Advances in diabetes for the millennium: an e-symposium.

Advances in Diabetes for the Millennium: Table of Contents In the past decade, the Internet has changed the way we acquire information. We exchange thoughts in a fast-paced world of computer displays. We still express our ideas in written words, but, more and more, paper is disappearing as a transfer and storage medium. Many had feared that personal interaction would suffer as computers are becoming the dominant mode of communication, but that fear has not materialized. On the contrary, the ability to instantly reach anyone in the world with a few keystrokes has greatly enhanced our relationships. When the millennium began, a group of the leading clinical investigators in diabetes came together in an organization known as the Association of Diabetes Investigators (ASNDI) with the goal of improving the investigative climate for clinical research in diabetes. We are located throughout the United States. Some of us work at major universities. Others are in full-time private practice. Our patient population reflects the widely different geographic locations of our sites. Some of us practice in rural areas, others in big cities. Some of us have large African American populations. Others have a majority representation of Hispanic patients. Yet, despite these apparent differences, we are quite similar in our outlooks and approach. We have the unifying force of many years of joint participation in the protocols that have brought many of the current new diabetes, lipid, and antihypertensive agents into general use. Our alliance is a realistic consequence of the many meetings we have attended jointly at different places over the years. We have had many wonderful discussions at meetings. It occurred to us that the new medium of the Internet could permit us to share our thoughts on a more frequent basis than allowed by even very frequent travel to meetings. We decided to use electronic communication to develop a symposium on the major advances that have improved the care of diabetic individuals over the past decade. Our further goal was to attempt to forecast the changes that we see coming to diabetes in this new millennium. We have assembled a great group. Dr. David Bell and Dr. Paresh Dandona have collaborated on the cardiovascular effects of diabetes and the new entity of endothelial dysfunction. Dr. Marc Rendell has reviewed the importance of cholesterol-lowering therapy in diabetes. Dr. Dan Einhorn and Dr. Rendell have analyzed the changes in insulin and other pharmaceutical therapies for diabetes, whereas Dr. Aaron Vinik explains the new world of transplantation and islet cell-regeneration approaches. Dr. Lois Jovanovic and Dr. Robert Harrison have reviewed the special issues of diabetes in minority populations and in women. Dr. Bruce Chertow and Dr. Rendell discuss nutritional therapy and supplementation in diabetes and the role of antioxidants. Dr. John Gerich and Dr. George Dailey consider insulin resistance as a factor in diabetes. Dr. Aaron Vinik and Dr. Leann Olansky offer their ideas on microvascular disease and neuropathy. Dr. Peter Bressler and Dr. Neal Friedman provide a lively counterpoint on managed care vs the needs of the physician caring for diabetic patients. Although each of these individuals is an expert in his/her own area, this symposium is clearly a group effort conducted with the Internet as our meeting place. It has been an outstanding experience to see how the interchange among these brilliant people has led to new concepts for the future. The typical symposium is very much a process of listening to the ideas of each speaker in a group setting in a large meeting room. There is a 1-time discussion, followed by each speaker documenting his/her ideas in a manuscript, archived in paper format. In contrast to this customary symposium meeting, we organized our symposium online. We were able to develop the important questions as a group. Then we shared our concepts on the Internet. Draft documents were prepared and shared among all group members. The critiques that followed permitted us to better identify key issues and respond to important questions. The e-symposium concept permits less time-constrained discussion with the development of new suggestions and ideas. Rather than occurring in a meeting of 1-2 days duration, we spent many months communicating as a group. We then were able to review and evaluate the contributions of each member of our group. It is our hope that this e-symposium will be an important resource both for physicians and for their patients to try to visualize a brighter future for diabetic patients in this new millennium. You will receive online CME credit for your electronic participation in this e-symposium. Questions will be found linked to each separate article. By registering for this symposium, you may obtain CME credits. You may do so on your own schedule, without travel or inconvenience. Also, please feel free to address comments or questions to our group by emailing to moc.idnsa@ofni. We are grateful for unrestricted educational grants provided for this symposium by many of the leading companies in the area of diabetes research. The list includes GlaxoSmithKline, Pfizer, Sanofi, Novartis, Takeda, and Aventis. These companies realize the importance of communication and interchange on new approaches and ideas. We hope that this e-symposium on diabetes will lead to future similar efforts in other areas of rapid medical progress. We have enjoyed the benefits of electronic communication and hope that many more meetings can be held in the new world of cyberspace.