Diabetes and Endocrinology

Biography

Biography: Jose Mario Franco de Oliveira

Abstract

Albeit diagnosed and defined as a “primary sugar disease of the adult”; i.e., also as namely a disease of the carbohydrate metabolism by most authors; so called type 2 diabetes mellitus should be better defined as a “No Man’s Land” state of disease in adults, at most diagnosed by a fasting glycaemia equal or higher than 126 mg/dL, and why this reality? Because in a global epidemic, which is badly out of control, among other reasons there is not much time to loose. So let’s get into some facts! Despite all controversies surrounding the etiology, pathogenesis, and therapeutic roles for hyperglycemia in type 2 diabetes mellitus, new anti-hyperglycemic drugs are still getting into the market at a high speed, due to the overconfidence in HbA1c as a surrogate outcome for microvascular complications; albeit all large recent randomized clinical trials and meta-analysis have shown that trying to achieve glycemic levels close to the normal range did not reduce the most clinically important microvascular or macro-vascular hard endpoints as end-stage renal disease, vision loss, stroke, cardiovascular and total mortality, with the added harm of substantial increase in the number of hypoglycemic episodes, and even death rates. If glucose or HbA1c were good surrogate disease markers, then why there is increased mortality in the ACCORD trial and the recent rosiglitazone saga, among other anti-hyperglycemic drugs? The above, among other core issues, will be covered during the presentation.