Novelties in Diabetes

Description

The field of diabetes mellitus research is currently characterized by rapid and remarkable growth that has led to the development of significant diagnostic and therapeutic advances. This is very important given the fact that the frequency of the disease continues to increase at alarming rates worldwide. This new volume is a comprehensive overview of the contemporary state of the art in the field. Experts shed light on a broad range of relevant aspects, from genetic background to topics related to diabetic complications such as diabetic retinopathy or diabetic nephropathy. This is expanded upon through papers reporting on the present state of diabetes in pregnancy and on the relationship between diabetes and cancer. There is also an inventory of currently used therapeutic tools and a review of novel therapeutic approaches like incretin-based therapies or sodium-glucose transporter-2 inhibitors. Additionally, the latest technological developments such as enhanced features for blood glucose meter or continuous and implantable glucose monitoring devices are included. Providing a concise but comprehensive update, this book will be essential to every clinician involved in the treatment of diabetes mellitus.

Informations

• Publié par: S. Karger AG
• Date de parution: 27 janvier 2016
• Nombre de lectures: 0
• EAN13: 9783318056396
• Langue: English
• Poids de l'ouvrage: 2 Mo

Extrait

Novelties in Diabetes
Endocrine Development
Vol. 31
Series Editor
P.-E. Mullis Bern
Novelties in Diabetes
Volume Editors
Christoph Stettler Bern
Emanuel Christ Bern
Peter Diem Bern
35 figures, 14 in color, and 19 tables, 2016
Endocrine Development Founded 1999 by Martin O. Savage, London
_______________________ Christoph Stettler, MD Department of Endocrinology, Diabetes and Clinical Nutrition Inselspital Bern University Hospital Bern, Switzerland
_______________________ Emanuel Christ, MD Department of Endocrinology, Diabetes and Clinical Nutrition Inselspital Bern University Hospital Bern, Switzerland
_______________________ Peter Diem, MD Department of Endocrinology, Diabetes and Clinical Nutrition Inselspital Bern University Hospital Bern, Switzerland
Library of Congress Cataloging-in-Publication Data
Names: Stettler, Christoph, editor. | Christ, Emanuel, 1961-, editor. | Diem, Peter, editor.
Title: Novelties in diabetes / volume editors, Christoph Stettler, Emanuel Christ, Peter Diem.
Other titles: Endocrine development ; v. 31. 1421-7082
Description: Basel ; New York: Karger, 2016. | Series: Endocrine development, ISSN 1421-7082 ; vol. 31 | Includes bibliographical references and indexes.
Identifiers: LCCN 2015046784| ISBN 9783318056389 (hard cover: alk. paper) | ISBN 9783318056396 (electronic version)
Subjects: | MESH: Diabetes Mellitus
Classification: LCC RC660.4 | NLM WK 810 | DDC 616.4/62--dc23 LC record available at
http://lccn.loc.gov/2015046784

Bibliographic Indices. This publication is listed in bibliographic services, including Current Contents ® and PubMed/MEDLINE.
Disclaimer. The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publisher and the editor(s). The appearance of advertisements in the book is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
© Copyright 2016 by S. Karger AG, P.O. Box, CH-4009 Basel (Switzerland)
www.karger.com
Printed in Germany on acid-free and non-aging paper (ISO 9706) by Kraft Druck, Ettlingen
ISSN 1421-7082
e-ISSN 1662-2979
ISBN 978-3-318-05638-9
e-ISBN 978-3-318-05639-6
Contents
Preface
Stettler, C.; Christ, E.; Diem, P. (Bern)
Treatment Goals in Diabetes
Melmer, A. (Innsbruck); Laimer, M. (Innsbruck/Bern)
The 'Old' Anti-Diabetic Agents: A Systematic Inventory
Buhse, S.; Mühlhauser, I.; Lenz, M. (Hamburg)
Novel Therapeutic Approaches in Diabetes
Gallwitz, B. (Tübingen)
Diabetes Technology
Pfützner, A. (Mainz)
Novelties in Diabetic Retinopathy
Ebneter, A.; Zinkernagel, M.S. (Bern)
Hypertension and Diabetic Nephropathy
Skov, J.; Christiansen, J.S.; Poulsen, P.L. (Aarhus)
The Diabetic Foot: The Never-Ending Challenge
Contemporary Options of Screening, Management and Prevention of Foot Pathologies in Diabetic Patients
Peter-Riesch, B. (Geneva)
Diabetes and Cancer
Holden, S.E. (Cardiff)
Beta-Cell Replacement: Pancreas and Islet Cell Transplantation
Niclauss, N.; Meier, R.; Bédat, B.; Berishvili, E.; Berney, T. (Geneva)
Gestational Diabetes Mellitus
Spaight, C.; Gross, J.; Horsch, A.; Puder, J.J. (Lausanne)
Genetic Defects of the β-Cell That Cause Diabetes
Stekelenburg, C.M.; Schwitzgebel, V.M. (Geneva)
Genetics of Type 2 Diabetes
Stančáková, A.; Laakso, M. (Kuopio)
Author Index
Subject Index
Preface
There is probably no other field in endocrinology developing as dynamically as that of diabetes mellitus. Novel diagnostic and therapeutic approaches have been and are currently emerging, and the knowledge regarding essential aspects of diabetes is enlarging at high speed. Accordingly, endocrinologists but also other physicians involved in treating diabetic patients face the challenge to translate these developments into optimized medical care.
This 31st volume of Endocrine Development does not aim at covering every single aspect of a disease as complex as diabetes mellitus. In contrast, renowned experts in the field provide a comprehensive balanced overview of the most important related topics. Starting with a chapter on the individualization of treatment goals, the book then provides an overview of potential means to achieve this target. This encompasses chapters weighing the role of well-known as opposed to novel therapeutic approaches, the latter including not only technical achievements (e.g. artificial pancreas), but also the state of the art in β-cell replacement. A focus is set on diabetic complications and the recently debated association between diabetes and cancer. This is followed by a current state-of-the-art chapter on gestational diabetes, an area of great importance due to increasing patient numbers but also growing scientific achievements. And the book is ended with two chapters shedding light on genetic aspects of diabetes mellitus.
Offering a concise synthesis of the current state of knowledge in diabetes, this book will provide clinicians and researchers with an up-to-date resource in this highly dynamic medical field. We sincerely thank all the authors for their contribution and dedicate this volume to the memory of our dear friend Prof. Primus-E. Mullis.
Christoph Stettler, Bern Emanuel Christ, Bern Peter Diem, Bern
Stettler C, Christ E, Diem P (eds): Novelties in Diabetes. Endocr Dev. Basel, Karger 2016, vol 31, pp 1-27 (DOI: 10.1159/000439364)
______________________
Treatment Goals in Diabetes
Andreas Melmer a Markus Laimer a , b
a Department of Internal Medicine, Division of Endocrinology, Gastroenterology and Diabetes, Medical University Innsbruck, Innsbruck, Austria; b Division of Endocrinology, Diabetes and Clinical Nutrition, Inselspital, University of Bern, Bern, Switzerland
______________________
Abstract
The quality of glycaemic control in diabetes mellitus relies on accurate individualization of available treatment options. Treatment targets depend on the type and duration of diabetes, the patients’ abilities and characteristics and the individual risk for acute and/or late-stage complications. These complications include hypoglycaemia, which can be severe and life threatening, hyperglycaemia, which is a main factor for the development of cardiovascular disease, and macrovascular and microvascular disease, both of which are hallmark features of diabetes-associated constraints. Moreover, other treatment goals in diabetic patients influence both glycaemic control and quality of life. Lipoproteins, blood pressure, weight control, mental health and lifestyle are important factors that contribute to the frequency of diabetes-associated complications.
© 2016 S. Karger AG, Basel
Introduction
Diabetes mellitus is a complex, chronic illness requiring continuous medical care involving multifactorial risk reduction strategies beyond glycaemic control. Regardless of diabetes classification, the treatment goals for every diabetic patient include the avoidance of short- and long-term complications and an improvement and maintenance of quality of life. To achieve these central goals, treatment has to be defined with respect to individual patients’ clinical abilities. Significant evidence indicates that a range of interventions aside from glycaemic control alone are necessary to improve diabetes outcomes [ 1 ]. Although type 1 diabetes (T1DM) and type 2 diabetes mellitus (T2DM) resemble a central pathophysiologic feature - a (complete) constraint of the functional levels of insulin - both entities differ in certain aspects regarding the short- and long-term targets of glycaemic control.
Type 1 Diabetes
An immediate need for exogenous insulin replacement is the hallmark feature of therapy for T1DM, for which lifetime treatment is necessary. Key questions remain regarding the epidemiology of T1DM, the effectiveness of current therapies, the aetiology of development of this disorder, and strategies to prevent or cure this disease [ 2 ]. The discovery of insulin in 1921 was clearly the most significant therapeutic event in the history of T1DM; however, exogenous insulin replacement does not always provide the metabolic regulation necessary to avoid one or more disease-associated complications (e.g. retinopathy, neuropathy, and cardiovascular disease (CVD)). After initial diagnosis and metabolic s