Recently, several large, long-term rendomized controlled trails (ACCORD, ADVANCE, VADT) and long-term epidemiologic follow-up studies (UKPDS, STENO-2) have compared the effects of intensive versus standard glycemic control on cardiovascular disease events. Based on reviewing aforementioned studies, the present article would suggest that intensive glycemia control is still considered as one of the principal therapies for the prevention of cardiovascular events in diabetes while stressing on safety and individualization for glucose-lowering strategy.

Despite autoimmune hypophysitis remains relatively rare, it still poses a significant problem.Currently, about a half of the hypophysitis patients are misdiagnosed as pituitary adenoma and undergo unnecessary surgery. It is increasingly being recognized the identification of the real pituitary autoantigens and development of serologic tests in the differential diagnosis of pituitary masses before surgery. It is necessary to establish disease registration for patients with autoimmnune hypophysitis and get enough well-characterized cases for both basic and clinical studies fostering innovation in the field.

With the progress of type 2 diabetes,there are more challenges for treatment.Traditional medications may not meet type 2 diabetes complicated clinical needs.Glucagon like peptide-1 ( GLP-1 ) has multiple physiological effects.Studies show that the liraglutide as the native GLP-1 analogue provides well glucose control in different stages of type 2 diabetes treatment,as well as β cell protection,body weight decrease and the prevalence of prediabetes reduction.Early usage of liraglutide especially suggests significant benefits,which will be summarized below.

Cardiovascular disease is the main cause of death in patients with type 2 diabetes. The protection of glucagon-like peptide-1 ( GLP-1 ) on endothelial function, ischemic myocardial damage, and heart failure have been reviewed. Based on the recently finished serial clinical studies, the effects that long-acting GLP-1 analogues liraglutide improved body weight, blood pressure, lipids, and other cardiovascular risk factors were discussed.

Normal β-cell is responsible for the glucose-induced insulin secretion.The β-cell plasticity plays an important role in glucose homeostasis,the mechanisms of which involve cell proliferation and apoptosis.β- cell dysfunction is a key factor in the impaired glncose metabolism,especially in the demand of increased insulin secretion to compensate insulin resistance.Impaired insulin secretion occurs in the early stages of type 2 diabetes and is characterized by the abnormal early phase secretion.

[Summary] There is a huge population of adults with pre-diabetes in China ,and the majority of whom are impaired glucose tolerance(IGT) patients. IGT is not only a risk factor for type 2 diabetes ,but is also closely related to diabetic microvascular and macrovascular complications. Preventing or delaying the development of diabetes by intervention on IGT has become imperative. When lifestyle intervention alone cannot achieve the ideal goal of diabetes prevention ,pharmacological intervention should be considered. This review will discuss thepathophysiology of IGT ,and the effectiveness ,safety and pharmacoeconomics of IGT pharmacological intervention.

Overall there is strong evidence that pharmacdosic therapy of hypertension in patients with diabetes is effective in producing substantial decrease in macrovascular and microvascular diseases.According to clinical evidence and guidelines,patients with diabetes mellitus and hypertension should receive drug treatment in addition to lifestyle/behavioral intervention.Combination therapy of rennin-ansiotensin system inhibitor with calcium channel blocker or low dose thiazide diuretics is quite efficient to reach the blood pressure target.As considering patient compliance with drug therapy,single pill combination may yield more benefits.

Epidemiology studies have shown that in patients with coronary heart disease (CHD), there was a higher rate of impaired glucose tolerance (IGT) and the plasma insulin response to glucose challenge was often augmented in those with clinical symptoms. In this prospective study, 24 patients with CHD were compared with 24 normal controls matched in age, sex and weight with special reference to OGTT and IRT. The results showed that in the patients with CHD, the peak values of glucose and insulin declined more slowly and their mean values at 3-hour were both higher than that of controls during OGTT. The frequency of IGT was found to be higher in the patients with CHD than that in the controls (0.05

To test if a lymphocyte subpopulation abnormality might be present at the onset of diabetes mellitus in new animal model of type 1 diabetes (NOD) and would serve as an early immunologic marker of the disease, the sequential changes, in peripheral lymphocyte subsets of 9female NOD and 11 ICR mice matched in age and sex were studied by using monoclonal antibodies. A significant increase in the proportion of Thy 1.2+(pan T) cells, Lyt 1+(helper /inducer) cells and Lyt 2+ (suppressor / cytotoxic) cells, but a significant decrease in Iak+ (B and activated T) cells and slight reduction of ratio of Lyt 1+/ Lyt 2+cells were noted. There was no tendency in these findings to change with increasing age of the mice and the changes of the lymphocyte subsets were not related to hyperglycemia. The results showed that not an abnormality of lymphocyte subsets could be used as a predictor for the onset of diabetes mellitus and the alterations in the proportion of T lymphocytes and their subsets could not account for the high incidence of diabetes mellitus nor could they be a prerequisite of T cell lymphopenia for the expression of DM gene(s) in NOD mice.

Twelve patients with diabetes insipidus, 6 males and 6 females with the ages of 14 to 48 years, were studied for the effect of 1-deamino-8-D-arginine vasopressin (DDAVP) in a double-blind manner. DDAVP was given for five days and the volume and osmolarity of 24-hour urine were measured every day. The results showed that the urine output decreased markedly and the urinary osmolarity increased during the therapy. DDAVP was well tolerated by the patients and their blood pressure and heart rate kept unchanged.