الصفحة 1
الصفحة 1
Mechanisms of Insulin Action
More than 18 million people in the United States have diabetes mellitus, and about 90% of these have the type 2 form of the disease. In addition, between 17 and 40 million people have insulin resistance, impaired glucose tolerance, or the cluster of abnormalities referred to variably as the metabolic syndrome, the dysmetabolic syndrome, syndrome X, or the insulin resistance syndrome. In all of these disorders, a central component of the pathophysiology is insulin resistance, i.e., reduced responsiveness to insulin in tissues such as muscle, fat and liver. Insulin resistance is also closely linked to other common health problems, including obesity, polycystic ovarian disease, hyperlipidemia, hypertension, and atherosclerosis. In this book, we will attempt to dissect the complexity of the molecular mechanisms of insulin action with a special emphasis on those features of the system that are subject to alteration in type 2 diabetes and other insulin resistant states. We explore insulin action at the most basic levels, through complex systems. The book will be appealing to basic and clinical scientists.
Endocrinology : Basic and Clinical Principles
For this new edition of Conn & Melmed's Endocrinology: Basic and Clinical Principles, a panel of distinguished scientists and clinicians has completely rewritten every chapter to reflect the latest advances in our understanding of the endocrine system. Maintaining the original goal of the first edition to integrate the basic science of endocrinology with its physiological and clinical principles, the authors have succinctly summarized in 450 pages the latest findings on hormone secretion and hormone action, as well as all of the most recent insights into the physiology and pathophysiology of hormonal disorders. Coverage extends across the entire spectrum of endocrinology-from mammalian cells, plants, and insects to animal models and human diseases-with much increased coverage of diabetes and metabolism. Highlights include cutting-edge discussions of appetite disorders, obesity, reproductive failure, control of thyroid function, hormone action in humans and the lower species, and the mechanisms subserving hormone secretion.
Diabetes mellitus and bacterial and fungal urinary tract infection
Diabetes mellitus is a heterogeneous group of disorders characterized by variable degrees of insulin resistance, impaired insulin secretion, and increased glucose production. Patients with type 2 diabetes mellitus are at increased risk of infections, with the urinary tract being the most frequent infection site. Various impairments in the immune system, in addition to poor metabolic control of diabetes, and incomplete bladder emptying due to autonomic neuropathy, may all contribute in the pathogenesis of urinary tract infections (UTI) in diabetic patients. Factors that were found to enhance the risk for UTI in diabetics include age, metabolic control, and long-term complications, primarily diabetic nephropathy and cystopathy. The spectrum of UTI in these patients ranges from asymptomatic bacteriuria (ASB) to lower UTI (cystitis), pyelonephritis, and severe urosepsis.
Diabetes Mellitus & Recent developments
Diabetes mellitus is a group of metabolic disease characterized by hyperglycemia resulting from defect in insulin secretion, insulin action, or both. Symptoms of marked hyperglycemia include polyuria, polydipsia, weight loss, sometimes with polyphagia, and blurred vision. Frequency of diabetic in the world About 1 in 11 adults worldwide now have diabetes mellitus, 90% of whom have type 2 diabetes mellitus (T2DM). Asia is a major area of the rapidly emerging T2DM global epidemic Classification Of Diabetic Mellitus. 1-Type 1 diabetes: which accounts for only5–10% of those with diabetes, results from a cellular-mediated autoimmune destruction of the cells of the pancreas. 2-Type 2 diabetes: which accounts for90 –95% of those with diabetes, result from insulin resistance. The chronic complications of diabetes mellitus affect many organ systems and are responsible for the majority of morbidity and mortality. Such as, retinopathy, diabetic foot, neuropathy, and nephropathy, sexual dysfunction, and skin changes.
