Dataset Information

Understanding Metabolic Memory: A Tale of Two Studies.

ABSTRACT: The results of the Diabetes Control and Complications Trial (DCCT) have given rise to much encouragement in the battle to stave off the complications of type 1 diabetes, showing dramatic declines in the development of severe retinopathy, nephropathy, and neuropathy in those treated intensively compared with conventional therapy. Particularly encouraging has been the continuing difference between the two groups despite both having similar HbA_1c (?8%) since the end of DCCT, when 96% of participants entered the observational Epidemiology of Diabetes Interventions and Complications (EDIC) study. This continuing relative benefit has been termed "metabolic memory," which implies altered metabolic regulation. Based on evidence from both the Epidemiology of Diabetes Complications (EDC) prospective cohort study of childhood-onset type 1 diabetes and DCCT/EDIC, we show that the metabolic memory effect can be largely explained by lower cumulative glycemic exposure in the intensive therapy group, and, on average, the development of complications increases with greater glycemic exposure, irrespective of whether this results from a high exposure for a short time or a lower exposure for a longer time. Thus, there is no need for a concept like "metabolic memory" to explain these observations. Potential mechanisms explaining the cumulative glycemic effect are also briefly discussed.

SUBMITTER: Miller RG

PROVIDER: S-EPMC7034186 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Understanding Metabolic Memory: A Tale of Two Studies.

Miller Rachel G RG Orchard Trevor J TJ

Diabetes 20200301 3

The results of the Diabetes Control and Complications Trial (DCCT) have given rise to much encouragement in the battle to stave off the complications of type 1 diabetes, showing dramatic declines in the development of severe retinopathy, nephropathy, and neuropathy in those treated intensively compared with conventional therapy. Particularly encouraging has been the continuing difference between the two groups despite both having similar HbA<sub>1c</sub> (∼8%) since the end of DCCT, when 96% of ...[more]

PMID: 32079705

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Project description:Unlike Dickens's novel, this is not a tale of light and darkness, order and chaos, good and evil…It is, though, a story worth to be told about two standpoints about games and sports, teaching and research, physical education simply put, that have pursued similar interests on parallel tracks for too long, despite their apparent closeness and shared cultural grounds. The objective of this conceptual analysis is to try and reconcile two perspectives, namely motor praxeology and teaching games for understanding (TGfU), born in the last third of the XX century in France and England with the intention to rethink the foundations of physical education (PE) and sports teaching. Pierre Parlebas, from the French side of the English Channel, claimed in 1967 that sports make part of PE, that team sports must be considered from a specific, sociomotor point of view, and that motor conducts (i.e., the significative organisation of motor behaviour), not sports techniques, are the corner-stone of PE and sports coaching. In the early 1980s, from the English side of La Manche, Almond, Thorpe, and Bunker made a plea for a shift in the way to teach games (sporting collective duels mostly), deeply concerned by the negative impact of the traditional technics-centred approach on motivation, competence and attained level of the least able in school situations. Our conclusion is that TGfU, or game-based approaches to sports coaching and teaching, can take great advantage of the motor-praxeological rationale for three reasons: firstly, because concepts like understanding, game sense and action principles are operatively, semiotically linked to the reality of the playing process; secondly, because the inner structures of the games that constrain players and guide their motor conducts, permit to integrate games in the general system of sporting games, no matter their level of institutionalisation; finally, because any motor intervention process is better thought of and more systematically developed upon the operational concepts of internal logic and expected practical effects of game playing. This time, Paris could be the place to go to in search of solutions, not the city to run away from in hope of consolation.

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Understanding Metabolic Memory: A Tale of Two Studies.

Publications

Understanding Metabolic Memory: A Tale of Two Studies.

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