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Ed Jean-Marie Ekoé
John Wiley and Sons, £120, pp 454
ISBN 0 471 97448 X
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In 1978, Dr Kelly West published his
monograph on the epidemiology of diabetes and its vascular
complications, earning himself the name of "father of diabetes
epidemiology." Almost a quarter of a century later we have a worthy
successor to this text. And, if ever there was a need for a compendium
of current epidemiology of diabetes and its complications, it is now.
Diabetes mellitus, as readers will quickly discover if they didn't
already know, is a worldwide pandemic straining medical resources and capacity.
Within the covers of this book are insights from the studies of
diabetes in different populations. For example, the incidence of type 1 diabetes in children is over 35 in 100 000 in Sardinia and Finland but
less than 10/100 000 in Italy and France. There are differences in sex
ratios in childhood type 1 diabetesa large excess in girls in
Slovenia and an equal but opposite excess in boys in Portugal. Diabetic
nephropathy is rapidly declining in some countries (in Sweden, it is
virtually disappearing). There are also two populations of
African-Americans with type 2 diabetesone with and one without
insulin resistance.
There are pithy, readable sections focusing on the major diabetic
complications (for example, nephropathy and neuropathy). Special praise
is due to Karvonen et al for a superb perspective on the global
epidemiology of diabetes; to Banerji and Lebovitz for insights into
type 2 diabetes in African-Americans; and to Ekoé and Shipp for a
fascinating compilation regarding the enigma of malnutrition-related diabetes.
Since each review stands on its own, one can dip into this volume at
any point to satisfy a particular curiosity. All of the chapters are as
up to date as they can be in a multiauthored text and provide
guides to the ferment and richness of current studies in this rapidly
changing clinical arena.
One hopes that this is just the first edition of what will become the
definitive textbook in the field.
Robert Matz Mount Sinai School
of Medicine, New York robert.matz@mountsinai.org
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