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Links to Medical Literature, Textbooks and
Websites
Medscape, a leading website for medical
information for physicians and patients.
Click here.
Literature
and Lectures
Updated USDA Dietary Guidelines Released
Updated guidelines for maintaining correct body weight and good health were
posted in January.
Click here for a
concise summation of these. NB: You must have a Medscape
membership to open this file. Membership is free and quickly established.
Atf4
Insulin
secretion and the organ-level responsiveness to the hormone appear to be closely
regulated by "cytokines" and other small proteins. An important and, as
yet, unanswered question is the relationship of these signal substances to
development of type 2 diabetes. Aft4 is one of these substances. It
appears to have a major role in many developmental processes and is a
major factor in nutritional sensing and metabolic responses. Current
knowledge concerning Atf4 is reviewed in a recent article in Nature.
Click
here to call up this important publication.
Banting Lecture
2009: An Unfinished Journey: Molecular Pathogenesis
to Prevention of Type 1A Diabetes, George S.
Eisenbarth
George
Eisenbarth give us essential insight into the
genetically determined autoimmune initiation of type
1 diabetes. This has been an area of confusion
for me and many others. We have long been
aware of the fact that the immune response
responsible for destroying beta cells is genetically
determined and yet, type 1 diabetes is less
connected to the genetic picture than type 2
diabetes. This lecture goes a long way in
explaining the causes of diabetes and the
possibilities of a future "cure".
Click here to download this lecture.
Navigating the Choices for
Diabetes Prevention, David M . Nathan, the New England Journal of Medicine
Many new drugs aimed at
preventing type 2 diabetes have been released during the past few years.
This important editorial in the New England Journal of Medicine gives guidelines
in interpreting findings concerned with two of these and provides a clear
suggestion for treatment of developing T2D. The editorial should be of
value to both doctors and patients.
Click
here to download the article.
"Connecting obesity, aging and
diabetes" and "A crucial role for adipose tissue p53 in the regulation of
insulin resistance"
A connection between obesity
and development of diabetes type 2 has been recognized for several years.
However, the mechanisms which underlie this have not been understood.
These 2 publications for the September 09 issue of Nature Medicine present data
suggesting a strong collocation between ROS, telomerase and p53 and the
development of aging-related disease and diabetes type 2. They are
especially well written and concepts and data are quickly comprehended.
Click
here to call of the "news" article and
here to call up
the research report.
Metformin Added to Insulin For
Type 2 Diabetes: Long-Term Effects, CME from Medscape.
We face a pandemic increase in
the incidence of T2D. This CME presents data from a large study and demonstrates that
adding metformin to insulin treatment improved glycemic control, reduced the
amount of insulin required, and improved weight loss and macrovascular
outcomes. This important publication can be downloaded by clicking here.
"When do the risks of diabetes
begin? A consensus statement from the American College of Endocrinology
and the American Association of Clinical Endocrinologists.
Blood glucose only slightly
above "normal" values have been associated with development of the "late
cellular damage" seen in diabetes. This "prediabetic" state is, in fact,
more widespread than type 2 diabetes and is a major danger to global health.
This paper gives essential insight into the risks involved in prediabetes and
valuable clinical approaches to control of further progress to type 2 diabetes.
Click here to download the
publication.
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.
Type 2 Diabetes: The
Pathophysiologic Basis of Treatment Design, Ramachandiran Cooppan, MD.
Part of a CME from medscape entitled Achieving Optimal Glycemic Control In
Type 2 Diabetes: The Clinitian's Perspective.
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.
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.
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.
Medical Biochemistry
Professor Michael W. King's extensive site for
medical students. Features an "interactive text book" highlighting most of
the elements of medical
biochemistry.
Diabetes for Professionals
This site presents information for students
and medical professionals. The latest research results in the field of
diabetes are summarized.