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.

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.

This book is a guide to the diagnosis and management of diabetes in children. Beginning with an overview of the disease and the effect of Type 1 diabetes on the growth and development of children, the next chapter explains clinical examination and laboratory investigations. The following sections provide in depth discussion on pharmacological and non-pharmacological managements techniques, and acute and chronic complications. The book concludes with the treatment of diabetes in special cases such as in neonates and infants, and a final section cover miscellaneous topics including genetics of Type 1 diabetes, and educational material for patients and their parents. This comprehensive text has been written in association with the Changing Diabetes (R) in Children (CDiC) program, providing care and life-saving medication for children with Type 1 diabetes in low and middle-income countries. Key points Comprehensive guide to the diagnosis and management of diabetes in children Covers both pharmacological and non-pharmacological treatment methods Includes discussion on special cases such as diabetes in neonates and infants Written in association with the CDiC program

This comprehensive volume discusses in vitro laboratory development of insulin-producing cells. It encompasses multiple aspects of islet biology-from embryonic development and stem cell differentiation to clinical studies in islet transplantation, regulation of islet beta-cell regeneration, pancreatic progenitors, mathematical modelling of islet development, epigenetic regulation, and much more. The chapter authors represent leading laboratories from around the world who contribute their international perspectives and global expertise. Collectively, they provide the reader with a concise yet detailed knowledge of processes and current developments in islet regenerative biology. Pancreatic Islet Biology, part of the Stem Cell Biology and Regenerative Medicine series, is essential reading for researchers and clinicians in stem cells or endocrinology, especially those focusing on diabetes.

About 29 million Americans (9.3% of the population) in 2012 had diabetes. Approximately 1.25 million American children and adults have type 1 diabetes, and almost all diabetes in children less than 10 years of age is type 1. About 208,000 people younger than 20 years (0.25 % of this age group) have been diagnosed with diabetes (type 1 or type 2). Diabetes care requires a collaborative approach with multi-disciplinary professionals involved from the health, nursing, social and educational fields in order to provide optimal service to the child or adolescent and their family. Early diagnosis, treatment and monitoring can prevent or delay the long-term complications in various organs of the body, and regular care and service to this population is therefore essential. In this book, we provide a short overview of issues involved in diabetes care for children and adolescents.

Imagine controlling, avoiding, reversing! The "health hazard of the 21st century" (World Health Organisation), the disease that afflicts nearly 26 million Americans and is an imminent threat to an additional 80 million adults and children. That's exactly the promise of Reverse Your Diabetes in 12 Weeks by Dr. George Kind, research director and chief science officer at Harvard's Joslin Diabetes Centre, the world's largest and most respected diabetes research centre, synonymous with revolutionising the diagnosis, treatment, and prevention of diabetes. Based on the most cutting edge research including the ground breaking discovery of brown fat in adults and its role in burning calories and enhancing the effects of the body's own insulin - Reverse Your Diabetes in 12 Weeks translates the latest findings into a plan that will let readers avoid, control, and even reverse type 2 diabetes. The program begins with losing weight and shows why losing only 5% of body weight makes a life changing difference, It explains how a good's night sleep can significantly lower blood glucose levels (and why sleep deprivation works in reverse). It disentangles the carbohydrate confusion, reveals how to decrease the body's inflammatory response, and explains the importance of moderate exercise. There are eight strategies in all - if you implement only one, your type 2 diabetes will improve. Pursue all eight of them, and you can stop type 2 diabetes in its tracks. You can even reverse it - effectively resetting your body's glucose metabolism for a long, healthy life.

Medical Applications of Electrochemistry, a volume of the series Modern Aspects of Electrochemistry, illustrates the interdisciplinary nature of modern science by indicating the many current issues in medicine that are susceptible to solution by electrochemical methods. This book also suggests how personalized medicine can develop.

Darwinian medicine looks at the ecological and evolutionary roots of disease. A disease is an interaction between a genome and its biotic or abiotic environment and therefore a disease is essentially an ecological process. Good understanding of ecology and a Darwinian way of thinking can give us novel and useful perspectives on health and disease. If we understand the disease process better, we can certainly prevent, control as well as treat diseases in a better way. Although the thought that the origins of obesity and type 2 diabetes (T2D) might lie in our hunter gatherer adaptations is not new, research over the last decade makes us rethink many of the classical concepts. Brain and behavior is increasingly being recognized as central to all the endocrine, metabolic and immunological changes that earmark type 2 diabetes and other metabolic syndrome disorders. A major change in paradigm appears to be on the horizon and the proposed book intends to speed up the paradigm shift by raising important questions, pointing out flaws and inadequacies in the prevalent paradigm and stimulating radical rethinking which would redirect and refine the line of research as well as bring some fundamental changes in drug discovery and clinical practice.

This book tackles the problem of overshoot and undershoot in blood glucose levels caused by delay in the effects of carbohydrate consumption and insulin administration. The ideas presented here will be very important in maintaining the welfare of insulin-dependent diabetics and avoiding the damaging effects of unpredicted swings in blood glucose - accurate prediction enables the implementation of counter-measures. The glucose prediction algorithms described are also a key and critical ingredient of automated insulin delivery systems, the so-called "artificial pancreas". The authors address the topic of blood-glucose prediction from medical, scientific and technological points of view. Simulation studies are utilized for complementary analysis but the primary focus of this book is on real applications, using clinical data from diabetic subjects. The text details the current state of the art by surveying prediction algorithms, and then moves beyond it with the most recent advances in data-based modeling of glucose metabolism. The topic of performance evaluation is discussed and the relationship of clinical and technological needs and goals examined with regard to their implications for medical devices employing prediction algorithms. Practical and theoretical questions associated with such devices and their solutions are highlighted. This book shows researchers interested in biomedical device technology and control researchers working with predictive algorithms how incorporation of predictive algorithms into the next generation of portable glucose measurement can make treatment of diabetes safer and more efficient.

The book covers areas of cellular physiology and metabolism that are of interest to scientists involved in research in diabetes and metabolic diseases. Some chapters of the book are specifically research-oriented, as all the authors are actively practicing either bench or clinical research in the area. Nonetheless, since the work is fully comprehensive of the discipline, it is also suitable for university classes of graduate and undergraduate students. In particular, the book discusses classical aspects of cellular physiology and the metabolism of physical exercise, as well as novel topics like exercise in transplantation and exercise in beta-cell failure, which mark the frontiers of research in sport-related sciences and research. Exercise physiologists, biologists and physicians are the specific professional and academic targets of this work. The team of authors together with the editor are world-renowned experts in the field of physiology and metabolism applied to sport sciences.

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.​ 

Diabetes is a complex disease and is also one of the most common. It is very difficult to reach an accurate estimate for the global prevalence of diabetes since the standards and methods of data collection vary widely in different parts of the world. In addition, many potential sufferers are not included in the count because according to an estimate about 50% of cases remain undiagnosed for up to 10 years. However, according to an estimate for 2010, globally, there are about 285 million people (amounting to 6.4% of the adult population) suffering from this disease. This number is estimated to increase to 439 million by 2030 if no cure is found. The general increase in life expectancy, leading to an ageing population, and the global rise in obesity are two main reasons for the increase.With the basic platform set, Editor presents his views and advice to the readers, especially to diabetic patients suffering from T2DM, on the basis of his observations and information collected from other diabetics.

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.

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.

Studies on Diabetes examines how increased oxidative and nitrosative stress - one of the leading causes of diabetes complications - pathologically affects multiple tissues in the body. The volume editors and chapter authors are leading investigators in the field of basic and clinical research in diabetes and vascular disease. Their contributions represent a wealth of knowledge on and research into how diabetes triggers metabolic abnormalities that lead to hyperactivation of cellular and mitochondrial pathways that ultimately result in oxidative and nitrosative stress that left un-neutralized, results in tissue damage. Each chapter provides the reader with invaluable insight to the complicated mechanisms responsible for diabetes complications and vascular disease. Potential treatments for diabetes complications from animal models to the patient will also be discussed. This is essential reading for researchers and clinicians in endocrinology, diabetes, vascular disease and oxidative stress.

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.

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.

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 SpringerBrief focuses on clinical nutrition research, particularly on the effects of slowly absorbed carbohydrates on postprandial glucose metabolism in type 2 diabetes. Slowlyabsorbed carbohydrates will cause gradual increases in blood glucose and insulin levels, and may therefore be effective as part of a treatment strategy for glycemic control and reduction of cardiovascular complications in type 2 diabetes.

The aim of this volume is to present current methodologies to predict and understand the pathogenesis of Type-1 Diabetes for clinical and non-clinical researchers. Written in the highly successful Methods in Molecular Biology series format, chapters include introductions to their respective topics, lists of the necessary materials and reagents, step-by-step, readily reproducible laboratory protocols, and key tips on troubleshooting and avoiding known pitfalls. Practical and reliable, Type-1 Diabetes: Methods and Protocols will aid researchers in using these methods to advance their own studies.

This book presents the state of the art of type 2 diabetes genetics, from the process of genetic discovery to its interpretation and clinical application, and illustrates a model for other complex human phenotypes.The first section explores genome-wide association studies, the extension of this method to less accessible phenotypes and the arrival of next-generation sequencing. A further section goes beyond genetics to illustrate how other data sources can help interpret genetic data, such as leveraging population diversity, the correlation of genetic associations with physiological measurements, gene expression modulation, environmental factors and our microbial commensals. The third section describes advances in elucidating the complex path from association to function using in-depth sequencing and functional studies of the cellular and molecular effects of genes in the loci identified by genetics. The final section links our current understanding with clinically relevant questions, such as prediction, interactions with drugs or nutrients, and disease prevention, and paints a realistic but hopeful vision of the future.

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.

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.