Mechanisms Of Insulin Action

More than 18 million people in the United States have diabetes mellitus, and about 90% of these have the type 2 form of the disease. This book attempts to dissect the complexity of the molecular mechanisms of insulin action with a special emphasis on those features of the system that are subject to alteration in type 2 diabetes and other insulin resistant states. It explores insulin action at the most basic levels, through complex systems.

In 1996 the 75th anniversary of the discovery of insulin was celebrated at the University of Toronto, the scene of that discovery in 1921. This volume was stimulated by the scientific program which was staged at that time and brought together much of the world's best talent to discuss and analyze the most recent developments in our understanding of pancreatic function, insulin secretion, the interaction of insulin with its target tissues, the mechanism of insulin action at the cellular level, and the defects which underlie both Type I (insulin-dependent diabetes mellitus, IDDM) and Type II (noninsulin-dependent diabetes mellitus, NIDDM) forms of the disease. We have chosen to focus the present volume on work related to insulin action.

Diabetes is now one of the major causes of morbidity worldwide. In many cases, the onset of diabetes is progressive, developing via a condition of insulin resistance. This book considers the development of this condition, its consequences and clinical and therapeutic aspects. The book reviews the normal biology of insulin action on glucose, lipids and proteins. It considers the pathological basis for insulin resistance in animal models and humans, and discusses the influence of heredity, dietary factors and exercise. Clinical consequences including dyslipidaemia, hypertension and polycystic ovary syndrome, and therapeutic strategies for treatment are also examined. * Provides an expert review of the phenomenon of insulin resistance * Brings together a host of recent research for the first time * Written by leading experts in biological and clinical research

Every year between three and four hundred papers are published on the topic of insulin action. This extraordinary publication rate prevents any author from includ ing an exhaustive bibliography in any review or book. Perhaps due to this there is no single text that attempts to cover the effects and the mechanism of action of insulin. This book is such an attempt. I intend to present a review of the physiological effects of insulin, the pathology of defects in the action of insulin, and the current views on the mechanism of action of this hormone. I make no apology for the fact that the bibliography will not be extensive and that the amount of experimental detail and data discussed will be kept to a relevant minimum. This book is not intended for the expert in the field, but for the second- or third-year undergraduate and graduate student of medicine, biochemistry, physiology or related disciplines, and will be valuable as a reference source for research workers. The book is presented as a guide, a summary of the ideas and facts; it will present a reader with a foretaste of a fascinating and ever-changing field. I have attempted to be up-to-date with published research work. Any significant contributions to the field not included in the first draft have been added as footnotes. I assume a basic knowledge of the metabolic pathways of carbohydrates, fats and proteins.

The International Textbook of Diabetes Mellitus has been a successful, well-respected medical textbook for almost 20 years, over 3 editions. Encyclopaedic and international in scope, the textbook covers all aspects of diabetes ensuring a truly multidisciplinary and global approach. Sections covered include epidemiology, diagnosis, pathogenesis, management and complications of diabetes and public health issues worldwide. It incorporates a vast amount of new data regarding the scientific understanding and clinical management of this disease, with each new edition always reflecting the substantial advances in the field. Whereas other diabetes textbooks are primarily clinical with less focus on the basic science behind diabetes, ITDM's primary philosophy has always been to comprehensively cover the basic science of metabolism, linking this closely to the pathophysiology and clinical aspects of the disease. Edited by four world-famous diabetes specialists, the book is divided into 13 sections, each section edited by a section editor of major international prominence. As well as covering all aspects of diabetes, from epidemiology and pathophysiology to the management of the condition and the complications that arise, this fourth edition also includes two new sections on NAFLD, NASH and non-traditional associations with diabetes, and clinical trial evidence in diabetes. This fourth edition of an internationally recognised textbook will once again provide all those involved in diabetes research and development, as well as diabetes specialists with the most comprehensive scientific reference book on diabetes available.

Diabetes mellitus is a very common disease which affects approximately 150,000,000 worldwide. With its prevalence rising rapidly, diabetes continues to mystify and fascinate both practitioners and investigators by its elusive causes and multitude of This textbook is written for endocrinologists, specialists in other disciplines who treat diabetic patients, primary care physicians, housestaff and medical students. It covers, in a concise and clear manner, all aspects of the disease, from its pathogenesis on the molecular and cellular levels to its most modern therapy.

One day, in a moment of weakness, I fell prey to the temptation to organize and edit this volume on the mechanism of insulin action. The major reason for attempting to resist, of course, is the amazing speed at which advances are being made in this field. The usefulness of books such as this is often quickly compromised by new findings obtained during and just after publication. Happily for the contributors to this volume and myself, this unfortunate fate does not appear to be in store for us. New and important findings will undoubtedly continue to flow in this field during the next few years, but I believe this will increase rather than decrease the usefulness of this volume. As a matter of fact, as we go to press, I am delighted both that I was tempted and that I failed to resist. There are two basic reasons for my enthusiasm about this book, and they both relate to this issue of timeliness. First, each of the contributors has had an opportunity to update the scientific content of the various chapters only a few months before actual publication of this volume. The material presented in this volume is, at publication, contemporary with the current original literature. This volume thus provides an ex cellent framework for assessing new discoveries in this field for some time to come.