References of "Scheen, André"
     in
Bookmark and Share    
Full Text
Peer Reviewed
See detailL’hyperglycémie provoquée par voie orale (HGPO) revisitée 2e partie : Indices d’insulinosécrétion, d’insulinosensibilité et de disposition orale
SCHEEN, André ULg; LUYCKX, Françoise ULg

in Médecine des Maladies Métaboliques (2010), 4(6), 684-690

Oral glucose tolerance test (OGTT) has been widely used for the diagnosis of impaired glucose tolerance, diabetes mellitus and gestational diabetes. Simultaneous measurements of plasma glucose and insulin ... [more ▼]

Oral glucose tolerance test (OGTT) has been widely used for the diagnosis of impaired glucose tolerance, diabetes mellitus and gestational diabetes. Simultaneous measurements of plasma glucose and insulin (or more rarely C-peptide) levels allow to derive indices of insulin secretion and insulin sensitivity that are helpful for the understanding of disturbances in glucose metabolism and, especially, for the prediction of progression from normal glucose tolerance to impaired glucose tolerance or type 2 diabetes. Certain indices, quite simple, may be used in clinical practice (“insulinogenic index” to assess early insulin secretion, Matsuda index to assess insulin sensitivity) while others, more complex (and most often based on modelling procedures), are essentially used in research. The oral disposition index, a recently introduced marker that integrates insulin secretion and insulin sensitivity, raises increasing interest, more particularly for the prediction of type 2 diabetes. [less ▲]

Detailed reference viewed: 141 (6 ULg)
Full Text
Peer Reviewed
See detailCentral nervous system: a conductor orchestrating metabolic regulations harmed by both hyperglycaemia and hypoglycaemia.
Scheen, André ULg

in Diabètes & Métabolism (2010), 36S3

Recent evidence suggests that the brain has a key role in the control of energy metabolism, body fat content and glucose metabolism. Neuronal systems, which regulate energy intake, energy expenditure, and ... [more ▼]

Recent evidence suggests that the brain has a key role in the control of energy metabolism, body fat content and glucose metabolism. Neuronal systems, which regulate energy intake, energy expenditure, and endogenous glucose production, sense and respond to input from hormonal and nutrient-related signals that convey information regarding both body energy stores and current energy availability. In response to this input, adaptive changes occur that promote energy homeostasis and the maintenance of blood glucose levels in the normal range. Defects in this control system are implicated in the link between obesity and type 2 diabetes mellitus. The central nervous system may be considered the conductor of an orchestra involving many peripheral organs involved in these homeostatic processes. However, the brain is mainly a glucose-dependent organ, which can be damaged by both hypoglycaemia and hyperglycaemia. Hypoglycaemia unawareness is a major problem in clinical practice and is associated with an increased risk of coma. Stroke is another acute complication associated with diabetes mellitus, especially in elderly people, and the control of glucose level in this emergency situation remains challenging. The prognosis of stroke is worse in diabetic patients and both its prevention and management in at-risk patients should be improved. Finally, chronic diabetic encephalopathies, which may lead to cognitive dysfunction and even dementia, are also recognized. They may result from recurrent hypoglycaemia and/or from chronic hyperglycaemia leading to cerebral vascular damage. Functional imaging is of interest for exploring diabetes-associated cerebral abnormalities. Thus, the intimate relationship between the brain and diabetes is increasingly acknowledged in both research and clinical practice. [less ▲]

Detailed reference viewed: 19 (0 ULg)
Full Text
Peer Reviewed
See detailChanges in pulse pressure, heart rate and the pulse pressure x heart rate product during squatting in Type 1 diabetes according to age.
Philips, Jean-Christophe ULg; Marchand, Monique ULg; Scheen, André ULg

in Diabetic Medicine : A Journal of the British Diabetic Association (2010), 27(7), 753-61

AIMS: We assessed changes in pulse pressure and heart rate during a squatting test, as indirect markers of arterial stiffness and cardiovascular autonomic neuropathy, respectively, according to age and ... [more ▼]

AIMS: We assessed changes in pulse pressure and heart rate during a squatting test, as indirect markers of arterial stiffness and cardiovascular autonomic neuropathy, respectively, according to age and sex in patients with Type 1 diabetes mellitus. METHODS: We evaluated 160 diabetic patients, divided into four groups of 20 men and 20 women according to age (G1, 20-30 years old; G2, 31-40 years old; G3, 41-50 years old; and G4, 51-60 years old), and 160 non-diabetic matched control subjects. Each subject underwent a 3 min posture test (standing-squatting-standing) with continuous measurement of arterial blood pressure and heart rate by a Finapres device. Overall values throughout the test, baseline levels in initial standing position and squatting-induced changes in pulse pressure, heart rate and the pulse pressure x heart rate product were compared between diabetic patients and healthy control subjects. RESULTS: In the standing position, a greater increase in pulse pressure and lower reduction in heart rate with age led to a significantly higher pulse pressure x heart rate product in diabetic patients compared with control subjects. In the squatting position, a more marked pulse pressure increase in the absence of appropriate reduction in heart rate resulted in a greater rise in the pulse pressure x heart rate product in diabetic patients than in healthy subjects. No major differences were noted between the sexes, with the exception of a stronger relationship between pulse pressure and age in the female population with diabetes. Squatting-derived indices of cardiovascular autonomic neuropathy were also noted with increasing age in diabetic patients. CONCLUSIONS: The marked increase in the pulse pressure x heart rate product ('pulsatile stress') according to age, combined with cardiovascular autonomic neuropathy, may contribute to the higher cardiovascular risk of patients with Type 1 diabetes. [less ▲]

Detailed reference viewed: 37 (0 ULg)
Full Text
Peer Reviewed
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)

Detailed reference viewed: 31 (4 ULg)
Full Text
Peer Reviewed
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)

Detailed reference viewed: 38 (5 ULg)
Full Text
Peer Reviewed
See detailAttempt to improve glucose control in type 2 diabetic patients by education about real-time glucose monitoring.
Thielen, Vinciane ULg; Scheen, André ULg; Bringer, J. et al

in Diabètes & Métabolism (2010), 36(3), 240-3

The effectiveness of a specific educational programme involving the use of a real-time glucose-sensor system (Guardian RT) to improve glucose control was investigated in patients with poorly controlled ... [more ▼]

The effectiveness of a specific educational programme involving the use of a real-time glucose-sensor system (Guardian RT) to improve glucose control was investigated in patients with poorly controlled type 2 diabetes despite insulin therapy. Ten patients participated in a randomized crossover study comparing two 3-month periods, during which glucose levels were monitored by either self-monitoring of blood glucose (SMBG) alone or by Guardian RT (restricted to 1 week per month) in addition to SMBG. Only four of the enrolled patients completed both periods, while dropouts were mainly due to technical difficulties in using the device. All six patients who completed the first 3-month period showed a reduction in glycated haemoglobin (HbA(1c)) level whatever the mode of glucose monitoring (study effect). A further reduction in HbA(1c) level was observed in two of the three patients using the Guardian RT during the second period. Less frequent symptomatic hypoglycaemic episodes were noted during the 3-month period with the device in the four patients who completed both study periods. These limited, but promising, results of this pilot study appear to justify the initiation of a larger study to assess the use of a real-time glucose sensor in carefully selected patients with type 2 diabetes. [less ▲]

Detailed reference viewed: 17 (0 ULg)
Full Text
Peer Reviewed
See detailControversy about the cardiovascular safety of sibutramine.
Scheen, André ULg

in Drug Safety : An International Journal of Medical Toxicology & Drug Experience (2010), 33(7), 615-8

Detailed reference viewed: 42 (0 ULg)
Full Text
Peer Reviewed
See detailCost effectiveness of atorvastatin in patients with type 2 diabetes mellitus: a pharmacoeconomic analysis of the collaborative atorvastatin diabetes study in the belgian population.
Annemans, L.; Marbaix, S.; Webb, K. et al

in Clinical Drug Investigation (2010), 30(2), 133-42

BACKGROUND AND OBJECTIVE: Patients with type 2 diabetes mellitus have a high risk of developing cardiovascular (CV) disease. The clinical benefit of use of statins in patients with type 2 diabetes has ... [more ▼]

BACKGROUND AND OBJECTIVE: Patients with type 2 diabetes mellitus have a high risk of developing cardiovascular (CV) disease. The clinical benefit of use of statins in patients with type 2 diabetes has been demonstrated in several randomized, controlled trials, including the CARDS clinical trial. Based on the clinical CARDS data, the favourable cost effectiveness of atorvastatin 10 mg in patients with type 2 diabetes has been demonstrated in countries such as the UK and France. This study aimed to estimate the cost effectiveness in the Belgian setting of atorvastatin 10 mg compared with no treatment for the primary prevention of CV events in type 2 diabetes patients without a history of CV disease. METHODS: A Markov model with 1-year cycles was developed to simulate the CV event and death risk according to the therapeutic approach initiated. The transition probabilities for CV events in the 'no statin treatment' group were derived from the risk equations reported from the large UKPDS. Risk reductions from the CARDS clinical trial were used to adjust these CV event probabilities in the atorvastatin 10 mg treatment group. The characteristics of type 2 diabetes patients without a CV history were derived from the Belgian OCAPI survey. The public healthcare payers' perspective was taken into account for costing. The direct medical costs of CV events were based on the Public Health Authorities' hospital database for acute care costs and on the literature for the follow-up costs. The impact on the reimbursement system of generic entry to the market was considered in the drug cost. Costs were valued as at year 2009; costs and outcomes were discounted at 3% and 1.5%, respectively. RESULTS: Based on a 5-year time horizon, atorvastatin was demonstrated to be cost effective with an incremental cost/quality-adjusted life-year (QALY) of euro 16,681. Over a lifetime horizon (25 years), atorvastatin was demonstrated to be a cost-saving therapeutic intervention. At a threshold of euro 30,000/QALY, atorvastatin had a 98.8% probability of being cost effective. CONCLUSION: Compared with 'no treatment', use of atorvastatin 10 mg as a primary prevention intervention in Belgian type 2 diabetes patients not only improves CV outcomes, but also appears to be cost saving over a lifetime horizon. [less ▲]

Detailed reference viewed: 28 (2 ULg)
Full Text
Peer Reviewed
See detailL'etude clinique du mois. NAVIGATOR: essai de prevention des complications cardio-vasculaires et du diabete de type 2 par le valsartan et/ou le nateglinide.
Scheen, André ULg

in Revue Médicale de Liège (2010), 65(4), 217-23

NAVIGATOR ("Nateglinide And Valsartan in Impaired Glucose Tolerance Outcomes Research") is a large international placebo-controlled trial that randomised 9,031 individuals at high risk because of impaired ... [more ▼]

NAVIGATOR ("Nateglinide And Valsartan in Impaired Glucose Tolerance Outcomes Research") is a large international placebo-controlled trial that randomised 9,031 individuals at high risk because of impaired glucose tolerance and established cardiovascular disease or cardiovascular risk factors. This trial aimed at investigating whether valsartan (a selective AT1 receptor antagonist) and/or nateglinide (a short-acting insulin-secreting agent) are able to reduce the incidence of type 2 diabetes and cardiovascular events. After a median follow up of 6.5 years, neither valsartan nor nateglinide improved cardiovascular prognosis in the tested population, which already benefited from a protective pharmacotherapy at baseline and a reinforcement of lifestyle modification throughout the trial. Nateglinide did not diminish the risk of new onset diabetes. In contrast, valsartan reduced the incidence of type 2 diabetes by 14%, confirming the potential interest of the blockade of the renin-angiotensin system in this high-risk population. [less ▲]

Detailed reference viewed: 31 (1 ULg)
Full Text
Peer Reviewed
See detail"Fitness" versus "fatness": impacts cardio-metaboliques respectifs aux differents ages de la vie.
Esser, N.; Paquot, Nicolas ULg; Scheen, André ULg

in Revue Médicale de Liège (2010), 65(4), 199-205

Almost 35% of overweight or obese individuals are free of any metabolic disorder. This may be explained by a favourable fat distribution. However, those individuals also have a higher level of physical ... [more ▼]

Almost 35% of overweight or obese individuals are free of any metabolic disorder. This may be explained by a favourable fat distribution. However, those individuals also have a higher level of physical fitness. Therefore, deleterious cardiometabolic effects of excessive fat mass ("fatness") might be counterbalanced by regular physical activity leading to high cardiorespiratory fitness ("fitness"). The present article first analyzes the various pathophysiological mechanisms explaining why muscular exercise has beneficial effects and second, describes the relationship between "fitness" and "fatness" and their respective cardiometabolic consequences at various ages: adolescents, adults and elderly people. [less ▲]

Detailed reference viewed: 64 (2 ULg)
Full Text
Peer Reviewed
See detailPoor glycaemic control in secondary care insulin treated patients correlates with bad process indicators
DEBACKER, N.; VAN CROMBRUGGE, P.; MATHIEU, C. et al

in Diabetologia (2010), 53(s407), 1018

Detailed reference viewed: 11 (0 ULg)
Full Text
Peer Reviewed
See detailMaladie cardiovasculaire et diabète chez les personnes atteintes d'une maladie mentale sévère 2ème partie : Evaluation du risque et stratégie de prise en charge
Scheen, André ULg; Gillain, Benoit; De Hert, Marc

in Médecine des Maladies Métaboliques (2010), 4(2), 223-230

Nous avons insisté, dans un premier article, sur le fait que les personnes souffrant de maladies mentales sévères telles que la schizophrénie, la dépression ou le trouble bipolaire sont en moins bonne ... [more ▼]

Nous avons insisté, dans un premier article, sur le fait que les personnes souffrant de maladies mentales sévères telles que la schizophrénie, la dépression ou le trouble bipolaire sont en moins bonne santé physique et ont une espérance de vie moindre que la population générale. Ils sont notamment exposés à de multiples facteurs de risque métabolique et cardiovasculaire conduisant à une surmortalité coronarienne et cérébrovasculaire. Ces patients peuvent avoir un accès restreint à la médecine générale, avec des opportunités de dépistage et de prévention du risque cardiovasculaire inférieures à celles que l'on est en droit d’attendre dans une population non-psychiatrique. L'European Psychiatric Association (EPA), soutenue par l'European Association for the Study of Diabetes (EASD) et l'European Society of Cardiology (ESC), a publié récemment une déclaration de position dans le but d'améliorer la prise en charge des patients atteints de maladies mentales sévères. L'intention est d'amorcer une coopération et une prise en charge partagée entre les différents professionnels de la santé et de sensibiliser les psychiatres et les médecins de première ligne qui s'occupent de patients souffrant de maladies mentales sévères au dépistage et au traitement des facteurs de risque cardiovasculaire et du diabète. Après avoir décrit l’épidémiologie des maladies cardiovasculaires et du diabète dans la population atteinte de maladies mentales sévères et analysé l’impact des médicaments psychotropes en termes de risques métabolique et cardiovasculaire dans une première publication, le présent article décrit comment évaluer le risque de maladies cardiovasculaires et donne des conseils quant à la prise en charge des facteurs de risque cardiovasculaire et du diabète dans cette population psychiatrique. [less ▲]

Detailed reference viewed: 67 (1 ULg)
Full Text
Peer Reviewed
See detailMaladie cardiovasculaire et diabète chez les personnes atteintes d'une maladie mentale sévère 1ère partie : Epidémiologie et influence des médicaments psychotropes
Scheen, André ULg; Gillain, Benoit; De Hert, Marc

in Médecine des Maladies Métaboliques (2010), 4

People with severe mental illnesses, such as schizophrenia, depression or bipolar disorder, have worse physical health and reduced life expectancy compared to the general population. The excess ... [more ▼]

People with severe mental illnesses, such as schizophrenia, depression or bipolar disorder, have worse physical health and reduced life expectancy compared to the general population. The excess cardiovascular mortality associated with schizophrenia and bipolar disorder is attributed in part to an increased risk of the modifiable coronary heart disease risk factors : obesity, smoking, diabetes, hypertension and dyslipidaemia. Antipsychotic medication and possibly other psychotropic medication like antidepressants can induce weight gain or worsen other metabolic cardiovascular risk factors. Patients may have limited access to general healthcare with less opportunity for cardiovascular risk screening and prevention than would be expected in a non-psychiatric population. The European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC) recently published a statement with the aim of improving the care of patients suffering from severe mental illness. This first paper summarizes the epidemiological data of coronary heart disease and stroke in this special population as well as the potential cardiometabolic consequences of psychotropic medications. A second article will explain how to evaluate the cardiovascular risk and give recommendations concerning the appropriate management of risk factors and diabetes in the psychiatric population. [less ▲]

Detailed reference viewed: 78 (2 ULg)