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Insulin Resistance - ECAB

Insulin Resistance - ECAB
Author: Gita Ganguly Mukherjee
Publisher: Elsevier Health Sciences
Total Pages: 147
Release: 2012-06-07
Genre: Medical
ISBN: 8131232212

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The insulin resistance syndrome can be defined as insulin resistance, compensatory hyperinsulinemia, and their associated co-morbidities. Clinically, the term insulin resistance syndrome describes a constellation of abnormalities such as obesity, hypertension, dyslipidemia, type 2 diabetes/hyperglycemia, and coronary artery disease. Insulin is responsible for glucose uptake into the body cells and tissues. The response of the cells to insulin varies from individual to individual. In some individuals, the tissue response to insulin may be diminished. This means that even with adequate levels of insulin, the glucose uptake into the cells and tissues is not optimal. This results in a compensatory over-secretion of insulin from the pancreas. The persistence of high levels of insulin in the blood or hyperinsulinemia is thought to be responsible for some of the abnormalities associated with this condition. However, the exact causal association of the condition with these disorders and the pathophysiology of their evolution are unclear. The most common underlying mechanism proposed is increased free fatty acids from abdominal fat in individuals with central obesity. This leads to deranged insulin signaling, reduced muscular glucose uptake, increased triglyceride synthesis, and hepatic gluconeogenesis. A genetic basis of the disease as well as several other factors such as tumor necrosis factor-α, adiponectin, leptin, Interleukin-6, and some adipokines have also been implicated. Insulin resistance syndrome is of clinical significance because of its association with potentially debilitating conditions that contribute to long-term morbidity and even mortality of the individual. People with insulin resistance syndrome are at an increased risk of developing type 2 diabetes, hypertension, dyslipidemia, myocardial infarction, polycystic ovarian disease, and fatty liver. In this book, we have tried to collate the experiences of the pioneers of this field on the subject and provide the reader a comprehensive view on the topic along with practical management points, which we are sure will benefit the physicians in their clinical practice. The contributors have focused on the condition as is prevalent in our subcontinent and have tried to give an insight on the issues pertaining to the same with a topical flavor.


Critical Issues and Diabetes - ECAB - E-Book

Critical Issues and Diabetes - ECAB - E-Book
Author: Samar Banerjee
Publisher: Elsevier Health Sciences
Total Pages: 124
Release: 2014-12-12
Genre: Medical
ISBN: 8131239241

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Critical Issues and Diabetes - ECAB - E-Book


Insulins in Diabetes - ECAB

Insulins in Diabetes - ECAB
Author: Rangasamy V. Jayakumar
Publisher: Elsevier Health Sciences
Total Pages: 122
Release: 2012-07-05
Genre: Medical
ISBN: 8131232077

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Decision making in instituting insulin therapy is an important aspect of diabetes management. The appropriate insulin regimen for an individual patient should take into account the patient’s lifestyle, age, motivation, general health, self-management skills, and treatment goals. In addition, a discussion of the newer insulins versus older insulin is a much desired topic in the Indian context. Another area of interest is the insulin delivery mechanism in the intensive care units in hospital settings. This CME module is designed to address such questions with supportive typical clinical scenarios, with which all readers will be able to identify. Thus it provides an excellent opportunity to widen one’s perspective in this area.


ECAB Diabetes and Exocrine pancreas - E-Book

ECAB Diabetes and Exocrine pancreas - E-Book
Author: A.G. Unnikrishnan
Publisher: Elsevier Health Sciences
Total Pages: 103
Release: 2014-12-11
Genre: Medical
ISBN: 8131239713

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ECAB Diabetes and Exocrine pancreas - E-Book


Microvascular Complications of Diabetes - ECAB

Microvascular Complications of Diabetes - ECAB
Author: V Seshiah
Publisher: Elsevier Health Sciences
Total Pages: 187
Release: 2009-09-15
Genre: Medical
ISBN: 8131232123

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The pathogenesis of microvascular complications is complex and multifactorial. Yet, hyperglycemia emerges as the most important single cause, which has been proved by the Diabetes Control and Complications Trial (DCCT). Thus, the importance of protecting the body from hyperglycemia cannot be overstated; the direct and indirect effects on the human vascular tree are the major source of morbidity and mortality in both type 1 and type 2 diabetes. Generally, the injurious effects of hyperglycemia are separated into macrovascular complications (coronary artery disease, peripheral arterial disease, and stroke) and microvascular complications (diabetic nephropathy, neuropathy, and retinopathy). It is important for physicians to understand the relationship between diabetes and vascular disease because the prevalence of diabetes continues to increase in our country, and the clinical requirements for primary and secondary prevention of these complications are also expanding.


Recent Advances in Metabolic Syndrome – I - ECAB

Recent Advances in Metabolic Syndrome – I - ECAB
Author: R R Kasliwal
Publisher: Elsevier Health Sciences
Total Pages: 207
Release: 2012-06-08
Genre: Medical
ISBN: 8131232182

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India in particular and South-Asia in general have witnessed a rapid increase in the prevalence and incidence of cardiovascular disease over the past 25 years. Lifestyles changes, unhealthy diet, lack of regular physical exercise, and obesity have all led to rising prevalence of metabolic syndrome. It is of no wonder that metabolic syndrome is being increasingly recognized as a clinical entity which is believed to be associated with increased risk of cardiovascular disease beyond individual risk factors, though this is at times debated. This monograph addresses the total nuance of metabolic syndrome in its entirety and answers questions frequently asked on this subject. The authors are internationally respected investigators in their own right having made major contributions in the particular field and are revered teachers as well. The book itself has clear sections which makes it very user friendly and divided into two volumes. The first volume has the evaluation of metabolic syndrome and the vastness of the problem and how it leads to smouldering dysfunctional endothelium making such a patient vulnerable to vascular disease. It purely deals with clinical issues we face daily in metabolic syndrome and patients. It is fairly broad-based to answer most of the queries which arise in a busy clinician’s head while dealing with metabolic syndrome on a day-to-day basis. Of special interest are chapters on metabolic syndrome in children, non-alcoholic fatty liver disease and hypogonadism.


Lipids in Diabetes - ECAB

Lipids in Diabetes - ECAB
Author: S V Madhu
Publisher: Elsevier Health Sciences
Total Pages: 134
Release: 2013-07-23
Genre: Medical
ISBN: 8131232131

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Type 2 diabetes mellitus is associated with a greater risk of developing atherosclerotic macrovascular diseases like myocardial infarction, stroke, and peripheral vascular disease. There is 2- to 4-fold increased risk of atherosclerotic heart disease and stroke in diabetic patients compared to non-diabetic patients. As the prevalence of type 2 diabetes is increasing rapidly, this diabetes related atherosclerotic disease is predicted to be a major public health problem. Atherosclerosis is a complex process and in diabetic patients, it behaves differently with increased lesion progression and severity. This accelerated atherosclerotic process in diabetics is explained on the basis of several risk factors like hyperglycemia, dyslipidemia, accelerated formation of advanced glycation end products, increased oxidative stress, and genetic factors. It is difficult to establish precisely the elements responsible for this atherosclerosis in diabetics, but by epidemiological, clinical, and by animal studies, it has been possible to get an idea of this problem in diabetics. Of the several risk factors for atherosclerosis in diabetes, dyslipidemia is the leading one, and an insight into the pathophysiologic relation of isolated triglyceridemia in Indian diabetics with the identification of the targets for control of lipids in diabetes (practical vs. ideal) needs to be well understood by the treating physician. This book is designed to address such issues with supportive typical clinical scenarios, with which the readers will be able to identify. Thus, it provides an excellent opportunity to widen one’s perspective in this area.


Hotspots in Diabetes - ECAB

Hotspots in Diabetes - ECAB
Author: Ambady Ramachandran
Publisher: Elsevier Health Sciences
Total Pages: 129
Release: 2013-07-12
Genre: Medical
ISBN: 8131232174

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Diabetes is one of the most important non-communicable lifestyle diseases. Diabetes is a multifaceted disorder which possibly influences and impacts body pathophysiology by different mechanisms and in varied ways. Diabetes has a very distinguished impact on cardiovascular system and plays a detrimental role in development of cardiovascular disorders. Metabolic memory is used to describe the impact of exposure to glucotoxicity, lipotoxicity and other metabolic disturbances, either as an adverse or a beneficial cell response which determines the later development of vascular complications. Terms such as metabolic imprint, legacy effect, glycemic memory or latent hyperglycemic damage are also used. Diabetes has significant impact on different facets of life. Diabetes has a distinguished but significant impact on development of various cancers. Diabetes has a positive, negative and even neutral impact on pathogenesis and progression of cancer depending upon the tumor site. On the contrary, cancer also has a significant effect on diabetes development and management. These facets tend to get overlooked in the study of diabetes development and management. All these aspects are being thoroughly covered in this project so as to facilitate better management of diabetics.


Unconventional Organ Damage in Diabetes - ECAB

Unconventional Organ Damage in Diabetes - ECAB
Author: Samar Banerjee
Publisher: Elsevier Health Sciences
Total Pages: 112
Release: 2012-09-14
Genre: Medical
ISBN: 813123214X

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Cell health depends on a steady supply of fuel from glucose and free fatty acids. Both these major fuels are regulated by insulin. Cells in the muscle, liver, and fat need insulin to receive glucose, and hence do not become exposed to high blood glucose levels when the blood sugars are high and insulin levels are low. The lack of insulin slows the movement of glucose into these cells, and probably spares them from damage when blood sugars are high. However, other cells such as those in the brain, nervous system, heart, blood vessels and kidneys pick up glucose directly from the blood without using insulin. These cells, except the brain, are more prone to damage from high blood sugars because they become exposed to high internal levels of glucose. This to quite an extent explains why damage tends to occur in specific organs such as in nerve and kidney cells, and in small blood vessels like those in the eyes. This project on the organ damage in diabetes is an attempt to elaborate on the various factors to be considered in managing these patients, the pointers for early diagnosis and prevention of the same.