Type 1 diabetes and cardiovascular disease

The presence of cardiovascular disease (CVD) in Type 1 diabetes largely impairs life expectancy. Hyperglycemia leading to an increase in oxidative stress is considered to be the key pathophysiological factor of both micro- and macrovascular complications. In Type 1 diabetes, the presence of coronary calcifications is also related to coronary artery disease. Cardiac autonomic neuropathy, which significantly impairs myocardial function and blood flow, also enhances cardiac abnormalities. Also hypoglycemic episodes are considered to adversely influence cardiac performance. Intensive insulin therapy has been demonstrated to reduce the occurrence and progression of both micro- and macrovascular complications. This has been evidenced by the Diabetes Control and Complications Trial (DCCT) / Epidemiology of Diabetes Interventions and Complications (EDIC) study. The concept of a metabolic memory emerged based on the results of the study, which established that intensified insulin therapy is the standard of treatment of Type 1 diabetes. Future therapies may also include glucagon-like peptide (GLP)-based treatment therapies. Pilot studies with GLP-1-analogues have been shown to reduce insulin requirements

Gentrification in Vilnius (Lithuania): the example of Uzupis

Auf der Basis eines sozialgeographischen Geländepraktikums, das unter Leitung der Bearbeiter im Juli/August 2003 mit Geographiestundenten der Universität Vilnius durchgeführt wurde, konnten ca. 260 Haushalte in zwei Gebieten des historischen Stadtkerns befragt werden, wobei der Untersuchungsschwerpunkt in der mittelalterlichen Vorstadt Užupis lag. Die Fragen richteten sich v.a. auf die Lebensbedingungen der Einwohner sowie auf den sozio-ökonomischen Wandel der seit 1991 eintrat, dem Jahr als Litauen seine politische Unabhängigkeit von der ehemaligen Sowjetunion erringen konnte und die Marktwirtschaft eingeführt wurde. Des weiteren befasst sich der Beitrag mit dem Einfluss des "Vilnius Old Town Revitalisation Program" auf die Erfolge bei der Renovierung des Gebäudebestands. Beim Vergleich des Aufwertungsprozesses in Užupis mit denjenigen Erkenntnissen zur Gentrification, die man aus anderen mittel- und westeuropäischen Städten bislang gewonnen hat, ergeben sich sowohl zahlreiche Gemeinsamkeiten als auch die Unterschiede zu den hier vorgefundenen Determinanten und Mustern des Wandels. (Autorenreferat

Der post-sozialistische Transformationsprozeß im großstädtischen Einzelhandel Ostmittel- und Osteuropas: der Versuch einer Typenbildung zum jüngsten Wandel der Innenstadtstrukturen sowie einer modellhaften Darstellung der sie beeinflussenden Determinanten

There is still considerable research deficit with regard to the post-socialist retail trade research and the geographic research of major cities in Eastern Central and Eastern Europe. Nonetheless, this article will attempt to state a summary of the most important, determining factors for the current changes in structure and regional function in the core areas of the Eastern Central and Eastern European major cities, and to typify the transformation in the city centre location patterns of retail trade. In th is context, the initial thesis is that new developments of company forms and city centre location patterns in retail trade which are manifest in Eastern Central and Eastern Europe are essentially determined by complex issues of company structures and regional factors. The influential factors of company structure are a) the course and results of transformation in ownership laws in retail trade, effected by both privatisation measures and the establishment of new companies, b) the general economic (endogenous and exogenous) framework which follows the privat isation and/or new establishment of companies and which decide the further development of retail trade and c) the transformation of the real estate and property markets. The three regional determinants, which are responsible for the changes in the location pattern in retail trade and for the transformation of the functional order of the city centre, refer to a) the structure and function of the existing building substance and the possibilities for its use in retail trade, b) competition with other locations of retail trade inside and outside of the city and c) the scope of private use and/or suitability of public space for use by informal retail trade such as kiosks and market stalls. Five different types of new location pattern in city centre retail trade and current regional changes in the cities of Eastern Central and Eastern Europe can be identified: 1.) A regionally disorganised location pattern with barely distinct hierarchical areas of function, for example in Moscow and St. Petersburg. 2.) City centres with clear tendencies of alignment to Central European city structures, such as in Prague or Budapest. 3.) The city centre retail trade st ructures in the new Federal states (former GDR), which are characterised in part by extreme exclusiveness and in part by a banalisation of the range of goods, and which are in very extreme competition with expansive, non-integrated retail trade which has developed outside of the cities. 4.) Relatively autochtonous / independent development within city centre retail trade, with a general formation of hierarchical location patterns, e.g. in Riga (Latvia), Tallinn (Estonia) and many large Polish cities. 5.) Relatively autochtonous development within city centre retail trade, without a general formation of hierarchical location patterns, e.g. in Vilnius (Lithuania)

Heart failure in diabetes: From an increased risk to a treatment target

Heart failure (HF) is one of the most common comorbidities of type 2 diabetes mellitus (T2DM) and poor glycaemic control can worsen the HF outcomes and increase the risk of hospitalisations. With the entry of several antihyperglycaemic agents for the management of T2DM over the last decade, there has been an increasing concern regarding the cardiovascular (CV) safety profile of these agents. In view of this, FDA mandated the demonstration of cardiovascular risk-benefit profile of these agents through specifically designed CV outcome trials. Although we have several findings from these trials, none of them included HF as a primary endpoint indicating the need of trials focusing on HF. Here, we briefly discuss the results of the CV outcome trials in the context of HF

Global associations between UVR exposure and current eczema prevalence in children from ISAAC Phase Three

We sought to examine the relationship globally between UV dose exposure and current eczema prevalences. ISAAC Phase Three provided data on eczema prevalence for 13-14 year-olds in 214 centres in 87 countries and for 6-7 year-olds in 132 centres in 57 countries. Linear and non-linear associations between (natural log transformed) eczema prevalence and the mean, maximum, minimum, standard deviation and range of monthly UV dose exposures were assessed using linear mixed-effects regression models. For the 13-14 year olds, the country-level eczema prevalence was positively and linearly associated with country-level monthly mean (prevalence ratio: 1.31, 95% confidence interval: [1.05, 1.63] per kJ/m2) and minimum (1.25 [1.06, 1.47] per kJ/m2) UV dose exposure. Linear and non-linear associations were also observed for other metrics of UV. Results were similar in trend, but non-significant, for the fewer centres with 6-7 year-olds (e.g. 1.24 [0.96, 1.59] per kJ/m2 for country-level monthly mean UV). No consistent within-country associations were observed (e.g. 1.05 [0.89, 1.23] and 0.92 [0.71, 1.18] per kJ/m2 for center-level monthly mean UV, for the 13-14 and 6-7 year-olds, respectively). These ecological results support a role for UV exposure in explaining some of the variation in global childhood eczema prevalence

Food Intake, Diet Quality and Behavioral Problems in Children: Results from the GINI-plus/LISA-plus Studies

Background/Aims: To assess the association between food intake and diet quality and behavioral problems at the 10-year follow-up of the two population-based birth cohorts of the studies German Infant Nutritional Intervention and `Influences of lifestyle-related factors on the immune system and the development of allergies in childhood'. Methods: Cross-sectional data on food intake over the past year were collected by a parent-reported food frequency questionnaire. Diet quality was based on reference values of food amounts of the optimized mixed diet. Behavioral problems were assessed by a parent-reported Strengths and Difficulties Questionnaire. Relationships between food category intake, diet quality and behavior problems were examined using multivariable regression modeling adjusted for gender, sociodemographic characteristics, body mass index, physical exercise, television viewing/PC use and total energy intake. A total of 3,361 children with complete data were analyzed. Results: Children with increased intake of confectionery had increased odds of having emotional symptoms {[}adjusted odds ratio (ORadj) 1.19, 95% confidence interval (CI) 1.08-1.32] compared to children with low intake. A higher diet quality score was associated with lower likelihood of emotional symptoms (ORadj 0.89, 95% CI 0.80-0.98). The un-adjusted significant relationship between diet quality and hyperactivity/inattention was attenuated by adjusting for several confounders to an ORadj of 0.92 (95% CI 0.82-1.03). Conclusions: Increased consumption of high-sugar products and lower diet quality are associated with a higher likelihood of emotional symptoms in children. Copyright (C) 2012 S. Karger AG, Base

Genetic Variation in FADS Genes and Plasma Cholesterol Levels in 2-Year-Old Infants

Single nucleotide polymorphisms (SNPs) in genes involved in fatty acid metabolism (FADS1 FADS2 gene cluster) are associated with plasma lipid levels. We aimed to investigate whether these associations are already present early in life and compare the relative contribution of FADS SNPs vs traditional (non-genetic) factors as determinants of plasma lipid levels. Information on infants' plasma total cholesterol levels, genotypes of five FADS SNPs (rs174545, rs174546, rs174556, rs174561, and rs3834458), anthropometric data, maternal characteristics, and breastfeeding history was available for 521 2-year-old children from the KOALA Birth Cohort Study. For 295 of these 521 children, plasma HDLc and non-HDLc levels were also known. Multivariable linear regression analysis was used to study the associations of genetic and non-genetic determinants with cholesterol levels. All FADS SNPs were significantly associated with total cholesterol levels. Heterozygous and homozygous for the minor allele children had about 4% and 8% lower total cholesterol levels than major allele homozygotes. In addition, homozygous for the minor allele children had about 7% lower HDLc levels. This difference reached significance for the SNPs rs174546 and rs3834458. The associations went in the same direction for non-HDLc, but statistical significance was not reached. The percentage of total variance of total cholesterol levels explained by FADS SNPs was relatively low (lower than 3%) but of the same order as that explained by gender and the non-genetic determinants together. FADS SNPs are associated with plasma total cholesterol and HDLc levels in preschool children. This brings a new piece of evidence to explain how blood lipid levels may track from childhood to adulthood. Moreover, the finding that these SNPs explain a similar amount of variance in total cholesterol levels as the non-genetic determinants studied reveals the potential importance of investigating the effects of genetic variations in early life