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Insulin
Deficiency, Excess and Resistance in Human Disease
1st Edition - January 18, 2024
Editor: Andrew J. Krentz
Language: English
Paperback ISBN:9780323917070
9 7 8 - 0 - 3 2 3 - 9 1 7 0 7 - 0
eBook ISBN:9780323985697
9 7 8 - 0 - 3 2 3 - 9 8 5 6 9 - 7
Insulin: Deficiency, Excess and Resistance in Human Disease provides an overview of the role of insulin in the pathogenesis of prevalent non-communicable diseases such as obesit…Read more
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Insulin: Deficiency, Excess and Resistance in Human Disease provides an overview of the role of insulin in the pathogenesis of prevalent non-communicable diseases such as obesity, type 2 diabetes, cardiovascular disease, and cancer, along with a comprehensive review of insulin replacement therapies and novel cardioprotective and insulin-sensitizing drugs. Notable advances in precision diagnosis and therapy for single gene subtypes of diabetes in recent years are also discussed.
The discovery of insulin and its lifesaving introduction into clinical practice is one of the most celebrated accomplishments of medical science. However, despite decades of progress and major technical advances, the goal of providing insulin replacement therapy that truly mimics normal physiology remains elusive.
Presents etiology and pathogenesis of insulin deficiency, insulin excess and insulin resistance in a wide spectrum of human diseases, ranging from rare to highly prevalent disorders
Discusses the latest developments in the diagnosis and management of insulin-related disorders and prospects for future developments
Explores the increasingly complex pharmacological landscape that comprises a bewildering range of drug-based interventions
Cover image
Title page
Table of Contents
Copyright
List of contributors
Foreword
Preface
Section 1: Normal physiology: insulin secretion and insulin action
Chapter 1. Insulin biosynthesis and release in health and disease
Abstract
Insulin biosynthesis
Insulin release
Concluding remarks
References
Chapter 2. Classic metabolic actions of insulin in humans: from physiology to disease and novel pharmacotherapeutics
Abstract
Introduction
Insulin structure and synthesis
Physiological actions of action
Clinical states of acute metabolic decompensation associated with insulin deficiency
References
Chapter 3. Nonclassic effects of insulin: physiological actions on the vascular tissues and pathophysiological contributions to atherogenesis, mitogenesis, and restenosis
Abstract
Introduction
Overview of insulin and cardiovascular disease
Effects of insulin on the vascular tissues and atherogenesis
Effects on insulin on blood flow and the vascular wall
Effects on endothelial cells and selective insulin resistance
Effects on vascular smooth muscle cells
Effects on thrombosis
Summary
Acknowledgments
References
Section 2: Role of insulin in human disease
Chapter 4. Type 1 diabetes pathogenesis: lessons learned and remaining questions
Abstract
Clinical scenario
Role of genetics in the pathogenesis of type 1 diabetes
References
Chapter 5. Insulin therapy: a century of continuing progress
Abstract
Introduction
The long way to insulin therapy
Evolution of insulin therapy over 100 years
Insulin analogs
Conclusions
Acknowledgments
Conflict of interest
References
Chapter 6. Treatment and prevention of type 1 diabetes in the 21st century
Abstract
Introduction
Prediction
Prevention of decline in β-cell function
Contemporary management of type 1 diabetes
Replacement of β cells
References
Chapter 7. Differentiation of diabetes by pathophysiology: focus on insulin deficiency versus insulin resistance
Abstract
Introduction
Type 2 diabetes
Type 1 diabetes
Diagnosis of MODY
Treatment of MODY
Other approaches to classification
Subclassification of people at risk for type 2 diabetes
Ethnicity considerations
Summary and conclusions
References
Section 2b: Syndromes of insulin excess
Chapter 8. Congenital hyperinsulinism
Abstract
Introduction
Epidemiology
Pathophysiology
Perinatal stress-induced hyperinsulinism
Congenital hyperinsulinism
Syndromic hyperinsulinism
Diagnosis
Management
Outcomes
Conclusion
References
Chapter 9. Hypoglycemic disorders in adults
Abstract
Clinical manifestations
Management
Postgastric bypass hypoglycemia
NIPHS
Recurrence, survival, and surveillance
Conclusion
References
Section 2c: Insulin resistance in human disease
Chapter 10. Obesity and insulin resistance: pathophysiology guiding precision therapy
Abstract
Introduction
Insulin resistance: substrates and genetics
Effect of adiposity on hepatic and extrahepatic insulin action
Insulin suppression of lipolysis
Insulin suppression of glycogenolysis and gluconeogenesis
Splanchnic glucose uptake and splanchnic glucose production
Nocturnal regulation of glucose homeostasis in type 2 diabetes
Therapeutic approaches
Summary and conclusions
References
Chapter 11. The cardiometabolic syndrome and vascular disease: pivotal role of insulin
Abstract
Introduction
Pathophysiology of atherosclerosis
Role of insulin resistance in atherosclerosis
Role of insulin resistance and hyperglycemia in microvascular disease
Genetic and epigenetic associations with insulin resistance and cardiovascular disease
Clinical features of cardiometabolic syndrome and insulin resistance
Prevention of diabetes and ASCVD
Medical therapies for primary prevention and treatment of metabolic syndrome components: a brief overview
Treatment of type 2 diabetes mellitus
Conclusions
References
Chapter 12. Insulin resistance, hyperinsulinemia, and cancer: pathogenic considerations and therapeutic opportunities
Abstract
Introduction
Visceral adipose tissue, inflammation, and insulin resistance
Insulin resistance, hyperinsulinemia and cancer: epidemiologic links
Insulin resistance, hyperinsulinemia, and cancer: mechanisms
Therapeutic considerations
Summary
Funding
Conflict of interest
References
Chapter 13. Insulin and neurodegenerative diseases
Abstract
Introduction
The brain is an insulin-sensitive organ
Receptor expression in the brain
Insulin production and transport across the blood-brain barrier
Insulin and insulin-like signaling in the brain
Control of cellular metabolism by insulin
Abnormalities associated with dysregulated insulin/IGF-1 signaling
AD brains show insulin and IGF1 resistance
Sources of brain insulin resistance in neurodegeneration
Diabetes interventions for the prevention or treatment of neurodegeneration
Conclusions
References
Chapter 14. Nonpharmacological, pharmacological, and surgical options for obesity-related cardiometabolic disorders
Abstract
Background
Nonpharmacological approaches
Pharmacological approaches
Surgical approaches
Clinical impact of weight reduction from obesity surgery
Conclusion
References
Chapter 15. Syndromes of severe insulin resistance: lessons from nature
Abstract
Introduction
Syndromes of severe insulin resistance
Conclusions
References
Index
No. of pages: 444
Language: English
Edition: 1
Published: January 18, 2024
Imprint: Academic Press
Paperback ISBN: 9780323917070
eBook ISBN: 9780323985697
AK
Andrew J. Krentz
Andrew Krentz has four decades of clinical and translational research experience in metabolic, endocrine and related cardiovascular disorders.
His expertise in the life sciences includes preclinical and early-phase clinical drug development; he has personally contributed translational medical innovations to endocrinology clinical practice. He is actively involved in projects focused on precision diagnostics and therapeutics, digital healthcare, and healthy longevity that bridge the academic-industry spaces.
Beyond his expertise in diabetes and endocrinology, he is accredited as a clinical specialist by the European Society for Hypertension and is a member of the Medical, Scientific & Research Committee of Heart UK. He is President-Elect of the Vascular, Lipid & Metabolism section of the Royal Society of Medicine as well as being a member of the European Group for the Study of Insulin Resistance (EGIR) and the Diabetes & Cardiovascular Study Group of the European Association for the Study of Diabetes (EASD).
He has authored more than 200 scientific publications and founded the journal Cardiovascular Endocrinology & Metabolism and serves as Editor-in-Chief.
Affiliations and expertise
Visiting Professor, Institute of Cardiovascular and Metabolic Research, University of Reading, UK