Type 2 Diabetes: Principles and Practice

610 Pages·2007·6.9 MB·english

by  J Goldstein Barry

2
Type
Diabetes

2
Type
Diabetes
Principles Practice
and
Second Edition
Edited by
Barry J. Goldstein
Jefferson Medical College of Thomas Jefferson University
Philadelphia, Pennsylvania, USA
Dirk Müller-Wieland
Asklepios Clinic St. Georg
Hamburg, Germany
InformaHealthcareUSA,Inc.
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ª2008byInformaHealthcareUSA,Inc.
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LibraryofCongressCataloging-in-PublicationData
Type2diabetes:principlesandpractice/editedbyBarryJ.Goldstein,
DirkMu¨ller-Wieland.—2nded.
p.;cm.
Rev.ed.of:Textbookoftype2diabetes.c2003.
Includesbibliographicalreferencesandindex.
ISBN-13:978-0-8493-7957-4(hardcover:alk.paper)
ISBN-10:0-8493-7957-1(hardcover:alk.paper) 1. Non-insulin-dependentdiabetes.
I.Goldstein,BarryJ.II.Mu¨ller-Wieland,Dirk.III.Textbookoftype2diabetes.
IV.Title:Typetwodiabetes.
[DNLM:1. DiabetesMellitus,Type2. WK810T99172007]
RC662.18.T9732007
616.4’62—dc22 2007026823
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To C. Ronald Kahn, an extraordinary mentor, who fostered our career interests in the molecular
pathogenesis of diabetes and its complications.
To our families for their love and support.
Toourpatients,whosufferwiththerestrictionsimposedbydiabetesontheirdailylives,withthe
hope that this book will help alleviate their burden.

Preface
The incidence and prevalence of type 2 diabetes mellitus have increased dramatically in
modernized and developing nations over the past few decades—and this “epidemic” shows
nosignsofabating.Physiciansandotherhealthcareprofessionalsworldwidearewellawareof
thisgrowingburden.Thepathogenesisandmanagementofthehyperglycemiaofdiabetesand
its associated risk factors and morbidities, especially involving cardiovascular and
microvascular complications, must be fully understood by all of the many providers that
care for patients with diabetes worldwide.
Patientsarealwaysasking,“Isn’tthereanythingnewtohelpmanagemydiabetes?”This
reflectstherelativeinadequaciesofmanyofourattemptsatlifestylechange,aswellassomeof
the shortcomings of currently available medications for the long-term management of this
disorder. Certainly, changes in lifestyle can be effective, but they are extremely difficult to
implement over an extended period of time. Diabetes patient management is often
implemented later in the course of the disease, since the disease can be asymptomatic and
therefore can go unrecognized for many years. Recent studies have shown clearly that the
onsetofdiabetescanbepreventedordelayedandmoreaggressive,earliertreatmentmayalso
helptoalteritscourseand,possibly,itschroniccomplications.Largeclinicaltrialswillhelpto
answer these questions in the future.
Inthissecondedition,wehavethoroughlyupdatedallexistingchaptersanddeveloped
newonesvitaltothemanagementofdiabetes,whilemaintainingtheinternationalperspective
and focus on clinical care found in the first edition. The entire clinical field is covered in
succinctchapterswrittenbyrecognizedexperts.Thecontentspansfromacurrentperspective
on diabetes demographics and epidemiology, pathophysiology, disease monitoring, ap-
proaches to glucose control, and managing complications. New to this edition are chapters
that expand on nonpharmacological management options; diabetes-related macrovascular
conditions,includingcoronaryheartdiseaseandperipheralvasculardisease;anddiscussions
onrareformsofdiabetes,polycysticovariansyndrome,andnon-alcoholicsteatohepatitis.As
before,thiseditioncloseswithalookatthefutureofnewdevicesforglucosemonitoringand
diabetes management.
We hope this book will be used frequently and successfully in the management of this
complex and widely prevalent disorder.
Barry J. Goldstein
Dirk Mu¨ller-Wieland
v

Contents
Preface v
Contributors ix
1. EpidemiologyofType 2Diabetes 1
Markku Laakso
2. Pathogenesis ofType2 Diabetes 13
Michael Stumvoll, Barry J.Goldstein,and Timon W. van Haeften
3. Rationale andGoals forGlucose Control inDiabetesMellitus and
GlucoseMonitoring 27
Ramachandiran Cooppan
4. The Roleofthe DiabetesEducator inthe Educationand Management of
DiabetesMellitus 45
Carole´ Mensing
5. Nutrition inthe Etiology andManagement ofType2 Diabetes 59
Monika Toellerand JimI.Mann
6. DiabetesandExercise 73
Gerhard Schulerand Axel Linke
7. Psychosocial Issues andType2 Diabetes 83
GarryW.Welch,Alan M. Jacobson,and Katie Weinger
8. OralHypoglycemic Agents: Sulfonylureasand Meglitinides 97
Andreas F.H. Pfeiffer
9. Metformin 107
Michael Stumvoll, Hans-UlrichHa¨ring,and StephanMatthaei
10. Alpha-Glucosidase Inhibitors 121
Markolf Hanefeld
11. Thiazolidinediones 135
Sunder Mudaliarand Robert R. Henry
12. TreatmentStrategies for Type2 DiabetesBased onIncretinAction 159
Baptist Gallwitz and MichaelNauck
13. PramlintideAcetate inthe TreatmentofType2 Diabetes 171
StevenV.Edelman,BrockE. Schroeder,and Juan P. Frias
14. InsulinTherapy inType2 Diabetes 181
KathleenL. Wyneand Pablo F. Mora
15. Combination Therapyfor Treatment ofType 2Diabetes 207
Anthony L. McCall
16. Hypoglycemia inType2 Diabetes 227
Philip E.Cryer
17. Diabetic Coma:CurrentTherapyofDiabetic Ketoacidosis and
Non-Ketoacidotic HyperosmolarComa 237
Johannes Hensen
vii