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Baillière’s Clinical Paediatrics: Childhood Diabetes.
  1. IAN G JEFFERSON, Consultant paediatrician/endocrinologist

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    Baillière’s Clinical Paediatrics: Childhood Diabetes. Edited by J P H Shield and J D Baum. (Pp 744; £30 hardback.) Baillière Tindall/W B Saunders, 1996. ISBN 0-7020-2254-3.

    Julian Shield and David Baum have brought together an impressive group of authors from various parts of the globe for this latest edition to the monograph series of Clinical Paediatrics on childhood diabetes.

    It makes an enjoyable read for anyone interested in this complex childhood endocrine disease but it is not a practical management manual.

    Only two of the chapters deal with any practical aspects of care, those on diabetic ketoacidosis and neonatal diabetes. The chapter on diabetic ketoacidosis discusses the physiology of the metabolic derangement in depth and includes the recent recommendations for its management from the British Society for Paediatric Endocrinology and Diabetes. The chapter on neonatal diabetes includes some useful pointers on management of this rare condition and an insight into its relationship to glucose intolerance in later life.

    The majority of the book is thus a series of ‘state of the art’ dissertations from renowned authors with an emphasis on science and potential clinical applications rather than current practice.

    There is an excellent series of three review chapters on epidemiology, genetics, and possible preventive interventions. The paediatric aspects of the Diabetes Control and Complications Trial are crystallised in a multiauthor chapter headed by William Tamborlane, which also poses some interesting questions on how to achieve optimal management. The issue of pathogenesis and screening for microvascular complications is taken up in a chapter by Henrik Mortensen with, as might be expected, the emphasis on microalbuminuria.

    There are also excellent chapters on maturity onset diabetes of the young, associated immunological diseases, and a final chapter on growth hormone and insulin-like growth factor-I and their role in the difficulties of adolescent management and possible therapeutic role in the future from Zvi Laron.

    This book should be essential and stimulating reading for all those paediatricians involved in the care of children with diabetes. Not that it will greatly improve our care of them in its own right but it will go a long way to explaining much of the frustration in management and put the all important science behind the clinical facade. It provides a stimulus to the ongoing care of these children and a hope that with just a little more knowledge more effective management, or possibly prevention, may not be too far away.

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