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Candidates propose and defend an architecture solution to a set of business requirements. Candidates are asked to modify their proposals “on the fly,” based on additional requirements presented by the board.

Prerequisites include a CCDE certification, approximately 10 years of industry experience, and acceptance into the program via an application process. Routing and Switching seem by far the most popular track, with 35, worldwide certified individuals as of May 18, Specifically, CCDE identifies network professionals who have expert network design skills.

Network design translates business requirements into end-to-end network designs and a solutions approach to network expansion and integration. CCDE supplies a vendor-neutral curriculum, testing business requirements analysis, design, planning, and validation practices.

It uses the same CCIE tools to verify qualified status. CCDE provides advanced network infrastructure design principles and fundamentals for large networks. A CCDE can demonstrate an ability to develop solutions which address planning, design, integration, optimization, operations, security, and ongoing support focused at the infrastructure level.

Most candidates pass after three or four lab attempts, but some have required more than six. Many have reputed that the lab exam seems as much a test of time management and planning as of technical expertise. As such, it involves a lot of back-and-forth fine tuning between the numerous platforms. After protest from current and aspirant CCIE Voice holders, whom argued that the differences remain too few to warrant retiring the track with no option to transition to the new track, Cisco offered a transition path for existing Voice holders.

The Collaboration written exam may have availability starting from November 21, The lab exam will transition from Voice to Collaboration on February 14, Cisco has announced the September availability of a CCIE Data Center certification, [57] which certifies the expert-level skills required to plan, prepare, operate, monitor, and troubleshoot complex data center networks.

Candidates who pass the CCIE Wireless certification exams demonstrate broad theoretical knowledge of wireless networking and a solid understanding of wireless local area networking WLAN technologies from Cisco.

In addition to the vast amount of Certifications above, Cisco also provides Specialist Certifications. By combining various exams, a Cisco partner can gain specialty status and thus qualify for additional partner benefits. Specialisations can be held at Express, Advanced and Master levels, reflecting the depth of a partners skills across certain technologies and architectures, and can be held in both a Technology portfolio, or an architecture.

Specialisations are: [1] [62]. From Wikipedia, the free encyclopedia. This article has multiple issues. Please help improve it or discuss these issues on the talk page. Learn how and when to remove these template messages. This article contains too many or overly lengthy quotations for an encyclopedic entry. Please help improve the article by presenting facts as a neutrally worded summary with appropriate citations. Consider transferring direct quotations to Wikiquote or, for entire works, to Wikisource.

July Relevant discussion may be found on the talk page. Now, of course, there are plenty of color options. So impressed. With every update PDF Expert only gets better. Bravo to the Readdle team! Congratulations on many excellent products backed by a superior customer experience!

Keep up the good work! The following data may be collected and linked to your identity:. The following data may be collected but it is not linked to your identity:.

Privacy practices may vary, for example, based on the features you use or your age. Learn More. App Store Preview. Screenshots iPhone iPad. Aug 3, Version 7. Our prep books and online resources provide the expert guidance that students need at every step of their educational journey — incorporating years of test-specific data and strategies tested by Kaplan students and our own expert psychometricians.

We offer preparation for more than 90 standardized tests — including entrance exams for secondary school, college, and graduate school, as well as professional licensing exams for attorneys, physicians, and nurses. With a full array of self-paced and live online courses, as well as print books and mobile apps, you can use Kaplan to study on your own schedule and at your own speed.

After helping millions of students, we know what works. Yu, C. Mechanism by which fatty acids inhibit insulin activation of insulin receptor substrate-1 IRS-1 -associated phosphatidylinositol 3-kinase activity in muscle. Bezy, O. Mechanism of hepatic insulin resistance in non-alcoholic fatty liver disease. Choi, C. Suppression of diacylglycerol acyltransferase-2 DGAT2 , but not DGAT1 , with antisense oligonucleotides reverses diet-induced hepatic steatosis and insulin resistance.

Morino, K. Reduced mitochondrial density and increased IRS-1 serine phosphorylation in muscle of insulin-resistant offspring of type 2 diabetic parents. Szendroedi, J. Larsen, P. On ceramides, other sphingolipids and impaired glucose homeostasis. Turpin, S. Obesity-induced CerS6-dependent C ceramide production promotes weight gain and glucose intolerance.

Cantley, J. Patti, M. The role of mitochondria in the pathogenesis of type 2 diabetes. Mitochondrial dysfunction as a causative factor in the development of insulin resistance in T2DM is reviewed.

Ritov, V. Deficiency of subsarcolemmal mitochondria in obesity and type 2 diabetes. Diabetes 54 , 8—14 Mitochondrial dysfunction in the elderly: possible role in insulin resistance. Impaired mitochondrial activity in the insulin-resistant offspring of patients with type 2 diabetes. Mogensen, M. Mitochondrial respiration is decreased in skeletal muscle of patients with type 2 diabetes. Diabetes 56 , — Decreased insulin-stimulated ATP synthesis and phosphate transport in muscle of insulin-resistant offspring of type 2 diabetic parents.

Wang, C. Mitochondrial dysfunction leads to impairment of insulin sensitivity and adiponectin secretion in adipocytes. FEBS J. Rains, J. Oxidative stress, insulin signaling, and diabetes. Free Radic. Regulation of mitochondrial biogenesis by lipoprotein lipase in muscle of insulin-resistant offspring of parents with type 2 diabetes. Diabetes 61 , — Romeo, G. Metabolic syndrome, insulin resistance, and roles of inflammation — mechanisms and therapeutic targets.

Arkan, M. De Alvaro, C. Howard, J. Attenuation of leptin and insulin signaling by SOCS proteins. Lebrun, P. SOCS proteins causing trouble in insulin action. Acta Physiol. Uysal, K. Endocrinology , — Ofei, F. Kim, J. Prevention of fat-induced insulin resistance by salicylate. Yuan, M. Goldfine, A. The effects of salsalate on glycemic control in patients with type 2 diabetes: a randomized trial. Lumeng, C. Inflammatory links between obesity and metabolic disease.

Nishimura, S. Feuerer, M. Lean, but not obese, fat is enriched for a unique population of regulatory T cells that affect metabolic parameters. Bertola, A. Identification of adipose tissue dendritic cells correlated with obesity-associated insulin-resistance and inducing Th17 responses in mice and patients.

Cai, D. Hepatic acetyl CoA links adipose tissue inflammation to hepatic insulin resistance and type 2 diabetes. Mori, M. A systems biology approach identifies inflammatory abnormalities between mouse strains prior to development of metabolic disease.

Diabetes 59 , — Mauer, J. Myeloid cell-restricted insulin receptor deficiency protects against obesity-induced inflammation and systemic insulin resistance.

PLoS Genet. Shi, H. TLR4 links innate immunity and fatty acid-induced insulin resistance. Ron, D. Signal integration in the endoplasmic reticulum unfolded protein response.

Boden, G. Increase in endoplasmic reticulum stress-related proteins and genes in adipose tissue of obese, insulin-resistant individuals. Diabetes 57 , — Eizirik, D. The role for endoplasmic reticulum stress in diabetes mellitus. A comprehensive review of ER stress and the UPR in the development of insulin resistance and obesity. Gregor, M. Endoplasmic reticulum stress is reduced in tissues of obese subjects after weight loss. Ozawa, K. The endoplasmic reticulum chaperone improves insulin resistance in type 2 diabetes.

Herschkovitz, A. Common inhibitory serine sites phosphorylated by IRS-1 kinases, triggered by insulin and inducers of insulin resistance. Sengupta, S. Regulation of the mTOR complex 1 pathway by nutrients, growth factors, and stress. Cell 40 , — Shah, O. Ozcan, U. Loss of the tuberous sclerosis complex tumor suppressors triggers the unfolded protein response to regulate insulin signaling and apoptosis.

Cell 29 , — Park, S. Stratton, I. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes UKPDS 35 : prospective observational study.

BMJ , — A seminal UK Prospective Diabetes Study study unequivocally demonstrating that improved glycaemic control reduced the incidence of microvascular, and to a lesser extent, macrovascular complications in patients with T2DM. Holman, R. Brownlee, M. The pathobiology of diabetic complications: a unifying mechanism. A lucid discussion of the molecular pathways involved in the development of diabetic microvascular complications.

Giacco, F. Oxidative stress and diabetic complications. Coutinho, M. The relationship between glucose and incident cardiovascular events.

A metaregression analysis of published data from 20 studies of 95, individuals followed for Diabetes Care 22 , — Taskinen, M.

New insights into the pathophysiology of dyslipidemia in type 2 diabetes. Atherosclerosis , — An up-to-date review of the pathogenesis of diabetic dyslipidaemia and its treatment.

Isomaa, B. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Adler, A. Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes UKPDS 36 : prospective observational study.

Williams, B. Treating hypertension in patients with diabetes: when to start and how low to go? The optimal blood pressure goal in hypertensive patients with T2DM is discussed in light of the controversial results observed in the blood pressure arm of the ACCORD trial. Lastra, G. Type 2 diabetes mellitus and hypertension: an update. International Expert Committee. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes.

Diabetes Care 32 , — Diabetes Care 20 , — A reference publication by the ADA on the diagnosis and classification of diabetes mellitus. Herman, W. Diabetes epidemiology: guiding clinical and public health practice: the Kelly West Award Lecture, A landmark lecture providing a comprehensive overview of the epidemiology of T2DM and the public health implications for diabetes prevention.

Is the current definition for diabetes relevant to mortality risk from all causes and cardiovascular and noncardiovascular diseases? Diabetes Care 26 , — Engelgau, M. Screening for type 2 diabetes. Diabetes Care 23 , — LeFevre, M. Behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors: U. The diabetes risk score: a practical tool to predict type 2 diabetes risk. Tabaei, B. A multivariate logistic regression equation to screen for diabetes: development and validation.

Diabetes Care 25 , — World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus WHO, Pan, X. Knowler, W. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. Ramachandran, A. Diabetologia 49 , — Chiasson, J. Kawamori, R. Voglibose for prevention of type 2 diabetes mellitus: a randomised, double-blind trial in Japanese individuals with impaired glucose tolerance.

Prevention of type 2 diabetes with troglitazone in the Diabetes Prevention Program. Effect of rosiglitazone on the frequency of diabetes in patients with impaired glucose tolerance or impaired fasting glucose: a randomised controlled trial.

Li, G. The long-term effect of lifestyle interventions to prevent diabetes in the China Da Qing Diabetes Prevention Study: a year follow-up study. Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study. Pathophysiologic approach to therapy in patients with newly diagnosed type 2 diabetes. Diabetes Care 36 , S—S A rational approach to the treatment of T2DM is presented based on its pathophysiology.

Raz, I. Nakagami, T. A year follow-up study. Lim, E. Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol. Jazet, I. Diabetologia 51 , — Initial combination therapy with metformin, pioglitazone and exenatide is more effective than sequential add-on therapy in subjects with new-onset diabetes. This prospective randomized trial using a combination of antidiabetic agents proven to reverse known pathophysiological abnormalities in T2DM demonstrated superiority of glycaemic control compared with the stepped approach of metformin followed by a sulfonylurea and then basal insulin recommended by most national diabetes organizations.

Harrison, L. Gram, J. Pharmacological treatment of the pathogenetic defects in type 2 diabetes: the randomized multicenter South Danish Diabetes Study. Diabetes Care 34 , 27—33 Combination of empagliflozin and linagliptin as second-line therapy in subjects with type 2 diabetes inadequately controlled on metformin.

Diabetes Care 38 , — Weng, J. Hu, Y. One of several recent studies demonstrating that intensive insulin therapy to correct the decompensated metabolic state in newly diagnosed patients with T2DM can lead to durable glycaemic control without or with a marked reduction in antidiabetic medications. Xiang, A. Astrup, A. Safety, tolerability and sustained weight loss over 2 years with the once-daily human GLP-1 analog, liraglutide. Metabolic effects of metformin on glucose and lactate metabolism in noninsulin-dependent diabetes mellitus.

Turner, R. Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 diabetes mellitus: progressive requirement for multiple therapies UKPDS A landmark UK Prospective Diabetes Study documenting the need for progressive add-on therapies in newly diagnosed patients with T2DM receiving initial therapy with metformin or with a sulfonylurea.

Brown, J. Secondary failure of metformin monotherapy in clinical practice. Glycemic durability of rosiglitazone, metformin, or glyburide monotherapy. A 5-year ADOPT study demonstrating long-term durable HbA1c reduction with rosiglitazone compared with a progressive rise in HbA1c observed with metformin and sulfonylureas, and a more rapid deterioration of glycaemic control with sulfonylureas compared with metformin. Madiraju, A. Metformin suppresses gluconeogenesis by inhibiting mitochondrial glycerophosphate dehydrogenase.

The target of metformin in type 2 diabetes.