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Merck Manuals

By David Mendosa

Last Update: March 30, 2001

It's a book! It's a Web site!

It's not a bird or a plane, and it is both a book and a Web site. Actually, three books and three sites.

It's the time-honored Merck Manual of Diagnosis and Therapy, which doctors have been using for more than 100 years. It's also two new versions, The Merck Manual of Medical Information: Home Edition and The Merck Manual of Geriatrics, just published a few months ago.

The manuals are…broad rather than deep

The new versions are geared to consumers. You can find all three versions at Merck Publications.

Start your search for information about diabetes or any other condition with the home edition, says Editor Emeritus Robert Berlow. Then go to the geriatrics manual for some more detail. Finally, if you want to see the technical information your doctor sees, particularly about medications, go to the original manual. That will give you the views of three different doctors who wrote at three different times.

While the print versions of the books cost as much as $35, they are all free on the Internet. The Web versions are all easier and quicker to use than their print counterparts.

The home edition actually comes in two versions, a text-based version and a new interactive version that includes illustrations and photos, animations, videos, and pronunciations of medical terms. Attractively presented, this version requires Windows 95 or better and a recent version of Microsoft Internet Explorer or Netscape. They are developing a version for the Macintosh.

The text-based version went on-line about a year ago. The interactive version came out in December.

Merck & Co. Inc. publishes all the Merck manuals through its nonprofit publishing arm. Merck is a giant pharmaceutical firm headquartered in Whitehouse Station, New Jersey.

The manuals are authoritative and broad rather than deep. To find the bulk of the manual's information on diabetes, click on Section 13 "Hormonal Disorders," which opens up the chapter headings. Then click on Chapter 147, "Diabetes Mellitus." While it covers all the essentials, it says its piece in seven pages when you print it out.

While lacking the bells and whistles, the organization by section and chapter of the text edition are the same as the interactive edition. The content is also the same.

For a different view of diabetes turn to Merck's Manual of Geriatrics. You might not think of diabetes as a geriatric condition, particularly if you have type 1 diabetes, which we used to call juvenile diabetes. But the older you are the more likely you are to get type 2 diabetes.

The print version of this manual, the most widely used textbook of geriatric medicine, is already in its third edition. But the on-line version is brand new.

To find its chapter on diabetes go to section 8 "Metabolic and Endocrine Disorders," where you will find chapter 64, "Disorders of Carbohydrate Metabolism." When I printed it out, it came to 17 pages, more than twice as much information as the Home Edition. Particularly noticeable, this manual has a much stronger section on oral medications than does the Home Edition.

In the Merck Manual of Diagnosis and Therapy, the technical version that your doctor uses, you can find diabetes in section 2, "Endocrine/Metabolic Disorders," chapter 13, "Disorders of Carbohydrate Metabolism." Like the Geriatric Manual, a printout runs 17 pages. It has more information on the pathogenesis, or causes, of diabetes than I have seen anywhere else.

But because of the rapid advances in oral medications in the past couple of years, this section of the manual is not up-to-date. It says, for example, that the only thiazolidinedione available in the United States is troglitazone. But the Food and Drug Administration took troglitazone (Rezulin) off the market a year ago, and it has been replaced by two other thiazolidinediones.

Still, these three manuals taken as a whole provide some of the best information you can find anywhere about diabetes and whatever else may ail you. 

The American Diabetes Association originally published this article on its Web site as one of my “About the Internet” columns.

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