Diabetes Research and Clinical Practice 68S1 (2005) S52–S53 www.elsevier.com/locate/diabres
Editorial
Introduction to Lilly Award Session The initiative of DIRECT was born 5 years ago. The main aim of this group was to improve care of diabetic patients and to support scientific initiatives coming from Central and Mediterranean European Region. One of DIRECT activities are the annual conferences with numerous lectures, workshops and case presentations which allow to present, summarise and discuss the current issues related to management of diabetes, diabetic complications as well as future directions of the research and treatment. This year on the occasion of the fourth conference we decided to establish an additional session as the forum for the presentation of the activity of young scientists working in our region. After initial assessment three papers were selected for the presentation followed by the publication in Symposium Proceedings. It was my pleasure and honour to moderate this session what allowed me to meet very interesting young scientists not yet widely known, but promising in the future both for their personality and for their achievements. All three presentations were impressive regarding the form and content and each received the Lilly Research Award. Dr Alexander Mayorow presented data of insulin resistance measured by euglycemic clamp in the group of 43 type 2 diabetic patients on oral therapy. He observed that initiation of insulin therapy and improvement of glycemic control reduced significantly insulin resistance and improved lipid profile in examined group of patients. This positive effect was found despite weight gain, which is usually observed after insulin application in type 2 diabetic patients. This study documents again that in certain cases the application of insulin is the only tool which can be used for normalisation of blood
glucose and this effect is partially related to the improvement of insulin sensitivity and is associated with reduction of the atherogenic lipid profile. Diabetology presents a very wide scope of medical problems requiring the involvement of different medical disciplines. The co-operation with cardiology, nephrology, surgery, etc. is well recognised and established. A relatively new aspect are metabolic disorders in psychiatric patients mainly those treated with new generation of antipsychotic drugs. Dr Palik measured ghrelin levels in 56 patients treated with antipsychotic drugs and 75 matched control subjects. The examined group showed significantly higher ghrelin levels when compared with control subjects. Higher body mass and higher percentage of glucose intolerance paralleled this observation. No difference related to particular antipsychotic drug was observed. Authors concluded that weight gain in patients, treated with new generation of antipsychotic drugs may be, at least partially, the result of increased food intake induced by altered ghrelin turnover. Endothelial dysfunction is one of the main disorders, which is responsible for the development of macrovascular complications. Dr Jarek-Martynowa aimed to establish the degree of endothelial dysfunction in type 1 diabetic patients with diabetic neph-ropathy. Flow mediated endothelium-dependent vasodilatation, plasma endothelin and serum von Willebrand factor antigen was measured in 93 subjects divided into four groups according to their renal function: normo-, micro-, macroalbuminuric and a group with chronic renal failure. Results obtained by Dr Jarek-Martynowa indicated that endothelial dysfunction is present in
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Editorial / Diabetes Research and Clinical Practice 68S1 (2005) S52–S53
patients with cardiovascular disturbances but it is additionally increased by co-existing renal damage. All three presentations were followed by fruitful discussion, elicited by a marked interest in the audience. It was my privilege to moderate this session and again I wish to congratulate all presenters and their colleagues on the award thy received.
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Krzysztof Strojek Silesian Medical Academy Department of Internal Disease Diabetology and Nephrology, Zabrze, Poland E-mail address:
[email protected] Available online 7 April 2005