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Related Concept Videos

Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
Type II Diabetes II: Pathophysiology01:24

Type II Diabetes II: Pathophysiology

PathophysiologyType 2 diabetes mellitus (T2DM ) is a chronic metabolic disorder characterized by insulin resistance and progressive pancreatic β-cell dysfunction, leading to impaired glucose homeostasis. It results from interactions among genetic predisposition, environmental factors, and metabolic stressors, such as overnutrition and a sedentary lifestyle.Insulin Resistance and Glucose DysregulationEarly T2DM involves insulin resistance in skeletal muscle, adipose tissue, and the liver.
Type I Diabetes II: Pathophysiology01:26

Type I Diabetes II: Pathophysiology

Type 1 diabetes mellitus arises from an immune-mediated destruction of pancreatic β-cells, resulting in an absolute deficiency of insulin. This process develops in genetically susceptible individuals when autoimmunity, environmental exposures, and immunologic dysregulation converge to trigger a targeted attack on the insulin-producing cells of the pancreas. The β-cells are located within the islets of Langerhans and are essential for regulating blood glucose by facilitating cellular uptake of...
Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis01:25

Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis

Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated hypertension...
Carbohydrate Metabolism01:36

Carbohydrate Metabolism

Carbohydrates are polymers composed of molecules containing atoms of carbon, hydrogen and oxygen. One gram of carbohydrate can provide four kilo-calories of energy, which makes it the most efficient instant energy source.
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in the...
Type II Diabetes I: Introduction01:26

Type II Diabetes I: Introduction

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance, in which target tissues such as the liver, muscle, and adipose tissue respond poorly to insulin. It is also associated with inadequate compensatory insulin secretion, where pancreatic β-cells fail to produce sufficient insulin. Together, these abnormalities lead to persistent hyperglycemia.EtiologyT2DM develops through a complex interaction of genetic predisposition and environmental or...

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Related Experiment Video

Updated: Jun 8, 2026

A Zebrafish Model of Diabetes Mellitus and Metabolic Memory
10:03

A Zebrafish Model of Diabetes Mellitus and Metabolic Memory

Published on: February 28, 2013

A1C and cardiovascular outcomes in type 2 diabetes: a nested case-control study.

Danielle C Colayco1, Fang Niu, Jeffrey S McCombs

  • 1University of Southern California School of Pharmacy, Department of Pharmaceutical Economics & Policy, Los Angeles, California, USA. colayco@usc.edu

Diabetes Care
|October 13, 2010
PubMed
Summary

Aggressive glycemic control in type 2 diabetes may increase cardiovascular risk. Both very low (≤6%) and high (>8%) average A1C levels are linked to higher cardiovascular event rates, suggesting a U-shaped risk.

Related Experiment Videos

Last Updated: Jun 8, 2026

A Zebrafish Model of Diabetes Mellitus and Metabolic Memory
10:03

A Zebrafish Model of Diabetes Mellitus and Metabolic Memory

Published on: February 28, 2013

Area of Science:

  • Cardiology
  • Endocrinology
  • Public Health

Background:

  • Type 2 diabetes (T2D) significantly elevates cardiovascular disease (CVD) risk.
  • The precise impact of intensive glycemic control on preventing CVD events in T2D patients remains incompletely understood.
  • Understanding optimal A1C targets is crucial for mitigating CVD risk in this population.

Purpose of the Study:

  • To investigate the association between average hemoglobin A1C (A1C) levels and cardiovascular outcomes in adults with T2D.
  • To evaluate whether achieving very low A1C levels or failing to lower high A1C levels impacts cardiovascular event risk.
  • To inform clinical guidelines regarding glycemic control targets for CVD prevention in T2D.

Main Methods:

  • A nested case-control study utilizing electronic health records from Kaiser Permanente Southern California.
  • Identification of T2D patients based on diagnosis codes and medication or A1C criteria.
  • Matching of case subjects (experiencing myocardial infarction, stroke, or CVD death) with control subjects (4:1 ratio) by age, sex, and index date.
  • Conditional logistic regression analysis to compare cardiovascular event risk across A1C categories: ≤6%, >6-8%, and >8%.

Main Results:

  • A total of 11,157 case subjects and 44,628 control subjects were analyzed.
  • Patients with average A1C ≤6% had a 20% increased likelihood of cardiovascular events compared to those with A1C >6-8% (P < 0.0001).
  • Patients with average A1C >8% showed a 16% increased likelihood of cardiovascular events versus the >6-8% group (P < 0.0001).
  • Significant interactions were observed between A1C levels and LDL cholesterol, cardiovascular medication use, and antipsychotic use.

Conclusions:

  • Both suboptimal glycemic control (A1C >8%) and potentially overly intensive control (A1C ≤6%) are associated with increased cardiovascular event risk in patients with type 2 diabetes.
  • These findings suggest a U-shaped relationship between A1C levels and cardiovascular risk.
  • Clinical management should aim for individualized glycemic targets, avoiding extremes of control to optimize cardiovascular outcomes.