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Type 1 Diabetes: Etiology and Treatment

Sperling MA, ed. 591 pages. Totowa, NJ: Humana Pr; 2003. $165.00. ISBN 0896039315. Order phone 973-256-1699. Field of medicine: Type 1 diabetes mellitus. Format: Hardcover book. Audience: Endocrinologists, internists, pediatricians, and clinical trainees in these disciplines; scientists establishing a contextual basis for research; and those who give academic seminars. Purpose: To fuse contemporary basic and clinical investigation with practical issues (such as advances in technology) as a resource to those who research and practice in type 1 diabetes. Content: This book extends P. Michael Conn's ambitious Contemporary Endocrinology series. Sperling, an eminent pediatric endocrinologist, has arranged the 29 chapters into 4 sections on etiology, management, and long-term complications. Leading national and international authorities and research groups wrote the chapters. Highlights: The complex interactions of genetics, autoimmunity, and insulin secretion are covered thoroughly and would gainfully challenge most experts in these fields. Of particular interest are chapters on type 1 diabetes in the autoimmune syndromes and on the molecular basis of diabetic complications (by Michael Brownlee). The refreshing chapters Living with Diabetes and Nutritional Management feature contributions of diabetes educators. The last 4 chapters are excellent and could have made up a fifth section on -cell and islet replacement. Limitations: Given recent advances, basic information is difficult to assimilate at times but can be stimulating if clinical relevance is apparent. Some cross-referencing in the form of footnotes among chapters would have been appreciated. In some chapters, tables are not always sourced. Information on the use of NaHCO3 for treating diabetic ketoacidosis is confusing, and the fluid volume replacement schedule for children lacks detail. Duplicated information appears in 2 chapters on hypoglycemia. Only brief references are made to therapeutic possibilities offered by novel agents such as glucokinase stimulators glucagon-like peptide-1 and amylin. The book could have expanded on exciting developments in closing the loop of insulin feedback on changing levels of blood glucose. Related readings: Schade and colleagues' Intensive Insulin Therapy (Elsevier Science, 1983) describes concepts that are much easier to implement today given our greatly enhanced technology. Web- and journal-based data provided by the Diabetes Control and Complications Trial will remain essential to those caring for patients with type 1 diabetes. Reviewer: N. Wilson Rodger, MD, University of Western Ontario, London, Ontario.