By Burton E. Sobel, David J. Schneider
This cutting-edge reference information present and potent symptom-specific concepts for the prognosis and administration of diabetic patients-emphasizing the exploration of healing techniques to be had for the therapy of speeded up coronary issues linked to diabetes.
Addresses the pathophysiology underlying complicated middle illness and descriptions remedies to hamper development in sort 2 diabetic patients.
Medical administration of Diabetes and center illness includes the latest discoveries in
and positive factors the most recent treatments within the therapy of coronary health problems in diabetic topics with
With over seven hundred references and the contributions of greater than 20 world-renowned specialists, scientific administration of Diabetes and center illness is a useful reference for fundamental care, family members perform, and inner drugs physicians; cardiologists; cardiothoracic surgeons; endocrinologists; general practitioner assistants; nurse practitioners; and scientific scholars in those disciplines.
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Extra info for Medical Management of Diabetes and Heart Disease (Clinical Guides to Medical Management)
Example text
Arterioscler Thromb Vasc Biol 2000; 20:823–829. 3 Recognition and Assessment of Insulin Resistance William T. Cefalu University of Vermont College of Medicine, Burlington, Vermont I. INTRODUCTION Insulin resistance, defined as an attenuation of normal insulin action, is a key pathogenic phenomenon observed in the natural history of type 2 diabetes (1,2). , muscle and fat) results in hyperinsulinemia, a compensatory mechanism required to maintain normal or near-normal glucose levels. This ‘‘compensated’’ state may be maintained for many years.
4 years (5). 58, respectively. Thus, there are overwhelming data to support the concept that accelerated atherosclerosis occurs many years prior to the onset of type 2 diabetes. The data can be interpreted to mean that subdiabetic levels of plasma glucose are responsible for the vascular disease or that type 2 diabetes is preceded by some metabolic state that causes both type 2 diabetes and accelerated atherosclerosis. Many population-based epidemiological studies published in the 1980s had suggested that high fasting or postprandial plasma insulin levels predicted the development of type 2 diabetes.
C. Signaling Pathways Regulating Glycogen Synthesis In addition to promoting glucose uptake, another major cellular effect of insulin is the production of glycogen. Thus, a reduction in glycogen synthesis is reflected by a decrease in nonoxidative glucose disposal assessed during clamp studies (see Sec. IV) and is a hallmark of insulin resistance. Glycogen synthesis involves the conversion of UDP-glucose to glycogen by GS, which is considered the ratelimiting step (43). GS is regulated by both allosteric and phosphorylation– dephosphorylation mechanisms (43,56,57).