Historically, clinical decisions in renal medicine have been challenged by the scarce availability of robust supportive evidence. Not only are the number of randomized controlled trials (RCTs) in Nephrology the third lowest amongst the medical specialties but in many instances the trials themselves are of poor quality. In addition, practice has been further influenced by extrapolation from the outcomes of general population clinical trials which exclude renal patients. The difference between the ideal trial participant and real complex cases encountered in daily practice is well recognized and further compounded in renal patients with complex pathophysiology - this ultimately makes decision making in this subset of patients a real challenge. Recently, there has been a growing interest in conducting well designed RCTs in different areas of renal medicine. However, though clinical guidelines are helpful in providing the clinicians with a frame of best available evidence for a clinical condition, it denies the unique nature of each individual patient. This book offers a thorough and critical appraisal and evaluation of the key published clinical trials that have shaped current practice in nephrology, dialysis and transplantation. It will help the practicing physician close the gap between the inflexible and generalized nature of clinical guidelines and the day-to-day clinical decision-making for individual patients. It will provide the clinician with the tools required to investigate and extract the appropriate guidance to apply to individual cases in daily practice. Moreover, it will help improve the ability of junior colleagues to appraise available evidence in a systematic way when there is lack of local guidelines or when the guidelines are difficult to apply due to logistic constraints or barriers. Lastly, this book will serve as a reference for key clinical trials in different areas of renal medicine together with literature and authors views of these trials and their impact on changing practice.​ 

The world is beset by a pandemic of obesity and type 2 diabetes and the need for new drugs is startlingly clear; recent years have seen a huge increase in research activity to fill this gap. The development of new drugs for diabetes and obesity must be founded upon a sound appreciation of the pathophysiology of these common disorders. The dual defects of insulin resistance and impaired insulin secretion are fundamental to the pathogenesis and progression of obesity-associated type 2 diabetes. There is a need to explain how new drugs can counter insulin resistance and insulin deficiency to a broad range of professionals, from clinical scientists active in early (and later) phase drug development to specialist physicians and increasingly primary care doctors who must tailor drug regimens to the individual patient. Clinical research methods for measuring insulin action and insulin secretion have become well-established in proof-of-mechanism studies; however, selection of the best techniques is by no means straightforward. The purpose of the book is to aid the selection of the most appropriate techniques for assessing insulin action, insulin secretion and body composition in humans (with particular reference to new drugs) in phase 1 and 2 studies and aid the understanding of drug effects and non-drug treatment strategies on key biochemical-hormonal defects of obesity and type 2 diabetes. The book will assume a working knowledge of human physiology relating to glucose metabolism and will be of interest to biomedical scientists, pharmacologists, academics involved in metabolic research and clinicians practicing in these specialties.

Mention diabetes and what are the first things that leap to mind? Sugar levels, gluclose monitoring, and insulin? According to leading diabetes specialist Dr. Stevan Joyal, to truly combat the diabetes epidemic--both preventing it and improving the quality of life for those who have it--we must start smaller, by focusing on the microscopic yet most critical factors that control your genes and your cells. In WHAT YOUR DOCTOR MAY NOT TELL YOU ABOUT DIABETES, Dr. Joyal tells readers how to prevent and treat type 2 diabetes and reverse prediabetes (a condition affecting half of all Americans), by positively influencing the genes and cells in the body that cause the condition--all without the use of special gadgets, or crazy fad diets. In this groundbreaking, integrative treatment plan, you will find:
-the testing procedures that EVERYONE should have to discover their diabetes and prediabetes risk level
-tools to prevent and significantly control minor to serious diabetic complications
-important guidelines on diet, including especially effective "superfoods"
-an individualized, scientifically-proven natural supplement regime
-a manageable and effective exercise program
-lifestyle changes, including stress reduction tips, that can really make a difference
-recommendations on pharmaceuticals when necessary

The increasing prevalence of morbid obesity has led the World Health Organization to coin the descriptive term "globesity" to reflect the worldwide nature of the problem. Providing health care to these patients, especially when surgery is required, can be extremely challenging owing to the specific needs in respect of logistics, facilities, and professional expertise. Appropriate care has to date often been unachievable and unaffordable outside of established bariatric centers, but such centers themselves usually have insufficient capacity and resources to cope with the demand among the general population. This book therefore provides a wealth of guidance and helpful tips and tricks on how to deal with obese patients within a general surgery setting. Importantly, it highlights the need for global rethinking on public health as regards resource allocation and patterns and standards of care, with the ultimate goal of improving outcomes through greater affordability.

This book outlines risk assessments for 28 diseases and medical conditions including the following aspects: genetics, biochemistry, serology, past medical history, family history, co-morbidities, age, gender, ethnicity, nutrition and lifestyle. Recommendations are made for how to avoid, eliminate or mitigate risks. Preventing measures concerning chemical compound intake, lifestyle and nutrition are proposed. The unique content and approach of the book to chronic disease management make it a state-of-the-art reference work, addressing a missing component of medical care and reflecting the cutting edge of preventive medicine.

Diabetes and Kidney Disease reviews the most up-to-date research on diabetic nephropathy, the current understanding of its pathophysiology, renal structural alterations and clinical features and summarizes recent evidence-based clinical treatment modalities for the prevention and management of diabetic kidney disease. General clinical aspects are covered, as well as an overview to the novel approaches being designed by leading researchers in the field. A convenient compendium for physicians involved in the care of diabetic patients with varying degrees of kidney involvement, Diabetes and Kidney Disease is also a handy resource for medical residents and students interested in the current status and future approaches to reducing the burden of diabetes and diabetic kidney disease.

As the incidence of diabetes increases worldwide, the need for recommendations on how to prevent and treat the condition grows exponentially, and so does the need for an authoritative source for information on the appropriate models to study the condition. The new edition of Animal Models of Diabetes is that source. The book presents updated and expanded information regarding the use of models in experiments with both Type 1 and Type 2 diabetes. The new edition compiles relevant time-saving information on well-recognized models, including various mice, rats, minipigs, and Rhesus monkeys, and provides extensive references for more in-depth study. It contains new and updated referenced reviews on animals with induced obesity as well as observations on retinopathy in spontaneous diabetes resembling human lesions. The book discusses nutritionally diabetes-prone animals and considerations of insulin resistance and obesity. The contributors also address the importance of recent findings on the pathogenesis of diabetes and its complications in relation to human disease. Including contributions from prominent experts in the field, the book brings together scattered data and lucidly presents it. This promotes the understanding of the etiopathology of diabetes and offers a new grasp of the insulin action, its negative feedback leading to insulin resistance, and its detrimental outcomes. The book also includes new knowledge on specific complications of diabetes, offering an incentive to test advanced modalities to prevent and inhibit their occurrence.

This concise handbook provides an overview of incretin-based therapies and guidance for incorporating them into the treatment of type 2 diabetes. Chapters include landmark clinical trials and international treatment guidelines in order to update readers with all major advances in the field. An ideal resource for medical professionals that treat patients with type 2 diabetes in hospital and clinical settings.

A Harvard Medical School diabetes specialist and a top exercise physiologist share a proven and effective 12-week plan to reverse the course of Type 2 diabetes, lose weight, and ditch the medication for good. In this groundbreaking book, diabetes and weight management expert Osama Hamdy, M.D., Ph.D., reveals how you can reverse the course of your type 2 diabetes, lose weight for good and finally reclaim your health-in just 12 weeks! This book will help you: * Cut your medications by 50-60%-or even stop them altogether! * Learn how to safely lose-and keep off-those 10, 20 or even 50 plus pounds that are holding you back from a healthy life. * Tailor your exercise plan to the way you really live and work, so you can get results without being a slave to the gym. * ...and more! With information on how to create checklists, goal worksheets, and including real-life success stories, The Diabetes Breakthrough will help keep you motivated in making smart decisions-even on the busiest days!

This contributed volume presents computational models of diabetes that quantify the dynamic interrelationships among key physiological variables implicated in the underlying physiology under a variety of metabolic and behavioral conditions. These variables comprise for example blood glucose concentration and various hormones such as insulin, glucagon, epinephrine, norepinephrine as well as cortisol. The presented models provide a powerful diagnostic tool but may also enable treatment via long-term glucose regulation in diabetics through closed-look model-reference control using frequent insulin infusions, which are administered by implanted programmable micro-pumps. This research volume aims at presenting state-of-the-art research on this subject and demonstrating the potential applications of modeling to the diagnosis and treatment of diabetes. The target audience primarily comprises research and experts in the field but the book may also be beneficial for graduate students.

This new volume provides a plethora of new information about potential medicinal herbs and their usefulness in treating diabetes and neurological diseases. Most large multinational companies are interested and engaged in the commercialization of herb-based formulations, and consumers continue to seek natural-based therapies. Herbs for Diabetes and Neurological Disease Management provides insight into plant-based novel molecules targeted for diabetes and neurological disorders. It looks at a selection of herbs that have proven effective in the management of diabetes and neurological disorders, including migraine, epilepsy, memory disorders, depression, and more. Divided into ten chapters focusing on diabetes and its macro- and microvascular complications (migraine, epilepsy, memory disorders, depression and other neuropsychiatric disorders), this book is structured to provide a source of reliable information and enrich the knowledge of readers. Each chapter briefly explains the epidemiology and pathophysiology of the disease state and the possible role of herbal drugs in the prevention of the particular disease. The reported pharmacological activities and possible mechanism of action of herbal drugs are also discussed in detail, which makes this book informative and unique. This new volume will be a reliable reference complementing the substantial information on the use of herbal drugs in diabetes and neurological disorders that serve as the pillars of drug discovery and development.

In modern medicine, the aging population is prone to many simultaneous cardiovascular (CV) risk factors which often produce co-incident pathology. Nowhere is this more obvious than in the interaction between Chronic Kidney Disease (CKD), Diabetes and diverse CV diseases (CVD). This is a complex and challenging area, as the presence of CKD/diabetes promotes CVD while also complicating its treatment. The emergence of CKD as a public health priority is one of the most challenging problems of modern medicine. It is now solidly established that renal dysfunction portends a high risk for cardiovascular disease. Cardiovascular diseases remains the main cause of death in western societies and the amplification of the death risk conveyed by coexisting CKD, even though still poorly understood, appears considerable. The bidirectional link that associates renal and cardiovascular diseases, the high risk of the death signalled by their coexistence and the considerable epidemiological burden imposed by this link is at the basis of the emergence of a new discipline aiming at making the borders between nephrology and cardiovascular medicine even more permeable than before. The term Cardio-Renal Syndrome was coined around 5 years ago to try to formalize this link, and act as a stimulus to interaction between clinical teams, researchers and others to achieve better management and outcomes for all. This book takes clinical presentations and clinical problems as its base, and then discuss the evidence for best management of common clinical problems as well as the reasons for the complex interplay between the cardiac and renal systems. Moreover, it addresses the issue of organizing healthcare to maximize the opportunities for prevention and best healthcare economic returns, building on cutting edge initiatives at the Karolinska, Stockholm. The book will be of immediate value and interest to all cardiologists and renal physicians.

"Approaches to Behavior" provides information and simple tools that healthcare professionals can use to help patients move beyond feelings that prevent them from benefiting fully from any learning opportunity. Each chapter opens with an introduction to experts' newest psychological understanding about a common emotion. This is followed by a list of easy techniques healthcare professionals can employ with their patients. Each technique was contributed by experienced mental health experts who counsel people with diabetes. None of these techniques can take the place of the in-depth guidance mental healthcare professionals provide. Instead, this book is a first aid kit that experts can use to help patients start to move past strong emotions and become more receptive to vital information that will improve their lives and help them take control of their diabetes.

This handbook is an overview of the diagnosis, treatment and long-term management of diabetic retinopathy, within the context of overall long-term diabetes disease management. Diabetes-related eye damage (diabetic retinopathy) is one of the most common complications of diabetes, affecting approximately 30-40% of people with diabetes. The situation is so severe that in countries such as the US and UK, diabetic retinopathy is currently the leading cause of blindness in people age 20 to 74 years old. Fortunately, there are several existing and emerging treatments on the horizon and with adequate control of the underlying diabetes, this condition can be successfully managed.

Over the last twenty years, type 2 diabetes skyrocketed to the forefront of global public health concern. In this book, Mari Armstrong-Hough examines the rise and response to the disease in two societies: the United States and Japan. Both societies have faced rising rates of diabetes, but their social and biomedical responses to its ascendance have diverged. To explain the emergence of distinctive strategies to explain and manage diabetes, Armstrong-Hough argues that physicians act on not only increasingly globalized professional standards but also on local knowledge, explanatory models, and cultural toolkits. As a result, strategies for clinical management diverge sharply from one country to another. Armstrong-Hough demonstrates how distinctive practices endure in the midst of intensifying biomedicalization, both on the part of patients and on the part of physicians, and how these differences grow from broader cultural narratives about diabetes in each setting.

This book is intended to provide up-to-date and emerging information in the field of diabetes mellitus with a focus on preventive, predictive and personalized medicine.

Diabetes has long been recognized as a disease of high blood sugar, and there has been a continuous search of the exact reason for its development and effective treatment. In 2005, the World Health Organization had estimated that more than 180 million people worldwide suffer from diabetes mellitus and indicated that this figure is likely to double within the next 20 years. Among the 3.8 million deaths each year associated with diabetes, about two thirds are attributable to cardiovascular complications, and diabetes is now considered to be a major metabolic risk factor for the occurrence of heart disease. Diabetic Cardiomyopathy: Biochemical and Molecular Mechanisms is a compilation of review articles devoted to the study on the topic with respect to biochemical and molecular mechanisms of hyperglycaemia. The wide range of areas covered here is of interest to basic research scientists, clinicians and graduate students, who are devoted to study the pathogenesis of diabetes-induced cardiovascular dysfunction. Furthermore, some chapters are directed towards increasing our understanding of novel ways for the prevention/treatment of cardiomyopathy. Twenty five articles in this book are organized in three sections. The first section discusses general aspects of the metabolic derangements in diabetic cardiomyopathy including metabolic alterations and substrate utilization as well as cardiac remodelling in the heart; role of diet in the development of metabolic syndrome in the heart; effect of hyperglycaemia in terms of biochemical and structural alterations in heart. In the second section, several cellular and molecular mechanisms are discussed indicating that diabetic cardiomyopathy is a multifactorial and complex problem. The third section discusses the prevention and treatment of diabetes using appropriate diet, proper supplements including antioxidants, angiotensin inhibitors and some other drugs. All in all, this book discusses the diverse mechanisms of diabetic cardiomyopathy with some information on new therapeutic approaches for finding solutions to prevent or reverse the development of cardiac dysfunction.

Insulin-like growth factor (IGF)-I is a widely expressed growth factor with diverse effects on many tissues throughout development and in adult life. The purpose of this work is to provide detailed and updated information on the role of the growth hormone (GH)-IGF axis in fetal and postnatal development, as well as its physiological functions and implications in pathology.

This is the first comprehensive volume on Dipeptidyl Aminopeptidases that can be marketed to a wide variety of disciplines, as well as to a variety of clinicians. Leading experts in the field contribute to this state-of-the-art view on these enzymes. This book comes at a time when our understanding of their function is growing ever more rapidly and therapeutic options have become imminent.

In the mid 1990s, Drs. Gerald Reaven identified a constellation of clinical findings, known variously as the metabolic syndrome, syndrome X, insulin resistance s- drome or insulin resistance-related disorders, that are associated with an increased risk of heart disease and diabetes. Interest in this topic grew rapidly, culminating in the publication by this series of the book, Insulin Resistance and the Metabolic Syndrome X, edited by Drs. Reaven and Laws in 1999. Since the original publication of that now classic volume, the world's population has continued to become more obese and sedentary and the prevalence of disorders related to insulin resistance has continued to increase throughout the developed and developing world. Of great concern in the last decade is the extension of these deleterious lifestyle patterns to the pediatric population, leading to both obesity and the appearance of insulin resistance-related disorders in youth as well as adults. Today, about one in three children and adolescents in the United States is overweight or obese, and this prevalence approaches one in two among adolescents in certain minority groups. In addition, components of this cardiovascular risk constellation are now being recognized in young adults, adolescents, and even children. Youth are increasingly developing type 2 diabetes, fatty liver disease, hypertriglyceridemia, hypertension, polycystic ovarian syndrome, sleep apnea, orthopedic and psychiatric complications, as well as other complications of obesity and insulin resistance.

This book provides critical insights into and appraisals of recent breakthroughs in type 1 diabetes modulation, with a particular emphasis on the potential impact of current prevention and treatment strategies. It also discusses recent successes and failures in clinical trials. Presenting an comprehensive overview of the disease, it is especially useful for newcomers in the field. It also includes illustrations, which make it easy for the reader to grasp the basic concepts involved. Furthermore, the tables include concise and easy-to-understand information on current clinical trials.

An essential reference for any laboratory working in the analytical fluorescence glucose sensing field. The increasing importance of these techniques is typified in one emerging area by developing non-invasive and continuous approaches for physiological glucose monitoring. This volume incorporates analytical fluorescence-based glucose sensing reviews, specialized enough to be attractive to professional researchers, yet appealing to a wider audience of scientists in related disciplines of fluorescence.

This book discusses both the beneficial and harmful aspects of NO in biology and medicine, and also introduces the emerging discovery of artemisinin in antitumor, antibacterial infection, anti-inflammation, and antiaging contexts. In 1992 nitric oxide (NO) was voted "Molecule of the Year" by Science magazine, and the discovery of its physiological roles has led to Nobel Prize-winning work in neuroscience, physiology and immunology. The book explains why we should maintain a steady-state NO level that is derived from neuronal or epithelial NO synthase, and avoid the extremely high NO level resulting from inducible NO synthase. The book offers a valuable resource for medical chemists, clinicians, biologists and all those interested in health and disease.

Western knowledge of progress in biomedical research in Russia is severely limited by the scarcity of Russian journals available to us as well as the fact that few of us can read Russian. Therefore, it is of special significance that this recent contribution to the Russian scientific literature has been trans lated into English. This publication, Thyroid Hormones, brings to us a detailed analysis of recent work in Russia, and in particular in the Laboratory of Hormone Biochemistry, Institute of Biochemistry, Academy of Science of the Uzbek SSR and the Laboratory of Pathological Physiology, Institute of Experi mental Endocrinology and Hormone Chemistry, Academy Medical of Science of the USSR. The review illustrates the parallel pathways of inves tigation taken by investigators in Russia and in the West, indicating where the results have complemented each other or stimulated new questions and approaches. Consequently, the book provides an excellent review of the contributions made by Russian scientists in thyroid research and couples it with Western thought on these subjects to produce a complete review of the thyroid hormones. The large amount of data provided and the inclusion of multiple view points toward specific problems provides an excellent survey of the mecha nisms of biosynthesis and control of hormone formation, physiological effects of the hormones, and the molecular mechanisms involved in thyroid hormone action."