By Mark N. Feinglos, Mary Angelyn Bethel
During this useful e-book, the authors of every bankruptcy have synthesized the at present on hand facts relating to particular concerns in diabetes care. The chapters were written via an interdisciplinary staff of scientists and doctors. Such an strategy emphasizes the necessity for collaboration within the care of any person with diabetes and within the attempt to discover new cures for the sickness. This reference presents useful counsel in one source.
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Extra info for Type 2 Diabetes Mellitus: An Evidence-Based Approach to Practical Management (Contemporary Endocrinology)
Of particular interest regarding the effect on skeletal muscle are TNF (152) and adiponectin (153–155), as well as the recently described retinol binding protein 4 (156). Another adipocyte-related factor of current interest is resistin, which was initially linked to the insulin resistance of obesity and diabetes (157). Subsequently its pathological role has been questioned (158). However, interest in resistin has returned, as resistin null mice have been shown to become hypoglycemic during fasting, and are protected against glucose intolerance and insulin resistance during fat feeding, confirming a physiologic effect (159).
Proposed sequence of the key pathological features of type 2 diabetes as discussed in this review. these changes have been most evident in children—numerous studies have reported the epidemic of childhood obesity (5) and its root causes of reduced physical activity and high caloric intake (6,7). Although returning to healthy lifestyles likely would reverse the rising incidence of type 2 diabetes, this may be an impractical solution. Instead the current focus is to investigate the pathogenesis, hoping to develop pharmaceuticals that target the key pathogenic elements.
An acute rise in glucose normally causes a burst of insulin secretion lasting 5–10 minutes (“first phase”), followed by another rise in insulin output lasting the duration of the hyperglycemic stimulus (“second phase”). The characteristic ß-cell defect in type 2 diabetes is loss of the first phase (48,66), which occurs early in the course of the disease, with the first phase being reduced in half with fasting blood glucose levels above 100 mg/dL, and absent at values greater than 115 mg/dL (46).
Type 2 Diabetes Mellitus: An Evidence-Based Approach to Practical Management (Contemporary Endocrinology) by Mark N. Feinglos, Mary Angelyn Bethel