Clinical implications of the DREAM study: Response to Davidson [14]

dc.authorid0000-0002-7361-8181
dc.contributor.authorKanat, Mustafa
dc.date.accessioned2021-06-23T18:54:10Z
dc.date.available2021-06-23T18:54:10Z
dc.date.issued2007
dc.departmentBAİBÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümüen_US
dc.description.abstractThe following points should be taken into consideration when determining “what circumstances TZDs [thiazolidinediones] should be used in people without documented diabetes,” as questioned by the commentary published in the February issue of Diabetes Care (1). The DREAM (Diabetes Reduction Assessment with Ramipril and Rosiglitazone Medication) study (2) has limitations that prevent generalizations for individuals with impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT). In this study, individuals with IFG (n = 739), IGT (n = 3,028), or both (n = 1,502) were included (3), and patient recruitment was completed between July 2001 and August 2003. Because these dates are earlier than November 2003 (4), when the American Diabetes Association accepted IFG as ≥100 mg/dl (5.6 mmol/l) and <126 mg/dl (7.0 mmol/l), individuals with glucose levels of ≥6.1 mmol/l (110 mg/dl) and <7.0 mmol/l (126 mg/dl) were included in the study. Since the inclusion criteria (3) for the DREAM study included a fasting plasma glucose concentration ≥6.1 mmol/l, this affects both the selection of glucose-loaded patients as well as the patients who were included in the study as IFG in terms of increased risk of development of diabetes, as there is an inverted U-shaped curve relationship between fasting blood glucose level and mean plasma insulin concentration, also called Starling's curve of the pancreas. Glucose-stimulated insulin response begins to decline at a fasting glucose concentration of ∼110–120 mg/dl as a sign of failing of compensatory insulin response (5). Subsequently, the effectiveness of rosiglitazone in this group (6.1 mmol/l ≤ IFG <7 mmol/l), which has already been approved for the treatment of diabetes, is an expected result. However, one cannot assume that rosiglitazone will be more affective than placebo in groups that have low risk of developing diabetes (5.6 mmol/l ≤ IFG <6.1 mmol/l).en_US
dc.identifier.doi10.2337/dc07-0245
dc.identifier.issn0149-5992
dc.identifier.issue5en_US
dc.identifier.pmid17468372en_US
dc.identifier.scopus2-s2.0-34247579139en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.urihttps://doi.org/10.2337/dc07-0245
dc.identifier.urihttps://hdl.handle.net/20.500.12491/4276
dc.identifier.volume30en_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.institutionauthorKanat, Mustafa
dc.language.isoenen_US
dc.relation.ispartofDiabetes Careen_US
dc.relation.publicationcategoryDiğeren_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectClinical Implicationsen_US
dc.subjectDiabetes
dc.titleClinical implications of the DREAM study: Response to Davidson [14]en_US
dc.typeLetteren_US

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