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Medical Management of Diabetes and Heart Disease

Sobel BE, Schneider DJ, eds. 292 pages. New York: Marcel Dekker; 2002. $125.00. ISBN 0824707451. Order phone 212-696-9000. Field of medicine: Endocrinology and cardiology. Format: Hardcover book. Audience: Specialists and primary care physicians who manage patients with diabetes. House officers and nonphysician providers will also find the book insightful regarding the complex link between diabetes and cardiovascular disease. Purpose: To provide the reader with an understanding of the pathophysiology of diabetic heart disease, to develop risk reduction strategies, and to provide drug and nondrug management options for the common cardiovascular complications of diabetes. Content: The book contains 16 chapters. The first chapter summarizes the metabolic defects of diabetes that contribute to cardiovascular disease and discusses targeted treatment strategies. The remaining chapters address cardiovascular disease in type 1 and type 2 diabetes; insulin resistance; syndrome X; hypertension, dyslipidemia, and the coagulationfibrinolytic system as contributing factors; the polycystic ovary syndrome; detection and diagnosis of heart disease; the management of diabetes and comorbid cardiovascular disease; the risks and benefits of coronary revascularization; and nondrug risk reduction strategies and targets for future therapies. Highlights: The book is appropriate for both veteran and less experienced clinicians. The chapters are pertinent, well written, easy to understand, and amply referenced or cross-indexed. The book's strength lies in the authors' attention to blending present-day basic science and clinical research data to explain the complex relationships shaping the development of diabetic cardiovascular disease. The chapter on coronary revascularization is particularly noteworthy. Limitations: Despite its title, the book is primarily devoted to characterizing the pathophysiologic basis for diabetic heart disease. Inconsistent attention is given to specific therapeutic, dosing, and monitoring issues or recommendations. Several of the figures require enlargement or revision to enhance understanding (for example, figure 3 on page 40; figure 1 on page 234). On page 77, it's stated that -blockers can also cause vasospasm in asthmatic patients, an obvious confusion with bronchospasm. Since the book's publication, several research trials and guidelines have been published or changed. This new information could affect interpretation of the book's present recommendations (for example, blood pressure goals). Related reading: The only comparable secondary reference is Garber's Type 2 Diabetes in Endocrinology and Metabolism Clinics of North America (WB Saunders, 2001). Although the subject matter of that book is more diverse, the contributing authors address many of the same issues. Given the shortcomings of published reference textbooks, the primary literature remains the best option for readers who want to stay current with the changing landscape of diabetes and heart disease. Reviewer: Charles D. Ponte, PharmD, Departments of Clinical Pharmacy and Family Medicine, West Virginia University, Schools of Pharmacy and Medicine, Morgantown, West Virginia.