Understanding Insulin and Insulin Resistance is written in a simple and clear language illustrated with diagrams that show the complex interplay of various factors in the initiation of insulin resistance. The design is systematic and meticulous, portraying topics in a flow from simple to complex. This resource is intended for a broad audience spanning across biochemistry, medicine, dentistry, academia, physicians, and research scholars. It extends the approach to biochemistry, physiology, metabolism of insulin along with the coverage of pathophysiology of insulin resistance, its effects on the body tissues, and its analysis on insulin resistance syndrome.
In 1996 the 75th anniversary of the discovery of insulin was celebrated at the University of Toronto, the scene of that discovery in 1921. This volume was stimulated by the scientific program which was staged at that time and brought together much of the world's best talent to discuss and analyze the most recent developments in our understanding of pancreatic function, insulin secretion, the interaction of insulin with its target tissues, the mechanism of insulin action at the cellular level, and the defects which underlie both Type I (insulin-dependent diabetes mellitus, IDDM) and Type II (noninsulin-dependent diabetes mellitus, NIDDM) forms of the disease. We have chosen to focus the present volume on work related to insulin action.
The discovery of insulin at the University of Toronto in 1921-22 was one of the most dramatic events in the history of the treatment of disease. Insulin was a wonder-drug with ability to bring patients back from the very brink of death, and it was no surprise that in 1923 the Nobel Prize for Medicine was awarded to its discoverers, the Canadian research team of Banting, Best, Collip, and Macleod. In this engaging and award-winning account, historian Michael Bliss recounts the fascinating story behind the discovery of insulin – a story as much filled with fiery confrontation and intense competition as medical dedication and scientific genius. Originally published in 1982 and updated in 1996, The Discovery of Insulin has won the City of Toronto Book Award, the Jason Hannah Medal of the Royal Society of Canada, and the William H. Welch Medal of the American Association for the History of Medicine.
Galenical pharmacy or galenics is the science dealing with the pro duction of drug substances from raw materials, the purity of such substances, their formulation into pharmaceutical preparations with the desired effects and safety in use, and the quality control, stability and storage of the preparations. The field has taken its name from the Greek physician Galen (131-201 A.D.), who had a profound influence on medicine for many centuries because he collected and systematized the medicinal knowledge of his time. The discovery of insulin is attributed to Banting and Best who, in 1921, prepared an extract of the pancreas of the fetal calf and showed that the extract was capable of reducing the blood sugar level of a diabetic dog. This outstanding discovery gave rise to the rapid develop ment of the manufacture of insulin of bovine and porcine origin. By 1925, two Danish manufacturers of insulin preparations were established; both have since been in the forefront ofthe development of insulin preparations, the latest achievement being the marketing of human insulin by Novo in 1982. The development of highly purified human insulin produced semisynthetically from porcine insulin or by DNA recombinant methods are significant contributions to safe and efficient insulin therapy. Insulin is a protein which is destroyed in the gastrointestinal tract.
Using Insulin shows how to set, test, and adjust fast-acting and long-acting insulin doses for those with Type 1 or Type 2 diabetes. It covers Lantus, Detemir, Humalog and Novolog insulins. Helpful chapters explain carb counting, the glycemic index, safe exercise, insulin use in pregnancy and gestational diabetes, combining insulin with diabetes medications, dosage guidelines for children and teens, prevention and treatment for highs and lows, and reversing hypoglycemia unawareness.
Since insulin became available for the treatment of diabetes in 1922 a number of major advances have been made, which include the modification of insulin to vary its timing of action, its purification, and latterly, the production of human insulin. Human insulin in quantities sufficiently large for therapy has been made available by two techniques developed in parallel during the late 1970s. These involve either (i) formulation in E. coli bacteria suitably encoded by DNA recombinant methods of the A- and B-chains of human insulin followed by a chain combination reaction ('biosynthetic' human insulin) or (ii) enzymatic conversion (transpeptidation) of porcine insulin brought to react with a threonine ester by porcine trypsin in a mixture of water and organic solvents, yielding human insulin ('semi-synthetic' human insulin). This book includes the first clinical-pharmacological studies of each of the highly purified 'semi-synthetic' human insulin preparations: Actrapid ® HM; Monotard® HM; Protaphane® HM; Actraphane® HM; and Ultratard® HM (Novo Industri A/S, Copenhagen). The preliminary studies established their safety and efficacy relative to their porcine and bovine counterparts emphasising the relevance of species and formulation on the pharmacokinetics and biological responses to insulin. Additional investigations with human insulin demonstrated the influence of insulin concentration, site of administration, the addition of aprotinin to insulin and the mixing of 'short-' and 'intermediate-acting' formulations on insulin 'bioavailability'. Examination of the 'within' and 'between' subject day-to-day variation in absorption and the effect of subcutaneous insulin also demonstrates the dominating influence of insulin responsiveness.
Intended for diabetes researchers and medical professionals who work closely with patients with diabetes, this newly updated and expanded edition provides new perspectives and direct insight into the causes and consequences of this serious medical condition from one of the foremost experts in the field. Using the latest scientific and medical developments and trends, readers will learn how to identify, prevent, and treat this challenging phenomenon within the parameters of the diabetes care regimen.
In Insulin Resistance: The Metabolic Syndrome X, outstanding investigators thoughtfully summarize our current understanding of how insulin resistance and its compensating hyperinsulinemia (Syndrome X) play a major role in the pathogenesis and clinical course of high blood pressure and cardiovascular disease-the so-called diseases of Western civilization-as well as polycystic ovary disease. Under the aegis of Gerald Reaven, the discoverer of Syndrome X, the distinguished authorities writing here detail for the first time the pathophysiological consequences and the clinical syndromes, excluding Type 2 diabetes, related to insulin resistance. They also examine the genetic and lifestyle factors that contribute to the wide differences in insulin action that exist in the population at large. Each author has been encouraged to present a point of view that reflects their unique insights. The first authoritative book on the subject, Insulin Resistance: The Metabolic Syndrome X illuminates the special importance of insulin resistance as a major cause of hypertension, heart disease, and polycystic ovary syndrome. Its thoughtful and detailed approach will make it an essential reference for basic and clinical researchers seeking to understand these critical phenomena.
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. This book attempts 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. It explores insulin action at the most basic levels, through complex systems.
A travel memoir through thirty countries, a thousand insulin injections, and one man’s journey from despair to confidence. With tips and information from the American Diabetes Association. In the middle of a yearlong backpacking trip around the world with his wife, Oren Liebermann is teaching English to young Buddhist monks in Pokhara, Nepal, when his body begins to fail him. He is constantly thirsty and exhausted, and by the time he steps on a scale, he has lost forty-five pounds. At a local clinic, a doctor gives him a diagnosis that will change his life forever: “I’m sorry to tell you, my friend, that you are a diabetic.” Devastated, Liebermann is trapped in a freezing hospital room, trying to recover enough to fly home. His friends and family urge him to call off the rest of his trip. He had quit his job as a TV news reporter for this dream-come-true journey, but the nightmare diagnosis has thrown his world into disarray. However, Liebermann and his wife, Cassie, make a decision. They have an adventure to finish, and he has the rest of his life to live. Bold, raw, and poignantly candid, The Insulin Express tells the story of what happens when the best-made travel plans are subject to the ever-present chaos of life, and how a major setback can turn into the opportunity of a lifetime. Despite struggling with a chronic disease that almost kills him in the Himalayas, Liebermann hikes along the Great Wall of China, conquers the Inca Trail to Machu Picchu, and sips cobra whiskey in Laos. What begins as a travel chronicle across thirty countries transforms into a single journey of resilience and self-discovery—going from hopelessly lost and then wonderfully found.
