Menu Expand
Diabetes Mellitus: Associated Conditions, An Issue of Endocrinology and Metabolism Clinics of North America, E-Book

Diabetes Mellitus: Associated Conditions, An Issue of Endocrinology and Metabolism Clinics of North America, E-Book

Leonid Poretsky

(2014)

Additional Information

Book Details

Abstract

This issue of the Endocrinology and Metabolism Clinics, guest edited by Drs. Leonid Poretsky and Emilia Pauline Liao, will focus on Diabetes Mellitus: Associated Conditions. Articles in this issue include Metabolic syndrome; The role of glucocorticoids and insulin resistance in adipose tissue function and lipid metabolism; Cardiovascular disease; The Relationships between Cardiovascular Disease and Diabetes: Focus on Pathogenesis; Interventions for coronary artery disease; Peripheral Arterial Disease; Hypertension; Sleep apnea; Osteoporosis; Vitamin D deficiency; Diabetes and cancer; Dementia; Depression; and Polycystic Ovary Syndrome.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Diabetes Mellitus:Associated Conditions i
copyright\r ii
Contributors iii
Consulting Editor iii
Editors iii
Authors iii
Contents vii
Endocrinology And\rMetabolism Clinics Of\rNorth America\r xi
Foreword xiii
Preface\r xvii
Metabolic Syndrome 1
Key points 1
Introduction 1
Definitions 2
Epidemiology 3
Consequences of MetS 8
Pathophysiology 10
Treatment 13
Controversies 15
Summary and future considerations 16
References 16
Cardiovascular Disease in Diabetes Mellitus 25
Key points 25
Introduction 25
Epidemiology 26
Assessing the risk of cardiovascular events 26
Pathophysiology 27
Mitigating the risks 28
Intensive Glycemic Control 28
Choosing the right agents 29
Lipids 31
Hypertension 32
Aspirin 33
Diagnosis of CHD in asymptomatic patients 33
Revascularization 34
Summary 34
Acknowledgments 35
References 35
The Relationships Between Cardiovascular Disease and Diabetes 41
Key points 41
Introduction 41
Diabetes and the vasculature 42
Oxidative Stress and the Vasculature 42
Diabetic Microvascular Dysfunction 44
Vascular Progenitor Cell Dysfunction and Diabetes 44
Impaired Reverse Cholesterol Transport 45
Summary of Relationships Between Diabetes and the Vasculature 45
Diabetes and the heart: diabetic cardiomyopathy 45
Mechanisms of Disease 46
Altered Substrate Metabolism 46
Activation of the Renin-angiotensin System 47
Cardiac Autonomic Neuropathy 47
Myocardial Fibrosis 48
Cardiovascular Findings 48
Diagnosing DCM 48
Diabetes and the cardiovascular patient 49
Coronary Artery Disease Risk Factors 49
Dyslipidemia 49
Hypertension 50
Glycemic control 50
Diabetes and Coronary Artery Disease 50
Heart Failure 52
Summary 52
References 53
Interventions for Coronary Artery Disease (Surgery vs Angioplasty) in Diabetic Patients 59
Key points 59
Introduction 59
Revascularization treatment options 60
Guidelines and other issues 63
Choice of conduit 63
Risk Scoring for CABG 64
Why is CABG Better than PCI? 65
Conclusions 66
Important Aspects of Perioperative Care: Glucose Control 66
What is the current role for PCI? 67
Summary 68
References 68
Mechanisms of Glucocorticoid-Induced Insulin Resistance 75
Key points 75
Introduction 75
Mechanisms of GC-induced insulin resistance 76
Tissue-specific regulation of insulin resistance 76
GC Regulation of Adipose Tissue Functionality, Mass, and Distribution 76
GC regulation of white adipose tissue lipolysis 76
GC regulation of de novo lipogenesis in white adipose tissue 78
GC regulation of insulin sensitivity in white adipose tissue 78
Chronic in vivo GC effects on adipogenesis and white adipose tissue mass and distribution in humans: studies on Cushing syn ... 79
GC regulation of the secretory profile of white adipose tissue 80
GC regulation of brown adipose tissue 81
Mechanisms of GC-Induced Insulin Resistance in Muscle 82
Mechanisms of GC-Induced Hepatic Insulin Resistance: Lipogenesis, Steatosis, and Circulating Lipids 82
GC Regulation of Circulating Lipids 83
Potential Effects of Brain GCs on Metabolic Homeostasis 84
11β-HSD1 as a gatekeeper for intracellular GC availability 85
The Potential Role of 11β-HSD1 Inhibition in Humans 86
The role of GCs in the development of common obesity 87
The paradox of GC anti-inflammatory yet diabetogenic actions: duration, location, or context? 87
Summary and future directions 88
References 89
Type 2 Diabetes Mellitus and Hypertension 103
Key points 103
Introduction 103
The burden 105
Epidemiology 105
Pathophysiology: converging pathways in coexisting DM and HTN 105
Role of oxidative stress 106
Insulin resistance and hyperinsulinemia 107
Treatment of HTN: rationale, strategies, and challenges in HTN 108
Impact of BP Control 108
BP Targets 108
Nonpharmacologic treatment: the role of therapeutic lifestyle intervention 109
Pharmacologic therapy 111
RAAS Blockade 111
CCBs 112
Diuretics 112
Incretin-based therapy and HTN: beyond glycemic control 113
Combined pharmacologic therapy 114
Perspectives 114
Telehealth 114
Renal Denervation 115
Acknowledgments 115
References 115
Polycystic Ovary Syndrome 123
Key points 123
History of polycystic ovary syndrome 123
Definition of PCOS 124
Clinical features of PCOS 125
Reproductive features of PCOS 125
Metabolic features of PCOS 126
Psychological features of PCOS 128
Risk factors for PCOS 128
Long-term consequences of PCOS 129
Insulin Resistance and Risk of Diabetes 129
Obesity 130
Hyperlipidemia 130
Cardiovascular Disease 130
Endometrial Cancer 131
Pregnancy Complications 131
PCOS in adolescence 131
Insulin resistance and PCOS 132
In Vitro Models 132
In Vivo Models 134
Genetics 134
Syndromes of Severe Insulin Resistance 135
Treatment of PCOS 136
Summary 138
References 138
Peripheral Arterial Disease 149
Key points 149
Introduction 149
Risk factors and pathogenesis 150
Risk Factors for PAD 150
Age, sex, and ethnicity 150
Cigarette smoking 150
Diabetes 150
Hypertension 151
Hyperlipidemia 151
Other factors 151
Atherosclerosis in PAD 151
Pathogenesis of the Complications of Diabetes in PAD 153
Hyperglycemia 153
Impaired lipid metabolism 154
Hypercoagulability and platelet dysfunction 154
Predictors of disease progression 154
C-reactive Protein 155
Fibrinogen 155
D-dimer 155
Hyperhomocysteinemia 155
Lipoprotein (a) 155
Clinical presentation 155
Intermittent Claudication 156
Critical Limb Ischemia 156
Diagnosis of PAD 157
Clinical Examination 157
ABPI Measurement 157
Treadmill Exercise Testing 158
Transcutaneous Oxygen Pressure Measurement 158
Duplex Ultrasound Scanning 159
Angiography 159
Management 159
Lifestyle and Risk Modifications 159
Cigarette smoking 159
Hyperglycemia 160
Hypercholesterolemia 160
Hypertension 161
Exercise 161
Drug Therapy 161
Antiplatelet agents 161
Vasoactive agents 161
Surgical Intervention 162
New therapies and future opportunities 162
Spinal Cord Stimulation 162
Intermittent Pneumatic Compression 163
Angiogenesis 163
Summary 163
References 163
Diabetes and Cancer 167
Key points 167
Introduction 167
Epidemiology of diabetes and cancer 168
Diabetes, Obesity, and the Metabolic Syndrome 168
Diabetes and Cancer Incidence 169
Diabetes and Cancer Mortality 170
Biologic mechanisms linking diabetes and cancer 171
IGF-1, insulin, and glucose 172
IGF-1 172
Insulin Resistance and Hyperinsulinemia 175
Hyperglycemia 176
Cytokines and adipokines 177
Inflammation 177
Adipokines 178
Summary 179
References 180
Obstructive Sleep Apnea 187
Key points 187
Introduction 187
Observational studies linking OSA with abnormalities of insulin and glucose metabolism and type 2 diabetes 188
Prevalence of OSA in subjects with type 2 diabetes 190
Insulin and glucose homeostasis assessment in patients with OSA 190
Impact of OSA on glycemic control in type 2 diabetes 191
Independent association of OSA with the metabolic syndrome 191
Pathophysiology of OSA and potential links to insulin resistance and type 2 diabetes 191
Chronic IH and insulin resistance 192
Chronic intermittent hypoxia, oxidative stress, and systemic inflammation 193
Impact of IH on pancreatic β-cell function 194
Sympathetic neural activation 194
Adipose tissue hypoxia and systemic inflammation 194
Human studies linking IH and sleep fragmentation with insulin resistance and pancreatic β-cell dysfunction 195
CPAP therapy in OSA and changes in insulin sensitivity 196
CPAP therapy in OSA and changes in glycosylated hemoglobin 197
Impact of CPAP therapy for OSA on the metabolic syndrome 197
Screening for OSA in patients with type 2 diabetes 198
Diagnosis and treatment of OSA 199
Summary 200
References 200
Vitamin D and Diabetes 205
Key points 205
Introduction 205
Review of vitamin D physiology 206
Classification of vitamin D status 206
Vitamin D intake requirements 207
Biologic plausibility of an association between vitamin D and type 2 diabetes 208
Vitamin D and Insulin Secretion 208
Vitamin D and Insulin Sensitivity 208
Vitamin D and Systemic Inflammation 209
Association between vitamin D status and type 2 diabetes 210
Cross-Sectional Studies 210
Longitudinal Studies 211
The influence of vitamin D supplementation on type 2 diabetes 217
Vitamin D and type 1 diabetes 225
Summary 226
References 227
Osteoporosis-associated Fracture and Diabetes 233
Key points 233
Introduction 233
T1D versus T2D and bone: similarities 234
T1D versus T2D and bone: differences 236
Quantifying risk of fracture associated with diabetes and osteoporosis 237
Management 238
Treatment 239
References 240
Relationships Between Diabetes and Cognitive Impairment 245
Key points 245
Introduction 245
Insulin signaling 246
The Master Hormone 246
Insulin-Stimulated Effects 246
IGFs 247
Insulin and IGF Signaling in the Brain 248
Insulin and IGF Signal Transduction 248
Insulin resistance and neurodegeneration 248
Insulin Resistance and its Consequences 248
AD Occurrence and Clinical Diagnosis 248
AD Neuropathology 249
AD is a Metabolic Disease with Brain Insulin/IGF Resistance 249
Brain Insulin and IGF Resistance and Deficiency in AD-Human Studies 252
Does AD = Type 3 Diabetes? 252
Experimental Evidence that Type 3 Diabetes = Sporadic AD 253
Metabolic Deficits in AD: the Starving Brain 253
Chronic Ischemic Cerebral Microvascular Disease 254
Brain metabolic derangements in other neurodegenerative diseases 256
Underlying causes of brain insulin resistance in AD 257
Aging 257
Lifestyle Choices and Aging 258
Obesity and Cognitive Impairment 258
T2DM 259
NAFLD/NASH 259
Metabolic Syndrome 259
Summary 260
References 260
Interactions Between Diabetes and Anxiety and Depression 269
Key points 269
Subtypes of diabetes and their relationship to anxiety and depression 270
Complex relationships between anxiety and depression and diabetes 270
Diabetes association with depression and anxiety 270
Depression and anxiety association with diabetes 271
Metabolic syndrome 272
Epigenetic risk 273
Treatment of depression: effect of medication 273
Antidepressants and antipsychotics: further analysis of risk/benefit 273
Treatment of diabetes as risk factor of depression and anxiety 275
Other biologic treatment modalities for depression 275
Cognitive behavioral therapy interventions 275
How to improve care for diabetes and anxiety and depression 276
Summary 277
References 278
Index 285