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Insulin resistance: a global epidemic in need of effective therapies

R.M. Califf*

Duke Clinical Research Institute, Durham, North Carolina, U.S.A.

* Robert M. Califf, Duke Clinical Research Institute, Box 3850, Durham, NC 27710, U.S.A.

Abstract

There is a worldwide rapid increase in the prevalence of type 2 diabetes, due to factors such as improved affluence, longevity, and obesity. To prevent the development of diabetes, individuals must be identified at an early stage of risk and targeted with preventive measures such as lifestyle advice and pharmacological therapy. A key indicator of risk is impaired glucose tolerance. We have recently begun the Nateglinide And Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) trial to gather epidemiological data and provide insight into the protective effects of the angiotensin receptor blocker valsartan in patients with improved glucose intolerance.

Key Words: Cardiovascular risk • impaired glucose tolerance • metabolic syndrome • nateglinide • valsartan

References

  1. Zimmet P. Globalization, coca-colonization and the chronic disease epidemic: can the Doomsday scenario be averted? J Intern Med. 2000;247:301–310[CrossRef][Web of Science][Medline]
  2. Mathers CD, Sadana R, Salomon JA, Murray CJ, Lopez AD. Healthy life expectancy in 191 countries, 1999. Lancet. 2001;357:1685–1691[CrossRef][Web of Science][Medline]
  3. Manton KG, Land KC. Active life expectancy estimates for the U.S. elderly population: a multidimensional continous-mixture model of functional change applied to completed cohorts, 1982–1996. Demography. 2000;37:253–265[Web of Science][Medline]
  4. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 1997;20:1183–1197[Web of Science][Medline]
  5. World Health Organization. Diabetes mellitus: report of a WHO study group. Geneva: World Health Organization; 1985.
  6. Pan XR, Li GW, Hu YH, et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care. 1997;20:537–544[Abstract]
  7. Tuomilehto J, Lindstrom J, Eriksson JG, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001;344:1343–1350[Abstract/Free Full Text]
  8. Zimmet P, Alberti KG, Shaw J. Global and societal implications of the diabetes epidemic. Nature. 2001;414:782[CrossRef][Medline]
  9. Alberti KG. Impaired glucose tolerance: what are the clinical implications? Diabetes Res Clin Pract. 1998;40:S3–S8 (suppl)
  10. Perry RC, Baron AD. Impaired glucose tolerance. Why is it not a disease? Diabetes Care. 1999;22:883–885[Web of Science][Medline]
  11. Hypertension in Diabetes Study Group. Hypertension in Diabetes Study (HDS): I. Prevalence of hypertension in newly presenting type 2 diabetic patients and the association with risk factors for cardiovascular and diabetic complications. J Hypertens. 1993;11:309–317[CrossRef][Web of Science][Medline]
  12. Harris M, Cowie C, Stern M, et al. Diabetes in America. Washington, DC: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 1995.
  13. Prescott-Clarke P, Primatesta P. Health survey for England 1995. London: HMSO; 1997.
  14. Adler AI, Stratton IM, Neil HA, et al. Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study. BMJ. 2000;321:412–419[Abstract/Free Full Text]
  15. Stratton IM, Adler AI, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321:405–412[Abstract/Free Full Text]
  16. UK Prospective Diabetes Study Group. Efficacy of atenolol and captopril in reducing risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 39. UK Prospective Diabetes Study Group. BMJ. 1998;317:713–720[Abstract/Free Full Text]
  17. UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. UK Prospective Diabetes Study Group. BMJ. 1998;317:703–713[Abstract/Free Full Text]
  18. Hansson L, Zanchetti A, Carruthers SG, et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. HOT Study Group. Lancet. 1998;351:1755–1762[CrossRef][Web of Science][Medline]
  19. Johnson KC, Graney MJ, Applegate WB, et al. Prevalence of undiagnosed non-insulin-dependent diabetes mellitus and impaired glucose tolerance in a cohort of older persons with hypertension. J Am Geriatr Soc. 1997;45:695–700[Web of Science][Medline]
  20. Dahlöf B, Devereux R, Kjeldsen S, et al. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet. 2002;359:995–1003[CrossRef][Web of Science][Medline]
  21. Hansson L, Lithell H. The study on cognition and prognosis in elderly hypertensives (SCOPE). Prague, Czech RepublicData presented at the 19th Scientific Meeting of the International Society of Hypertension and 12th European Meeting on Hypertension — European Society of Hypertension. June 23–27, 2002.
  22. Yusuf S, Gerstein H, Hoogwerf B, et al. Ramipril and the development of diabetes. JAMA. 2001;286:1882–1885[Abstract/Free Full Text]
  23. Svensson P, de Faire U, Sleight P, Yusuf S, Ostergren J. Comparative effects of ramipril on ambulatory and office blood pressures: a HOPE Substudy. Hypertension. 2001;38:E28–E32
  24. Paolisso G, Tagliamonte MR, Gambardella A, et al. Losartan mediated improvement in insulin action is mainly due to an increase in non-oxidative glucose metabolism and blood flow in insulin-resistant hypertensive patients. J Hum Hypertens. 1997;11:307–312[CrossRef][Web of Science][Medline]
  25. Top C, Cingozbay BY, Terekeci H, et al. The effects of valsartan on insulin sensitivity in patients with primary hypertension. J Int Med Res. 2002;30:15–20[Web of Science][Medline]
  26. Haffner S, Holman R, Califf R, et al. Targeting post-prandial hyperglycemia to prevent type 2 diabetes: rationale and design of the NAVIGATOR trial. Budapest, HungaryPresented at the 38th annual of the European Association for the Study of Diabetes. September 3, 2002.
  27. Sato Y, Nishikawa M, Shinkai H, Sukegawa E. Possibility of ideal blood glucose control by a new oral hypoglycemic agent, N-[trans-4-isopropylcyclohexyl)-carbonyl]-D-phenylalanine (A-4166), and its stimulatory effect on insulin secretion in animals. Diabetes Res Clin Pract. 1991;12:53–59[CrossRef][Web of Science][Medline]
  28. Hanefeld M, Bouter KP, Dickinson S, Guitard C. Rapid and short-acting mealtime insulin secretion with nateglinide controls both prandial and mean glycemia. Diabetes Care. 2000;23:202–207[Abstract]
  29. Cohn JN, Tognoni G, Valsartan Heart Failure Trial Investigators. A randomized trial of the angiotensin-receptor blocker valsartan in chronic heart failure. N Engl J Med. 2001;345:1667–1675[Abstract/Free Full Text]
  30. Viberti G, Wheeldon NM, MARVAL study investigators. Microalbuminuria reduction with valsartan in patients with type 2 diabetes mellitus: a blood pressure independent effect. Circulation. 2002;106:672–678[Abstract/Free Full Text]
  31. Horton ES, Clinkingbeard C, Gatlin M, et al. Nateglinide alone and in combination with metformin improves glycemic control by reducing mealtime glucose levels in type 2 diabetes. Diabetes Care. 2000;23:1660–1665[Abstract/Free Full Text]
  32. Markham A, Goa KL. Valsartan. A review of its pharmacology and therapeutic use in essential hypertension. Drugs. 1997;54:299–311[Web of Science][Medline]
  33. Burnier M, Brunner HR. Angiotensin II receptor antagonists in hypertension. Kidney Int. 1998;68:107–110 (suppl)
  34. Hedner T, Oparil S, Rasmussen K, et al. A comparison of the angiotensin II antagonists valsartan and losartan in the treatment of essential hypertension. Am J Hypertens. 1999;12:414–417[CrossRef][Web of Science][Medline]
  35. Wadden TA. Treatment of obesity by moderate and severe caloric restriction. Results of clinical research trials. Ann Intern Med. 1993;119:688–693[Abstract/Free Full Text]
  36. Wing RR, Venditti E, Jakicic JM, Polley BA, Lang W. Lifestyle intervention in overweight individuals with a family history of diabetes. Diabetes Care. 1998;21:350–359[Abstract]
  37. Gerstein HC. Reduction of cardiovascular events and microvascular complications in diabetes with ACE inhibitor treatment: HOPE and MICRO-HOPE. Diabetes Metab Res Rev. 2002;18(suppl 3):S82–S85

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This Article
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