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"Se me quitaron las ansias por harinas y dulces... y a los dos meses
salí embarazada."
60 años de edad, con
obesidad o sobrepeso.
Isabela, 39. Recientemente diagnosticada con diabetes
y más de 10 años en tratamiento por infertilidad.
G r u p o 1
Grupo 2 Su diabetes
dolores de cabeza, la tensión se normalizó, el azúcar bien... un
milagro".
Josefina, 38.
This adiviíy is no! sanctioned by, ñor a part of, the American Diabetes Assooation. Conference news does not ra
iriiospective cohort study
ndependently.
From Heartwire íhr Lancet, Volume 375» issue9713. Pages 481 - 489, 6 February 2010
ACCORD/ADVANCE?
lubtfshed O n l i n e : 27 J a n u a r y 2 0 1 0
Sue Hughes
Authors a n d D i s c i o s u r e s r >M
I Wned cohorts, compartid with the glycated haemogtobin (HbA ) Afeite wfih the iowest tward «median HDA, 7-5S, IQR
1e C
/ -. i the adjusted haxarti ratio (MR) of ais-cause mortaitly in thetowestHbA, decile (4-«, 6t-4-6)was 1-52 (95» Cl 1-JZ-
£
I /Al. »f.d in ttehighest HbA, detile (median 10-SX, m l O - l - t V » ) was %-n {95XCI 1-M~2-06>. Resultó stowed a genera! U-
c
Csrdiologists OJSRppo¡ntf*d
tloprd aíjociation. with trie ¡owest HR at an HhA, of about 7-556. HR for ali-cause mortality in people giren Insultn based
c
• .2814 deathsi versus those gtven combinatfoo oral sgents (2015) was t-49 (95% CI ¡-19 1 59».
The two cardioiogtsts who commented on the lases! dato for heartw/ne bofh expressed disappointmerit ovef (he
cardiovascular resulte. Or Steven Nissen (Cleveland Clinic. OH) sald: "What we have fearned from ACCQRD and liiUrpretation
ADVANCE is terrtbly dfsappotnttng, in my view-that ihe strategies we are usirtg to Sower blood sugar are slroply not E mid M|h mean HbA, vaiues were ajjocfsted with increased aü-cause mortaíity and cardias events. if confirmad, diabetes
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efectiva ai reducing cardiovascular dísease. Yes, the reductton ín microvascular complicalions ¡s importan; but me gnlilrhnes mifht need reráton to include a mínimum HbA, valué. c
magnitud© of this beneflt is reiatívely modest considering there are more hypoglycemtc episodes and other adverse
effects with intensivo care I can't sea a fot of beneflt in stoiggimg to get down ¡o very ¡ow levéis of A . l'm afraid the
ADVANCE study does not advanca the field much at aít, in my opinión."
Inncet 1 9 9 8 S e p 1 2 ; 3 5 2 { 9 1 3 1 ) 8 3 7 - 5 3 .
Krumhotz eomments: "Tbese siudies drum horra to me that we can't sepárate the idea of reducing btood sugar from Intensive blood-glucose control with sulphonylureas or insulin
the strategies that are we using to do that. Knowing that a drug iowers blood glucosa obviously laní enough, i don't compared with conventional treatment and risk of complications
think we should give up m the idea of iowering blood sugar. but the strategies used in (hese triáis (particuiarty
ACCORO) were not that impressiva,! thiok what we have seen here is that the more meds you use, the more hkety
In patients with type 2 diabetes (UKPDS 33). UK Prospective
you are to expose patients to potential ríate. We had hoped that the benefite of the glucosa iowering woukí be wortti Diabetes Study (UKPDS) Group.
it. but that'snot howit pannedout*
uiuvni'.iiy ol Molbourne, Department of Medicine, Royal Melbourne Hospital, Melboume, Vic., Australia.
Depaitnent of Human Nutrition, Deakin University, Geelong, Vic.
Almtract
CONCLUSION: It is suggested that insulin resistance was important to the survival of Aborigines as hunter- Km mm of the presen! study was to identify in young, diabetes-prone subjects the early abnormalities which
may predispose to the development of type 2 diabetes. We studied 10 full-blood Australian Aborigines all of
gatherers, but is also trie underiying metabolic characterístic predisposing them to obesity, NIDDM and CHD *iiom had a family history of diabetes and who were from an urbanised community with a high prevalence of
after westemisation. Intervention strategies to prevent chronic diseases related to insulin resistance should be .ir.nrder. They were compared to 10 age- and body-mass-index-matched Caucasian controls with no
•My
directed at lifestyle modiftcation. To be effective sucri programmes will have to be developed and implemented
history of diabetes. Glucose kinetics were measured basally and following an oral glucose load. Fasting
!•....• i,i glucose was equal in the two groups, but 2 h following the 75 g glucose load, the Abohginal subjects
atlhecommunity level. imd higher glycaemia than the controls (P less than 0.01). Insullnaemia was higher in the Aborigines both
hannlly and following the glucose drink (P less than 0.05). Despite the hyperinsulinaemia, hepatic glucose
liioduction was higher in the Aboriginal subjects (P less than 0.01). while metabolic clearance rate was lower.
PMID: 1875844 [PubMed • mdexed for MEDLINE1 II la concluded that in young Australian Aborigines with a strong family history of type 2 diabetes, both hepatic
and penpheral insulin resistance are early abnormalities.
motivated vo.unteers with *YPe 2 ^ e t e ' 5 t the low gtycemlc Index diet.
indicar nuevas medicinas, en estadios donde la reserva
dí3b€tes.
pancreática lo permite.
Una tercera consideración ausente en el tratamiento dti i un cuarto y último factor, tampoco reconocido por el
las "academias", que también deberá ser comprendida iMi.imiento de las "academias", es la Hipomagnesemia
para el correcto tratamiento de la diabetes, es el G A M t Q liiii.Kolular como gestor de la patología cardiovascular,
Excursión Glicémica c o m o factor de evolución en su ni h i;. antes inclusive de que la glicemia se eleve.
desarrollo, aun con la glicemia "controlada" (HbA1c
inferiora 6,2%).
IM.II.. i. . Ur; Clin Pract. 2009 Feb;83(2):257-62. Epub 2009 Jan 4.
Glucose F l u c t u a t i o n s Compared With Sustained llrnii Mde L, GruzX Rodriguéis .LE, Bomfirn O, Meló J, Correia R, Porto M, Cedro A, Vicente
I
Chronic Hyperglycemia in Patients With Type 2 I i«|Mirtment of Medicine, Faculty of Medicine, Federal University of Bahía, Brazil.
Diabetes iiiii.iinioslima@hotmail.com
Louis Monnier, MD; Emilie Mas, PhD; Christine Ginet, MD; Francoise Michel,
MD; Laetitia Villon, MD; Jean-Paul Cristo!, MD; Claude Colette, PhD American Diabetes Association
Intraceilular Free Magnesium Deficieney
Conclusions Ctucose fluctuations during postprandial periods and, more
generally, during glucose swings exhibited a more specific tríggering effect on
Plays a Key Role in Increased Platelet
oxidative stress than chronic sustained hyperglycemia. The present data suggest Reactívity in Type II Diabetes Mellitus
that interventional triáis in type 2 diabetes should target not only hemoglobm
l.-rry L Nadier, MD, Sam Malayan, MD, Heten L u o n g . BS, Sytvia Shaw, MD,
Aic and mean glucose concentrations but also acute glucose swings. Rama D Natarajan, PHD and Robert K Rude, MD
Microvascular Complications
doi:
10.2337/diacare.!5.7.835
Diabetes Care July 1992 vol.
1 5 no. 7 8 3 5 - 8 4 1
Iri B, Kirsch, MD; Michael Brownlee, MD