|
|
Content
|
|
|
|
Diabetes ~ equivalent to MI
|
|
|
|
Dia 3
|
|
|
|
Blood pressure and vascular risk in diabetes Best evidence: 2000
|
|
|
|
Blood pressure: best evidence 2009
|
|
|
|
All-cause mortality
|
|
|
|
Dia 7
|
|
|
|
Population in ACCORD
|
|
|
|
Intensive BP lowering (<120) versus standard BP treatment (<140)
|
|
|
|
Intensive BP lowering (<120) is not better than standard BP (<140)
|
|
|
|
Intensive BP lowering (<120) is not better than standard BP (<140)
|
|
|
|
Aspirin in diabetes
|
|
|
|
Belch J et al. BMJ 2008; 337:1030-44.
|
|
|
|
Role of glucose in CV-disease
|
|
|
|
Dia 15
|
|
|
|
Glucose control in ACCORD
|
|
|
|
Effect of intensive glucose regulation on major cardiovascular events
|
|
|
|
UK General Practice Research Base
1986 –2008
Twee cohorten:
intensivering van orale medicatie
Intensivering naar insuline
Sterfte versus HbA1c decilen
|
|
|
|
Survival versus HbA1c (oral treatment)
|
|
|
|
Survival versus HbA1c (insulin treatment)
|
|
|
|
Atherosclerosis Risk in Communities
(ARIC) study
Populatie-based sample 11,092 persons
No history of diabetes or cardiovascular disease
HbA1c measured in whole blood samples 1990-1992
|
|
|
|
Higher HbA1c more CV-disease
|
|
|
|
Higher HbA1c more stroke
|
|
|
|
Holman R ea. N Engl J Med 2008;359:1577-89.
|
|
|
|
Holman R ea. N Engl J Med 2008;359:1577-89.
|
|
|
|
Interpretation
|
|
|
|
Dia 27
|
|
|
|
galega
officinalis
|
|
|
|
Medical management of hyperglycaemia in type 2 diabetes mellitus: a consensus algorithm for the initiation and adjustment of therapy
|
|
|
|
Metformin: evidence and pitfalls
|
|
|
|
SU-derivatives
|
|
|
|
Pioglitazone versus gliclazide added to metformin
|
|
|
|
Time to treatment failure
|
|
|
|
Thiazolidine-diones
|
|
|
|
Dia 35
|
|
|
|
Fracture risk in ADOPT
|
|
|
|
Thiazolidine-diones
|
|
|
|
Alpha-glucosidase inhibitors
|
|
|
|
Diabetes Market Forecast to 2013
|
|
|
|
The
incretin concept
|
|
|
|
Nauck MA ea. JCEM 1986; 63:492
|
|
|
|
Nauck MA ea. JCEM 1986; 63:492
|
|
|
|
Incretin effect
|
|
|
|
The incretin effect
|
|
|
|
“The incretins”
|
|
|
|
Incretins (GLP-1 and GIP) Regulate Glucose Homeostasis Through Effects on Islet Cell Function
|
|
|
|
After release incretins are rapidly inactivated
|
|
|
|
GLP-1 is Rapidly Degraded by the DPP-4 enzyme
|
|
|
|
Degradation of incretins can be decreased by inhibition of the DPP-4 enzyme
|
|
|
|
Effect of sitagliptin on top of metformin
|
|
|
|
Vildagliptin Add-on to Metformin
|
|
|
|
Dia 52
|
|
|
|
DPP-4 remmers
|
|
|
|
When to use incretins?
|
|
|
|
Dia 55
|
|
|
|
Effects of GLP-1
|
|
|
|
General Prescribing Considerations: How It Is Supplied
|
|
|
|
Effect of Exenatide on HbA1c (30 Weeks)
|
|
|
|
Effect of Exenatide on Body Weight
|
|
|
|
Adverse Events
|
|
|
|
Insulin compared to GLP-1 analogue Change in HbA1c compared to baseline
|
|
|
|
Insulin compared to GLP-1 analogue Effect on weight
|
|
|
|
Samenvatting GLP-1 analogen
|
|
|
|
Approach after combination therapy
|
|
|
|
Dia 65
|
|
|
|
Shah ND, et al. NEJM 2010; 363:2081-4.
|
|
|
|
DeSouza C ea. Nat Rev Drug Discov 2009; 8:361-7.
|
|
|
|
FDA guidance on CV outcome trials
|
|
|
|
MACE analysis: Major Adverse Cardiovascular Events
|
|
|
|
Best JH et al. Diabetes Care 2010; on line
|
|
|
|
CV outcome trials investigating incretin based therapies
|
|
|
|
Medical management of hyperglycaemia in type 2 diabetes mellitus: a consensus algorithm for the initiation and adjustment of therapy
|
|
Deel deze pagina met collega's en vrienden: