Five years ago, a new system of classification of the various types of diabetes was proposed. This publication provides an inte grated picture of the latest information on the similarities and dissimilarites of two types of diabetes. It contains contributions from morphologists, physiologists, biochemists, immunologists, pathologists, geneticists, clinicians and epidemiologists. In the first section, the basis for the present classification and its limitations are discussed. In addition, there is a discussion of gestational diabetes and heterogeneity of some sub-classes of diabetes. The next section deals with genetics and immunology. The third section discusses abnormalities of insulin secretion and act ion on both the receptor and post . . . receptor levels. The role of gastrointestinal peptides in Type I and Type II diabetes is also considered. In the last section, both types of diabetes are compared with respect to diabetic complications. The closing sec tion summarizes the present status and offers a stimulating view of future development. We hope that this book will be a useful source of information for both researchers and practicing clinicians. M. Vranic G. steiner C. H. Hollenberg v ACKNOWLEDGEMENTS The symposium from which this volume arose (June 28-29, 1984) was organized by the Banting and Best Diabetes Centre, University of Toronto. We would like to express our appreciation to the following sponsors: Ames Educational Institute, Ayerst Laboratories, Becton Dickinson Canada Inc. , Canadian Soft Drink Association, Connaught Laboratories Limited, Connaught Novo Ltd. , Eli Lilly Canada Inc.

The pathogenesis of non-insulin-dependent diabetes mellitus (NIDDM) has attracted the interest of our group during the last three decades. As early as 1969, a Nobel Symposium dealing with this topic was organized in Stockholm. This was followed in 1987 by a Nobel Conference devoted to the same subject. The main purpose of these meetings was to bring together the most distinguished scientists from all over the world and present theories on molecular and genetic mechanisms responsible for the development of glucose intolerance in NIDDM. This idea was followed also in the present symposium, "New Concepts in the Pathogenesis of NIDDM," organized with diabetologists from Toronto in Canada. Our purpose is to biannually organize international meetings covering important aspects of dia betes research, hoping that this type of interaction may result in new concepts and treat ment alternatives. For us, participating in this symposium in September 1992, the meeting in Stockholm was very stimulating and innovative. It is a special pleasure that almost all invited lecturers submitted manuscripts. Thus, the publication of the proceedings of the symposium makes it possible for all interested in diabetes research to share new ideas and findings presented at the meeting. Claes-G6ran Ostenson Suad Efendic Mladen V ranic v CONTENTS REGULATION OF INSULIN SECRETION Impaired Glucose-Induced Insulin Secretion: Studies in Animal Models with Spontaneous NIDDM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C. -G. Ostenson, A. Khan, and S. Efendic Perturbation ofIslet Metabolism and Insulin Release in NIDDM. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 WJ. Malaisse 2 Regulation of Cytoplasmic Free Ca+ in Insulin-Secreting Cells. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ."

This book has a dual purpose, to review in depth the control of fuel homeostasis in the brain and the role of the nervous system in the control of fuel deposition in the body. From the methodological point of view the emphasis is on the application of advanced technologies to assess fuel transport and brain metabolism, the role of peptides in the neuroendocrine system and the response of the brain to hypoglycemia. These technologies include positron emmission tomography, nuclear magnetic resonance, immunocytochemistry, molecular biology, autoradiography. To study fuel homeostasis in the body advanced tracer methods that include modelling are set out. From the pathophysiological point of view the emphasis is on abnormalities in stress, brain metabolism in diabetes, eating and degenerative disorders. This book contains contributions from endocrinologists, physiologists, neurologists, psychoneuroendocrinOlogists, biophysicists, biochemists and experts in nutrition. This authorship represents a unique diversity of researchers who, for the first time, cover comprehensively the interaction between the nervous system and fuel homeostasis, both in health and disease. We hope this book will be an important source of information for both researchers and practicing clinicians. Mladen Vranic Suad Efendic Charles Hollenberg v ACKNOWLEDGEMENTS The Symposium from which this volume arose (University of Toronto, June 27-28, 1990) was the first Toronto-Stockholm symposium on Perspectives in Diabetes Research. These Symposia are organized triennially by the Banting and Best Diabetes Centre, University of Toronto and the Department of Endocrinology, Karolinska Institute, Stockholm.