Advances in Diabetes: Novel Insights GR Sridhar
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1Advances in Diabetes Novel Insights2
3Advances in Diabetes Novel Insights
Editor GR Sridhar MD DM FACE FRCP Director Endocrine and Diabetes Centre Visakhapatnam, Andhra Pradesh, India Foreword PV Rao
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Advances in Diabetes: Novel Insights
First Edition: 2016
Printed at5
Dedicated to
Professor GM Narayanaswamy and Professor G Nirmala
My parents and my teachers
Professor MMS Ahuja
A teacher of teachers, renowned clinician, dedicated researcher My mentor and guide.
Contributing Authors
Knowledge about diabetes is exploding. It threatens to overwhelm, rather than inform and educate. Attending any of the many conferences entails a careful choice of sessions of interest. The editor and contributors of this monograph have done a wonderful job in making some of the choices for its readers, who wish to read, rather than listen. From the topics and the expertise of the authors, these are choices well made; a synthesis of clinical and basic science and other topics that both educate and amuse.
This is an intriguing addition to the literature on diabetes.
PV Rao MD PhD FRCP (London)
Professor and Head
Department of Endocrinology and Metabolism
Nizams Institute of Medical Sciences
Hyderabad, Telangana, India12
Does diabetes need yet another publication? Ever since the ‘Progress in Medicine’ series edited by Professor MMS Ahuja, there have been similar efforts in various specialties of medicine. Diabetes seems to be relatively untouched by such efforts, and hence this monograph. Even with the proliferation and access to information, one sometimes wants a crystallized digest of the field, that as described in the Foreword both educates and amuses.
The genetic basis of diabetes, its relation with epigenetics and the limitations of genomics are well brought out, followed by an account of β cell development, which can be utilized to replicate and replenish lost pancreatic β cells. Insulin signaling pathway is then brought up, as a basis for the use of insulin and the perceived adverse effects that have been recently highlighted. Other molecules and ligands, which have come into mainstream such as incretins and dual peroxisome proliferator-activated receptors (PPAR) agonists are also covered, where basic science leads to newer drug molecules. In the management aspects, the status of bariatric surgery as a potential cure and its current limitations are highlighted.
To put into perspective that science and knowledge alone cannot change behavior, psychological stress, and relaxation response have been delineated; the role of physical exercise, often prescribed to prevent obesity and diabetes, also seems to preserve cognition. Depression, which is in close companionship with obesity and diabetes, finds a place. Scientific advances in society – the electric light have changed the distinction between day and night and its relation to sleep, and to diabetes completes the behavioral aspects.
There are some surprising associations with diabetes which have come to the fore; the close relation of bone and energy metabolism is being increasingly recognized. Oral health seems to be important in the pathogenesis of diabetes and has been highlighted. The field of bioinformatics provides new areas of investigation; sequences related to human insulin were found in plant kingdom, suggesting that plants may be a source of glucose modulating agents. Finally, if a bariatric surgeon can ‘cure’ diabetes, can hypertension be left off? Ablation of sympathetic nerves in the treatment of resistant hypertension, seen also in diabetes, is an emerging concept.
I thank all the contributors for sparing their time to share their expertise for this volume.
GR Sridhar