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Intensified Multifactorial Intervention in Patients with Type 2 Diabetes Mellitus
Takayoshi Sasako, Toshimasa Yamauchi, Kohjiro Ueki
Diabetes Metab J. 2023;47(2):185-197.   Published online January 12, 2023
DOI: https://doi.org/10.4093/dmj.2022.0325
  • 6,841 View
  • 404 Download
  • 13 Web of Science
  • 13 Crossref
AbstractAbstract PDFPubReader   ePub   
In the management of diabetes mellitus, one of the most important goals is to prevent its micro- and macrovascular complications, and to that end, multifactorial intervention is widely recommended. Intensified multifactorial intervention with pharmacotherapy for associated risk factors, alongside lifestyle modification, was first shown to be efficacious in patients with microalbuminuria (Steno-2 study), then in those with less advanced microvascular complications (the Anglo-Danish-Dutch Study of Intensive Treatment In People with Screen Detected Diabetes in Primary Care [ADDITION]-Europe and the Japan Diabetes Optimal Treatment study for 3 major risk factors of cardiovascular diseases [J-DOIT3]), and in those with advanced microvascular complications (the Nephropathy In Diabetes-Type 2 [NID-2] study and Diabetic Nephropathy Remission and Regression Team Trial in Japan [DNETT-Japan]). Thus far, multifactorial intervention led to a reduction in cardiovascular and renal events, albeit not necessarily significant. It should be noted that not only baseline characteristics but also the control status of the risk factors and event rates during intervention among the patients widely varied from one trial to the next. Further evidence is needed for the efficacy of multifactorial intervention in a longer duration and in younger or elderly patients. Moreover, now that new classes of antidiabetic drugs are available, it should be addressed whether strict and safe glycemic control, alongside control of other risk factors, could lead to further risk reductions in micro- and macrovascular complications, thereby decreasing all-cause mortality in patients with type 2 diabetes mellitus.

Citations

Citations to this article as recorded by  
  • Exploring mechanisms underlying diabetes comorbidities and strategies to prevent vascular complications
    Takayoshi Sasako
    Diabetology International.2024; 15(1): 34.     CrossRef
  • Targeting ERS-mitophagy in hippocampal neurons to explore the improvement of memory by tea polyphenols in aged type 2 diabetic rats
    Wenjuan Feng, Chenhui Lv, Le Cheng, Xin Song, Xuemin Li, Haoran Xie, Shuangzhi Chen, Xi Wang, Lushan Xue, Cheng Zhang, Jie Kou, Lili Wang, Haifeng Zhao
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    BMC Endocrine Disorders.2024;[Epub]     CrossRef
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    Takayoshi Sasako
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    Silvia Ferreira Bortoto, Jacira Xavier de Carvalho, Mozania Reis de Matos, Cristiane das Graças Dias Cavalcante, Elenilda Almeida Silva Andrade, Márcia Silva Queiroz
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    Seung-Hwan Lee
    Endocrinology and Metabolism.2023; 38(3): 302.     CrossRef
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    Takayoshi Sasako, Kohjiro Ueki
    Journal of Diabetes Investigation.2023; 14(10): 1145.     CrossRef
Obesity and Metabolic Syndrome
Perspective of Small-Molecule AdipoR Agonist for Type 2 Diabetes and Short Life in Obesity
Miki Okada-Iwabu, Masato Iwabu, Kohjiro Ueki, Toshimasa Yamauchi, Takashi Kadowaki
Diabetes Metab J. 2015;39(5):363-372.   Published online October 22, 2015
DOI: https://doi.org/10.4093/dmj.2015.39.5.363
  • 7,819 View
  • 70 Download
  • 41 Web of Science
  • 45 Crossref
AbstractAbstract PDFPubReader   

Obesity associated with unhealthy diet and lack of exercise is shown to contribute to the onset and/or aggravation of the metabolic syndrome and diabetes, thus placing affected individuals at increased risk of cardiovascular disease and cancer. Plasma adiponectin levels are decreased in obesity, which causes insulin resistance and diabetes. Therefore, we identified adiponectin receptors (AdipoRs) as the therapeutic target. It was suggested that, similarly to caloric restriction and exercise, activation of the AdipoRs may have the potential not only to improve lifestyle-related diseases but to contribute to prolonged the shortened lifespan on a high caloric unhealthy diet. To this end, we have identified "AdipoRon" as an adiponectin receptor agonist. Indeed, AdipoRon ameliorated diabetes associated with obesity as well as to increase exercise endurance, thus prolonging shortened lifespan of obese mice fed on a high fat diet. Additionally, we have recently determined the crystal structures of the human AdipoRs. The seven-transmembrane helices of AdipoRs are structurally distinct from those of G-protein coupled receptors. It is expected that these findings will contribute not only to the elucidation of the AdipoR-related signal transduction but to the development and optimization of AdipoR-targeted therapeutics for obesity-related diseases such as diabetes.

Citations

Citations to this article as recorded by  
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    RSC Medicinal Chemistry.2024; 15(7): 2413.     CrossRef
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  • AdipoRon Effect on Expression of Lipid Metabolism Genes in Cultured Human Primary Macrophages
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    Molecular Biology.2023; 57(4): 616.     CrossRef
  • The Antiviral Potential of AdipoRon, an Adiponectin Receptor Agonist, Reveals the Ability of Zika Virus to Deregulate Adiponectin Receptor Expression
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