Nutritional and Therapeutic Interventions for Diabetes and Metabolic Syndrome - 1st Edition - ISBN: 9780123850836, 9780123850843

Nutritional and Therapeutic Interventions for Diabetes and Metabolic Syndrome

1st Edition

Editors: Debasis Bagchi Sreejayan Nair
eBook ISBN: 9780123850843
Hardcover ISBN: 9780123850836
Imprint: Academic Press
Published Date: 31st January 2012
Page Count: 544
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Diabetes mellitus affects approximately 20 million people in the US, or nearly 7% of the population. It is expected to increase by 70% within the next 25 years, and numerous epidemiologic studies have demonstrated that type 2 diabetes increases the risk of cardiovascular morbidity and mortality. It is estimated to cost over $92 billion in health care costs and lost productivity. The increased risk is due to the detrimental vascular effects of prolonged exposure to a hyperglycemic, oxidant-rich environment yielding associated cardiovascular risk factors: atherosclerosis, hypertension and clotting abnormalities. Hypertension and dyslipidemia in diabetic patients produces substantial decreases in cardiovascular and microvascular diseases.

Nutritional and Therapeutic Interventions for Diabetes and Metabolic Syndrome provides an overview of the current epidemic, outlines the consequences of this crisis and lays out strategies to forestall and prevent diabetes, obesity and other intricate issues of metabolic syndrome. The contributing experts from around the world give this book relevant and up-to-date global approaches to the critical consequences of metabolic syndrome and make it an important reference for those working with the treatment, evaluation or public health planning for the effects of metabolic syndrome and diabetes.

Key Features

  • Scientific discussion of the epidemiology and pathophysiology of the relationship between diabetes and metabolic syndrome
  • Includes coverage of Pre-diabetes conditions plus both Type I and Type II Diabetes
  • Presents both prevention and treatment options


Nutritionist researchers and practitioners, food microbiologists and toxicologists, and pharmacologists, public health officials, health professionals, endocrinologists, nurses and general practitioners

Table of Contents




SECTION I. Epidemiology and Overview

Chapter 1. Type 1 Diabetes Mellitus






Clinical Presentation




Prevention and Intervention Trials

Chapter 2. Overview of Type 2 Diabetes

Definition and Diagnostic Criteria

Epidemiology of Type 2 Diabetes and Its Complications

Genetic Risk Factors for Type 2 Diabetes

Risk Factors and Screening for Type 2 Diabetes

Diabetes in Pregnancy: Implications for Mother and Offspring

Evidence for Metabolic Programming of Diabetes in Early Life

Early Intervention in Type 2 Diabetes

Clinical Management of Type 2 Diabetes

Treatment Guidelines

Nutrition and Lifestyle Intervention

Pharmacological Treatments

Bariatric Surgery

Economic Impact of Type 2 Diabetes

Future Directions

Chapter 3. Pathogenesis of Type 2 Diabetes—A Comprehensive Analysis


Genetics of Type 2 Diabetes

Maintenance of Normal Glucose Homeostasis

Impaired Glucose Homeostasis in Patients with Type 2 Diabetes

Mechanistic Actions Which Lead to Progressive β-Cell Failure and Type 2 Diabetes


Chapter 4. Managing the Broad Spectrum of Type 2 Diabetes


Evolving Pathophysiology of Type 2 Diabetes

Altering The Progression of Type 2 Diabetes

Need for Early Intervention

Aggressive Management After Diagnosis

How Low Do We Go for Glycemic Control?

Treatment Options

Self-Management Education

Lifestyle Modification

Meal Planning

Physical Activity

Pharmacological Treatment

When to Adjust Treatment

Initiating Insulin Therapy

Insulin Delivery Devices


Chapter 5. Prediabetes





Recognition of Enhanced Risk

Means for Cardiometabolic Risk Factors



Chapter 6. Obesity and Type 2 Diabetes in Youths

Obesity: The 21st Century Epidemic

Metabolic Complications of Obesity in Children and Adolescents

Type 2 Diabetes in Children and Adolescence: a New Frightening Epidemic?

Pathogenesis of Type 2 Diabetes in Obese Children and Adolescents

Role of Ectopic Fat Deposition in the Pathogenesis of Insulin Resistance

The β-Cell in the Storm of Insulin Resistance

Therapy of Type 2 Diabetes in Youths

Conclusions and Future Perspectives

Chapter 7. Diabetes Pathophysiology


Dietary Treatment for Diabetes at The Turn of The 20th Century

Dietary Recommendations

Glucose Control

Low-Carbohydrate Diets


Chapter 8. Diabetes Mellitus


Nursing Perspective

Prevention and Management of Diabetes by Nursing Professionals



Chapter 9. Roles of Environmental Pollution and Pesticides in Metabolic Syndrome and Diabetes


Dioxins, Furans and Polychlorinated Biphenyls



Air Pollution

Toxic Metals

Summary and Future Research


Chapter 10. Preventing Diabetes with Diet and Exercise


Diet and Exercise Interventions to Prevent Diabetes

Weight Loss and Exercise Both Contribute to Reducing Diabetes Risk

What Type of Diet Best Encourages Weight Loss?

The Role of Exercise


SECTION II. Types of Diabetes and its Correlation with other Diseases

Chapter 11. The Role of Insulin Resistance in the Cardiorenal Syndrome


Epidemiologic Evidence

Pathophysiologic Links Between Insulin Resistance, Obesity, and the Cardiorenal Syndrome

Microalbuminuria in the Cardiorenal Syndrome

Insulin Resistance in the Cardiorenal Syndrome

Oxidative Stress and Endoplasmic Stress in the Cardiorenal Syndrome

Inappropriate Activation of the Raas

Conclusions and Perspectives

Chapter 12. An Overview of Diabetic Nephropathy


Clinical Features of Diabetic Nephropathy

Involvement of Metabolic Factors in Diabetic Nephropathy

Role of Ras in Diabetic Nephropathy


Chapter 13. An Overview of Diabetes and Ocular Health


Epidemiology/Risk Factors


Clinical Assessment



Chapter 14. An Overview of Diabetic Retinopathy




Randomized Clinical Trials

Treatment Guidelines


Chapter 15. Role of Peripheral Neuropathy in the Development of Foot Ulceration and Impaired Wound Healing in Diabetes Mellitus


Diabetic Neuropathy

Diabetic Foot Ulcers

Wound Healing


Chapter 16. An Overview of Gestational Diabetes




Screening and Diagnosis

Effects of Untreated Gestational Diabetes

Effectiveness of Treatment

Glucose Monitoring

Lifestyle Modification—Diet and Exercise

Insulin Therapy

Oral Hypoglycemic Agents

Fetal Surveillance

Timing and Mode of Delivery

Follow-Up Testing and Long-Term Implications


SECTION III. Molecular Insights of Diabetes and Metabolic Syndrome

Chapter 17. Gene–Environment Interaction in the Pathogenesis of Type 2 Diabetes


The Genetic Component

The Environmental Component



Chapter 18. Epigenetics in the Pathophysiology of Type 2 Diabetes


An Overview of Epigenetic Mechanisms

Epigenetic Modifications in Patients with Type 2 Diabetes

Aging and Epigenetic Modifications

Environmental Factors and Epigenetic Impact on Type 2 Diabetes

Intrauterine Environment and Epigenetic Modifications

Genetics and Epigenetic Modifications


Chapter 19. Targeting the Metabolic Syndrome and Type 2 Diabetes by Preventing Inflammation


Il-1β Links Obesity and Diabetes

Activation of The NLRP3 Inflammasome in Fat, Liver and Islets Results in Il-1β Production

Il-1β and β-Cell Transcriptional Regulation

Il-1β and Genetic Predisposition

The Dysbalance of Il-1β and Il-1Ra in Diabetes54

Blocking Il-1β Signals in vivo Inhibits Diabetes Progression54


Chapter 20. Interleukin-18 in Metabolic Syndrome and Diabetes


The Biological Effect of Interleukin-18 Depends on the Local Cytokine Milieu

Interleukin-18 is Closely Associated with the Metabolic Syndrome and its Components

Interleukin-18 is Associated with the Initiation and Complications of Diabetes

Interleukin-18 and Cardiovascular Disease

Potential Mechanisms for the Role of Interleukin-18 in Diabetes, Metabolic Syndrome and Atherosclerosis

Interleukin-18 and Effect of Lifestyle Interventions


SECTION IV. Pathophysiology

Chapter 21. Sleep, Hypertension, and Diabetes

Background and Introduction

Sleep and Hypertension

Sleep and Pulmonary Arterial Hypertension (PAH)


Sleep and Type 2 Diabetes


Sleep, Pregnancy-Induced Hypertension, Pre-Eclampsia, and Gestational Diabetes

Prevention and Public Health Importance


Chapter 22. Roles of Pancreatic Cell Functions, Liver, Skeletal Muscle, and Adipose Tissues in Diabetes and Metabolic Syndrome


Adipose Tissue

Why is Visceral Fat More Metabolically Dangerous?


Skeletal Muscle



Key Concepts (Figure 22.4)


Chapter 23. Liver Disease


Non-Alcoholic Fatty Liver Disease: Current Concepts and Natural History

Introducing Liver Check-Up in Diabetes

Conclusions and Future Prospects


SECTION V. Prevention and Treatment 1: Diet, Exercise, Supplements and Alternative Medicines

Chapter 24. Antioxidants, Healthy Diet, and Diabetes


What is Oxidative Stress? ROS and RNS

General Aspects of Antioxidant Therapy

Antioxidant Molecules and Diabetes

Healthy Diet

Chapter 25. Molecular Mechanisms of Diabetes Prevention by Structurally Diverse Antioxidants


ROS-Mediated Mechanisms of T2DM

Molecular Mechanisms and Therapeutic Potential of Chosen Antioxidants


Chapter 26. Cardioprotective Roles of Selenium in Diabetes

Introduction: Selenium and Selenoproteins

Selenium Effects on the Control of Cardiac Activity

Effects of Selenium Supplementation in Diabetic Hearts

Concluding Remarks

Chapter 27. Exercise and Physical Activity in the Prevention of Diabetes and Metabolic Syndrome



Insulin Resistance

Evidence on the Role of Lifestyle Interventions in the Prevention of Type 2 Diabetes

The Effect of Exercise on Insulin Resistance

The Role of Aerobic and Resistive Exercise in Preventing Diabetes

Metabolic Syndrome

Evidence on the Role of Exercise and Physical Activity in the Prevention of Metabolic Syndrome

Exercise Prescription


Chapter 28. An Overview on Nutraceuticals and Herbal Supplements for Diabetes and Metabolic Syndrome


Bitter Melon (Momordica Charantia)

Cinnamon (Cinnamomum Cassia)

Fenugreek (Trigonella Foenum-Graecum)

Gymnema (Gymnema Sylvestre)

Prickly Pear Cactus (Nopal Species) (Opuntia Streptacantha and Fulginosa)

Other Nutraceuticals Used for The Management of Diabetes and Metabolic Syndrome


Chapter 29. Therapeutic Effect of Fucoxanthin on Metabolic Syndrome and Type 2 Diabetes


Fucoxanthin and its Absorption Mechanism

Antiobesity Effect of Fucoxanthin

Lowering Effect of Fucoxanthin on Blood Glucose

TNF-α, IL-6, MCP-1, and PAI-1 as Target Adipokines of Fucoxanthin

Regulatory Effect of Fucoxanthin on Pro-Inflammatory Adipokines

Effect of Fucoxanthin on GLUT4 Expression in Muscle


Chapter 30. Beneficial Effects of Chromium(III) and Vanadium Supplements in Diabetes




Chapter 31. Role of n-6 and n-3 Polyunsaturated Fatty Acids in Type 2 Diabetes


Nutritional and Biochemical Basis of N-6 and N-3 Polyunsaturated Fat Metabolism

Fatty Acid Quality and Type 2 Diabetes

Fatty Acid Quality and Insulin Resistance

Fatty Acid Quality and Insulin Secretion

Dietary Fat Recommendations in Type 2 Diabetes


Chapter 32. Effects of Supplemental Fiber in Type 2 Diabetes Mellitus






Chapter 33. The Effects of Resveratrol on Diabetes and Obesity


Resveratrol: A Multifunctional Compound

Resveratrol and Diabetes

Resveratrol in Diabetic Cardiomyopathy

Effects of Resveratrol on Endothelial Cell Function and Vascular Disease

Resveratrol and Renal Effects of Diabetes

Resveratrol in Neuroprotection

Resveratrol and Fat Metabolism

Other Beneficial Effects


Chapter 34. Meal Plans for Diabetics


Calorie Intake and Energy Balance

Caloric Intake and Health Consequences

Glycemic Index: Definition and General Characteristics

Metabolic, Biochemical, and Health Effects

Chapter 35. and Metabolic Diseases


T2DM and Cluster of Metabolic Diseases

Epidemiology, Mortality, Morbidity, and Global Economic Burden

Ayurveda Understanding of Metabolic Diseases

Pathogenesis of T2DM

Oxidative Stress and Advanced Glycated End Products (AGE)

Approaches for Studying Herbals

Herbal Market: Expectations and Confusion from the Known

New Strategies for Integrated Research on Metabolic Diseases Based on Ayurveda


SECTION VI. Prevention and Treatment 2: Drugs and Pharmaceuticals

Chapter 36. The Evolution of Glucose-Lowering Drugs for Type 2 Diabetes


Well-Established Drugs

New Drugs for Type 2 Diabetes

Drugs Currently in Development for Type 2 Diabetes


Chapter 37. Antidiabetic Drugs for Elderly Population


Non-Pharmacological Therapy

Drug Therapy


SECTION VII. Diabetes in Animals and Treatment

Chapter 38. Diabetes Mellitus in Animals


Diabetes in Dogs and Cats

Treatment of Diabetes Mellitus in Cats and Dogs

Monitoring Diabetic Animals

Chapter 39. Overview of Diabetes Treatment in Animals


Types of Diabetes

Clinical Features



Diabetic Remission

Monitoring of Glycemic Control


Diabetes in Horses

APPENDIX. Living with Diabetes: A Running Commentary


Color Plates


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© Academic Press 2012
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About the Editor

Debasis Bagchi

Debasis Bagchi, PhD, MACN, CNS, MAIChE, received his Ph.D. in Medicinal Chemistry in 1982. He is a Professor in the Department of Pharmacological and Pharmaceutical Sciences at the University of Houston College of Pharmacy, Houston, TX, and Chief Scientific Officer at Cepham Research Center, Piscataway, NJ, Adjunct Faculty in Texas Southern University, Houston, TX. He served as the Senior Vice President of Research & Development of InterHealth Nutraceuticals Inc, Benicia, CA, from 1998 until Feb 2011, and then as Director of Innovation and Clinical Affairs, of Iovate Health Sciences, Oakville, ON, until June 2013. Dr. Bagchi received the Master of American College of Nutrition Award in October 2010. He is the Past Chairman of International Society of Nutraceuticals and Functional Foods (ISNFF), Past President of American College of Nutrition, Clearwater, FL, and Past Chair of the Nutraceuticals and Functional Foods Division of Institute of Food Technologists (IFT), Chicago, IL. He is serving as a Distinguished Advisor on the Japanese Institute for Health Food Standards (JIHFS), Tokyo, Japan. Dr. Bagchi is a Member of the Study Section and Peer Review Committee of the National Institutes of Health (NIH), Bethesda, MD. He has published 321 papers in peer reviewed journals, 30 books, and 18 patents. Dr. Bagchi is also a Member of the Society of Toxicology, Member of the New York Academy of Sciences, Fellow of the Nutrition Research Academy, and Member of the TCE stakeholder Committee of the Wright Patterson Air Force Base, OH. He is also Associate Editor for the Journal of Functional Foods, Journal of the American College of Nutrition, and the Archives of Medical and Biomedical Research, and is also serving as Editorial Board Member of numerous peer reviewed journals, including Antioxidants & Redox Signaling, Cancer Letters, Toxicology Mechanisms and Methods, and The Original Internist, among others.

Affiliations and Expertise

University of Houston College of Pharmacy, TX, USA

Sreejayan Nair

Dr. Sreejayan Nair is a Professor of Pharmacology and the Associate Dean for Research in the School of Pharmacy, College of Health Sciences, University of Wyoming. He also serves as the Director of the interdisciplinary Biomedical Sciences Graduate Program in the University of Wyoming. Dr. Nair earned his bachelors, masters and PhD degree in Pharmaceutical Sciences from the College of Pharmaceutical Sciences, Manipal, India. He received his post-doctoral trainings at the Department of Medicine-II, Ludwig Maximillians University, Klinikum Grosshadern, Munich, Germany, and at the Department of Physiology, University of Tennessee Health Sciences Center, Memphis, TN. His research interests are diabetes and cardiovascular disease. He has published over 75 research papers in peer-reviewed journals and presented at various national and international conferences. His research has been funded by the American Heart Association, American Diabetes Association, and the National Institutes of Health. He has co-edited three books related to diabetes and cardiovascular disease. He is a Fellow of the American College of Nutrition.

Affiliations and Expertise

School of Pharmacy, University of Wyoming, Laramie, WY, USA

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