by 22% to 24% across the age spectrum, from preschool children to adults. There is a dose-response gradient with increasing duration of breast-feeding, and lowest risk with prolonged, exclusive b...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-008-0050-x
更新日期：2008-08-01 00:00:00
abstract：:Although type 1 diabetes remains the most common type of diabetes in the pediatric population, there has been a dramatic rise in type 2 diabetes in youth. Clinical distinctions between these two major types have become blurred. As genetic and biochemical measures become more affordable and available, practical applica...
journal_title：Current diabetes reports
pub_type： 杂志文章
doi：10.1007/s11892-006-0020-0
更新日期：2006-04-01 00:00:00
abstract：PURPOSE OF REVIEW:Diabetic nephropathy, a major microvascular complication of diabetes and the most common cause of end-stage renal disease, is characterized by prominent accumulation of extracellular matrix. The membrane microdomains caveolae, and their integral protein caveolin-1, play critical roles in the regulatio...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-017-0844-9
更新日期：2017-03-01 00:00:00
abstract：:Mobile and smartphone (mHealth) technologies have the potential to improve diabetes care and self-management, but little is known about their effectiveness and how patients, providers, and payers currently interact with them. We conducted a systematic review and found only 20 peer-reviewed articles, published since 20...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-015-0680-8
更新日期：2015-12-01 00:00:00
abstract：PURPOSE OF REVIEW:The increasing prevalence of type 2 diabetes is driving the boundaries of clinical diabetes care outside of the traditional office setting. The purpose of this paper will be to review recent technological advances in the medical management of people with type 2 diabetes, spanning the spectrum of care ...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-019-1278-3
更新日期：2019-12-20 00:00:00
abstract：:The unbiased approach of genome-wide linkage analysis has shown evidence for linkage of type 2 diabetes mellitus to the chromosome 1q21-25 region in at least eight independent studies. More than 26 candidate genes have already been evaluated, but to date none explain the evidence for linkage in this gene-dense region....
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-007-0025-3
更新日期：2007-04-01 00:00:00
abstract：PURPOSE OF REVIEW:Ambient air pollution is strongly linked to cardiovascular and respiratory diseases. We summarize available published evidence regarding similar associations with diabetes across the life course. RECENT FINDINGS:We performed a life-course survey of the recent literature, including prenatal, gestation...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-019-1181-y
更新日期：2019-07-19 00:00:00
abstract：:Diabetes mellitus and obesity have become increasingly prevalent problems worldwide. Unfortunately, with traditionally prescribed glucose-lowering medications most individuals with diagnosed diabetes do not achieve and maintain adequate glycemic control over time; it may be even more challenging to lower blood glucose...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-007-0060-0
更新日期：2007-10-01 00:00:00
abstract：PURPOSE OF REVIEW:Evidence-based treatments for prediabetes can prevent and delay the development of type 2 diabetes in adults. In this review, we propose a framework for population-based diabetes prevention that links screening and prevention activities across key stakeholders. We also discuss gaps in current practice...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-018-1090-5
更新日期：2018-09-19 00:00:00
abstract：PURPOSE OF REVIEW:Review innovations in health care financing promoting health system investments in addressing medical and social determinants of health (SDH) for patients with diabetes. RECENT FINDINGS:Particular payment models implemented in the public and private sectors increasingly offer flexibility in health ca...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-019-1275-6
更新日期：2019-11-20 00:00:00
abstract：:Hyperglycemia and dyslipidemia are significant and independent risk factors for the vascular complications in patients with diabetes. They have been suggested to cause cardiovascular pathologic changes in diabetic states through the following molecular mechanisms: formation and accumulation of advanced glycation end p...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-005-0034-z
更新日期：2005-04-01 00:00:00
abstract：:In normal physiology, glucagon from pancreatic alpha cells plays an important role in maintaining glucose homeostasis via its regulatory effect on hepatic glucose production. Patients with type 2 diabetes suffer from fasting and postprandial hyperglucagonemia, which stimulate hepatic glucose production and, thus, cont...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-014-0555-4
更新日期：2014-12-01 00:00:00
abstract：:Hyperglycemia is common following organ transplantation, regardless of the pre-transplant diabetes status. Transient post-transplant hyperglycemia and/or new-onset diabetes after transplantation (NODAT) are common and are associated with increased morbidity and mortality. NODAT and type 2 diabetes share similar charac...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-015-0707-1
更新日期：2016-02-01 00:00:00
abstract：:Diabetic patients are at increased risk for developing cardiovascular disease, and they constitute a large proportion of the global cardiovascular disease burden. Although multiple drugs exist for treating the hyperglycemia associated with diabetes, few have been shown to reduce cardiovascular risk. Great hope surroun...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-010-0099-1
更新日期：2010-04-01 00:00:00
abstract：:Autonomic dysfunction is a frequent and relevant complication of diabetes mellitus, as it is associated with increased morbidity and mortality. In addition, it is today considered as predictive of the most severe diabetic complications, like nephropathy and retinopathy. The classical methods of screening are the cardi...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-016-0804-9
更新日期：2016-11-01 00:00:00
abstract：PURPOSE OF REVIEW:To assess evidence to date for use of non-insulin agents in treatment of gestational diabetes mellitus. RECENT FINDINGS:There has been increasing interest in the use of non-insulin agents, primarily metformin and glyburide (which both cross the placenta). Metformin has been associated with less mater...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-019-1243-1
更新日期：2019-12-06 00:00:00
abstract：:Although numerous chemokine/chemokine receptor pathways have been described to be implicated in the pathogenesis of type 1 diabetes (T1D), the CXCR1/2 axis has recently been proved to be crucial for leucocyte recruitment involved in insulitis and β cell damage. Multiple strategies blocking the CXCR1/2 pathway are avai...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-015-0638-x
更新日期：2015-10-01 00:00:00
abstract：:Comparative results from national strategies for diabetes care and prevention are needed to understand the impact and barriers encountered during the implementation process. Long-term outcomes are limited, but results on intermediate outcomes and processes of diabetes care measures are available from translational res...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-015-0637-y
更新日期：2015-09-01 00:00:00
abstract：PURPOSE OF REVIEW:The purpose of the study is to examine and summarize studies reporting on the epidemiology, the risk of developing diabetes, and the cardiovascular effects on individuals with diabetes of different levels of alcohol consumption. RECENT FINDINGS:Men consume more alcohol than women in populations with ...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-017-0950-8
更新日期：2017-11-04 00:00:00
abstract：:Recent studies support the concept that the retinal vasculature may provide a summary measure of lifetime exposure to the effects of hyperglycemia. Advances in retinal photographic techniques and in image analysis have allowed objective and precise in vivo measurement of retinal vascular changes. In particular, quanti...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-009-0043-4
更新日期：2009-08-01 00:00:00
