Postgraduate Medicine
ISSN: 0032-5481 (Print) 1941-9260 (Online) Journal homepage: https://www.tandfonline.com/loi/ipgm20
Managing diabetes Philip Felig (Professor and Vice Chairman) (Chief) To cite this article: Philip Felig (Professor and Vice Chairman) (Chief) (1976) Managing diabetes, Postgraduate Medicine, 59:1, 113-113, DOI: 10.1080/00325481.1976.11716528 To link to this article: https://doi.org/10.1080/00325481.1976.11716528
Published online: 07 Jul 2016.
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introduction • Diabetes mellitus is one of the most common clinical disorders encountered in the general population. Estimates are there are 4 to 6 million known diabetics in the United States and an additional 2 million people with undiagnosed diabetes. The significance of this disease is underscored by its chronicity, necessitating lifelong treatment, and its frequent association with the major causes of death in the American population: ischemie heart disease, hypertension, and renal failure. This symposium addresses itself to three principal areas of concern to the primary care physician in managing diabetes: use of diet, oral agents, insulin, or a combinatian of these in long-term management: diagnosis and management of acute hyperglycemic-ketoacidotic states (diabetic ketoacidosis, hyperosmolar nonketotic coma); and acute infectious and long-term degenerative (neuropathic and microangiopathic) complications. Dr. Davidson provides many useful tips to improve the success of diet management and emphasizes the importance of diet as the primary form of treatment in the vast majority of patients with adult-onset disease. Dr. Owen and his coauthors give precise recommandations regarding insulin dosage in initiating and adjusting therapy. Dr. Colwell provides a balanced review of the oral hypoglycemie agents, taking cognizance of the findings of the University Group Diabetes Program study while delineating, in specifie terms, those circumstances in which administration of sulfonylurea agents is considered justifiable. 1discuss the di~gnosis and management of acute hyperglycemic-ketoacidotic states, with emphasis on new approaches to insulin administration. Dr. Bagdade and Dr. Beisswenger caver the infectious, neuropathic, and angiopathic complications of diabetes with respect to specifie clinical entities as weil as to pathophysiologic disturbances (eg, alterations in host defense in diabetes, basement membrane thickening). Currently, much of the research effort in diabetes is directed at islet cell transplantation, development of an artificial endocrine pancreas, and the role of viral and autoimmune factors in pathogenesis. lt is anticipated that such research will ultimately lead to a cure and, possibly, to the prevention of diabetes. However, the state of the art is such that the attainment of either goal is unlikely in less than five to ten years. This symposium thus provides useful guidance until such time as truly curative treatment and prevention become available. •
Vol. 59 o No. 1 o January 1976 • POSTGRADUATE IEDICINE
managing diabetes
Philip Fellg, MD Professer and Vice Chairman Department of Internai Medicine Chief, Section of Endocrinology Yale University School of Medicine New Haven, Connecticut
113
ISSN: 0032-5481 (Print) 1941-9260 (Online) Journal homepage: https://www.tandfonline.com/loi/ipgm20
Managing diabetes Philip Felig (Professor and Vice Chairman) (Chief) To cite this article: Philip Felig (Professor and Vice Chairman) (Chief) (1976) Managing diabetes, Postgraduate Medicine, 59:1, 113-113, DOI: 10.1080/00325481.1976.11716528 To link to this article: https://doi.org/10.1080/00325481.1976.11716528
Published online: 07 Jul 2016.
Submit your article to this journal
Article views: 1
View related articles
Citing articles: 1 View citing articles
Full Terms & Conditions of access and use can be found at https://www.tandfonline.com/action/journalInformation?journalCode=ipgm20
introduction • Diabetes mellitus is one of the most common clinical disorders encountered in the general population. Estimates are there are 4 to 6 million known diabetics in the United States and an additional 2 million people with undiagnosed diabetes. The significance of this disease is underscored by its chronicity, necessitating lifelong treatment, and its frequent association with the major causes of death in the American population: ischemie heart disease, hypertension, and renal failure. This symposium addresses itself to three principal areas of concern to the primary care physician in managing diabetes: use of diet, oral agents, insulin, or a combinatian of these in long-term management: diagnosis and management of acute hyperglycemic-ketoacidotic states (diabetic ketoacidosis, hyperosmolar nonketotic coma); and acute infectious and long-term degenerative (neuropathic and microangiopathic) complications. Dr. Davidson provides many useful tips to improve the success of diet management and emphasizes the importance of diet as the primary form of treatment in the vast majority of patients with adult-onset disease. Dr. Owen and his coauthors give precise recommandations regarding insulin dosage in initiating and adjusting therapy. Dr. Colwell provides a balanced review of the oral hypoglycemie agents, taking cognizance of the findings of the University Group Diabetes Program study while delineating, in specifie terms, those circumstances in which administration of sulfonylurea agents is considered justifiable. 1discuss the di~gnosis and management of acute hyperglycemic-ketoacidotic states, with emphasis on new approaches to insulin administration. Dr. Bagdade and Dr. Beisswenger caver the infectious, neuropathic, and angiopathic complications of diabetes with respect to specifie clinical entities as weil as to pathophysiologic disturbances (eg, alterations in host defense in diabetes, basement membrane thickening). Currently, much of the research effort in diabetes is directed at islet cell transplantation, development of an artificial endocrine pancreas, and the role of viral and autoimmune factors in pathogenesis. lt is anticipated that such research will ultimately lead to a cure and, possibly, to the prevention of diabetes. However, the state of the art is such that the attainment of either goal is unlikely in less than five to ten years. This symposium thus provides useful guidance until such time as truly curative treatment and prevention become available. •
Vol. 59 o No. 1 o January 1976 • POSTGRADUATE IEDICINE
managing diabetes
Philip Fellg, MD Professer and Vice Chairman Department of Internai Medicine Chief, Section of Endocrinology Yale University School of Medicine New Haven, Connecticut
113
