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Colwell’s diabetes text offers latest disease management by Cindy Abole Public Relations When MUSC professor John A. Colwell, M.D., Ph.D., was asked to write a book about diabetes, little did he know that his book would be praised and accepted among both clinical and scientific circles. Colwell has held a lifetime interest in diabetes as clinician, educator and research scientist. For 22 years, he was director of MUSC’s Division of Endocrinology, Diabetes and Metabolism. Colwell is board chairman of the Diabetes Initiative of South Carolina and director of the MUSC Diabetes Center. Statewide outreach, surveillance and professional education are the main functions of the Diabetes Initiative of South Carolina. He has been involved in individual and collaborative research with many colleagues nationally and internationally, as well as across campus. So when he sat down to write his 225-page publication, he wanted to provide health care providers with the latest data, information and care techniques needed in the care of diabetic patients. To do this, he turned to recent research that emphasizes an evidence-based approach to care for patients with diabetes. Colwell, who has written extensively on diabetes in previous texts, chapters and papers, presented collective research and findings from study results, methods and patient cases. The book reviews both type 1 and type 2 diabetes management and prevention and other complications using solid data from research and clinical trials. Although credible data for much of this information has appeared at a rapid rate, there are few opportunities and resources that have gathered and managed this information through a central source.  “This book is a critical reference developed from recent large collaborative trials which have provided the evidence needed for guidelines of care for type 1 and type 2 diabetes,” said Pam Arnold, an advance practice registered nurse at the MUSC Diabetes Center and clinical director of the Diabetes Initiative of South Carolina. “Each chapter provides rationale, key points and caveats to diabetes management. It will especially assist primary care providers with the latest information and tools needed to improve outcomes in their patients with diabetes.” As people age and the prevalence of obesity rises, so does the risk of developing type 2 diabetes. Statewide, 60 percent of people with diabetes are overweight or obese, and 8.1 percent of adults are aware that they have diabetes. Epidemiologic surveys indicate that for every two persons who have known diabetes, there is one who has it and does not know it. This translates to about 350,000 people with diabetes in the state.  An additional 450,000 people are estimated to have a condition called prediabetes (and/or the metabolic syndrome) which makes them at very high risk to eventually develop diabetes and major vascular complications. Thus, more than 25 percent of the adult population in South Carolina has diabetes or is at high risk to develop it. The impact of this on the nation's health care system is astounding, since these individuals have a risk for a heart attack or stroke which is three to four times that of their counterparts who do not have diabetes. Thus, the average life span for South Carolinians with diabetes is shortened by at least eight years. Thus, diabetes is a serious public health problem. At highest risk for diabetes in South Carolina are blacks. Some 75-80 percent of these individuals with diabetes also have hypertension and many have high blood cholesterol. Hypertension and lipid alterations increase the incidence of heart attacks and strokes.  “If you add one cardiovascular risk into diabetes, it doubles the complications of what diabetes does,” said Colwell, who was inspired to enter diabetes research by his father, former University of Chicago diabetologist Arthur R. Colwell, M.D. “Hypertension increases the incidence of heart attacks and strokes.” Some of the pioneering research being done is conducted locally with Maria Lopes-Virella, M.D., Ph.D., professor of endocrinology, diabetes and medical genetics. Lopes-Virella is conducting basic research on lipid abnormalities, a problem in more than half of all diabetics. Research on the risk of hypertension and diabetes link is headed by Department of Biometry and Epidemiology’s Dan Lackland, Dr. PH., and Brent Egan, M.D., professor of cell and molecular pharmacology. Egan is also co-director of Project EXPORT, a program that examines the effects of metabolic syndrome among African American populations, especially within the Palmetto state.  More than six months in the making, Hot Topics Diabetes is part of a series of texts that provides expert information on the diagnosis and management of health issues and diseases published by Hanley and Belfus and distributed by Elsevier (http://www.elsevierhealth.com). It is being offered at various professional gatherings including the American College of Physicians, the Endocrine Society and the American Diabetes Association.  Other books featured in this series cover topics like exercise, hypertension, infectious disease, osteoporosis and pain management.   Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to petersnd@musc.edu or catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778.