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		Literature Compendium

Current Concepts in Type 2 Diabetes

Volume 1
Overview of Type 2 Diabetes Pathogenesis, Complications, Risk Reduction, and Lifestyle Intervention

Introduction From the Co-Editors

Jaime A. Davidson
Alistair Emslie-Smith

In people with Type 2 diabetes, β-cell function appears to decline over time. Hyperglycaemia develops gradually, followed later by a rise in fasting plasma glucose levels. Hence, impaired glucose tolerance and impaired fasting glucose represent intermediate steps in the progression to the clinical diagnosis of diabetes. For many patients, complications, including microvascular and macrovascular changes, begin well in advance of their Type 2 diabetes being diagnosed.

In terms of glycaemic control, numerous studies, including landmark randomized controlled trials, have demonstrated that tight glycaemic control reduces the risk of complications. Studies in pre-diabetes have shown that early intervention slows the progression to diabetes. Ongoing trials are examining the effects of glycaemic interventions on macrovascular complications of diabetes, the impact of early treatment on the course of diabetes, and whether there are differences depending on the nature of the intervention used.

A large proportion of people with Type 2 diabetes develop cardiovascular disease (CVD), with substantial loss of life expectancy. Non-fatal CVD contributes greatly to decreased quality of life in persons with diabetes. Moreover, the current epidemic of obesity has raised expectations that CVD associated with Type 2 diabetes will become an even greater public health challenge. The difficulty in achieving adequate glycaemic control has led to further study of the pathogenesis of the disease and insight into new drug discovery.

This compendium presents key literature related to the pathogenesis of diabetes (Chapter 1) and the need for tight glycaemic control (Chapter 3) and lifestyle intervention (Chapter 4). Chapter 2, on end-organ complications, illustrates the extent to which poor glycaemic control can lead to diminished quality of life and increased mortality. Chapter 3 presents key objective evidence showing that tight glycaemic control reduces the risk of diabetes-related complications and adverse CVD outcomes and includes important study results presented at the June 2007 annual meeting of the American Diabetes Association.

This compendium is the first in a series of 3 volumes presenting the foundational literature that demonstrates fundamental understandings related to Type 2 diabetes. Articles are reprinted in their entirety with commentary from the editors.* It is our hope that the reader will review the commentaries and study the literature to gain a better understanding of the importance of treating Type 2 diabetes and reducing the complications of this devastating disease.

*Note: articles are reprinted in their entirety in the printed version of the compendium. If you would like to be contacted when the printed volume is available, please e-mail WorldWIDE at worldwide@worldwidediabetes.org.

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Click to proceed to Chapter 2.
Click to proceed to Chapter 3.
Click to proceed to Chapter 4.
Click to proceed to Programme Evaluation and Post-test.

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The Literature Compendium is funded by an educational grant from Pfizer Inc.

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