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Diabetic Medicine
Year: 2007  |  Volume: 24  |  Issue: 6  |  Page No.: 582 - 586

Hypothesis: the ‘metabolic memory’, the new challenge of diabetes

M. A. Ihnat, J. E. Thorpe and A. Ceriello    

Abstract: Large randomized studies have established that early intensive glycaemic control reduces the risk of diabetic complications, both micro- and macrovascular. However, epidemiological and prospective data support a long-term influence of early metabolic control on clinical outcomes. This phenomenon has recently been defined as ‘metabolic memory’. Potential mechanisms for propagating this ‘memory’ are the non-enzymatic glycation of cellular proteins and lipids, and an excess of cellular reactive oxygen and nitrogen species, in particular originated at the level of glycated-mitochondrial proteins, perhaps acting in concert with one another to maintain stress signalling. Furthermore, the emergence of this ‘metabolic memory’ suggests the need for very early aggressive treatment aiming to `normalize` glycaemic control and the addition of agents which reduce cellular reactive species and glycation in order to minimize long-term diabetic complications.

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