Vol 8, No 7 (2007): Practical Diabetology
Other materials agreed with the Editors
Published online: 2007-08-01
Hypothesis: the "metabolic memory" - the new challenge of diabetes
Diabetologia Praktyczna 2007;8(7):289-294.
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.
Keywords: diabetic complicationsmetabolic memorymitochondrianonenzymatic glycationoxidative stress