Chronic hyperglycemia is associated with the presence and evolution of diabetic complications in type 1 and type 2 diabetes. Intensive glycemic control can have beneficial effects on such complications, particularly diabetic nephropathy. This Review discusses the phenomenon of 'metabolic memory', in which the beneficial effects of intensive glycemic control persist after a return to more usual (often worse) glycemic control. This phenomenon is not well understood, but preliminary studies indicate that biochemical mechanisms such as advanced glycation and molecular pathways involving epigenetic events might have a role.
- Stephen Tonna
- Assam El-Osta
- Chris Tikellis
