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For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
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The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
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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...
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Updated: Mar 6, 2026

A Zebrafish Model of Diabetes Mellitus and Metabolic Memory
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Are diabetes guidelines truly evidence based?

Matthew F Bouchonville1, Sara Matani2, Jason J DuBroff3

  • 1Division of Endocrinology, Diabetes, and Metabolism, Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, United States.

Diabetes Research and Clinical Practice
|March 21, 2017
PubMed
Summary

Preventing cardiovascular disease in diabetes requires careful evidence review. While diet, glycemic, and blood pressure control are supported, evidence for aspirin and statins in diabetes prevention remains inconclusive.

Keywords:
Cardiovascular diseaseDiabetesPrevention

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Area of Science:

  • Cardiology
  • Endocrinology
  • Evidence-Based Medicine

Background:

  • Obesity and diabetes epidemics drive cardiovascular disease (CVD) risk.
  • Clinical guidelines for managing diabetes patients often lack consensus and robust evidence.
  • Effective CVD prevention strategies are crucial for this high-risk population.

Purpose of the Study:

  • To critically review the evidence supporting the American Diabetes Association (ADA) 2016 guidelines for CVD prevention in diabetes.
  • To evaluate the strength of evidence for specific interventions recommended by the ADA.
  • To identify discordances and limitations in current guideline recommendations.

Main Methods:

  • Focused review on randomized controlled trials (RCTs) with hard clinical endpoints (mortality, CVD events) in diabetic populations.
  • Critical analysis of evidence supporting ADA guidelines on diet, glycemic control, blood pressure, aspirin, and statin therapy.
  • Assessment of potential biases from study exclusion and over-reliance on subgroup analyses or meta-analyses.

Main Results:

  • Supported ADA recommendations for Mediterranean diet, glycemic control, and blood pressure control.
  • Found inconclusive evidence for the routine use of aspirin and statin therapy in diabetes for CVD prevention.
  • Highlighted potential multifactorial reasons for guideline discordance, including methodological limitations.

Conclusions:

  • Clinicians should individualize CVD prevention strategies in diabetes.
  • Treatment decisions must carefully weigh the risks and harms of interventions like aspirin and statins.
  • Further research is needed to clarify the role of aspirin and statins in reducing mortality and clinical events in diabetes.