naa a22 4500 510779565 CHVBK 20180411083242.0 cr unu---uuuuu 180411e20130601xx s 000 0 eng 10.1007/s11892-013-0371-2 doi (NATIONALLICENCE)springer-10.1007/s11892-013-0371-2 Hyperglycemia and Vascular Metabolic Memory: Truth or Fiction? [Elektronische Daten] [Cristina Bianchi, Roberto Miccoli, Stefano Del Prato] Prevention of long-term complications remains the main challenge in the treatment of diabetes. A strong relationship between glucose control and development of complications is apparent in all epidemiologic studies. Yet, intervention trials have yielded questionable results, particularly when intensive treatment was introduced in patients with long-standing diabetes. It has been postulated that in these subjects, prior exposure to chronic hyperglycemia may have generated a negative "metabolic memory,” preventing full exertion of the beneficial effects of any subsequent improvement of glucose control. This phenomenon has been replicated in animal models and it recognizes a molecular basis in the role of oxidative stress, advanced glycation processes, and epigenetic mechanisms accounting for self-perpetuating modifications of gene expression. Conversely, early intervention in both type 1 and type 2 diabetes has proven that good glycemic control reduces the risk of development and progression of complications with a beneficial effect that extends well beyond the duration of near-normoglycemia. This has brought up the concept of "metabolic legacy,” an advantage handed down by early and effective implementation of treatments designed to reduce blood glucose levels as safely as possible along with multifactorial intervention of all cardiovascular risk factors. The evidence, nature, and clinical implication of these concepts are reviewed. Springer Science+Business Media New York, 2013 Vascular metabolic memory nationallicence Metabolic legacy nationallicence Intervention trials nationallicence Glucose control nationallicence Hyperglycemia nationallicence Epigenetic mechanisms nationallicence Advanced glycation nationallicence Oxidative stress nationallicence Type 1 diabetes nationallicence Type 2 diabetes nationallicence UKPDS nationallicence VADT nationallicence ACCORD nationallicence ADVANCE nationallicence ORIGIN nationallicence Bianchi Cristina Department of Clinical and Experimental Medicine, Section of Diabetes and Metabolic Diseases, Nuovo Ospedale Santa Chiara, Via Paradisa, 2, 56124, Pisa, Italy aut Miccoli Roberto Department of Clinical and Experimental Medicine, Section of Diabetes and Metabolic Diseases, Nuovo Ospedale Santa Chiara, Via Paradisa, 2, 56124, Pisa, Italy aut Del Prato Stefano Department of Clinical and Experimental Medicine, Section of Diabetes and Metabolic Diseases, Nuovo Ospedale Santa Chiara, Via Paradisa, 2, 56124, Pisa, Italy aut Current Diabetes Reports Current Science Inc. 13/3(2013-06-01), 403-410 1534-4827 13:3<403 2013 13 11892 https://doi.org/10.1007/s11892-013-0371-2 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11892-013-0371-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Bianchi Cristina Department of Clinical and Experimental Medicine, Section of Diabetes and Metabolic Diseases, Nuovo Ospedale Santa Chiara, Via Paradisa, 2, 56124, Pisa, Italy aut NATIONALLICENCE 700 1- Miccoli Roberto Department of Clinical and Experimental Medicine, Section of Diabetes and Metabolic Diseases, Nuovo Ospedale Santa Chiara, Via Paradisa, 2, 56124, Pisa, Italy aut NATIONALLICENCE 700 1- Del Prato Stefano Department of Clinical and Experimental Medicine, Section of Diabetes and Metabolic Diseases, Nuovo Ospedale Santa Chiara, Via Paradisa, 2, 56124, Pisa, Italy aut NATIONALLICENCE 773 0- Current Diabetes Reports Current Science Inc 13/3(2013-06-01), 403-410 1534-4827 13:3<403 2013 13 11892 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer