Ceriello, Antonio, Ihnat, Michael A. and Thorpe, Jessica E. (2009) The "metabolic memory": is more than just tight glucose control necessary to prevent diabetic complications? Journal of Clinical Endocrinology & Metabolism, Vol.94 (No.2). pp. 410-415. ISSN 0021-972x

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Abstract

Context: The concept of a "metabolic memory," that is of diabetic vascular stresses persisting after glucose normalization, has been supported both in the laboratory and in the clinic and in both type 1 and type 2 diabetes. Evidence Acquisition: Using PubMed, we searched for publications on diabetic micro- and macrovascular complications using terms such as persistence, prolongation, sustained, and "memory" and focusing on the mechanistic basis behind this metabolic memory. Evidence Synthesis: We found that as early as the mid-1980s this memory phenomenon was described in diabetic animals and isolated cells exposed to high glucose followed by normalized glucose and then, beginning around 2002, in results from large clinical trials such as the Diabetes Complications and Control Trial-Epidemiology of Diabetes Interventions and Complications and the United Kingdom Prospective Diabetes Study. Furthermore, mechanisms for propagating this memory appear focused on the nonenzymatic glycation of cellular proteins and lipids and on an excess of cellular reactive oxygen and nitrogen species, in particular originating at the level of glycated mitochondrial proteins and perhaps acting in concert with one another to maintain stress signaling independent of glucose levels. Conclusions: The emergence of this metabolic memory suggests the need for early aggressive treatment aiming to "normalize" metabolic control together perhaps with the addition of agents which reduce cellular reactive species and glycation in order to minimize long-term diabetic complications. (J Clin Endocrinol Metab 94: 410-415, 2009)

Item Type:	Journal Item
Subjects:	R Medicine > RC Internal medicine
Divisions:	Faculty of Medicine > Warwick Medical School
Journal or Publication Title:	Journal of Clinical Endocrinology & Metabolism
Publisher:	Endocrine Society
ISSN:	0021-972x
Date:	February 2009
Volume:	Vol.94
Number:	No.2
Number of Pages:	6
Page Range:	pp. 410-415
Identification Number:	10.1210/jc.2008-1824
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
URI:	http://wrap.warwick.ac.uk/id/eprint/28587

Data sourced from Thomson Reuters' Web of Knowledge

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