[Will the theory of metabolic memory change our therapeutic strategies in the face of type 2 diabetes?]

Abstract

Many prospective studies have shown that tight glucose control reduces the risk of vascular complications in type 1 and type 2 diabetes. Besides, the intensive treatment group benefited from a preventive effect several years after the end of the study. In type 2 diabetes, the low glucose levels at the time of the diagnosis strongly correlate to the risk reduction of late complications. These various elements suggest the presence of a metabolic memory which would engage in very premature stages various pathways favoring the vascular development of diabetic complications. Our therapeutic strategy, based on thresholds of intervention favors the therapeutic slowness and strengthens negatively the metabolic memory. Therapeutic approach based on the tendencies to hyperglycemia could improve the prevention of the diabetic vascular complications.