BARI-2D BYPASS ANGIOPLASTY REVASCULARIZATION INVESTIGATION 2 DIABETES

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。所列机构为中心机构，不一定为研究者机构。糖尿病是一种血糖（葡萄糖）水平异常高的疾病，会对许多器官造成损害，如眼睛，肾脏和神经。将血糖水平降低到正常水平有助于防止这种损害。我们怀疑高血糖对心脏也不好，因为血糖特别高的糖尿病患者更容易患心脏病和死亡。在2型糖尿病中，高血糖是由两件事引起的：（1）胰腺不能提供足够的胰岛素;（2）身体对它接受的任何胰岛素反应都不够好。我们现在有药物来改善这两个问题，并使血糖水平下降到接近正常。胰岛素提供者（IP）是增加胰岛素供应的药物类型，胰岛素增敏剂（IS）是增加身体对胰岛素反应的药物。然而，我们不知道哪种类型的药物更好，特别是对于像你这样的2型糖尿病患者。 冠状动脉疾病是导致动脉硬化的过程。当为心肌提供血液和氧气的动脉堵塞或变窄时，可能会导致心脏病发作，或者即使在休息时也会感到胸部不适（心绞痛）。2型糖尿病患者发生冠状动脉疾病和其他心血管并发症的频率是无糖尿病的相似年龄人群的2-3倍。糖尿病合并冠状动脉疾病患者的最佳治疗方法尚不清楚。有三种方法：药物治疗，冠状动脉搭桥术（心脏直视手术）和球囊血管成形术。 作为一名患有心脏病的糖尿病患者，您被要求参加一项名为巴里2D的研究。这项在美国和加拿大进行的2300例患者、为期8年的研究旨在比较冠状动脉疾病的初始治疗是否采用血管成形术（PCI）或手术（CABG），而不是采用积极的医疗计划，重点是改变您的风险因素，如高胆固醇和肥胖。同时，本研究将比较上述两种不同的糖尿病治疗方法。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Diabetes is a disease in which blood sugar (glucose) levels are abnormally high, causing damage to many organs, such as the eyes, kidneys, and the nerves. Lowering blood glucose levels to normal helps to prevent such damage. We suspect that high blood glucose is also bad for the heart, because diabetic individuals with especially high blood glucose are more likely to suffer heart attacks and death. In type 2 diabetes, high blood glucose results from two things: (1) the pancreas does not supply enough insulin; and (2) the body does not react well enough to whatever insulin it receives. We now have drugs to improve both of these problems and bring blood glucose levels down close to normal. Insulin Providers (IP) are types of drugs that increase the supply of insulin, and Insulin Sensitizers (IS) are drugs that increase the reaction of the body to insulin. However, we do not know which type of drug is better, particularly for type 2 diabetics, like yourself. Coronary artery disease is a process that results in hardening of the arteries. When the arteries that supply blood and oxygen to your heart muscle become clogged or narrowed, a heart attack may result, or you may feel chest discomfort (angina) sometimes even while resting. Patients with Type 2 Diabetes develop coronary artery disease and other cardiovascular complications 2-3 times more often as similarly aged persons without diabetes. The best treatment for patients with diabetes and coronary artery disease is unclear. There are three kinds of approaches: treatment with medicines, coronary artery bypass (open heart) surgery, and balloon angioplasty. As a diabetic patient with heart disease, you are being asked to take part in a research study know as BARI 2D. This 2300 patient, 8-year study in the U.S. and Canada in designed to compare whether initial treatment of coronary artery disease with angioplasty (PCI) or surgery (CABG) is better than starting with an aggressive medical program which focuses on modifying your risk factors such as high cholesterol and obesity. At the same time, this study will compare the two different approaches for the treatment of diabetes explained above.