This book discusses the latest research in the pathophysiology, diagnosis, and screening of diabetes and its management. It reviews novel technologies for early diagnosis and highlights the molecular mechanisms of microvascular and macrovascular complications of diabetes 2 mellitus. The book covers the applications of nanotechnology in diagnostics, monitoring, and treatment of diabetes mellitus. The chapter also presents the latest developments in differentiating pancreatic cells from PSCs and illustrates the challenges of their therapeutic application in treating diabetes. The book also explores the prospective medicinal plants comprising either plant extract or isolated bioactive phytoconstituents bearing anti-diabetic potential, which has been reported in several in vitro, in vivo, or clinical studies. It further examines the major mechanisms involved in cardiovascular complications among type 2 diabetes mellitus individuals and discusses the various pharmacological interventions and agents developed to delay cardiovascular events and thereby the quality and duration of the patients. Towards the end, the book summarizes the potential impact of ketogenic diets on diabetic patients, and the role of genetic vulnerability in diabetic nephropathy. As such, this book is a valuable source for students, researchers, and practitioners working in glucose metabolism, diabetes, and human health.

The critically ill patient in intensive care may present with serious metabolic alterations caused directly by the illness or secondarily by complications (e.g. infections, organ failure or sepsis) developing within a few hours of hospitaliza tion or in the following days. Among the situations which maintain and further trigger rapidly evolving altered metabolism are complex hormonal reactions, particularly those of the hypothalamus-hypophysis-adrenal axis, and abnormal stimulation of the autonomic nervous system. In fact, the sympathetic nervous system is known to cause significant metabolic alterations. For example, a surgery patient afflicted by septic complications may become hypercatabolic and experience significant nitrogen loss; the altered protein metabolism may in turn heavily influence carbohydrate and lipid metabolism as well. Thus, it is apparent that for optimal care of patients with altered metabolic functions, further knowledge is necessary regarding the physiopathology of metabolism and the physiopathological mechanisms, which alter the consump tion of principal energy substrates. Many experimental and clinical studies have investigated the metabolic aspects of individual organs or organ systems. However, for a correct evaluation of such metabolic events, in addition to studying the roles of metabolic enzymes, active metabolites, and the glutathione system, it is interesting to consider the use of indirect calorimetry as a valid and important investigative technique. The critically ill patient with major alterations in nutritional status may require artificial nutritive support administered through either parenteral or enteral routes."

As an endocrinologist and research scientist--and a diabetic for over 29 years--Dr. Joseph Juliano has devoted his life to understanding the disease. Now, he shows the millions of Type I, insulin-dependent diabetes sufferers how to avoid complications and overcome them if they occur, empowering readers with the motivation and information to control their disease.

The author, blind since 1984 from complications of diabetes, talks about his own experiences.

Take control of your weight--and your diabetes. Managing your weight is critical when you have diabetes. In fact, losing as little as 10 to 20 pounds can improve diabetes control. With this innovative book, you can manage your weight and your diabetes by making gradual lifestyle changes you'll be able to live with for the rest of your life--like following a low-fat meal plan, becoming more active, and managing stress. Weight Management for Type II Diabetes will help you assess habits, teach you techniques of behavior change, and motivate you to find the support you need to manage both diabetes and your weight. This interactive guide takes you through the steps of developing a personalized plan that considers your lifestyle, personality, family situation, and wants and needs. Authors Jackie Labat, MS, RD, CDE, and Annette Maggi, MS, RD, will help you:
* Set reasonable goals
* Keep pace with an exercise program
* Design your own meal plan
* Handle special occasions
* Manage stress
* Learn to deal with lapses
The book also provides fat and calorie counts, grocery shopping tips, and a lesson in low-fat cooking.

1. 1 Scientific Aims In recent years, there has been a definite trend away from the casuistic scientific thinking which has dominated the scientific world, at least in the field of medicobi ological research. Now, in the last decade of this century, scientists are returning to a conceptual way of thinking that characterized the beginning of this century, namely organismal thinking. The holistic concept is not a new one; it was rekindled by a small group of scientists who, in the previous two decades, have begun to warn against too great an emphasis being placed on a molecular casuistic approach as the final pursuit to science (see Duncker 1983). These thinkers were perhaps instrumental in helping to turn the tide, to instruct and encourage fellow researchers to extend their findings from the molecular and to the organismal (see Duncker 1983, 1992a, b; Duncker and Kreite 1987). Having observed the ceca of many different animals for many years and having described their morphology at different levels of study -from the macroscopic to the electron microscopy level - the need to compare and observe these morphological entities in a quantitiative way became increasingly imminent. Quantitative methodol ogy in morphology requires the use of morphometry, which in the most general terms can be described as the measurement of the forms of animals. As defined by Reith and Meyhew (1988), it is quantitative morphology, i. e., the measurement of structures by any method, including stereology."

This introduction to the mechanisms by which the body metabolizes and excretes administered drugs is directed at advanced undergraduate biochemists, pharmacologists, pre-clinical medical strudents and advanced undergraduate/postgraduate toxicologists. The subject is approached from both biochemical and physiological angles. The examples of drug metabolism have been kept clinically relevant, so that the practical importance of the subject can be easily appreciated. The book contains a section of experimental procedures for setting up student practicals in drug metabolism.

Recent years have seen a greater industrial emphasis in undergraduate and postgraduate courses in the pharmaceutical and chemical sciences. However, textbooks have been slow to adapt, leaving the field without a text/reference that is both instructional and practical in the industrial setting - until now. A Handbook of Bioanalysis and Drug Metabolismis a stimulating new text that examines the techniques, methodology, and theory of bioanalysis, pharmacokinetics, and metabolism from the perspective of scientists with extensive professional experience in drug discovery and development. These three areas of research help drug developers to optimize the active component within potential drugs thereby increasing their effectiveness, and to provide safety and efficacy information required by regulators when granting a drug license. Professionals with extensive experience in drug discovery and development as well as specialized knowledge of the individual topics contributed to each chapter to create a current and well-credentialed text. It covers topics such as high performance liquid chromatography, protein binding, pharmacokinetics and drug-drug interactions. The unique industrial perspective helps to reinforce theory and develop valuable analytical and interpreting skills. This text is an invaluable guide to students in courses such as pharmaceutical science, pharmacology, chemistry, physiology and toxicology, as well as professionals in the biotechnology industry.

An intimate relation between hormones and lipoprotein metabolism has been known for a long time especially from hormone-deficiency or -overproduction syndromes. The mechanisms through which hormones influence lipid metabolism have become a field of major interest in sci ence. The more we learn about cellular hormonal actions the better we understand regulatory processes and phenomena occuring in patients. The present book summarizes data discussed at an International Meet ing at Marburg, Germany, on "Hormones in Lipoprotein Metabolism." It was an attempt to pull together knowledge in basic science from the mode of action of hormones all the way to clinical appearance of hor monal disorders involving lipoprotein metabolism. Thus data on molec ular biology, on hormonal regulation of apolipoprotein synthesis, on lipoprotein receptors and enzyme induction are discussed together with the large field of oral contraceptive use, postmenopausal estrogen sub stitution, lipid disorders in diabetes mellitus, in thyroid dysfunction, in adrenal insufficiency and in glucocorticoid application. We are aware of the fact that such an overview cannot be complete but should serve as a collection of data and ideas for those interested in hormonal regulation of lipid metabolism. We thank all authors for taking an extra effort in writing up their presentations and thus making this edition possible. We also thank Bristol-Myers-Squibb for generous support of the meeting and of the final publication. Marburg, Germany ARMIN STEINMETZ JURGEN SCHNEIDER HANS KAFFARNIK Contents Molecular Biology Chairmen: D. J. Rader, A."

With contributions from 66 world-renowned authorities on the subject, Genomics And Proteomics In Nutrition focuses on the effect of genetic expression on protein production, establishing links between gene expression and nutrition, the influence of micro- and macronutrients on cellular homeostasis, and the relationship between diet, genetic predisposition, and human disease. Shows how bioinformatics and functional genomic databases can transform molecular biology research using a yeast ELO2/ human HELO1 protein cloning example. A cutting-edge reference, Genomics and Proteomics in Nutrition reveals new applications and insights in nutrition science and explores tools for nutrition research in the post-genomic era.

Although prostaglandin El (PGE ) has been clinically available for a long 1 time, only in recent years has its effectiveness in peripheral arterial occlusive disease been confirmed in controlled studies. Not surprisingly, the favour able results achieved both in patients with critical limb ischaemia and in those with intermittent claudication has stimulated research activities into the clinical pharmacology of this prostaglandin. As a consequence of these efforts, exciting new findings have revealed that PGE has anti thrombotic, endothelium-stabilizing and leucocyte-stabi 1 lizing properties as well as effects on lipid metabolism, all of which, quite apart from its well-known anti-aggregating and vasodilator effects, may add to the clinical efficacy of the substance. New data have also been gathered on the metabolism of PGE most b notably the detection of 13,14-dihydro-PGE a metabolite which was b recently isolated in humans following the administration of PGE . Being 1 biologically active, the pharmacodynamic spectrum of 13,14-dihydro-PGE 1 very closely resembles that of PGE . This finding may help to explain the 1 efficacy of PGE despite its rapid metabolization when given intravenously."

Iron is indispensable for the growth, development and well-being of almost all living organisms. Biological systems from bacteria, fungi and plants to humans have evolved systems for the uptake, utilisation, storage and homeostasis of iron. Its importance for microbial growth makes its uptake systems a natural target for pathogenic microorganisms and parasites. Uniquely, humans suffer from both iron deficiency and iron overload, while the capacity of iron to generate highly reactive free radicals, causing oxidative stress, is associated with a wide range of human pathologies, including many neurodegenerative diseases. Whereas some essential metal ions like copper and zinc are closely linked with iron metabolism, toxic metals like aluminium and cadmium can interfere with iron metabolism. Finally, iron metabolism and homeostasis are key targets for the development of new drugs for human health. The 4th edition of Iron Metabolism is written in a lively style by one of the leaders in the field, presented in colour and covers the latest discoveries in this exciting area. It will be essential reading for researchers and students in biochemistry, molecular biology, microbiology, cell biology, nutrition and medical sciences. Other interested groups include biological inorganic chemists with an interest in iron metabolism, health professionals with an interest in diseases of iron metabolism, or of diseases in which iron uptake systems are involved (eg. microbial and fungal infections, cancer, neurodegenerative disorders), and researchers in the pharmaceutical industry interested in developing novel drugs targeting iron metabolism/homeostasis.

This is an intergated approach to exercise physiology explaining how the major systems are all affected by autonomic neural control during exercise. It considers physiology, energy metabolism, the cardiovascular, respiratory system and temperature regulation.;These areas have been selected for their significance during exercise because of the crucial importance of the autonomic nervous system in their control. In each case resting physiology is described before the derangements caused by exercise are discussed. It also examines some of the factors which affect autonomic nervous activity during exercise, namely age, sex, training and drugs and considers the clinical application of applied physiology.;The book is intended primarily for undergraduate and postgraduate students in sport science with a specialist interest in exercise physiology. It is assumed that the reader will already have studied some physiology and physiology of exercises, and therefore this text is intended to supplement general textbooks and lecture material. Since exercise physiology provides a good example of a disturbance of homeostasis and the subsequent role of physiological control mechanisms to restore equilibrium, it is hoped that this text will also prove useful for students in medical and life sciences.

On November 6 and 7, 1987, lipid and lipoprotein researchers from all over Europe convened in Munich on the occasion of the second European Workshop on Lipid Metabolism (EWLM). This informal gathering was devoted to two main topics, and recent research results were presented and discussed during a poster session. Recent developments in the physiology and pathophysiology of lipoprotein sub fractions were discussed on the first day of the meeting. In recent years, new analytical tools have been created for analyzing lipoprotein subfractions, particularly the apolipoprotein component. With the, introduction of immunological and elec trophoretic methods it has become clear that the heterogeneity of the plasma lipopro tein system is even greater than had been assumed only a decade or so ago. Despite this, it is apparent from the contributions to this volume that new methods for differentiating lipoprotein subfractions will increase our understanding of lipoprotein metabolism, especially of the triglyceride-rich lipoprotein particles and the high density lipoproteins. The complex functions of the various plasma apolipoproteins and their association with the lipoprotein lipid in single or complex lipoprotein particles give rise to a complex and dynamic metabolic system that changes constantly during the day. While it has for some time been possible to delineate fairly accurately the atherogenic potential of low-density lipoproteins, which are comparatively simple lipoprotein particles, the new methods of lipoprotein subfraction analysis will be needed to select and differentiate amongst the potentially atherogenic triglyceride rich particles, especially the chylomicron and very low density lipoprotein remnants.

Ein Screening auf angeborene endokrine und metabole Stoerungen ermoeglicht die Fruherkennung von Krankheiten wie Hypothyreose, AGS (adrenogenitales Syndrom), Phenylketonurie, Galaktosamie, Biotinidasemangel, Cystische Fibrose oder Homocystinurie. Je nach Land und politischen Bestimmungen unterscheiden sich jedoch die routinemassig durchgefuhrten Untersuchungen. Dieses Handbuch beschreibt praxisbezogen die biochemischen Grundlagen, die Grundsatze der Labor- und Bestatigungsdiagnostik sowie Therapiemoeglichkeiten zu insgesamt zwoelf Krankheiten. Daruber hinaus werden praanalytische Fragen, wie Zeitpunkt und Art der Blutentnahme oder moegliche Stoerfaktoren, umfassend behandelt. Der allgemeine Teil geht auf ethische und psychosoziale Aspekte des Screenings ein. Ein Verzeichnis der Screeningzentren und jener Labors, die fur die Bestatigungsdiagnostik Dienste anbieten, sowie ein Adressenverzeichnis von Elterngruppen und Informationsquellen im Internet komplettieren dieses Buch.

A number of clinical and epidemiological studies have shown that disorders of lipoprotein metabolism constitute one of the most important risk factors for the development of atherosclerosis and coronary heart disease. This volume examines the state of the art of lipoprotein subclass metabolism and its relation to these diseases. The authors also report on new developments concerning the role of lipoprotein recptors, macrophages and apolipoprotein E polymorphism in cholesterol homeostasis. The combination of general outline form and very specific aspects of cholesterol transport will interest those in other disciplines following developments in the field, as well as those directly involved in lipoprotein research.

Initiated in 1975, the Eberbach/Wiesloch Study is a prospective preventive study modeled after the Cardiovascular Comprehensive Community Central Programme of the WHO, with the aim of lowering the incidence of cardiac infarctions in a population representative of that of the Federal Republic of Germany. Part of the study is devoted to a description of smoking habits, and in particular, of the effect of cigarette smoking on plasma lipid and lipoprotein levels. Important components of this investigation were the inclusion of plasma levels of cotinine (a stable metabolite of nicotine and the only precise parameter of cigarette consumption), as well as the correlation of cotinine with other plasma parameters. Not only are these studies unique in the Federal Republic of Germany, but they also provide significant insight into the development of arteriosclerosis in connection with the established risk factors of smoking and hyperlipidemia. The data collected point to a considerable influence of smoking behavior on plasma lipid protein parameters.

The association of diabetes mellitus and hypertension has been well known for a long time. However, the important impact of hypertension on the development of chronic complications of diabetes and on the prognosis of the diabetic patient has only recently been realized. The increasing number of patients with endstage diabetic nephropathy who need regular dialysis or renal transplantation reflects only one important aspect of this problem. As new targets for the treatment of hypertension were considered, it became evident, that drug treatment of hypertension in diabetics must take side effects into account which may be negligible in the nondiabetic patient. Basic research has granted much new insight into the mechanisms which function to link diabetes, kidney function, hypertension, and vascular disease. As a result of the high specialisation in research, such new information diffuses only slowly out of the circles of experts into clinical practice. Therefore, it was a most rewarding initiative of the Bayer Company to sponsor a conference which aimed at a mutual exchange of ideas between clinicians and researchers who are experts in either hypertension or diabetes.

His scientific contributions are regarded as classics: the studies about the insulin effect on adipose tissue (together with George F. Cahill Jr. ), his work on the biosyn- thesis and secretion of insulin (together with Lelio Orci and Claes W ollheim) and his studies on various spontaneous and induced diabetes syndromes in rodents (together with Bernard Jeanrenaud and Eleazar Shafrir). Albert Renold will be remembered for a long time by all who knew him for his achievements, for his kindness and his humanity. We dedicate the Proceedings of this symposium to his memory. Werner Creutzfeldt Pierre Lefebvre G6ttingen Liege History and Philosophy of Bayer Pharmaceutical Research W. -D. Busse Fachbereich Forschung Pharma, Bayer AG, D-5600 Wuppertal, FRG Research has a long tradition at Bayer. This year, 1988, marks 100 years of our pharmaceutical activities. In 1888 the first Bayer drug - phenacetin, an antipyreti- was synthesized, starting from a by-product of dye manufacture. This finding led to the establishment of a Pharmaceutical Department within Friedrich Bayer and Co. in Elberfeld, with all its associated facilities (Fig. 1). The beginning of the company itself, however, dates back to 1863. In that year, Friedrich Bayer started the produc- tion of aniline dyestuffs in his private house in Barmen-Rittershausen. During the 125 years of the company's life and the 100 years of pharmaceuticals, many developments and products have been discovered by Bayer researchers and launched by Bayer.

"Endocrine and Metabolic Disease" is in two sections. The first is a systematic review of clinical and therapeutic aspects of endocrine diseases, whilst the second considers the clinical pharmacology of drugs used in endocrinology. All the major areas of endocrinology and metabolism are covered. Thyroid, adrenal and pancreatic disease are discussed in depth and there are separate chapters on the ovary and testes as well as on the pituitary gland and parathyroids. There is a useful pharmacopoeia of drugs used in endocrinology at the end of the volume.