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Recent advances in the management of diabetes mellitus

  • Symposium: Endocrinology—Part I
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Abstract

The Diabetes Control and Complications Trial (DCCT) demonstrated that the improved control of blood glucose levels could delay or prevent long-term complications in patients with insulin dependent diabetes mellitus (IDDM). However, there are questions as to whether this degree of tight control is realistic in community settings. This review will cover new strategies for the management and prevention of IDDM.

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References

  1. DCCT Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin dependent diabetes mellitus.N Engl J Med 1993; 329: 977–986.

    Article  Google Scholar 

  2. DCCT Research Group. The effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin dependent diabetes mellitus.J Pediatr 1994; 125: 177–188.

    Article  Google Scholar 

  3. American Diabetes Association. Implications of the diabetes control and complications trial.Diabetes Care 1993; 16: 1517–1520.

    Google Scholar 

  4. Geffner ME. Reviewing the diabetes control and complications trail: One member of the “control panel” speaks.J Pediatr 1994; 125: 228–229.

    Article  PubMed  CAS  Google Scholar 

  5. Drash AL. The child, the adolescent, and the diabetes control and complications trail.Diabetes Care 1993; 16: 1515–1516.

    PubMed  CAS  Google Scholar 

  6. American Diabetes Association. Multiple component insulin regimens and insulin infusion pump therapy. In: Farkas-Hirsch R, Ed.Intensive Diabetes Management, Alexandria, VA: American Diabetes Association. 1995; 51–78.

    Google Scholar 

  7. Cryer PE, Fisher JN, Shamoon H. Hypoglycemia.Diabetes Care 1994; 17: 734–754.

    PubMed  CAS  Google Scholar 

  8. Cryer PE. Hypoglycemia unawareness in IDDM.Diabetes Care 1993; 16: 40–46.

    PubMed  Google Scholar 

  9. Gold AE, MacLeod KM, Frier BM. Frequency of severe hypoglycemia in patients with type one diabetes with impaired awareness of hypoglycemia.Diabetes Care 1994; 17: 697–703.

    Article  PubMed  CAS  Google Scholar 

  10. Amiel SA, Tamborlane WV, Simonson DC, Sherwin RS. Defective glucose counterregulation after strict glycemia control of insulin dependent diabetes mellitus.N Engl J Med 1987; 316: 1376–1383.

    Article  PubMed  CAS  Google Scholar 

  11. Bolye TJ, Kempers SF, O'Connor AM, Nagy RJ. Brain glucose uptake and unawareness of hypoglycemia in patients with insulin dependent diabetes mellitus.N Engl J Med 1995; 333: 1726–1731.

    Article  Google Scholar 

  12. Molitch ME. ACE inhibitors and diabetic nephropathy.Diabetes Care 1994; 17: 756–760.

    PubMed  CAS  Google Scholar 

  13. Lewis EJ, Hunsicker LG, Bain RP, Rodhe RD. The effect of angiotensin-converting enzyme inhibition on diabetic nephropathy.N Engl J Med 1993; 329: 1456–1462.

    Article  PubMed  CAS  Google Scholar 

  14. Galloway JA, Chance RE. Insulin agonist therapy: A challenge for the 1990's.Clinical Therapeutics 1990; 12: 460–472.

    PubMed  CAS  Google Scholar 

  15. Pampanelli S, Torlone E, Lalli Cet al. Improved postprandial metabolic control after subcutaneous injection of a short-acting insulin analog in IDDM of short duration with residual pancreatic B-cell function.Diabetes Care 1995; 18: 1452–1459.

    Article  PubMed  CAS  Google Scholar 

  16. Bougneres PF, Carel JC, Castano Let al. Factors associated with early remission of type-I diabetes in children treated with cyclosporine.N Engl J Med 1988; 318: 663–670.

    Article  PubMed  CAS  Google Scholar 

  17. Bougneres PF, Landais P, Boisson Cet al. Limited duration of remission of insulin dependency in children with recent overt type I diabetes treated with low dose cyclosporin.Diabetes 1990; 39: 1264–1272.

    Article  PubMed  CAS  Google Scholar 

  18. Rakotoambinina B, Timsit J, Deschamps Iet al. Cyclosporin A does not delay insulin dependency in asymptomatic IDDM patients.Diabetes Care 1995; 18: 1487–1490.

    Article  PubMed  CAS  Google Scholar 

  19. Drash AL. It it time to draw the curtain on immune intervention trials in newly diagnosed patients with IDDM?Diabetes Care 1994; 18: 1499–1500.

    Google Scholar 

  20. Gotfredsen CF, Buschard K, Frandsen EK. Reduction of diabetes incidence of BB Wistar rats by early prophylactic insulin treatment of diabetes-prone animals.Diabetologia 1985;28: 933–935.

    Article  PubMed  CAS  Google Scholar 

  21. Keller RJ, Eisenbarth GS, Jackson RA. Insulin prophylaxis in individuals at high risk of type I diabetes.Lancet 1993; 341: 927–928.

    Article  PubMed  CAS  Google Scholar 

  22. Zhang ZJ, Davidson L, Eisenbarth G, Weiner HL. Suppression of diabetes in nonobese diabetic mice by oral administration of porcine insulin.Proc Natl Acad Sci 1991; 88: 10252–10256.

    Article  PubMed  CAS  Google Scholar 

  23. Muir A, Schatz D. Prevention of insulin-dependent diabetes-1995.Trends in Endocrin and Metab 1995; 6: 312–317.

    Article  CAS  Google Scholar 

  24. Elliott RB, Chase HP. Prevention or delay of type I diabetes mellitus in chidlren using nicotinamide.Diabetologia 1991; 34: 362–365.

    Article  PubMed  CAS  Google Scholar 

  25. Karjalainen J, Martin JM, Knip Met al. A bovine albumin peptide as a possible trigger of IDDM.N Engl J Med 1992; 327: 302–307.

    Article  PubMed  CAS  Google Scholar 

  26. Drash AL, Kramer MS, Swanson J, Udall JN. Infant feeding practices and their possible relationship to the etiology of diabetes mellitus.Pediatrics 1994; 94: 752–754.

    Google Scholar 

  27. Gerstein H. Cow's milk exposure and type I diabetes mellitus.Diabetes Care 1994; 17: 13–19.

    Article  PubMed  CAS  Google Scholar 

  28. Sutherland DER. Current status of pancreas transplantation.J Clin Endocrin Metab 1991; 73: 461–463.

    Article  CAS  Google Scholar 

  29. American Diabetes Association. Pancreas transplantation for patients with diabetes mellitus.Diabetes Care 1995; 18: 37.

    Google Scholar 

  30. Bloomgarden VT. IDDM: Treatment and prevention.Diabetes Care 1996; 19: 96–98.

    PubMed  CAS  Google Scholar 

  31. Pyzdrowski KL, Kendall DM, Halter JBet al. Preserved insulin secretion and insulin independence in recipients of islet autografts.N Engl J Med 1992; 327: 220–226.

    Article  PubMed  CAS  Google Scholar 

  32. Ricordi C, Tzakis AG, Carroll PBet al. Human islet isolation and allotransplatation in 22 consecutive cases.Transplantation 1992; 53: 407–414.

    Article  PubMed  CAS  Google Scholar 

  33. Lacy PE. Status of islet cell transplantation.Diabetes Reviews 1993; 1: 76–92.

    Google Scholar 

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Schwartz, R.P. Recent advances in the management of diabetes mellitus. Indian J Pediatr 64, 33–41 (1997). https://doi.org/10.1007/BF02795774

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