Skip to main content
Top
Published in: Diabetologia 5/2003

01-05-2003 | Article

Indinavir uncovers different contributions of GLUT4 and GLUT1 towards glucose uptake in muscle and fat cells and tissues

Authors: A. Rudich, D. Konrad, D. Török, R. Ben-Romano, C. Huang, W. Niu, R. R. Garg, N. Wijesekara, R. J. Germinario, P. J. Bilan, A. Klip, PhD

Published in: Diabetologia | Issue 5/2003

Login to get access

Abstract

Aims/hypothesis

Insulin-dependent glucose influx in skeletal muscle and adipocytes is believed to rely largely on GLUT4, but this has not been confirmed directly. We assessed the relative functional contribution of GLUT4 in experimental models of skeletal muscle and adipocytes using the HIV-1 protease inhibitor indinavir.

Methods

Indinavir (up to 100 µmol/l) was added to the glucose transport solution after insulin stimulation of wild-type L6 muscle cells, L6 cells over-expressing either GLUT4myc or GLUT1myc, 3T3-L1 adipocytes, isolated mouse brown or white adipocytes, and isolated mouse muscle preparations.

Results

100 µmol/l indinavir inhibited 80% of both basal and insulin-stimulated 2-deoxyglucose uptake in L6GLUT4myc myotubes and myoblasts, but only 25% in L6GLUT1myc cells. Cell-surface density of glucose transporters was not affected. In isolated soleus and extensor digitorum longus muscles, primary white and brown adipocytes, insulin-stimulated glucose uptake was inhibited 70 to 80% by indinavir. The effect of indinavir on glucose uptake was variable in 3T3-L1 adipocytes, averaging 45% and 67% inhibition of basal and maximally insulin-stimulated glucose uptake, respectively. In this cell, fractional inhibition of glucose uptake by indinavir correlated positively with the fold-stimulation of glucose uptake by insulin, and was higher with sub-maximal insulin concentrations. The latter finding coincided with an increase only in GLUT4, but not GLUT1, in plasma membrane lawns.

Conclusion/interpretation

Indinavir is a useful tool to assess different functional contributions of GLUT4 to glucose uptake in common models of skeletal muscle and adipocytes.
Literature
1.
go back to reference Kraegen EW, Sowden JA, Halstead MB et al. (1993) Glucose transporters and in vivo glucose uptake in skeletal and cardiac muscle: fasting, insulin stimulation and immunoisolation studies of GLUT1 and GLUT4. Biochem J 295:287–293PubMed Kraegen EW, Sowden JA, Halstead MB et al. (1993) Glucose transporters and in vivo glucose uptake in skeletal and cardiac muscle: fasting, insulin stimulation and immunoisolation studies of GLUT1 and GLUT4. Biochem J 295:287–293PubMed
2.
go back to reference Buse MG, Robinson KA, Marshall BA, Hresko RC, Mueckler MM (2002) Enhanced O-GlcNAc protein modification is associated with insulin resistance in GLUT1-overexpressing muscles. Am J Physiol Endocrinol Metab 283:E241–250PubMed Buse MG, Robinson KA, Marshall BA, Hresko RC, Mueckler MM (2002) Enhanced O-GlcNAc protein modification is associated with insulin resistance in GLUT1-overexpressing muscles. Am J Physiol Endocrinol Metab 283:E241–250PubMed
3.
go back to reference Katz EB, Stenbit AE, Hatton K, DePinho R, Charron MJ (1995) Cardiac and adipose tissue abnormalities but not diabetes in mice deficient in GLUT4. Nature 377:151–155 Katz EB, Stenbit AE, Hatton K, DePinho R, Charron MJ (1995) Cardiac and adipose tissue abnormalities but not diabetes in mice deficient in GLUT4. Nature 377:151–155
4.
go back to reference Abel ED, Peroni O, Kim JK et al. (2001) Adipose-selective targeting of the GLUT4 gene impairs insulin action in muscle and liver. Nature 409:729–733PubMed Abel ED, Peroni O, Kim JK et al. (2001) Adipose-selective targeting of the GLUT4 gene impairs insulin action in muscle and liver. Nature 409:729–733PubMed
5.
go back to reference Zisman A, Peroni OD, Abel ED et al. (2000) Targeted disruption of the glucose transporter 4 selectively in muscle causes insulin resistance and glucose intolerance. Nat Med 6:924–928PubMed Zisman A, Peroni OD, Abel ED et al. (2000) Targeted disruption of the glucose transporter 4 selectively in muscle causes insulin resistance and glucose intolerance. Nat Med 6:924–928PubMed
6.
go back to reference Ryder JW, Kawano Y, Galuska D et al. (1999) Postexercise glucose uptake and glycogen synthesis in skeletal muscle from GLUT4-deficient mice. FASEB J 13:2246–2256PubMed Ryder JW, Kawano Y, Galuska D et al. (1999) Postexercise glucose uptake and glycogen synthesis in skeletal muscle from GLUT4-deficient mice. FASEB J 13:2246–2256PubMed
7.
go back to reference Ebstensen RD, Plagemann PG (1972) Cytochalasin B: inhibition of glucose and glucosamine transport. Proc Natl Acad Sci USA 69:1430–1434PubMed Ebstensen RD, Plagemann PG (1972) Cytochalasin B: inhibition of glucose and glucosamine transport. Proc Natl Acad Sci USA 69:1430–1434PubMed
8.
go back to reference Klip A, Walker D (1983) The glucose transport system of muscle plasma membranes: characterization by means of [3H]cytochalasin B binding. Arch Biochem Biophys 221:175–187PubMed Klip A, Walker D (1983) The glucose transport system of muscle plasma membranes: characterization by means of [3H]cytochalasin B binding. Arch Biochem Biophys 221:175–187PubMed
9.
go back to reference Hellwig B, Joost HG (1991) Differentiation of erythrocyte-(GLUT1), liver-(GLUT2), and adipocyte-type (GLUT4) glucose transporters by binding of the inhibitory ligands cytochalasin B, forskolin, dipyridamole, and isobutylmethylxanthine. Mol Pharmacol 40:383–389PubMed Hellwig B, Joost HG (1991) Differentiation of erythrocyte-(GLUT1), liver-(GLUT2), and adipocyte-type (GLUT4) glucose transporters by binding of the inhibitory ligands cytochalasin B, forskolin, dipyridamole, and isobutylmethylxanthine. Mol Pharmacol 40:383–389PubMed
10.
go back to reference Joost HG, Steinfelder HJ (1987) Forskolin inhibits insulin-stimulated glucose transport in rat adipose cells by a direct interaction with the glucose transporter. Mol Pharmacol 31:279–283PubMed Joost HG, Steinfelder HJ (1987) Forskolin inhibits insulin-stimulated glucose transport in rat adipose cells by a direct interaction with the glucose transporter. Mol Pharmacol 31:279–283PubMed
11.
go back to reference Klip A, Ramlal T, Douen AG, Bilan PJ, Skorecki KL (1988) Inhibition by forskolin of insulin-stimulated glucose transport in L6 muscle cells. Biochem J 255:1023–1029PubMed Klip A, Ramlal T, Douen AG, Bilan PJ, Skorecki KL (1988) Inhibition by forskolin of insulin-stimulated glucose transport in L6 muscle cells. Biochem J 255:1023–1029PubMed
12.
go back to reference Murata H, Hruz PW, Mueckler M (2000) The mechanism of insulin resistance caused by HIV protease inhibitor therapy. J Biol Chem 275:20251–20254CrossRefPubMed Murata H, Hruz PW, Mueckler M (2000) The mechanism of insulin resistance caused by HIV protease inhibitor therapy. J Biol Chem 275:20251–20254CrossRefPubMed
13.
go back to reference Murata H, Hruz PW, Mueckler M (2002) Indinavir inhibits the glucose transporter isoform Glut4 at physiologic concentrations. AIDS 16:859–863CrossRefPubMed Murata H, Hruz PW, Mueckler M (2002) Indinavir inhibits the glucose transporter isoform Glut4 at physiologic concentrations. AIDS 16:859–863CrossRefPubMed
14.
go back to reference Romanek R, Sargeant R, Paquet MR, Gluck S, Klip A, Grinstein S (1993) Chloroquine inhibits glucose-transporter recruitment induced by insulin in rat adipocytes independently of its action on endomembrane pH. Biochem J 296:321–327PubMed Romanek R, Sargeant R, Paquet MR, Gluck S, Klip A, Grinstein S (1993) Chloroquine inhibits glucose-transporter recruitment induced by insulin in rat adipocytes independently of its action on endomembrane pH. Biochem J 296:321–327PubMed
15.
go back to reference Wang Q, Khayat Z, Kishi K, Ebina Y, Klip A (1998) GLUT4 translocation by insulin in intact muscle cells: detection by a fast and quantitative assay. FEBS Lett 427:193–197CrossRefPubMed Wang Q, Khayat Z, Kishi K, Ebina Y, Klip A (1998) GLUT4 translocation by insulin in intact muscle cells: detection by a fast and quantitative assay. FEBS Lett 427:193–197CrossRefPubMed
16.
go back to reference Volchuk A, Wang Q, Ewart HS et al. (1996) Syntaxin 4 in 3T3-L1 adipocytes: regulation by insulin and participation in insulin-dependent glucose transport. Mol Biol Cell 7:1075–1082PubMed Volchuk A, Wang Q, Ewart HS et al. (1996) Syntaxin 4 in 3T3-L1 adipocytes: regulation by insulin and participation in insulin-dependent glucose transport. Mol Biol Cell 7:1075–1082PubMed
17.
go back to reference Sweeney G, Somwar R, Ramlal T, Volchuk A, Ueyama A, Klip A (1999) An inhibitor of p38 mitogen-activated protein kinase prevents insulin- stimulated glucose transport but not glucose transporter translocation in 3T3-L1 adipocytes and L6 myotubes. J Biol Chem 274:10071–10078CrossRefPubMed Sweeney G, Somwar R, Ramlal T, Volchuk A, Ueyama A, Klip A (1999) An inhibitor of p38 mitogen-activated protein kinase prevents insulin- stimulated glucose transport but not glucose transporter translocation in 3T3-L1 adipocytes and L6 myotubes. J Biol Chem 274:10071–10078CrossRefPubMed
18.
go back to reference Omatsu-Kanbe M, Zarnowski MJ, Cushman SW (1996) Hormonal regulation of glucose transport in a brown adipose cell preparation isolated from rats that shows a large response to insulin. Biochem J 315:25–31PubMed Omatsu-Kanbe M, Zarnowski MJ, Cushman SW (1996) Hormonal regulation of glucose transport in a brown adipose cell preparation isolated from rats that shows a large response to insulin. Biochem J 315:25–31PubMed
19.
go back to reference Konrad D, Bilan PJ, Nawaz Z et al. (2002) Need for GLUT4 activation to reach maximum effect of insulin-mediated glucose uptake in brown adipocytes isolated from GLUT4myc-expressing mice. Diabetes 51:2719–2726PubMed Konrad D, Bilan PJ, Nawaz Z et al. (2002) Need for GLUT4 activation to reach maximum effect of insulin-mediated glucose uptake in brown adipocytes isolated from GLUT4myc-expressing mice. Diabetes 51:2719–2726PubMed
20.
go back to reference Roy D, Perreault M, Marette A (1998) Insulin stimulation of glucose uptake in skeletal muscles and adipose tissues in vivo is NO dependent. Am J Physiol 274:E692–699PubMed Roy D, Perreault M, Marette A (1998) Insulin stimulation of glucose uptake in skeletal muscles and adipose tissues in vivo is NO dependent. Am J Physiol 274:E692–699PubMed
21.
go back to reference Mitsumoto Y, Klip A (1992) Development regulation of the subcellular distribution and glycosylation of GLUT1 and GLUT4 glucose transporters during myogenesis of L6 muscle cells. J Biol Chem 267:4957–4962PubMed Mitsumoto Y, Klip A (1992) Development regulation of the subcellular distribution and glycosylation of GLUT1 and GLUT4 glucose transporters during myogenesis of L6 muscle cells. J Biol Chem 267:4957–4962PubMed
22.
go back to reference Ueyama A, Yaworsky KL, Wang Q, Ebina Y, Klip A (1999) GLUT-4myc ectopic expression in L6 myoblasts generates a GLUT-4-specific pool conferring insulin sensitivity. Am J Physiol 277:E572–578PubMed Ueyama A, Yaworsky KL, Wang Q, Ebina Y, Klip A (1999) GLUT-4myc ectopic expression in L6 myoblasts generates a GLUT-4-specific pool conferring insulin sensitivity. Am J Physiol 277:E572–578PubMed
23.
go back to reference Li D, Randhawa VK, Patel N, Hayashi M, Klip A (2001) Hyperosmolarity reduces GLUT4 endocytosis and increases its exocytosis from a VAMP2-independent pool in l6 muscle cells. J Biol Chem 276:22883–22891CrossRefPubMed Li D, Randhawa VK, Patel N, Hayashi M, Klip A (2001) Hyperosmolarity reduces GLUT4 endocytosis and increases its exocytosis from a VAMP2-independent pool in l6 muscle cells. J Biol Chem 276:22883–22891CrossRefPubMed
24.
go back to reference Foster LJ, Li D, Randhawa VK, Klip A (2001) Insulin accelerates inter-endosomal GLUT4 traffic via phosphatidylinositol 3-kinase and protein kinase B. J Biol Chem 276:44212–44221CrossRefPubMed Foster LJ, Li D, Randhawa VK, Klip A (2001) Insulin accelerates inter-endosomal GLUT4 traffic via phosphatidylinositol 3-kinase and protein kinase B. J Biol Chem 276:44212–44221CrossRefPubMed
25.
go back to reference Khayat ZA, Tsakiridis T, Ueyama A, Somwar R, Ebina Y, Klip A (1998) Rapid stimulation of glucose transport by mitochondrial uncoupling depends in part on cytosolic Ca2+ and cPKC. Am J Physiol 275:C1487–1497PubMed Khayat ZA, Tsakiridis T, Ueyama A, Somwar R, Ebina Y, Klip A (1998) Rapid stimulation of glucose transport by mitochondrial uncoupling depends in part on cytosolic Ca2+ and cPKC. Am J Physiol 275:C1487–1497PubMed
26.
go back to reference Patel N, Khayat ZA, Ruderman NB, Klip A (2001) Dissociation of 5' AMP-activated protein kinase activation and glucose uptake stimulation by mitochondrial uncoupling and hyperosmolar stress: differential sensitivities to intracellular Ca2+ and protein kinase C inhibition. Biochem Biophys Res Commun 285:1066–1070CrossRefPubMed Patel N, Khayat ZA, Ruderman NB, Klip A (2001) Dissociation of 5' AMP-activated protein kinase activation and glucose uptake stimulation by mitochondrial uncoupling and hyperosmolar stress: differential sensitivities to intracellular Ca2+ and protein kinase C inhibition. Biochem Biophys Res Commun 285:1066–1070CrossRefPubMed
27.
go back to reference Somwar R, Kim DY, Sweeney G et al. (2001) GLUT4 translocation precedes the stimulation of glucose uptake by insulin in muscle cells: potential activation of GLUT4 via p38 mitogen- activated protein kinase. Biochem J 359:639–649CrossRefPubMed Somwar R, Kim DY, Sweeney G et al. (2001) GLUT4 translocation precedes the stimulation of glucose uptake by insulin in muscle cells: potential activation of GLUT4 via p38 mitogen- activated protein kinase. Biochem J 359:639–649CrossRefPubMed
28.
go back to reference Pilch PF, Wilkinson W, Garvey WT, Ciaraldi TP, Hueckstaedt TP, Olefsky JM (1993) Insulin-responsive human adipocytes express two glucose transporter isoforms and target them to different vesicles. J Clin Endocrinol Metab 77:286–289PubMed Pilch PF, Wilkinson W, Garvey WT, Ciaraldi TP, Hueckstaedt TP, Olefsky JM (1993) Insulin-responsive human adipocytes express two glucose transporter isoforms and target them to different vesicles. J Clin Endocrinol Metab 77:286–289PubMed
29.
go back to reference Garvey WT (1992) Glucose transport and NIDDM. Diabetes Care 15:396–417PubMed Garvey WT (1992) Glucose transport and NIDDM. Diabetes Care 15:396–417PubMed
30.
go back to reference Garvey WT, Maianu L, Zhu JH, Hancock JA, Golichowski AM (1993) Multiple defects in the adipocyte glucose transport system cause cellular insulin resistance in gestational diabetes. Heterogeneity in the number and a novel abnormality in subcellular localization of GLUT4 glucose transporters. Diabetes 42:1773–1785PubMed Garvey WT, Maianu L, Zhu JH, Hancock JA, Golichowski AM (1993) Multiple defects in the adipocyte glucose transport system cause cellular insulin resistance in gestational diabetes. Heterogeneity in the number and a novel abnormality in subcellular localization of GLUT4 glucose transporters. Diabetes 42:1773–1785PubMed
31.
go back to reference Gaster M, Staehr P, Beck-Nielsen H, Schroder HD, Handberg A (2001) GLUT4 is reduced in slow muscle fibers of type 2 diabetic patients: is insulin resistance in type 2 diabetes a slow, type 1 fiber disease? Diabetes 50:1324–1329 Gaster M, Staehr P, Beck-Nielsen H, Schroder HD, Handberg A (2001) GLUT4 is reduced in slow muscle fibers of type 2 diabetic patients: is insulin resistance in type 2 diabetes a slow, type 1 fiber disease? Diabetes 50:1324–1329
33.
go back to reference Carr A, Samaras K, Burton S et al. (1998) A syndrome of peripheral lipodystrophy, hyperlipidaemia and insulin resistance in patients receiving HIV protease inhibitors. AIDS 12:F51–58PubMed Carr A, Samaras K, Burton S et al. (1998) A syndrome of peripheral lipodystrophy, hyperlipidaemia and insulin resistance in patients receiving HIV protease inhibitors. AIDS 12:F51–58PubMed
34.
go back to reference Carr A, Samaras K, Thorisdottir A, Kaufmann GR, Chisholm DJ, Cooper DA (1999) Diagnosis, prediction, and natural course of HIV-1 protease-inhibitor- associated lipodystrophy, hyperlipidaemia, and diabetes mellitus: a cohort study. Lancet 353:2093–2099CrossRefPubMed Carr A, Samaras K, Thorisdottir A, Kaufmann GR, Chisholm DJ, Cooper DA (1999) Diagnosis, prediction, and natural course of HIV-1 protease-inhibitor- associated lipodystrophy, hyperlipidaemia, and diabetes mellitus: a cohort study. Lancet 353:2093–2099CrossRefPubMed
35.
go back to reference Vigouroux C, Gharakhanian S, Salhi Y et al. (1999) Adverse metabolic disorders during highly active antiretroviral treatments (HAART) of HIV disease. Diabetes Metab 25:383–392PubMed Vigouroux C, Gharakhanian S, Salhi Y et al. (1999) Adverse metabolic disorders during highly active antiretroviral treatments (HAART) of HIV disease. Diabetes Metab 25:383–392PubMed
36.
go back to reference Wanke CA (1999) Epidemiological and clinical aspects of the metabolic complications of HIV infection the fat redistribution syndrome. AIDS 13:1287–1293CrossRefPubMed Wanke CA (1999) Epidemiological and clinical aspects of the metabolic complications of HIV infection the fat redistribution syndrome. AIDS 13:1287–1293CrossRefPubMed
37.
go back to reference Yarasheski KE, Tebas P, Sigmund C et al. (1999) Insulin resistance in HIV protease inhibitor-associated diabetes. J Acquir Immune Defic Syndr 21:209–216PubMed Yarasheski KE, Tebas P, Sigmund C et al. (1999) Insulin resistance in HIV protease inhibitor-associated diabetes. J Acquir Immune Defic Syndr 21:209–216PubMed
38.
go back to reference Hadigan C, Corcoran C, Stanley T, Piecuch S, Klibanski A, Grinspoon S (2000) Fasting hyperinsulinemia in human immunodeficiency virus-infected men: relationship to body composition, gonadal function, and protease inhibitor use. J Clin Endocrinol Metab 85:35–41 Hadigan C, Corcoran C, Stanley T, Piecuch S, Klibanski A, Grinspoon S (2000) Fasting hyperinsulinemia in human immunodeficiency virus-infected men: relationship to body composition, gonadal function, and protease inhibitor use. J Clin Endocrinol Metab 85:35–41
39.
go back to reference Carr A, Samaras K, Chisholm DJ, Cooper DA (1998) Pathogenesis of HIV-1-protease inhibitor-associated peripheral lipodystrophy, hyperlipidaemia, and insulin resistance. Lancet 351:1881–1883CrossRefPubMed Carr A, Samaras K, Chisholm DJ, Cooper DA (1998) Pathogenesis of HIV-1-protease inhibitor-associated peripheral lipodystrophy, hyperlipidaemia, and insulin resistance. Lancet 351:1881–1883CrossRefPubMed
40.
go back to reference Walli R, Herfort O, Michl GM et al. (1998) Treatment with protease inhibitors associated with peripheral insulin resistance and impaired oral glucose tolerance in HIV-1-infected patients. AIDS 12:F167–173PubMed Walli R, Herfort O, Michl GM et al. (1998) Treatment with protease inhibitors associated with peripheral insulin resistance and impaired oral glucose tolerance in HIV-1-infected patients. AIDS 12:F167–173PubMed
41.
go back to reference Purnell JQ, Zambon A, Knopp RH et al. (2000) Effect of ritonavir on lipids and post-heparin lipase activities in normal subjects. AIDS 14:51–57CrossRefPubMed Purnell JQ, Zambon A, Knopp RH et al. (2000) Effect of ritonavir on lipids and post-heparin lipase activities in normal subjects. AIDS 14:51–57CrossRefPubMed
42.
go back to reference Noor MA, Lo JC, Mulligan K et al. (2001) Metabolic effects of indinavir in healthy HIV-seronegative men. AIDS 15:F11–18CrossRefPubMed Noor MA, Lo JC, Mulligan K et al. (2001) Metabolic effects of indinavir in healthy HIV-seronegative men. AIDS 15:F11–18CrossRefPubMed
43.
go back to reference Caron M, Auclair M, Vigouroux C, Glorian M, Forest C, Capeau J (2001) The HIV protease inhibitor indinavir impairs sterol regulatory element- binding protein-1 intranuclear localization, inhibits preadipocyte differentiation, and induces insulin resistance. Diabetes 50:1378–1388PubMed Caron M, Auclair M, Vigouroux C, Glorian M, Forest C, Capeau J (2001) The HIV protease inhibitor indinavir impairs sterol regulatory element- binding protein-1 intranuclear localization, inhibits preadipocyte differentiation, and induces insulin resistance. Diabetes 50:1378–1388PubMed
44.
go back to reference Rudich A, Vanounou S, Riesenberg K et al. (2001) The HIV protease inhibitor nelfinavir induces insulin resistance and increases basal lipolysis in 3T3-L1 adipocytes. Diabetes 50:1425–1431PubMed Rudich A, Vanounou S, Riesenberg K et al. (2001) The HIV protease inhibitor nelfinavir induces insulin resistance and increases basal lipolysis in 3T3-L1 adipocytes. Diabetes 50:1425–1431PubMed
45.
go back to reference Nolte LA, Yarasheski KE, Kawanaka K, Fisher J, Le N, Holloszy JO (2001) The HIV protease inhibitor indinavir decreases insulin- and contraction-stimulated glucose transport in skeletal muscle. Diabetes 50:1397–1401PubMed Nolte LA, Yarasheski KE, Kawanaka K, Fisher J, Le N, Holloszy JO (2001) The HIV protease inhibitor indinavir decreases insulin- and contraction-stimulated glucose transport in skeletal muscle. Diabetes 50:1397–1401PubMed
46.
go back to reference Huang C, Somwar R, Patel N, Niu W, Torok D, Klip A (2002) Sustained exposure of L6 myotubes to high glucose and insulin decreases insulin-stimulated GLUT4 translocation but upregulates GLUT4 activity. Diabetes 51:2090–2098PubMed Huang C, Somwar R, Patel N, Niu W, Torok D, Klip A (2002) Sustained exposure of L6 myotubes to high glucose and insulin decreases insulin-stimulated GLUT4 translocation but upregulates GLUT4 activity. Diabetes 51:2090–2098PubMed
Metadata
Title
Indinavir uncovers different contributions of GLUT4 and GLUT1 towards glucose uptake in muscle and fat cells and tissues
Authors
A. Rudich
D. Konrad
D. Török
R. Ben-Romano
C. Huang
W. Niu
R. R. Garg
N. Wijesekara
R. J. Germinario
P. J. Bilan
A. Klip, PhD
Publication date
01-05-2003
Publisher
Springer-Verlag
Published in
Diabetologia / Issue 5/2003
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-003-1080-1

Other articles of this Issue 5/2003

Diabetologia 5/2003 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.