Early Diabetes: Definition, Present Concept.- Early Diabetes. Concept. Terminology.- Early Stages of Diabetes: Definitions and Present Concepts.- Prediabetes in the Pima Indians.- The Prognosis of Insulin Dependent Diabetes Mellitus and the Importance of Supervision.- Discussion.- Genetic Influences on Islet Cell Function.- HLA System.- HLA and the Genetic Aspects of the Predisposition to Juvenile Diabetes Mellitus. A Follow-Up.- HLA Studies in Diabetics.- Discussion.- Familial Patterns of Inheritance.- On the Genetic Heterogeneity of Juvenile Hyperglycemia.- Familial Patterns of Inheritance of Diabetes Mellitus. Maturity-Onset Type Diabetes of Young People (MODY).- Discussion.- Metabolic Aspects of Islet Cell Function.- Phosphate Translocations During Secretory Stimulation of Pancreatic Islets.- The Role of Phosphoenolpyruvate and Lactate Production in Insulin Secretion.- Effects of Insulinotropic Agents on Cationic Fluxes in Islet Cells.- Glucose-Induced Changes of the Membrane Potential of Pancreatic B-Cells: Their Significance for the Regulation of Insulin Release.- Discussion.- Abnormal Development of the Pancreas.- Effect of Maternal Carbohydrate Intolerance on the Development of the Autonomic Innervation of the Fetal Rat Pancreas.- Discussion.- Environmental Factors Influencing Islet Cell Function.- Nutritional.- Suppression of Insulin Secretion by Protein Deprivation in Obesity.- Discussion.- Viruses.- Virus-Induced Diabetes Mellitus: Infection of Mice with Variants of Encephalomyocarditis Virus, Coxsackievirus B4, and Reovirus Type 3.- Autoimmunity.- Immunological Aspects of Diabetes Mellitus.- Detection and Possible Functional Influence of Antibodies Directed Against the Pancreatic Islet Cell Surface.- Discussion.- Patterns of Insulin Secretion.- Heterogeneity of Insulin Responses in Maturity-Onset Type Diabetes (MOD) and in Maturity-Onset Type Diabetes of Young People (MODY).- Progression of Early Diabetes.- Insulin Resistance and Insulin Secretion in Patients with Chemical Diabetes: Implications Concerning the Pathogenesis of Idiopathic Diabetes Mellitus.- Inquiries into the Pathogenesis of Gestational Diabetes.- Effect of Intravenous Glucose, Leucine and Arginine on Concentration of Insulin in Maternal and Umbilical Cord Serum.- Discussion.- Mechanism of Salvaging Beta Cell Function.- Beta Cell Dysfunction in Maturity-Onset Diabetes: Reversible Loss of Glucose-Induced Insulin Secretion with Retention of Response to Arginine.- Improvement of Insulin Secretion in Diabetics by a Prostaglandin Synthesis Inhibitor.- Discussion.- Diet Therapy.- Decreased Food Intake.- Effect of Diet Limitation on Development of Diabetes in Non-Hyperphagic Prediabetic Chinese Hamsters.- Riboflavin in CHO Metabolism.- The Role of Riboflavin in Carbohydrate Metabolism.- Discussion.- Responses to Different Complex Carbohydrates.- Effect of Variations in Carbohydrate Intake on Plasma Glucose, Insulin and Triglyceride Responses in Normal Subjects and Patients with Chemical Diabetes.- High Carbohydrate, High Fiber Diets for Patients with Diabetes.- Dietary Fiber and Diabetic Therapy: A Progressive Effect with Time.- Discussion.- High Myoinositol.- Dietary myo-Inositol and Diabetic Neuropathy.- Discussion.- Long Term Treatment with Insulin.- Animals.- Effect of Insulin Treatment on the Mesangial Structure of KK Mice.- Humans.- Insulin Treatment for Adult Onset Diabetes: A Report of the University Group Diabetes Program.- Refuting the UGDP Conclusion That Insulin Treatment Does Not Prevent Vascular Complications in Diabetes.- Discussion.- New Insulins.- New Synthetic Insulins.- Differential Response of Insulin-Dependent Diabetics to Infusions of Bovine and Highly-Purified Porcine Insulins: A Preliminary Report.- Discussion.- Enzyme Inhibitors.- Delay of Carbohydrate Absorption by Inhibitors of Intestinal ?-Glucosidases.- Inhibition of Polyol Pathway Activity in Diabetic and Galactosemic Rats by the Aldose Reductase Inhibitor CP-45,634.- Discussion.- Mechanism of Action of Oral Compounds.- Genetic Control of Tolbutamide Metabolism in Humans.- Insulin Resistance in Patients with Insulin Independent Diabetes Mellitus: Partial Amelioration by the Sulfonylurea Glipizide.- Discussion.- Long Term Treatment with Oral Compounds.- Animals.- Diabetic Glomerulosclerosis in KK Mice and Its Prevention by Glyburide and Pyridinolcarbamate.- Discussion.- Humans.- Long Term Treatment of Asymptomatic Diabetes.- Metabolic Fate, Vascular Outcome and the Effect of Treatment in Borderline Diabetics.- Long-Term Treatment of Subjects with Borderline Glucose Tolerance.- Discussion.- New Oral Agents: Comparisons.- Glipizide: A New Second Generation Sulfonylurea.- Effect of the Oral Hypoglycemic Agent Pirogliride Tartrate on Insulin and Glucagon Secretion In Vivo and In Vitro.- Gliclazide in the Treatment of Diabetic Retinopathy.- Discussion.- Exercise.- The Effect of Repetitive Exercise on Daily Control of Glycemia in Insulin-Dependent Diabetic Patients.- Discussion.- Substitution of Islet Cell Function.- Transplant.- Isolation and Preservation In Vitro of Human Pancreatic Islets Intended for Transplantation.- The Development, Enhancement and Reversibility of Diabetic Glomerulopathy.- Discussion.- Newer Delivery Systems.- Substitution of Islet-Cell Function with "Open-Loop" Insulin Infusion Systems.- Newer Insulin Delivery Systems: Continuous Subcutaneous Insulin Infusion.- Discussion.- Mechanical Devices.- Substitution of Islet Cell Function by Mechanical Device: Extracorporeal Artificial Pancreas.- Glycemic Normalization Using a Preprogrammed Insulin Delivery Device in Unrestrained Diabetic Dogs.- Discussion.- List of Participants.
To obey the precepts of therapeutic rationality, we should avoid treating the "effect" when there is a way to attack the cause. But what is the cause of diabetes? Diabetes is a molecular disease, that is, a disease in which important cellular components are seriously impaired. Eventually, the activities or the products arising from the impairment find expression in various ways, finally culminating in the abnormalities of diabetes. How early is early enough to attempt to delay this sequence of events? What will provide us with the basis to explore ways and means of halting the progression of the pathological process? What are the new approaches for the treatment of early diabetes? The Fourth International Symposium on Early Diabetes, sponsored by the Diabetes Center of the New York Medical College, held in Algarve, Portugal in November 1978, from which this book evolved, attempted to answer some of these questions. A list of the participants, including their affiliations, will be found preceding the index. Rafael A. Camerini-Davalos v Acknowledgments To our sponsors, U.S.V. Pharmaceutical Corp., Pfizer Pharmaceuticals, Ames Company, Hoechst, Frankfurt; supporters, Boehringer, Manheim, Laboratoires Servier, Nordisk Laboratory, The Upjohn Company, Eli Lilly and Company, F. Hoffman La Roche; and contributors, Bayer A. G. Leverkusen, McNeil, Novo Research Institute, ICI Belgium, Hope for Diabetics Foundation, New York, we express our appreciation for the financial support which made possible the Fourth International Symposium on Early Diabetes. THE ORGANIZING COMMITTEE Rafael A. Camerini-Davalos, M.D.
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