References of "PHILIPS, Jean-Christophe"
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See detailPulse pressure and pulsatile stress in overweight/obese patients versus lean subjects in absence of hypertension or diabetes.
Scheen, André ULg; Philips, Jean-Christophe ULg; Marchand, Monique ULg

in Obesity Reviews : An Official Journal of the International Association for the Study of Obesity (2010)

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See detailPulse pressure and pulsatile stress in overweight/obese nonhypertensive patients with versus without type 2 diabetes.
Scheen, André ULg; Philips, Jean-Christophe ULg; Marchand, Monique ULg

in Obesity Reviews : An Official Journal of the International Association for the Study of Obesity (2010)

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See detailInertie clinique dans la prise en charge du patient diabetique de type 2: quelles solutions proposer?
Philips, Jean-Christophe ULg; Scheen, André ULg

in Revue Médicale de Liège (2010), 65(5-6), 318-25

Although strict glucose control can prevent or delay the onset of complications in patients with diabetes, optimal control frequently is not achieved. A partial explanation for this phenomenon can be ... [more ▼]

Although strict glucose control can prevent or delay the onset of complications in patients with diabetes, optimal control frequently is not achieved. A partial explanation for this phenomenon can be attributed to so-called clinical inertia of physicians, defined as "recognition of the problem but failure to act". Such therapeutic inertia may result from patient's reluctance, difficulties inherent to available treatments and physician's attitudes. Clinical inertia may be present at each successive step in the management of type 2 diabetes. This article describes some solutions to help physicians reducing therapeutic inertia and improving patient care. [less ▲]

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See detailDiabete et grossesse: impact de l'inertie medicale et de l'observance therapeutique.
Pintiaux, Axelle ULg; Chabbert-Buffet, N.; Philips, Jean-Christophe ULg et al

in Revue Médicale de Liège (2010), 65(5-6), 399-404

Pregnancy and infant outcomes are related to maternal blood glucose profile. Managing preexisting diabetes and achieving euglycaemia before and during the pregnancy reduce the risk for complications ... [more ▼]

Pregnancy and infant outcomes are related to maternal blood glucose profile. Managing preexisting diabetes and achieving euglycaemia before and during the pregnancy reduce the risk for complications. Screening, diagnosis and treatment of gestational diabetes are important issues from a public health point of view, more particularly because of the progression of this disease due to obesity epidemics among young people. Pregnancy in a diabetic woman is a critical situation where neither clinical inertia nor patient's non-compliance could be accepted. [less ▲]

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See detailPulsatile stress in middle-aged patients with Type 1 or Type 2 diabetes compared to nondiabetic controls.
Philips, Jean-Christophe ULg; Marchand, Monique ULg; Scheen, André ULg

in Diabetes Care (2010), 33(11), 2424-2429

AbstractBackground: Arterial pulse pressure (PP) is considered as an independent cardiovascular risk factor. We compared PP during an active orthostatic test in middle-aged patients with type 1 diabetes ... [more ▼]

AbstractBackground: Arterial pulse pressure (PP) is considered as an independent cardiovascular risk factor. We compared PP during an active orthostatic test in middle-aged patients with type 1 diabetes and with type 2 diabetes, and corresponding nondiabetic controls. Methods: 40 patients with type 1 diabetes (mean age 50 years, diabetes duration 23 years, BMI 23.0 kg/m(2)) were compared to 40 non hypertensive patients with type 2 diabetes (respectively, 50 years, 8 years, 29.7 kg/m(2)). Patients taking antihypertensive agents or with renal insufficiency were excluded. All patients were evaluated with a continuous noninvasive arterial blood pressure monitoring (Finapres(R)) in standing (1 min), squatting (1 min) and again standing position (1 min). Patients with type 1 or type 2 diabetes were compared with two groups of 40 age-, sex- and BMI-matched healthy subjects. Results: Patients with type 1 diabetes and patients with type 2 diabetes showed significantly higher PP, heart rate (HR) and PPxHR double product (type 1 : 5263 vs 4121 mmHg/min, p=0.0004; type 2 : 5359 vs 4321 mmHg, p=0.0023) levels than corresponding controls. There were no significant differences between patients with type 1 diabetes and type 2 diabetes regarding PP (59 vs 58 mmHg), HR (89 vs 88/min), and PPxHR product (5263 vs 5359 mmHg/min). Conclusion: Patients with type 1 diabetes have comparable increased levels of peripheral PP, an indirect marker of arterial stiffness, and PPxHR, an index of pulsatile stress, as non-hypertensive patients with type 2 diabetes at similar mean age of 50 years. [less ▲]

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See detailPulse pressure and pulse wave velocity as markers of arterial stiffness in patients with type 1 diabetes
Philips, Jean-Christophe ULg; Xhignesse, Patricia ULg; Marchand, Monique ULg et al

Conference (2009, October 19)

Type 1 diabetes was associated with an increase in both PP and PWV as compared to a nondiabetic population. In the diabetic population, a close correlation between the two indirect markers of arterial ... [more ▼]

Type 1 diabetes was associated with an increase in both PP and PWV as compared to a nondiabetic population. In the diabetic population, a close correlation between the two indirect markers of arterial stiffness was found and also between each of them and age (or diabetes duration), but not in controls. These observations support the concept of an earier arterial stiffness in type 1 diabetes with rather poor glycemic control. [less ▲]

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See detailPulse pressure and ambulatory arterial stiffness index (AASI) in patients wit type 1 diabetes
Philips, Jean-Christophe ULg; Marchand, Monique ULg; Saint-Remy, Annie ULg et al

Conference (2009, September 19)

Results of PP and AASI measurements performed during a 24H AMBP recording and a 3 min posture test are not superimposable, but gave complementary information, in a population with type 1 diabetes mellitus ... [more ▼]

Results of PP and AASI measurements performed during a 24H AMBP recording and a 3 min posture test are not superimposable, but gave complementary information, in a population with type 1 diabetes mellitus. Our proof-of-concept study does not support the use of AASI as a cardiovascular risk marker when calculated during a short posture test. [less ▲]

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See detailAnticorps monoclonaux en diabétologie : jusqu’au bout du rêve ?
Philips, Jean-Christophe ULg; Keymeulen, B.; Mathieu, C. et al

in Revue Médicale de Liège (2009), 64(5-6), 3327-333

SUMMARY : Type 1 diabetes is characterized by the autoimmune- mediated destruction of the insulin-producing beta cells of the pancreatic islets of Langerhans. Several cells are potentially implicated in ... [more ▼]

SUMMARY : Type 1 diabetes is characterized by the autoimmune- mediated destruction of the insulin-producing beta cells of the pancreatic islets of Langerhans. Several cells are potentially implicated in the selective destruction of beta cells, including the beta cells themselves, and T-lymphocytes and B- lymphocytes that are working as antigen-presenting cells. Both types of lymphocytes play also a role in the progressive loss of graft function after islet transplantation. Therefore, immunotherapy may represent a great opportunity to prevent, treat or even cure type 1 diabetes, and the input of monoclonal antibodies (mAb) appears crucial in such a strategy. The concept has first been validated in various animal models, especially the classical one of the NOD mouse. During recent years, promising results of a few clinical trials have been published with the administration of anti-CD3 mAbs targeting T lymphocytes at the time of diagnosis of type 1 diabetes. Results showed a more sustained residual insulin secretion during the following months associated with a reduction in insulin needs. Interesting results may also be expected from the use of anti-CD20 mAbs targeting B lymphocytes. Finally, when considering immunosuppressive therapies after beta-cell transplantation, mAbs, especially those blocking interleukin-2, are already used in clinical practice, but new trials are expected with mAbs targeting T or B lymphocytes. Thus, mAbs might be efficacious in a near future in the prevention (when administered early in the natural course of the disease, in high risk patients) and the treatment of type 1 diabetes, and therefore could avoid, or at least minimize, the constraints of intensive subcutaneous insulin therapy. [less ▲]

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See detailMieux Traiter le diabète permet-il de vivre plus longtemps?
Scheen, André ULg; Philips, Jean-Christophe ULg

in Médecine Clinique Endocrinologie & Diabète (2009), hors série(avril 2009), 2-7

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See detailPulse pressure and cardiovascular autonomic neuropathy according to duration of type 1 diabetes.
Philips, Jean-Christophe ULg; Marchand, Monique ULg; Scheen, André ULg

in Diabetes/Metabolism Research & Reviews (2009)

BACKGROUND: To evaluate changes in pulse pressure (PP) and markers of cardiovascular autonomic neuropathy (CAN) according to duration of type 1 diabetes mellitus (T1DM). METHODS: This cross-sectional ... [more ▼]

BACKGROUND: To evaluate changes in pulse pressure (PP) and markers of cardiovascular autonomic neuropathy (CAN) according to duration of type 1 diabetes mellitus (T1DM). METHODS: This cross-sectional controlled study evaluated 159 diabetic patients during a 3-min posture test (standing-squatting-standing) with continuous measurement of systolic (SBP), diastolic (DBP) and mean (MBP) blood pressure by a Finapres device. Arterial stiffness was indirectly assessed by PP and the slope of PP as a function of MBP calculated during the whole 3-min test. CAN was assessed by the expiration/inspiration pulse interval ratio (E/I R-R ratio) during deep breathing and by three indices measured during the squatting test. Patients were divided into four groups according to diabetes duration (<10 years, 11-20 years, 21-30 years and > 30 years from group 1 to group 4, respectively) and compared with age-matched non-diabetic subjects. RESULTS: PP progressively increased (p < 0.0001) and PP/MBP decreased (p < 0.0005) according to T1DM duration, whereas these parameters remained almost unchanged in age-matched control subjects. E/I ratio (p < 0.0001) and baroreflex gain (p < 0.0005) progressively decreased with T1DM duration. The parasympathetic index (squatting test vagal ratio-SqTv) significantly increased (p < 0.0001), whereas the sympathetic index (squatting test sympathetic ratio-SqTs) only tended to decrease (p = 0.12) according to diabetes duration. No such changes in CAN indices were observed in the non-diabetic population. CONCLUSIONS: PP increased according to T1DM duration in an age range where PP remained almost stable in controls, in agreement with accelerated arterial stiffening due to chronic hyperglycaemia. The baroreflex gain decreased and other indices of CAN also deteriorated with diabetes duration, more so indices reflecting parasympathetic rather than sympathetic dysfunction. [less ▲]

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See detailLa neuropathie autonome: une complication méconnue du diabète
Philips, Jean-Christophe ULg; Marchand, Monique; Scheen, André ULg

in Association belge du diabète (2009), 52(1), 24-29

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See detailInsuline detemir (Levemir) dans l'etude predictive: resultats obtenus chez les patients diabetiques de type 1 de la cohorte belge.
Philips, Jean-Christophe ULg; Scheen, André ULg

in Revue Médicale de Liège (2009), 64(3), 124-30

Insulin detemir (Levemir) is a soluble human insulin analogue acylated with a 14-carbon fatty acid, which reversibly binds to albumin, thereby providing a more prolonged metabolic effect with lower ... [more ▼]

Insulin detemir (Levemir) is a soluble human insulin analogue acylated with a 14-carbon fatty acid, which reversibly binds to albumin, thereby providing a more prolonged metabolic effect with lower variability as compared to NPH insulin taken as reference. Thanks to this pharmacokinetic and pharmacodynamic profile, insulin detemir is essentially used within a basal-bolus regimen. We report the results obtained in 232 type 1 diabetic patients recruited in Belgium in the frame of the international observational, open, prospective PREDICTIVE study. In patients initially treated with either NPH insulin or glargine, followed for 26 weeks, the shift to insulin detemir did not change HbA1c levels, but significantly reduced both the mean and the variability of fasting blood glucose levels while diminishing the risk of hypoglycaemic episodes, especially at night. Therefore, insulin detemir was associated with significantly improved quality of life. These changes were obtained with a slight increase in daily insulin doses but without weight gain. [less ▲]

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See detailL'etude clinique du mois. Controle glycemique et morbimortalite cardio-vasculaire chez le patient diabetique de type 2. Resultats des etudes ACCORD, ADVANCE et VA-Diabetes.
Radermecker, Régis ULg; Philips, Jean-Christophe ULg; Jandrain, Bernard ULg et al

in Revue Médicale de Liège (2008), 63(7-8), 511-8

Type 2 diabetes is associated with a high risk of complications, essentially macrovascular events. Surprisingly, the effect of improved glucose control on coronary and cerebrovascular complications in ... [more ▼]

Type 2 diabetes is associated with a high risk of complications, essentially macrovascular events. Surprisingly, the effect of improved glucose control on coronary and cerebrovascular complications in this population remains questionable. Furthermore, the target level of glycated haemoglobin (HbA1c) to minimise the risk of diabetic complications is controversial. We report the results of three recent randomised control trials (ACCORD, ADVANCE, Veterans Affairs Diabetes), which assessed the impact on cardiovascular events of intensive glucose-lowering therapy. None of these studies was able to demonstrate a significant reduction of cardiovascular events in the intensive group as compared to the standard group. On the contrary, in ACCORD, the study with the most ambitious goal (HbA1c < 6%), the overall and cardiovascular mortality was greater in the intensive group. In contrast, in the ADVANCE trial, the mortality and the incidence of cardiovascular events were not statistically different between the two treatment groups, whereas the risk of microangiopathic complications, especially nephropathy, was significantly decreased in the intensive group (HbA1c < or = 6.5%, with modified release gliclazide as main treatment). Finally, VA-Diabetes showed that the effect of better glucose control on cardiovascular complications disappeared with duration of the disease and that the risk of cardiovascular events increased in patients with severe hypoglycaemic episodes. In the three studies, the hypoglycaemic risk was indeed increased in the intensive group, which may contribute to reduce the positive impact of better glucose control on cardiovascular complications. The best way to protect type 2 diabetic patients against coronary and cerebrovascular disease is to target all cardiovascular risk factors. [less ▲]

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