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Type 1 Diabetes, An Issue of Endocrinology and Metabolism Clinics of North America, E-Book

Type 1 Diabetes, An Issue of Endocrinology and Metabolism Clinics of North America, E-Book

Desmond A. Schatz | Michael Haller | Mark Atkinson

(2010)

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Book Details

Abstract

This issue of Endocrinology and Metabolism Clinics of North America provides the endocrinologist with essential updates on treatment of type 1 diabetes, with an eye toward future trends and developments. The Guest Editors brought together a remarkable group of notable authors, such as Paul Robertson, President of the National Diabetes Association. Topics covered include epidemiology; economics; contemporary management; inpatient management; update on insulin pumps and continuous glucose monitoring systems; update on studies aimed at interdicting and preventing type 1 diabetes; advances in the prediction, natural history, and mechanisms leading to type 1 diabetes; complications; hypoglycemia in type 1 diabetes; new lessons from animal models; the role of the gut in the genesis of type 1 diabetes and other autoimmune diseases; and an update on transplantation for reversing type 1 diabetes.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Contributors iii
Contents vii
Foreword xiii
Preface xvii
Chapter 1. Epidemiology of Type 1 Diabetes 481
INCIDENCE AND PREVALENCE OF T1D 482
INCIDENCE: TEMPORAL TRENDS 483
RISK FACTORS FOR DEVELOPMENT OF T1D 484
SEASONALITY OF ONSET AND BIRTH 486
OTHER RISK FACTORS 487
CLINICAL COURSE 488
TREATMENT AND MANAGEMENT 488
PREVALENCE OF COMPLICATIONS 489
SUMMARY 490
REFERENCES 491
Chapter 2. Economics of Type 1 Diabetes 499
COST OF ILLNESS: METHODS AND DATA 500
T1D COSTS 504
SUMMARY 509
REFERENCES 510
Chapter 3. Advances in the Prediction and Natural History of Type 1 Diabetes 513
GENETIC MARKERS OF T1D RISK 514
ISLET AUTOANTIBODIES: FORENSIC PREDICTION 516
NATURAL HISTORY OF ISLET AUTOIMMUNITY 519
SPECULATIONS FROM THE NATURAL HISTORY FINDINGS 520
SUMMARY 521
ACKNOWLEDGMENTS 522
REFERENCES 522
Chapter 4. Efforts to Prevent and Halt Autoimmune Beta Cell Destruction 527
PREVENTION VERSUS INTERVENTION 527
PREVENTION STRATEGIES 529
INTERVENTION STRATEGIES 530
SUMMARY 536
REFERENCES 536
Chapter 5. Use of Nonobese Diabetic Mice to Understand Human Type 1 Diabetes 541
IMMUNOLOGY AND PATHOLOGY OF T1D: COMPARING MICE AND MEN 543
GENETICS 548
PRECLINICAL TRIALS 552
SUMMARY 553
REFERENCES 553
Chapter 6. The Intestinal Microbiome: Relationship to Type 1 Diabetes 563
THE HUMAN SUPERORGANISM 564
INTESTINAL MUCOSAL IMMUNOLOGY IN RELATION TO T1D 565
ALTERED INTESTINAL MICROBIOTA IN T1D 566
INTESTINAL MUCOSAL BARRIER—MICROBIAL INTERACTION 566
PROBIOTICS AND T1D 568
MICROBIAL INTERACTION WITH NUTRIENTS, IMMUNITY AND PATHOGENESIS OF T1D 568
SUMMARY 569
REFERENCES 569
Chapter 7. Contemporary Management of Patients with Type 1 Diabetes 573
HISTORICAL BACKGROUND 573
MULTIDISCIPLINARY DIABETES TEAM 574
INSULIN ANALOGUES 574
INSULIN REGIMENS 582
INSULIN PUMP THERAPY 583
MEDICAL NUTRITION THERAPY 585
BLOOD GLUCOSE MONITORING 586
SUMMARY 587
REFERENCES 587
Chapter 8. Inpatient Management of Adults and Children with Type 1 Diabetes 595
INSULIN PHARMACOKINETICS AND PHARMACODYNAMICS 596
FUNDAMENTALS OF INSULIN MANAGEMENT 597
METHODS OF SUBCUTANEOUS INSULIN ADMINISTRATION 598
INPATIENT GLYCEMIC GOALS 599
INSULIN SELF-MANAGEMENT 601
ADJUSTING THE INPATIENT REGIMEN 601
ADJUSTING SUBCUTANEOUS INSULIN 602
TPN, TUBE FEEDING, AND GLUCOCORTICOIDS 602
INTRAVENOUS INSULIN 603
PERIOPERATIVE INSULIN 604
TRANSITION FROM INTRAVENOUS TO SUBCUTANEOUS INSULIN 604
WRITING ORDERS 605
ADDITIONAL CONSIDERATIONS FOR CHILDREN 606
DISCHARGE PLANNING 606
SUMMARY 606
REFERENCES 606
Chapter 9. Toward Closing the Loop: An Update on Insulin Pumps and Continuous Glucose Monitoring Systems 609
SENSORS 611
CLINICAL POINTERS IN THE USE OF CGM SENSORS TODAY 613
PUMPS 615
INFUSION SETS 617
INSULIN 617
ALGORITHMS 617
POTENTIAL FUTURE APPLICATIONS OF A CLOSED-LOOP SYSTEM 619
SUMMARY 619
REFERENCES 620
Chapter 10. Complications of Type 1 Diabetes 625
BIOCHEMICAL AND MOLECULAR PATHWAYS OF DAMAGE 626
METABOLIC MEMORY 627
MICROVASCULAR COMPLICATIONS 628
MACROVASCULAR COMPLICATIONS 636
REFERENCES 637
Chapter 11. Hypoglycemia in Type 1 Diabetes Mellitus 641
THE LIMITING FACTOR IN GLYCEMIC CONTROL 641
INCIDENCE AND IMPACTS OF HYPOGLYCEMIA IN T1DM 642
DEFINITION OF HYPOGLYCEMIA IN T1DM 642
PHYSIOLOGY OF GLUCOSE COUNTER-REGULATION 643
PATHOPHYSIOLOGY OF GLUCOSE COUNTER-REGULATION IN T1DM 643
RISK FACTORS FOR HYPOGLYCEMIA IN T1DM 646
MINIMIZING THE RISK OF HYPOGLYCEMIA IN T1DM 646
TREATMENT OF HYPOGLYCEMIA IN T1DM 649
SUMMARY OF RECOMMENDATIONS 650
ACKNOWLEDGMENTS 650
REFERENCES 651
Chapter 12. Update on Transplanting Beta Cells for Reversing Type 1 Diabetes 655
HISTORY OF PANCREAS AND ISLET TRANSPLANTATION 655
GRAFT SURVIVAL RATES 656
PATIENT SURVIVAL RATES AND COMPLICATIONS OF TRANSPLANTATION 657
PANCREAS AND ISLET CELL FUNCTION POST TRANSPLANT 658
IMPACT ON SECONDARY COMPLICATIONS OF DIABETES 661
PROBLEMS WITH IMMUNOSUPPRESSIVE DRUGS 663
PROBLEMS WITH TRANSPLANTATION SITES 664
PROBLEMS WITH SUPPLY AND DEMAND 664
SUMMARY 665
REFERENCES 665
Index 669