Abstract
Steno-2 Study has previously shown that intensified multifactorial intervention reduces the risk of nonfatal cardiovascular disease in patients with type 2 diabetes. Further, in the recent follow-up study, intensive therapy was found to have sustained beneficial effects on cardiovascular events and death in this population. A similar outcome was reported in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT-EDIC) Research, which revealed that original intensive therapy reduced the risk of cardiovascular events to about 50% of that of conventional treatment in type 1 diabetic patients 11 years after the end of the trial, although glycosylated hemoglobin values in the two groups had almost converged during the follow-up periods. These two clinical studies strongly suggest that so-called 'metabolic memory' causes chronic vascular damage in diabetic patients, that are not easily reversed, even by subsequent, relatively good control of metabolic risk factors. Potential mechanisms for propagating this 'metabolic memory' are the non-enzymatic glycation of proteins. Indeed, the formation and accumulation of advanced glycation end products (AGEs) have been known to progress at an ...Continue Reading
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