Cover Page

International Textbook of Diabetes Mellitus

Fourth Edition


Ralph DeFronzo MD

Professor of Medicine and Chief, Diabetes Division
The University of Texas Health Science Center at San Antonio (UTHSCSA)
Deputy Director, Texas Diabetes Institute
San Antonio, TX, USA

Ele Ferrannini MD

Professor of Internal Medicine
Department of Clinical and Experimental Medicine
University of Pisa
Pisa, Italy

Paul Zimmet AO, MD, PhD, FRACP, FRCP, FTSE

Director Emeritus, Victor Smorgon Diabetes Centre
Baker IDI Heart and Diabetes Institute
Adjunct Professor, Monash University
Honorary President, International Diabetes Federation
Chair, Programme Committee, World Diabetes Congress 2013
Melbourne, VIC, Australia

K. George M. M. Alberti MA, DPhil, PRCP, FRCPath, FRCP

Senior Research Investigator, Imperial College, London, UK
Chair of King's College Hospital NHS Foundation Trust
Emeritus Professor of Medicine, University of Newcastle upon Tyne
Newcastle upon Tyne, UK

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Section Editors

Knut Borch-Johnsen MD, DMSc

Professor of Quality in Health Care

Medical Director, Holbæk Hospital

Holbaek, Denmark


Mark Cooper MD, PhD, FRACP

Deputy Director and Chief Scientific Officer

Baker IDI Heart and Diabetes Institute

Melbourne, VIC, Australia


Stefano Del Prato MD

Professor of Endocrinology and Metabolism

School of Medicine, University of Pisa;

Chief, Section of Diabetes and Metabolic Diseases

University of Pisa

Pisa, Italy


Robert H. Eckel MD

Charles A. Boettcher Endowed Chair in Atherosclerosis

Professor of Medicine

Division of Endocrinology, Metabolism and Diabetes, and Cardiology

Professor of Physiology and Biophysics

University of Colorado School of Medicine

Aurora, CO, USA


W. Timothy Garvey MD, FACE

Butterworth Professor and Chair,

Department of Nutrition Sciences

University of Alabama at Birmingham

Director, UAB Diabetes Research Center

GRECC Investigator and Staff Physician

Birmingham VA Medical Center

Birmingham, AL, USA


Rury R. Holman FRCP

Professor of Diabetic Medicine

Director, University of Oxford Diabetes Trials Unit

Oxford Centre for Diabetes, Endocrinology and Metabolism

Churchill Hospital

University of Oxford

Oxford, UK


Steven E. Kahn MB, ChB

Professor of Medicine

Division of Metabolism, Endocrinology and Nutrition

Director, Diabetes Research Center

University of Washington

VA Puget Sound Health Care System

Seattle, WA, USA


James B. Meigs MD

Massachusetts General Hospital

Boston, MA, USA


Eric Ravussin PhD

Associate Executive Director, Obesity & Diabetes

Pennington Biomedical Research Center

Baton Rouge, LA, USA


Jay S. Skyler MD, MACP

Professor of Medicine, Pediatrics, & Psychology

Division of Endocrinology, Diabetes, & Metabolism

Deputy Director— Diabetes Research Institute

University of Miami Miller School of Medicine

Miami, FL, USA


Hannele Yki-Järvinen MD, FRCP

Professor of Medicine

University of Helsinki;

Minerva Foundation Institute for Medical Research

Helsinki, Finland


Bernard Zinman CM, MD, FRCPC, FACP

Director, Leadership Sinai Centre for Diabetes

Sam and Judy Pencer Family Chair in Diabetes Research

Senior Scientist, Samuel Lunenfeld Research Institute

Professor of Medicine, University of Toronto Mount Sinai Hospital

Toronto, ON, Canada