The Diabetic Pancreas

Since the publication of the first edition of The Diabetic Pancreas in 1977, much progress has been made in various areas of diabetes research. While only a rela tively short while ago diabetes was considered a single disease, in more recent years it has become apparent that it is a heterogeneous group of disorders, all of which are characterized by a decreased tolerance of carbohydrates and most of which have a genetic basis, although the genetic types vary. In more recent years, an International Work Group sponsored by the National Diabetes Data Group of the NIH proposed a now generally accepted classification, according to which the insulin-dependent ketosis-prone diabetes, formerly and inappropriately called the juvenile type, is considered a subclass of diabetes, type 1. Because it can occur at any age, it was recommended that the diagnosis based on age be eliminated. The non-insulin-dependent, non-keto sis-prone type of diabetes, which is not secondary to other diseases or conditions, and which was formerly called matu rity-onset diabetes, was considered a second subclass, type II, because although this form usually develops after age 40, it also occurs in young persons, who do not require insulin or are not ketotic. Although this classification is not entirely agreed upon by all diabetologists, for practical purposes it has been generally accepted and has been utilized by the contributors to this volume.

The all-in-one, comprehensive resource for the millions of people with diabetes who use insulin, revised and updated. Few diabetes books focus specifically on the day-to-day issues facing people who use insulin. Diabetes educator Gary Scheiner provides the tools to "think like a pancreas" -- to successfully master the art and science of matching insulin to the body's ever-changing needs. Comprehensive, free of medical jargon, and packed with useful information not readily available elsewhere, such as: Day-to-day blood glucose control and monitoring Designing an insulin program to best match your lifestyle Up-to date medication and technology New insulin formulations and combinations and more With detailed information on new medications and technologies -- both apps and devices -- surrounding insulin, as well as new injection devices, and dietary recommendations, Think Like a Pancreas is the insulin user's go-to guide.

Diabetes mellitus represents one of the most frequent and serious clinical syn dromes in contemporary medicine. Since the end of the nineteenth century, the endocrine pancreas has been implicated in the pathogenesis of this disease. Several pathologists of the twentieth century detected various lesions and mor phologic alterations in the pancreatic islets of diabetic patients, but the patho physiologic basis of their findings remained long obscure. The systematic mi croscopic work of WILLY GEPTS clarified the views and related the variety in histopathology to differences in origin, duration and clinical expression of the disease. Over the past two decades, the concept of a multifactorial origin of diabetes has become widely accepted. Various agents and mechanisms have been identified which can lead to a quantitative or qualitative deficit in pancre atic B-cells. The purpose of this book is to bring an update on the many path ways which may induce an absolute or relative insufficiency in insulin release and hence a diabetic state. Rather than bringing a complete account on all re search relevant to the understanding of the pathology of the diabetic pancreas, the authors of the various chapters of this volume have focussed on selected processes which can impair B-cell function, survival or regeneration.

Dr. Robert L. Jackson, Professor of Child Health at the Uni versity of Missouri-Columbia, decided to retire from clinical practice in 1977 and the Department of Child Health planned a con ference in his honor. The Thirteenth Annual MidweSt Conference on Endocrinology and Metabolism also was in the planning stages and scheduled for two days in the fall. It seemed appropriate to com bine the two into an expanded three-day conference. In view of Dr. Jackson's international reputation in the study and care of children with diabetes mellitus, the conference topic was not dif ficult to find. Experts in this field were delighted to be asked to speak at a conference in Dr. Jackson's honor. We selected a number of excellent speakers to survey the physiology and pathophy siology of pancreatic hormones and their effects in diabetes mel litus, to discuss current knowledge of the microvascular complica tions of the disease, and to put it all into the proper historical perspective of where we have been and where we are going. We think the conference achieved its objective to pay meaningful trib ute to a distinguished member of the scientific community. As with any conference, the conversion of the presentations and discussions to the printed page is a long and arduous process. Many manuscripts were completed well after the conference and references often are more recent than the date of the conference.

The beta cells of the pancreatic islets of Langerhans are the only cells in the body that produce and secrete insulin. This metabolic hormone plays a central role in the maintenance of glucose homeostasis. This book provides a comprehensive review of the beta cell in health and disease. The book’s primary aim is to encourage investigators to become actively involved in diabetes research and the search for new approaches to prevent and treat diabetes.

The 1997 classification of diabetes mellitus, now accepted worldwide, includes a large section of ‘Other specific types of diabetes’, a good part of which is made up of diabetes secondary to other endocrine or pancreatic disorders. However, a comprehensive overview on how these disorders may lead to diabetes, and how to diagnose and treat them, was not available so far. Filling this gap, this book includes detailed descriptions of glucose metabolism derangements in other endocrine and pancreatic disorders. Leading experts in their fields present an exhaustive overview of the most-updated evidence on the etiopathological mechanisms underlying the development of diabetes in patients with endocrine and pancreatic disorders, and the relevant diagnostic and therapeutic approaches. Because of its multidisciplinary approach, this book is of great interest to endocrinologists, diabetologists, general practitioners, internal medicine specialists and surgeons, and will remain a reference source for years to come.