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Links to Medical Literature, Textbooks and Websites
Literature and Lectures
Understanding and Addressing the Epidemic of Obesity: An Energy Balance Perspective. J. O. Hill, Endocrine Reviews 27, 750-761 2006.
Hill presents a sound and well-documented approach to the extremely difficult problem of controlling overweight over time. Many of the "almost magical" approaches to dieting are discussed. Most interesting is his discussion of maintaining reduced weight. Most "dieters" regain weight after a short period, but some few do manage to maintain their reduced body weight. What characterizes this group? This article should be be "required reading" for all interested in this problem. Click here to come further.
Multihormonal Treatment Approaches and the Diabetes-Obesity Continuum, a CME from Medscape.
Pancreatic ß-cells secrete amylin in addition to insulin and C-peptide. Amylin has previously been shown to be involved in central regulation of appetite. An analog, Pramlintide, is now clinically available. Pramlintide has been shown to decrease the rate of gastric emptying, decrease the rate of postprandial glucagon secretion and increase satiety, leading to weight loss. This CME presents animal and clinical studies with this hormone, PYY and leptin. Type 2 diabetes and obesity are discussed in detail. Lectures by S. L. Aronoff, I. B. Hirsch and C. H. Wysham, Purdue University. Pick up this CME here.
The important role of glucagon in development of type 2 diabetes has received little attention during the past years. Dr. Cooppan presentation is an informative masterpiece, covering this and many other aspects of insulin resistance and the T2D epidemic. You can call it up here. The CME as a whole gives an up-to-date overview of causes and treatment of T2D. Goto it here.
Management of type 2 diabetes; a consensus statement from the ADA and EASD, October 2008. This is presented in a CME from Medscape which you can call up here.
The ADA and EASD have issued a updated guide for the treatment of hyperglycemia seen in T2D. This is quite timely since there have come several new approaches to control of hyperglycemia. Summarized, the consensus gives most support to "well-validated core therapies" but presents good advice for use of other alternatives.
The Diabetes-Obesity Continuum: The Growing Body of Evidence for a Multi-hormonal Approach to Treatment, (CME, Medscape, December 2007). Click here to call it up.
There has been much discussion concerning the roles of gut hormones in control of metabolism, plasma glucose levels and body weight. Furthermore, amylin, a peptide hormone co-released with insulin from pancreatic beta-cells strongly influences these factors. This course gives insight into the actions of these hormones as well as the commercially available analogue of amylin, pramlintide.
Neurohormonal Regulators of Obesity: Mediating Weight Loss Through Peptide Hormone Therapeutics: (CME, Medscape, February 2008).
Overeating and obesity are strongly correlated development of type 2 diabetes. Three outstanding lectures; Why Can't People Lose Weight?, Neurohormonal Regulation of Energy Balance, and Advances in Neurohormonal Therapy in Treatment of Obesity present up-to-date insight into hormonal and central control of body weight and appetite. This is a program that should be of interest to all those concerned with obesity and associated illnesses. Click here to call it up.
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Websites
SUGARS-4-KIDS.COM
Sugars4kids is an attempt to present an important nutritional topic in an understandable way for teenagers. You can call it up here.
Wikipedia:
The English Wikipedia has a very good review article over insulin and its actions. You can call it up by clicking here.
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More links to literature:
Orchestration of Glucose Homeostasis: The Banting Lecture 2006.
Professor Richard N. Bergman presents a new approach to defining the factors involved in development of type 2 diabetes. Most modern research has focused on the molecular mechanisms of insulin action. Dr. Bergman and his associates have taken a more physiologically oriented approach. They have shown that transport of insulin to target cells is rate-limiting for initiation of insulin action and that this is disturbed in T2D. Furthermore, changes in FFA release to the circulation correlate well with loss of sensitivity to the hormone. These actions appear to account for over half of the loss of insulin sensitivity seen in T2D patients. This paper is a must for all those who work with diabetic patents. It can be downloaded from Medscape (click here) or from Diabetes 2007;56(6):1489-1501 (click here).
New Mechanisms of Glucose Control: Expanding Therapeutic Options with Incretin Mimetic Therapies.
This new CME from Medscape (J. P. Sheehan and P. N. Weissman, Joslin Diabetes Center) is a must for medical students and all those who work with diabetic patients. Quote from Medscape: "This activity will discuss the multiple pathophysiologic factors causing type 2 diabetes, including incretin function and dysfunction, and will outline the newer mechanisms and resulting clinical strategies to target these factors. The goal is for clinicians to more effectively, safely and precisely achieve near-normal metabolic control for their patients". This resource is a "slide show"; a lot of info on the slides with somewhat limited texts. Click here to download this comprehensive article.
Primary Prevention of Cardiovascular Diseases in People With Diabetes Mellitus: A Scientific Statement from the American Heart Association and the American Diabetes Association (Medscape).
Diabetes patients, both type 1 and type 2, run a high risk of developing cardiovascular disease. This is a new and concise review of present standings of the AHA and ADA on prevention CVD in these patients. Recommendations concerning diet, dietary supplements and exercise are presented and weighted. Click here to call up this important publication.
The Nuclear Receptor LXR is a Glucose Sensor.
N. Mitro, P. A. Mak, L. Vargas, C. Godio, E. Hampton, V. Molteni, A. Kreusch and E. Saez, Nature 445, 219-223 (2007). The authors clearly demonstrate that glucose directly binds and activates LXR-α and LXR-ß. Glucose in physiological levels inhibits synthesis of PEPCK and, therefore, activation of gluconeogenesis and activates energy storage by increasing lipid synthesis. These are most exciting observations and might perhaps lead to an understanding of the development of T2DM. This paper has been cited by most of the leading journals involved with endocrinology and is a "must" for students and physicians involved in the field. Click on the title to come further.
Type 2 Diabetes: Reducing Insulin Resistance and Cardiovascular Risk.
Enrique Caballero, MD and Paul S. Jellinger, MD, MACE at The Joslin Diabetes Center (affiliated with Harvard Medical School) have produced an outstanding CME program. This gives insight into the causes of diabetes and relationship to cardiovascular disease. The program is mounted at Medscape and can be downloaded by clicking here. Remember, you must register with Medscape.com. There is no fee.
Resurrecting the Beta Cell in Type 2 Diabetes: Examining Tomorrow's Breakthroughs Today.
Robert R. Henry, MD; Charles F. Burant, MD, PhD; Daniel J. Drucker, MD; Educational Reviewer: Melissa Meredith, MD: Medscape 2006.
New methods of treating diabetes have emerged during the past few years. This CME from Medscape gives clear insight into some of the progress made and future expectations. Download this very interesting publication by clicking here.
Through the Looking Glass: Current and Future Perspectives on the Role of Hormonal Interplay in Glucose Homeostasis.
A CME course from Medscape which gives an up-to-date insight into regulation of blood sugar levels, control of glucagon-induced hepatic gluconeogenesis and appetite by amylin and pramlintide (a synthetic derivative of amylin). Click here to call up this publication.
NDEI.org; Literature and CMEs for physicians and medical students.
The National Diabetes Education Initiative is an excellent source for information for clinicians and students. You can download articles, slides and CME's. Registration is required but is free. The monograph "ß-Cell Adaptation and Failure: Opportunities for Prevention and Treatment of Type 2 Diabetes" is especially useful. Click here to come further.
From Medscape:
The "metabolic syndrome" has been
widely sighted as the initiator of diabetes type 2, hypertension and CVD.
Here is an important addition to the debate. Click the underlined text to
come further.
A Debate on the Metabolic Syndrome: Evolving Challenges and
Controversies CME/CE 09/28/2005
Patients with metabolic
syndrome have increased risk for cardiovascular and renal disease. This program
reviews data from several large trials and offers ways to help patients manage
their risk factors.
Textbooks:
Metabolic Regulation, a Human Perspective, Keith N. Frayn; 2nd ed., 2003, Blackwell Science, Malden, MA.
Pocket Atlas of Nutrition, H. K. Biesalski and P. Grimm; 3rd ed., 2004, Thieme New York, N. Y.
These two books are concise and, at the same time, give excellent overviews of our anatomy, physiological functions, and energy requirements throughout life.
Frayn's book is a joy to read. It gives an up-to-date insight into our metabolism and the factors controlling this. The anatomy, physiology, and biochemistry of our daily live are most clearly explained with just the right degree of details. The Pocket Atlas of Nutrition, in spite of its title, gives an unusually rich insight into our functions and combines anatomy, physiology and biochemistry in a series of detailed but clear diagrams and good texts. Distribution of nutrients in food sources is extremely well documented as are bodily requirements from birth to old age. Good balanced arguments for and against supplements are presented.
Sorry, no links here. You must go to a book shop or library to thumb through these references.
Integration of metabolism: is it "all in the mind"?
It has been commonly assumed that hormonal integration of metabolism occurs mainly at target organs such as the liver, adipose tissue and muscles. However, appreciation of the important role of the hypothalamus in these processes has become apparent this spring (2005). The following articles are keys to understanding of the role of the hypothalamus in coordination of weight control, appetite and blood glucose levels. Hypothalamic receptors for glucose, long-chain fatty acids, leptin and insulin appear to be involved in neurogenic regulation of hepatic metabolism. Central resistance to fatty acids and peptide hormones may lie behind development of type 2 diabetes and obesity. These concepts are discussed in the section on "Central control of appetite and body weight" here at MedBio.
Medscape, "Insulin
Resistance and Type 2 Diabetes: A Comprehensive Review".
This case-based study goes through the
association between type 2 diabetes and cardiovascular disease.
Life-style, diet and exercise are discussed in depth. This article gives a
good all-round picture of situation of the type 2 diabetic patient.
Medscape's Resource Center for Incretin Hormones in Diabetes and Metabolism
Is a new method of treating type 2 diabetes now developing? An excellent introduction can be found here at Medscape. "Incretin hormones are produced by the gastrointestinal tract in response to nutrient entry and are necessary for the maintenance of glucose homeostasis. These compounds are now being investigated for their therapeutic potential in type 2 diabetes. Many of these agents are first-in-class compounds that target physiologic defects not addressed by current medications, and may represent a significant addition to our armamentarium for the treatment of type 2 diabetes and other metabolic disorders".
A new and important CME from Medscape. This program can be run as multimedia lectures or read on your screen. The first section gives an overview of the endocrinology of gastrointestinal hormones. The second section and third sections present clinical applications of the incretin system. Control of diabetes type 2 with conventional agents and the newer glucagon-like-peptide 1 (GLP-1) and associated agents is comprehensively presented. The incretin hormones may represent a dramatic start for a new approach to treatment of insulin resistance and diabetes type 2. The program was written for physicians and interested medical students.
"Flash in the Pan" or the science and politics of our diets. A really good analysis from Nature, Vol 433 No 7028 pp785-906 of Dietary Guidelines for Americans, 2005 (the official guidelines published every five years by the US Department of Health and Human Services and the US Department of Agriculture). The suggestions in the guidelines are very sound and should help establish similar global guidelines to combat the overweight epidemic. But the politics...
See also "Food FAQs" from the same issue of Nature. Choosing "the right" foods is not easy!
This is a new journal, first issued in January 2005. It is designed to fill to present high-quality research in the field of metabolic diseases. Overweight, diabetes, hypertension and atherosclerotic heart disease threaten ever-increasing numbers globally. In spite of this, a single publication presenting advances in knowledge in this field has been lacking. Cell metabolism should be a "must" for all of us who work in this area.
Science 299, 845-860, 2003. A special section of Science giving the most up-to-date coverage of the overweight problem . Energy-balance, and genetic mechanisms of weight and appetite regulation are discussed. A must for those interested in weight control and good health.
An special issue of Nature which takes up many key issues concerning the molecular biology of obesity. This is "required reading" for comprehension of causes the global overweight epidemic.
NCIB: The Genetic Landscape of Diabetes
The National Center for Biotechnology Information's
service dedicated to presentation of the latest genetic findings in
the field of diabetes. The few genes found to be involved in development
of various forms of diabetes are listed.
WHO, a "fact-sheet" about diabetes.
Diabetes is a rapidly expanding global threat. Here are the facts!
Websites for students and physicians:
Medscape: Diabetes and Endocrinology
Medscape is perhaps the world's leading source for medical news and up-to-date information. This section is dedicated to the control of metabolism and related illnesses. New users must register; this is gratis.
Professor Michael W. King's extensive site for medical students. Features an "interactive text book" highlighting most of the elements of medical biochemistry.
This site presents information for students and medical professionals. The latest research results in the field of diabetes are summarized.