Endocrine Abstracts

Insulin resistance is an insulin signalling defect, defined as resistance of the body to the biological actions of insulin. It is present in around 25% of the UK adult population and, although genetic factors are involved, the major arbiters are obesity and sedentary lifestyle. The tendency of cardiovascular risk factors to co-occur in the same patient may relate to insulin resistance as a primary abnormality. This hypothesis remains controversial particularly as to whether th...

The UKPDS trial confirmed that improving glycaemic control (median 0.9 % HbA1c difference over median 10 years), with sulphonylurea or insulin therapy, could reduce significantly the risk of microvascular complications (25%, p=0.0099) and was associated with a 16% trend (p=0.052) to a reduced risk of coronary heart disease (CHD). In overweight UKPDS patients allocated metformin as first line therapy the 0.6% median HbA1c difference obtained was associated...

Treatments of hyperglycaemia have mostly focussed on targeting fasting glucose. These include Metformin, most sulphonylureas and conventional insulin therapy and, more recently, the glitazones. However, management of postprandial hyperglycaemia in day-to-day practice in both type 1 and type 2 diabetes is now becoming clinically relevant for a number of reasons.There is now robust evidence in women with gestational diabetes that specifically targeting pos...