Abstract
The presence of cardiovascular disease (CVD) in Type 1 diabetes largely impairs life expectancy. Hyperglycemia leading to an increase in oxidative stress is considered to be the key pathophysiological factor of both micro- and macrovascular complications. In Type 1 diabetes, the presence of coronary calcifications is also related to coronary artery disease. Cardiac autonomic neuropathy, which significantly impairs myocardial function and blood flow, also enhances cardiac abnormalities. Also hypoglycemic episodes are considered to adversely influence cardiac performance. Intensive insulin therapy has been demonstrated to reduce the occurrence and progression of both micro- and macrovascular complications. This has been evidenced by the Diabetes Control and Complications Trial (DCCT) / Epidemiology of Diabetes Interventions and Complications (EDIC) study. The concept of a metabolic memory emerged based on the results of the study, which established that intensified insulin therapy is the standard of treatment of Type 1 diabetes. Future therapies may also include glucagon-like peptide (GLP)-based treatment therapies. Pilot studies with GLP-1-analogues have been shown to reduce insulin requirements.
MeSH terms
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Antihypertensive Agents / therapeutic use
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Autonomic Nervous System Diseases / complications
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Autonomic Nervous System Diseases / metabolism
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Cardiovascular Diseases / complications
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Cardiovascular Diseases / drug therapy
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Cardiovascular Diseases / metabolism*
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Diabetes Mellitus, Type 1 / complications
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Diabetes Mellitus, Type 1 / drug therapy
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Diabetes Mellitus, Type 1 / metabolism*
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Diabetic Angiopathies / complications
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Diabetic Angiopathies / drug therapy
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Diabetic Angiopathies / metabolism
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Diabetic Neuropathies / complications
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Diabetic Neuropathies / metabolism
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Drug Therapy, Combination
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Exenatide
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Exercise Therapy
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Glucagon-Like Peptide 1 / agonists
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Glucagon-Like Peptide 1 / metabolism
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Humans
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Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
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Hypoglycemia / chemically induced
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Hypoglycemia / metabolism
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Hypoglycemic Agents / therapeutic use
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Insulin / therapeutic use
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Oxidative Stress / physiology
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Peptides / therapeutic use
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Pyrazines / therapeutic use
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Sitagliptin Phosphate
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Triazoles / therapeutic use
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Venoms / therapeutic use
Substances
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Antihypertensive Agents
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Hydroxymethylglutaryl-CoA Reductase Inhibitors
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Hypoglycemic Agents
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Insulin
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Peptides
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Pyrazines
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Triazoles
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Venoms
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Glucagon-Like Peptide 1
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Exenatide
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Sitagliptin Phosphate