Contents

Preface, first edition ix

Preface, second edition xi

Preface, third edition xiii

Preface, fourth edition xiv

Preface, fifth edition xv

Preface, sixth edition xvi

Contributors xvii

1. Rationale for early screening for diabetic renal disease 1

Tom Hostetter

2. Pressure-induced and metabolic alterations in the glomerulus: cytoskeletal 13 changes

Pedro Cortes and Jerry Yee

3. The Steno hypothesis for cardiovascular and renal disease revisited 27 Giovanni Gambaro, Monica Ceol and Augusto Antonello

4. Microalbuminuria and cardiovascular disease 45 Stephen M. Thomas and GianCarlo Viberti

5. The heart in diabetes: results of trials 63 Giulio Zuanetti and Elena Sarugeri

6. Microalbuminuria and GFR in type 1 and type 2 diabetes 77 George Jerums, Sianna Panagiotopoulos and Richard Maclsaac

7. Serum creatinine and other measures of GFR in diabetes 107 Peter Rossing

8. Familial factors in diabetic nephropathy 117

Guiseppina Imperatore, David J. Pettitt, Robert L. Hanson, William C. Knowler and Robert G. Nelson

9. Genetics and diabetic nephropathy 129

Lise Tarnow

10. Low birth weight and diabetic nephropathy 149

Susan E. Jones and Jens R. Nyengaard

11. Effects of insulin on the cardiovascular system and the kidney 163 Andrea Natali, Monica Nannipieri and Ele Ferrannini

12. Value of screening for microalbuminuria in people with diabetes as well 181 as in the general population

Bo Feldt-Rasmussen, Jan Skov Jensen and Knut Borch-Johnsen

13. Dysfunction of the vascular endothelium and the development of renal 197 and vascular complications in diabetes

Coen D.A. Stehouwer

14. Pathogenesis and management of bacterial urinary tract infections in 223 adult patients with diabetes mellitus

Andy I.M. Hoepelman

15. Pathology of the kidney in diabetes mellitus 241

Steen Olsen

16. Renal structural changes in patients with type 1 diabetes and 255 microalbuminuria

Hans-Jacob Bangstad and Susanne Rudberg

17. Renal structure in type 2 diabetes 271 Paola Fioretto, Michele Dalla Vestra, and Michael Mauer

18. Nephropathy in type 2 diabetic patients, predictors of outcome 287 Gozewijn D Laverman, Piero Ruggenenti and Giuseppe Remuzzi

19. Advanced glycation end-products and diabetic renal disease 303 Merlin C Thomas, Mark Cooper and George Jerums

20. Protein kinase C activation and its inhibition for the treatment of diabetic 323 renal pathologies

Roald Ma, Keiji Isshiki and George L. King

21. Biochemical aspects of diabetic nephropathy 341 Cora Weigert and Erwin D. Schleicher

22. Pathogenesis of diabetic glomerulopathy: the role of glomerular 363 hemodynamic factors

Sharon Anderson and Radko Komers

23. The emerging role of growth factor hormone (GH) and vascular endothelial 383 growth factor (VEGF) in diabetic kidney disease

Allan Flyvbjerg, Dinah Khatir and Ruth Rasch

24. Transforming growth factor-p and other cytokines in experimental 397 and human diabetic nephropathy

Belinda Jim, Sheldon Chen and Fuad N. Ziyadeh

25. Blood pressure elevation in diabetes: the results from 24-h ambulatory 433 blood pressure recordings

Klavs Wurgler Hansen, Per Logstrup Poulsen, Eva Ebbehoj, Soren Tang Knudsen, Carl Erik Mogensen

26. Microalbuminuria in young patients with type 1 diabetes 457

Henrik B. Mortensen

27. Early renal hyperfunction and hypertrophy in IDDM, including 479 comments on early intervention

Margrethe Mau Pedersen

28. Autoregulation of glomerular filtration rate in patients with diabetes 495

Per K. Christensen and Hans-Henrik Parving

29. The role of renal biopsy in the clinic 515

Satishkumar A Jayawardene and Neil S. Sheering

30. Inhibition of the renin angiotensin aldosterone system, with particular 527 reference to the dual blockade principle

Niels Holmark Andersen

31. The concept of incipient diabetic nephropathy and the effect of early 541 antihypertensive intervention

Per Logstrup Poulsen

32. The role of proteinuria in the diagnosis and treatment of type 2 diabetes 555

William F. Keane and Paulette A. Lyle

33. Antihypertensive treatment in type 2 diabetes, with special reference to 579 abnormal albuminuria: a focus on the new trials

Geoffrey Boner, Paul G McNally and Mark Cooper

34. Blood pressure lowering treatment and the prevention of stroke in the 611 diabetic patient

John Chalmers and Neil Chapman

35. Non-glycaemic intervention in diabetic nephropathy: the role of dietary 631 protein and salt intake

Henrik Post Hansen

36. Diabetic nephropathy and pregnancy 647

John L. Kitzmiller

37. Evolution worldwide of renal replacement therapy in diabetes 687

Rudy Bilous

38. Hemodialysis and CAPD in type 1 and type 2 diabetic patients with 703 endstage renal failure

Ralf Dikow and Eberhard Ritz

39. Renal and pancreas transplants in diabetes 725 Amy L. Friedman and Eli A. Friedman

40. Combination therapy for hypertension and renal disease in diabetes 767 Peter D. Hart and George L. Bakris

41. Microalbuminuria in essential hypertension: cardiovascular and 785 renal implications

Vito M. Campese, Roberto Bigazzi and Stefano Bianchi

42. A comparison of progression in diabetic and non-diabetic renal disease: 801 similarity of progression promoters

Gerjan Navis, Peter L. Luik, Dick De Zeeuw and Paul E. De Jong

43. Scientific basis for new guidelines for the treatment of hypertension in 821 type 2 diabetes

Klavs Wurgler Hansen, Per Logstrup Poulsen and Carl Erik Mogensen

44. Regulatory considerations in the development of therapies for diabetic 837 nephropathy and related conditions

G. Alexander Fleming

45. Diabetes, hypertension, and kidney disease in the Pima Indians 857

William C. Knowler, Robert G. Nelson, David J. Pettitt

46. The development and progression of clinical nephropathy in white 871 patients with type 2 diabetes

Amanda I. Adler

47. Microalbuminuria, blood pressure and diabetic renal disease: origin 883 and development of ideas

Carl Erik Mogensen

Index 939

The first sporadic observations describing renal abnormalities in diabetes were published late in the 19th century, but systematic studies of the kidney in diabetes started only half a century ago after the paper by Cambier in 1934 and the much more famous study by Kimmelstiel and Wilson in 1936. These authors described two distinct features of renal involvement in diabetes: early hyperfiltration and late nephropathy. Diabetic nephropathy is, despite half a century of studies, still a very pertinent problem, renal disease in diabetes now being a very common cause of end-stage renal failure in Europe and North America and probably throughout the world. It is a very important part of the generalized vascular disease found in long-term diabetes as described by Knud Lundb^k in his monograph Long-term Diabetes in 1953, published by Munksgaard, Copenhagen.

Surprisingly, there has not been a comprehensive volume describing all aspects of renal involvement in diabetes, and the time is now ripe for such a volume summarizing the very considerable research activity within this field during the last decade and especially during the last few years.

This book attempts to cover practically all aspects of renal involvement in diabetes. It is written by colleagues who are themselves active in the many fields of medical research covered in this volume: epidemiology, physiology and pathophysiology, laboratory methodology, and renal pathology. New studies deal with the diagnosis and treatment of both incipient and overt nephropa-thy by metabolic, antihypertensive, and dietary invention.

Considerable progress has been made in the management of end-stage renal failure and also in the management and treatment of nephropathy in the pregnant diabetic woman. Diabetic nephropathy is a world-wide problem, but it is more clearly defined in Europe and North America where facilities for the diagnosis and treatment of diabetes and its complications are readily available. Much more work needs to be done in other parts of the world, as it appears from this book.

It is hoped that we now have a handbook for the kidney and hypertension in diabetes and that further progress can be made in clinical work in diagnosing and treating diabetic patients. Much more work still needs to be done regarding patient education with respect to complications. Many diabetics have now been trained to take part in the management of their metabolic control; they should also be trained to take part in the follow-up and treatment of complications.

This volume also underlines the considerable need for future research. So far, research in this field has been carried out in relatively few countries and centres in the world. The editor is sure that this volume will also stimulate further advancement in clinical science within the field of diabetic renal disease.

In 1952, the book Diabetic Glomerulosclerosis, The Specific Renal Disease in Diabetes Mellitus, by Harold Rifkin and co-workers, published by Charles C. Thomas, Springfield, Illinois, USA, summarized all current knowledge on the diabetic kidney in about 100 short pages, including many case histories. Much more space is needed now and the many disciplines involved will undoubtedly attract many readers.

Carl Erik Mogensen

The sum of clinical problems caused by diabetic renal disease has been steadily increasing since the first edition of this book was published in 1988. Indeed, it is now estimated that throughout the world about 100,000 diabetic individuals are receiving treatment for end-stage renal failure. Obviously, this means a burden with respect to human suffering, disease and premature mortality, but additionally these treatment programmes are extremely costly, so costly that in many areas resources are not available for this kind of care. It is therefore clear, that every efforts should be made to prevent or postpone the development of end-stage disease.

The years since the first edition appeared we have seen a tremendous progress in research activities. Importantly, this also includes improvement in the treatment programmes to prevent end-stage renal failure. Thus it has become clear that the diabetic kidney is extremely pressure-sensitive, responding to effective antihypertensive treatment by retarded progression of disease. Some agents may be more beneficial in this respect than other, although the effective blood pressure reduction per se is crucial throughout the stages of diabetic renal disease. However, the prime cause of diabetic renal disease is related to poor metabolic control and it is now documented beyond doubt that good metabolic control is able to postpone or perhaps even prevent the development of renal disease. However, in many individuals we are not able to provide such a quality of control that will prevent complications, and therefore non-glycaemic intervention remains important. Maybe in the future non-glycaemic intervention will become the most important research area in diabetic nephropathy.

With respect to the exact mechanisms behind poor metabolic control and development of renal disease, much information is now being gained. It is likely that a combination of genetic predisposition and metabolic and haemodynamic abnormalities explain the progression to renal disease, seen in about 30% of the diabetic individuals. Much of this development probably relates to modifiable genetic factors, such as blood pressure elevation or haemodynamic aberrations. However, mechanisms related to the response to hyperglycaemia are also of clear importance as is the possibility that these metabolic or haemodynamic pathway may be inhibited.

This volume reviews older data as well as the progress seen within the research of diabetic nephropathy over the last five years and provides a state of the art of the development. However, we are still far from the main goal, which is the abolition of end-stage renal disease in diabetic individuals. Obviously, much work still needs to be done and one of the intentions of this book is to stimulate further research in this area where so many sub-disciplines of medical science are involved from the extremes of genetic and molecular biology to clinical and pharmacological research trials.

Carl Erik Mogensen January 1994

Many new dimensions have been added to the concepts regarding diabetic renal disease in the past few years. In addition some considerably amounts of new studies have been published since the second edition of this book. Therefore, there is a clear need to update the issue on diabetic renal disease. Ever more focus is placed on pressure-induced and metabolic related aberration, in relation to genetic abnormalities and also changes developing in foetal life. New chapters also include exercise, lipidemia and retinopathy in diabetic renal disease. New data are also included regarding structural changes in NIDDM-patients. Much of the development in diabetic renal disease is also relevant to non-diabetic renal disease, and therefore chapters comparing diabetic and non-diabetic renal disease have been included. As a result of the studies on pathogenesis of treatment of diabetic renal disease, new guidelines have been published as recently reviewed in the Lancet 1995. These guidelines are also included in this new edition, where the editor has tried to focus on all major issues relevant to diabetic renal disease. Many groups are working within this field, but the most cited authors are the following as recently reviewed by JDF (for the years 1981-95).

Measure Diabetes Research 1981-95 - Hypertension, Nephropathy (T-10)

Cites

Papers 2499 2659 4229 2975 2220 2307 3456 4702 1570 2820

Brenner B Christiansen JS Deckert T Knowler WC Krolewski AS Mauer SM Mogensen CE Parving HH Passa P Viberti GC

33 115 157 127 74 101 146 216 196 119

76 23 27 23 30

24 22 8

Carl Erik Mogensen August 1996

We have witnessed a rapid development within the field of the kidney and hypertension in diabetes mellitus. A lot of work within the traditional areas has been published, and several new dimensions are now being developed, mostly in the experimental setting as discussed in several chapters. Therefore, there is now a need for an updated edition of this volume. A clear policy has been to have completely updated versions of the book, at disposal for the clinicians and the scientists in the area.

New guidelines are being developed within the field of hypertension and also in the field of diabetes mellitus, where new definitions are being introduced, mainly relevant for type 2 diabetes. The number of patients entering end-stage renal failure programmes are still increasing, underscoring the need for better management of these patients. The number of patients with diabetes is predicted to increased over the next decade, mainly due to changing patterns of life-style and an older population. Therefore, we need to be even more prepared to look after these patients, also with respect to renal, hypertensive and cardiovascular complications.

Since diabetic nephropathy is in most cases associated with heart disease and with retinopathy, new chapters on these aspects have been added. Very importantly, there is now more and more scientific support for early treatment in normotensive patients with microalbuminuria with ACE-inhibitors. This treatment seems beneficial also for diabetic heart disease and diabetic retinopathy according to new studies, also discussed in the book. The maxim is that diabetic nephropathy, retinopathy and heart disease often go together. The same seems to be the case regarding treatment and prevention.

Carl Erik Mogensen January 1998

Over the years this volume may have developed as the OPUS MAGNUM within in diabetic renal disease and hypertension. This is a rapidly expanding area as will be seen from all the new references, which have been included since the fourth edition.

Also knowledge within the field of hypertension in type 2 diabetes has developed very rapidly with the publication of many new trials, including the UKPDS. This study and other studies really emphasise the importance of good glycemic control and especially control of hypertension in these patients. Effective treatment would greatly minimise all vascular complications.

It is likely that the number of patients entering renal end-stage programs is still increasing but we can expect that this is due to better survival and postponement of the disease and also to better acceptance of patients that were earlier not allowed into this treatment programme.

The number of publications regarding microalbuminuria is continuously increasing, not only regarding diabetic nephropathy in its early phase, but also as a marker for cardiovascular disease, both in hypertension and in the general background population.

The maxim is still true that diabetic nephropathy, retinopathy, heart disease and vascular disease all go together often with neuropathy. This is also apparent in this volume, with focus on good glycemic control and the best possible antihypertensive treatment program to be implemented early.

Carl Erik Mogensen March 2000

The main subjects of this book, hypertension and renal disease in diabetes, are areas where developments rapidly occur all the time, and therefore there is a clear need for a new edition - also even though it is only three years after the latest volume. During these three years, there have been many important new publications and numerous new trials have been conducted.

Increasing emphasis is now put on screening meaning identifying patients early on by measuring microalbuminuria. Microalbuminuria is a unique predictor of worsening of renal disease, cardiovascular disease and also early mortality. An increasing number of studies documents that treatment improve prognosis.

Unfortunately, the number of end-stage renal disease related to type 2 diabetes is increasing but there seems to be a decline, at least in some countries of patients with type 1 diabetes - and it seems that also the age where patients enter advanced renal disease programmes has increased, probably related to greatly improved medical care in general.

With this new edition it is my hope that the number of diabetic patients entering ESRD finally will start to decrease.

Carl Erik Mogensen January 2004

Amanda Adler, MD, PhD, FRCP Radcliffe Infirmary

Oxford Diabetes Research Laboratories

Woodstock Road

Oxford OX2 6HE, UK

Tel: +44 1865 2245 25

Fax: +44 1865 723884

E-mail: [email protected]

Niels Holmark Andersen Medical Dept. M Aarhus Kommunehospital Aarhus University Hospital DK-8000 Aarhus, Denmark Fax: +45 8949 2010 E-mail: [email protected]

Sharon Anderson, M.D.

Division of Nephrology and Hypertension

Oregon Health and Science University

Portland, OR 97201, USA

Tel: +1-503-494-8490

Fax: +1-503-721-7810

E-mail: [email protected]

George L. Bakris, MD, F.A.C.P Rush University Hypertension Center Rush-Presbyterian-St. Luke's Medical Center 1700 W. Van Buren Suite #470

Chicago, IL 60612-3833, USA Tel: +1 312 563 2195 Fax: +1 312 942 4464 E-mail: [email protected]

Hans-Jacob Bangstad, M.D.

Unit of Nephrology

Pediatric Department

Aker Diabetes Research Center

Ulleval University Hospital

0407 Oslo, Norway

Tel: +47 2211 7954

Fax: +47 2211 8663

E-mail: [email protected]

Rudy W. Bilous, MD, FRCP

Professor of Clinical Medicine

Audrey Collins Teaching Unit

Education Centre

James Cook University Hospital

Marton Road, Middlesbrough TS4 3BW, UK

E-mail: [email protected]

Geoffrey Boner, M.B.B.Ch. Diabetic Complications Group Baker Heart Res. Institute Commercial Rd Prahran 3181, VIV Australia E-mail: [email protected]

Knut Borch-Johnsen, M.D. Steno Diabetes Center Niels Steensens Vej 2 2820 Gentofte, Denmark Tel: +45 4443 9415 Fax: +45 4443 8233 E-mail: [email protected]

Vito M. Campese, M.D. LAC/USC Medical Center 1200 North State St. Los Angeles, CA 90033, USA Tel: +1 213 226 7307 Fax: +1 213 226 5390 E-mail: [email protected]

Professor John Chalmers

Institute for International Health

University of Sydney

PO Box 576 Newtown

NSW 2042, Australia

Tel: +61 2 9351 0063

Fax: +61 2 9352 0064

E-mail: [email protected]

Per K. Christensen Steno Diabetes Center Niels Steensens Vej 2 2820 Gentofte, Denmark tel: +45 3968 0800 fax: +45 3968 1048 E-mail:[email protected]

Mark Cooper, M.D. Diabetes Complications Group Baker Medical Research Institute PO Box 6492

Melbourne 8008 VIC, Australia Tel: +613 8532 1362 Fax: +613 8532 1480 E-mail: [email protected]

Pedro Cortes, M.D., Director Henry Ford Hospital & Medical Centers Nephrology and Hypertension 2799 West Grand Boulevard Detroit, Michigan 48202-2689, USA Tel: +1 313 876 2711/2702 Fax: +1 313 876 2554 E-mail: [email protected]

Dr. Ralf Dikow

Department of Internal medicine Ruperto Carola University Heidelberg, Germany E-mail: [email protected]

Bo Feldt-Rasmussen, M.D. Medical Department P 2132 Rigshospitalet

DK-2100 Copenhagen 0, Denmark Tel: +45 3545 2135 Fax: +45 3545 2240 E-mail: [email protected]

Ele Ferrannini, M.D. Istituto di Fisiologia Clinica del CNR CNR Institute of Clinical Physiology Consiglio Nazionale delle Ricerche - C.N.R. c/o Universita di Pisa

Via Savi, 8 I-56100 Pisa, Italy Tel: +39 50 500087 Fax: +39 50 553235 E-mail: [email protected]

Paola Fioretto, M.D. Istituto di Medicina Interna Universitá di Padova Via Giustiniani, 2 I-35128 Padova, Italy Tel: +39 49 821 2150 Fax: +39 49 821 2151 E-mail: [email protected]

G. Alexander Fleming, MD President and CEO Kinexum LLP 550 Ridge St

Harper's Ferry, WV 25425

PO Box 1476, USA

E-mail: [email protected]

Allan Flyvbjerg, MD. D.Sc. Ass. Professor Medical Department M Diabetes & Endocrinology Aarhus Kommunehospital Aarhus University Hospital DK-8000 Aarhus C, Denmark Fax: +458949 2010/86 56 00 87 E-mail: [email protected]

Amy L. Friedman

Department of Surgery, Yale University School of Medicine,

New Haven, Connecticut, USA E-mail: [email protected]

Division of Renal Disease

Department of Medicine

State University of New York Health Science

Center at Brooklyn

450 Clarkson Avenue, Box 52

Brooklyn, NY 11203, USA

Tel: +1 718 270 1584

Fax: +1 718 270 3327

E-mail: [email protected]

Giovanni Gambaro

Division of Nephrology,

Dept. of Medical and Surgical Sciences

School of Medicine

Universita di Padova

I-35128 Padova, Italy

E-mail: [email protected]

Andy IM Hoepelman

University Medical Centre Utrecht

Dept. of Medicine,

3508 GA Utrecht, The Netherlands

Tel: +31 30 2506288

Fax: +31 302523741

e-mail: [email protected]

Henrik Post Hansen Steno Diabetes Center Copenhagen, Denmark e-mail: [email protected]

Klavs Würgler Hansen, M.D. Medical Department Silkeborg Centralsygehus Falkevej 1-3

DK-8600 Silkeborg, Denmark E-mail: [email protected]

Tom Hostetter, Director

National Kidney Disease Education Program

Senior Scientific Advisor

National Instutes of Health

National Institutes of Diabetes, Digestive and

Kidney Diseases,

6707 Democracy Blvd., Room 625 Bethesda, Maryland 20892, USA. Tel: 301 594 8864 Fax: 301 480 3510

E-mail: [email protected]

Dr. Giuseppina Imperatore Division of Diabetes Translation Centers for Disease Control and Prevention Atlanta, Georgia, USA E-mail: [email protected]

George Jerums, M.D. Endocrine Unit Austin Hospital Burgundy Street

Heidelberg Victoria 3084, Australia Tel: +61-39-496-5489 Fax: +61-39-496-3365 E-mail: [email protected]

Dr. Susan E. Jones Department of medicine The Medical school Framlington Place

Newcastle Upon Tyne NE2 4HH, UK Tel: +44 (0) 191 2227 019 Fax: +44 (0) 191 2220 723 E-mail: [email protected]

Professor William F. Keane, M.D. Merck & Co. Inc One Walnut Grove, HM 215 Horsham PA 19044, USA E-mail: williamf [email protected]

Vascular Cell Biology and Complications

Joslin Diabetes Center

One Joslin Place 02215

Boston, MA, USA

Tel: +1-617-732-2660

Fax: +1-617-732-2637

E-mail: [email protected]

John L. Kitzmiller, M.D.

Chief, Maternal Fetal Medicine

Good Samaritan Health System

Perinatal Associates of Santa Clara Valley

2425 Samaritan Drive

San Jose, California 95124, USA

Tel: +1 408 559 2258

Fax: +1 408 559 2658

E-mail: [email protected]

Chief, Diabetes and Arthritis Epidemiology

Section

National Institute of Diabetes and Digestive and

Kidney Diseases

1550 East Indian School Road

Phoenix, Arizona 85014, USA

Tel: +1 602 200-5206

Fax: +1 602 200-5225

E-mail: [email protected]

Gozewijn D. Laverman

Department of Internal Medicine, Division of nephrology, University Hospital Groningen, Groningen, The Netherlands E-mail: gd [email protected]

Paulette Lyle

One Walnut Grove, HM 215

Horsham PA 19044, USA

E-mail: paulette [email protected]

Professor Carl Erik Mogensen, M.D.

Medical Department M

Aarhus Kommunehospital

Aarhus University Hospital

DK-8000 Aarhus C, Denmark

Tel: +45 8949 2011

Fax: +45 8613 7825/8949 2010

E-mail: [email protected]

Henrik Bindesbol Mortensen, M.D. Pediatric Department L Amtssygehuset i Glostrup Ndr. Ringvej

DK-2600 Glostrup, Denmark

E-mail: [email protected]

Gerjan J. Navis, M.D. Department of Internal Medicine Division of Nephrology University Hospital Hanzeplein 1

9700 RB Groningen, The Netherlands Fax: +31 50 3169310 E-mail: [email protected]

Steen Olsen, M.D. Professor Emeritus Department of Pathology Herlev Hospital DK-2730 Herlev, Denmark Tel: (home: 45 3976 2520) E-mail: [email protected]

Hans-Henrik Parving, M.D.

Steno Diabetes Center

Niels Steensens Vej 2

2820 Gentofte, Denmark

E-mail: [email protected]

Dr. Margrethe Mau Pedersen Department of Internal Medicine and Cardiology, Aarhus University Hospital DK-8000 Aarhus, Denmark E-mail: [email protected]

Sansum Medical Research Foundation

2219 Bath Street

Santa Barbara, CA 93105, USA

Tel: +1 805 682 7640

Fax: +1 805 682 3332

E-mail: [email protected]

Per Logstrup Poulsen, M.D. Medical Department M Aarhus Kommunehospital Aarhus University Hospital DK-8000 Aarhus C, Denmark Tel: +45 8949 2019 Fax: +45 8949 2010 E-mail: [email protected]

Eberhard Ritz, M.D.

Sektion Nephrologie

Klinikum der Universität Heidelberg

Medizinische Klinik

Bergheimer Strasse 56a

D-69115 Heidelberg, Germany

Tel: +49 6221 91120

Fax: +49 6221 162476

E-mail: [email protected]

Peter Rossing, M.D. Steno Diabetes Center Niels Steensensvej 2 DK-2820 Gentofte, Denmark Fax: +45 4443 8232 E-mail: [email protected]

Dr. Piero Ruggenenti

Mario Negri Institute for Pharmacological

Research

Via Gavazzeni 11

24125 Bergamo, Italy

Tel: +39 035 319 888

Fax: +39 035 319 331

E-mail: [email protected]

Erwin Schleicher, M.D.

Institute of Internal Medicine

Dep. Of Endocrinology, Metabolism and

Pathobiochemistry

University of Tübingen

Otfried-Müller-Str. 10

D-72076 Tübingen, Germany

Tel: +49 7071 29 87599

Fax: +49 7071 29 5974

e-mail: [email protected]

Dr. Neil Sheerin

Department of Nephrology and Transplantation

Guy's King's and St Thomas' School of Medicine

King's College London

London SE1 9RT, UK

E-mail: [email protected]

Coen D.A. Stehouwer, M.D. Department of Internal Medicine VU University Medical Centre De Boelelaan 1117

1081 HV Amsterdam, The Netherlands Tel: +31 20 444 309 Fax: +31 20 444 313 E-mail: [email protected]

Lise Tarnow, M.D. Steno Diabetes Center Niels Steensensvej 2 2820 Gentofte, Denmark Fax: +45 4443 8232 E-mail: [email protected]

Merlin C Thomas

Danielle Alberti Memorial Centre for Diabetes Complications

Baker Heart Research Institute Melbourne 8008, Victoria, Australia E-mail;: [email protected]

Dr. Stephen .M. Thomas King's Diabetes Centre Kings College Hospital London, UK

E-mail: [email protected]

GianCarlo Viberti, M.D. Division of Medicine Guy's and St Thomas's Medical and Dental School

Unit for Metabolic Medicine Diabetes, Endocrinology, Metabolism Floor 5 Hunt's House, Guy's Hospital London Bridge, London SE1 9RT, UK Tel: +44 1 71 955 4826 Fax: +44 1 71 955 2985 E-mail: [email protected]

Dr. Cora Weigert

Department of medicine

Div. of Endocrinology, Metabolism and

Pathobiochemistry

University of Tübingen, Germany

E-mail: [email protected]

Renal-Electrolyte and Hypertension Division

700 Clinical Research Building

University of Pennsylvania Medical Center

415 Curie Boulevard

Philadelphia, PA 19104-6144, USA

Tel: +1 215 573 1837

Fax: +1 215 898 0189

E-mail: [email protected]

Giulio Zuanetti, M.D.

Department of Cardiovascular Research

Istituto Mario Negri via Eritrea 62

I-20157 Milan, Italy

Tel: +39 2 3901 4454

E-mail: [email protected]

Get The Body Of Your Dreams

Get The Body Of Your Dreams

Everybody wants to lose weight. This is one fact that is supported by the countless weight loss programs on the market along with the numerous weight loss products, ranging from snack bars, powdered juices, shakes and even slimming soaps and lotions.

Get My Free Ebook


Post a comment