Abstract
The current diagnostic threshold for diabetes mellitus is imposed on a continuous distribution of blood glucose measurement. A more clinical approach estimates a threshold above which the rate of diabetes-specific complications rises steeply. However, the diagnostic threshold for diabetes is essentially established on the risk of microvascular and not cardiovascular complications. Indeed, while there appears to be a continuous relationship between blood glucose, cardiovascular risk and overall mortality, this association extends into the sub-diabetic range, with no threshold identified. In this regard, the assumption that the diagnosis of diabetes can effectively identify patients at elevated risk of cardiovascular morbidity and mortality is potentially flawed, and questions the utility of diabetes status (as a dichotomous variable) for the assessment and management of cardiovascular risk. Indeed, the increased risk of cardiovascular complications may not be related to diabetes status per se but the frequent association of diabetes with a high-risk phenotype, now recognised as the so-called ‘metabolic syndrome’. By implication, cardiovascular disease prevention should not be dominated by a drive for the prevention of diabetes, but this broader clinical syndrome of increased cardiovascular risk.
Keywords: oral glucose tolerance testing, cardiovascular risk, dyslipidaemia, International Diabetes Federation, metabolic syndrome
Current Pharmaceutical Design
Title: From Diabetes to Metabolic Syndrome: A View Point on An Evolving Concept
Volume: 13 Issue: 25
Author(s): Hoong Sern Lim and Gregory Y.H. Lip
Affiliation:
Keywords: oral glucose tolerance testing, cardiovascular risk, dyslipidaemia, International Diabetes Federation, metabolic syndrome
Abstract: The current diagnostic threshold for diabetes mellitus is imposed on a continuous distribution of blood glucose measurement. A more clinical approach estimates a threshold above which the rate of diabetes-specific complications rises steeply. However, the diagnostic threshold for diabetes is essentially established on the risk of microvascular and not cardiovascular complications. Indeed, while there appears to be a continuous relationship between blood glucose, cardiovascular risk and overall mortality, this association extends into the sub-diabetic range, with no threshold identified. In this regard, the assumption that the diagnosis of diabetes can effectively identify patients at elevated risk of cardiovascular morbidity and mortality is potentially flawed, and questions the utility of diabetes status (as a dichotomous variable) for the assessment and management of cardiovascular risk. Indeed, the increased risk of cardiovascular complications may not be related to diabetes status per se but the frequent association of diabetes with a high-risk phenotype, now recognised as the so-called ‘metabolic syndrome’. By implication, cardiovascular disease prevention should not be dominated by a drive for the prevention of diabetes, but this broader clinical syndrome of increased cardiovascular risk.
Export Options
About this article
Cite this article as:
Lim Sern Hoong and Lip Y.H. Gregory, From Diabetes to Metabolic Syndrome: A View Point on An Evolving Concept, Current Pharmaceutical Design 2007; 13 (25) . https://dx.doi.org/10.2174/138161207781663028
DOI https://dx.doi.org/10.2174/138161207781663028 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Antifungal Drugs for Systemic Mycosis: An Overview of Mechanism of Action and Resistance
Anti-Infective Agents in Medicinal Chemistry Editorial (Hot Topic: Achieving Current Goals in Prevention and Treatment of Vascular Disease: An Update)
Current Pharmaceutical Design Purine Ionotropic (P2X) Receptors
Current Pharmaceutical Design A Possible Link of Gut Microbiota Alteration in Type 2 Diabetes and Alzheimer’s Disease Pathogenicity: An Update
CNS & Neurological Disorders - Drug Targets A Pilot Study of Exenatide Actions in Alzheimer’s Disease
Current Alzheimer Research Association of Platelet Activation with Vascular Cognitive Impairment: Implications in Dementia Development?
Current Vascular Pharmacology Investigating the Practices of Patients and Hospitals in Treatment of Diabetes - A Survey Questionnaire for Arabic Speaking Countries
Current Diabetes Reviews Prevention of Vascular Complications in Diabetes Mellitus Patients: Focus on the Arterial Wall
Current Vascular Pharmacology “Metabolically Healthy” Obesity: Fact or Threat?
Current Diabetes Reviews Glycation Induced Generation of Amyloid Fibril Structures by Glucose Metabolites
Protein & Peptide Letters Resistin: An Inflammatory Cytokine. Role in Cardiovascular Diseases, Diabetes and the Metabolic Syndrome
Current Pharmaceutical Design Hidden Hunger of Vitamin E among Healthy College Students: A Cross- Sectional Study
Endocrine, Metabolic & Immune Disorders - Drug Targets Genomics and Proteomics of Nucleoside Transporters
Current Pharmacogenomics Preeclampsia: A Couples Disease with Maternal and Fetal Manifestations
Current Pharmaceutical Design The Biology and Therapeutic Potential of the DDAH/ADMA Pathway
Current Pharmaceutical Design Systemic Delivery of Peptide Hormones Using Nasal Powders: Strategies and Future Perspectives
Drug Delivery Letters Possible Usefulness of Growth Hormone/Insulin-like Growth Factor-I Axis in Alzheimer’s Disease Treatment
Endocrine, Metabolic & Immune Disorders - Drug Targets Obesity and Arterial Compliance Alterations
Current Vascular Pharmacology The Role of Genetic Polymorphism in the Formation of Arterial Hypertension, Type 2 Diabetes and their Comorbidity
Current Pharmaceutical Design Lipoprotein (a) and Cardiovascular Risk: The Show Must go on
Current Medicinal Chemistry