David J Schneider and Burton E Sobel

University of Vermont, Burlington, Vermont

Optimal treatment of patients with diabetes requires an understanding of the mechanisms underlying the disease. Treatment must be designed not only to control hyperglycemia but also to prevent or retard complications that result from diverse processes underlying the development of diabetes. This chapter will focus on the therapeutic promise of elucidation of such processes and their cardiovascular consequences.

All diabetic subjects exhibit hyperglycemia. Yet hyperglycemia is only the tip of an iceberg of abnormalities in carbohydrate, lipid, and protein metabolism. Although insulin deficiency is the hallmark of type 1 diabetes, 90% of diabetic subjects suffer from type 2 diabetes, a disorder of dysinsulinemia. For decades before its onset, insulin resistance and compensatory increases in the concentration of insulin and its precursors in blood are present, particularly postprandially. Impaired glucose tolerance occurs eventually as compensatory mechanisms fail. Early treatment may delay the onset of frank diabetes and prevent or retard the development of cardiovascular complications.

Diabetes per se, independent of coexistent cardiovascular risk factors, accelerates the progression of cardiovascular disease. In addition, diabetes acts synergistically with other determinants of cardiac risk such as hypertension and hyperlipidemia. The specific pathways involved must be identified to optimize prevention of the resultant cardiovascular sequelae.

Supplements For Diabetics

Supplements For Diabetics

All you need is a proper diet of fresh fruits and vegetables and get plenty of exercise and you'll be fine. Ever heard those words from your doctor? If that's all heshe recommends then you're missing out an important ingredient for health that he's not telling you. Fact is that you can adhere to the strictest diet, watch everything you eat and get the exercise of amarathon runner and still come down with diabetic complications. Diet, exercise and standard drug treatments simply aren't enough to help keep your diabetes under control.

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