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Textbook of Diabetes
Editors:  John C. Pickup and Gareth Williams
Pages:  1520, 2 volume set

Blackwell Publishing  2002

Reviewed By:  Joseph Russo, M.S.

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Our Review:

     Textbook of Diabetes 3rd Edition by Pickup & Williams is one of the foremost texts covering the group of metabolic disorders encompassing this devastating disease.  This edition in particular can be characterized by its concise writing and rich illustration program which combine to make the book a pleasure to read.  Since diabetes cannot be understood as a single disease state and has such pervasive systemic effects, the editors have done a fine job of organizing the large body of knowledge that is currently in existence.  This organization is truly a testament to the stated goals of the editors in the preface of the text; to make the information accessible and easy to read even for the non-specialist.  In the preface the editors also share their view of the role of textbooks in these days of the computer-based reference, to provide a ready reference on a wide range of topics at the fingertips of the reader.  This they have done with great success.

     Information is logically divided between the two volumes for ease of reference.  Volume I of the textbook is focused on the etiology and general pathophysiology associated with both type I and type II diabetes.  Additionally, other types of diabetes-like syndromes causing severe insulin resistance are also discussed.  Volume 2 is concerned largely with the resultant pathology from diabetes throughout the body.  Each chapter is preceded by a highlighted "Summary" box which includes all the major ideas that are presented in the text which makes the book especially responsive to the needs of those in search of a quick answer.  Readers will also be pleased to see that all the graphs and figures throughout the text are of high quality and brightly colored for ease of use.  Extensive reference sections close each chapter and include a majority of current literature. 

     A special feature of this text, and one that makes it desirable to the allied health professional that works with diabetic patients, is the dedication to the biopsychosocial aspects of the disease.  The first section of the text is actually entitled "the historical and social contexts of diabetes".  The concept that our current treatment of patients is affected by the history of a disease and the quality of life that the patient throughout history could expect, was not lost in the writing of this text.  Additionally there are several chapters toward the close of the text that are strictly focused on how patients live with the disease in the context of social interactions such as their ability to drive, be employed, and gain access to health insurance.  These aspects of the patients' experience are too often ignored completely in medical texts in light of the fact that this valuable information can certainly lead to a more positive medical intervention. 

     Diabetes is one of the few chronic diseases that are so closely aligned with day to day changes in the patient's life, and this poses quite a challenge for those who are charged with making recommendations to patients regarding their disease management.  Extensive coverage is given to such lifestyle factors as diet and exercise, along with a chapter on educating the patient with diabetes.  Included in this discussion is an evaluation of insulin therapy in its various forms and how each fits in the routine of patients with different needs and lifestyles.  New and innovative therapies are also touched upon including the possibility of inhaled therapy.

     As with any major work in the medical sciences, the text leaves the reader with a sense of where the boundaries of knowledge on diabetes therapy exist and in which direction research is headed to expand those boundaries.  One of the major areas of likely expansion is in the newly decoded human genome and the hope for targeted gene therapy.  This and several other promising lines of inquiry are outlined in the final section of the text.
     This text is recommended not only for physicians specializing in diabetes but would also be an excellent choice for primary care physicians, nurse practitioners, or any professional who requires not only a better overall understanding of diabetes but also a patient-oriented treatment of the material.       

Ratings (1-4 , 4 being the highest):

Organization of information:    4

Usefulness of book:     3

Suitable for intended audience:    4

Authorís objectives met:     3

Significant number of illustrations:     3

Quality of illustrations:    3


Table of Contents: 

Section I:  Diabetes in its Historical and Social Context  

Chapter 1.     The History of Diabetes Mellitus

Chapter 2.     The Diagnosis and Classification of Diabetes and Impaired Glucose regulation

Chapter 3.     Type 1 Diabetes: an Overview

Chapter 4.     Type 2 Diabetes: an Overview

Chapter 5.     Epidemiology of Type 1 Diabetes

Chapter 7.     The Social Cost of Diabetes Mellitus and the Cost-effectiveness of Interventions

Chapter 8.     The Challenges of Diabetes in the Developing World


Section 2: Normal Metabolism


Chapter 9.     Normal Metabolism: The Physiology of Fuel Homeostasis

Chapter 10.   The Anatomy, Organization and Ultrastructure of the Islets of Langerhans

Chapter 11.   The Hormonal and Neural Control of Endocrine Pancreatic Function

Chapter 12.   The Structure and Phylogeny of Insulin

Chapter 13.   The Biosynthesis and Secretion of Insulin

Chapter 14.   Insulin Receptor Signalling and Regulation


Section 3:  Pathogenesis of Type 1 Diabetes


Chapter 15.   Genetic Factors in the Pathogenesis of Type 1 Diabetes

Chapter 16.   Viruses in the Pathogenesis of Type 1 Diabetes

Chapter 17.   Environmental Agents and Type 1 Diabetes

Chapter 18.   The Immunology of Human Type 1 Diabetes

Chapter 19.   Animal Models of Type 1 Diabetes


Section 4:  Pathogenesis of Type 2 Diabetes


Chapter 20.   Genetic Factors in the Pathogenesis of Type 2 Diabetes

Chapter 21.   Obesity and Nutritional Factors in the Pathogenesis of Type 2 Diabetes Mellitus

Chapter 22.   Insulin Resistance in Type 2 Diabetes

Chapter 23.   B-Cell Defects and Pancreatic Abnormalities in Type 2 Diabetes

Chapter 24.   Maturity-onset Diabetes of the Young

Chapter 25.   Animal Syndromes Resembling Type 2 Diabetes


Section 5:  Other Types of Diabetes


Chapter 26.   Drug-induced Diabetes

Chapter 27.   Endocrine Diseases and Diabetes

Chapter 28.   Pancreatic Diseases and Diabetes

Chapter 29.   Heredity and acquired syndromes of severe insulin resistance

Chapter 30.   Genetic Syndromes and Diabetes


Section 6:  Metabolic Disturbances of Diabetes


Chapter 31.   Metabolic Disturbances in Diabetes Melitus

Chapter 32.   Acute Metabolic Complications of Diabetes: Diabetic Ketoacidosis, Hyperosmolar Non-Ketotic Hyperglycaemia and Lactic Acidosis

Chapter 33.  Hypoglycaemia and Diabetes


Section 7:  Measurements in Diabetes


Chapter 34.   Diabetic Control and its Measurement

Chapter 35.   Clinical Research Methods in Diabetes


Section 8:  General Management Issues in Diabetes


Chapter 36.   Management of diabetes: Diet and Lifestyle Modification

Chapter 37.   Exercise and diabetes Mellitus

Chapter 38.   Educating People with W+Diabetes

Chapter 39.   Drug Therapy:  Special Considerations in Diabetes

Chapter 40.   Infection and Diabetes

Chapter 41.   Surgery in Patients with Diabetes Mellitus


Volume 2

Section 9:  Drug Therapy of Diabetes


Chapter 42.   Insulin Pharmacology

Chapter 43a.  Insulin Treatment and its complications

Chapter 43b.  Causes and Management of Poor Metabolic Control

Chapter 44.   Alternatifve Forms of Insulin Delivery

Chapter 45.  The Drug Treatment of Type 2 Diabetes


Section 10:  Mechanisms in Chronic Diabetes


Chapter 46.   The Epidemiology of Diabetic Complications and the Relationship to Blood Glucose Control

Chapter 47.   The Biochemical Mechanisms of Diabetic Tissue Damage


Section 11:  Diabetic Eye Disease


Chapter 48.   Pathogenesis of Diabetic Eye Disease

Chapter 49.   Clinical Features and Management of Diabetic Eye Disease


Section 12:  Diabetic Neuropathy


Chapter 50.   Pathogenesis of diabetic Neuropathies

Chapter 51.   The Clinical Features and Management of Diabetic Neuropathy


Section 13:  Diabetic Nephropathy


Chapter 52.   Pathogenesis of Diabetic Nephropathy

Chapter 53.   Clinical Features and Management of Diabetic Nephropathy


Section 14:  Macrovascular Disease


Chapter 54.   Lipid Disorders in Diabetes

Chapter 55.   Hypertension in Diabetes Mellitus

Chapter 56.   Cardiovascular Diseases and Diabetes


Section 15:  Other Complications of Diabetes


Chapter 57.   Foot Problems in Diabetes

Chapter 58.   Sexual Function in Diabetic Men and Women

Chapter 59.   Gastrointestinal Disorders in Diabetes

Chapter 60.   Skin Disorders in Diabetes

Chapter 61.   Rheumatic Disorders and Bone Problems in Diabetes Mellitus

Chapter 62.   The Central Nervous System and Diabetes Mellitus

Chapter 63.   Psychological Factors and Diabetes Mellitus

Chapter 64.   Mental Health Problems in People with Diabetes


Section 16:  Diabetes in Special Groups


Chapter 65.   Pregnancy and Diabetes Mellitus

Chapter 66.   Diabetes in Childhood and Adolescence

Chapter 67.   Diabetes in Old Age


Section 17:  Living with Diabetes


Chapter 68.   Diabetes Mellitus and Lifestyle: Driving, Employment, Prison, Insurance, Smoking, Alcohol and Travel

Chapter 69.   Genetic Counselling in Diabetes Mellitus


Section 18:  Delivery and Organization of Diabetes Care


Chapter 70.   The Role of the Hospital and General Practice in Diabetes Care

Chapter 71.   The Changing Role of the Diabetes Specialist Nurse


Section 19:  Future Directions in Diabetes Research


Chapter 72.   Pancreas and Islet Transplantation

Chapter 73.   New Approaches to the Pharmacotherapy of Diabetes

Chapter 74.   Immunotherapy for Interdicting the Type 1 Diabetes Disease Process

Chapter 75.   Stem Cell Therapy in Diabetes

Chapter 76.   Gene Therapy for Diabetes



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