Index

A Practical Guide to Diabetes Mellitus Nihal Thomas, Kanakamani Jeyaraman, Asha HS, Jachin Velavan, Senthil Vasan, Thomas V Paul, Kishore Kumar Behera, Simon Rajaratnam

1:Physiology
- PANCREAS
- DIABETES MELLITUS
2:Pathogenesis, Diagnosis and Classification of Glycemic Disorders
- INTRODUCTION
- CLASSIFICATION
- PATHOGENESIS
  - Type 1 DM (T1DM)
  - Type 2 DM (T2DM)
- DIAGNOSIS OF DIABETES MELLITUS
- THE CONCEPT OF PRE-DIABETES
- DIAGNOSIS OF IFG AND IGT
- THE CONCEPT OF “THE METABOLIC SYNDROME”
- SCREENING FOR DIABETES
- SUMMARY OF RECOMMENDATIONS FOR ADULTS WITH DIABETES
- GLYCOSYLATED HEMOGLOBIN (HBA1C)
3:Practical Medical Nutritional Therapy
- THE GOALS OF MNT INCLUDE
- RECOMMENDED NUTRIENT INTAKE ASPERCENT OF TOTAL CALORIES
- CARBOHYDRATE
- PROTEIN
- FAT
- NON-NUTRITIVE SWEETENERS
- ALCOHOL AND DIABETES
4:Exercise
- INTRODUCTION
- PHYSIOLOGICAL CHANGES OCCURING DURING EXERCISE
- CLINICAL IMPLICATIONS OF THE EFFECTS OF EXERCISE IN DIABETES
- BENEFITS OF EXERCISE IN PATIENTS WITH DIABETES
- POTENTIAL ADVERSE EFFECT OF EXERCISE IN PATIENTS WITH DIABETES
- EXERCISE PRESCRIPTION
- TYPES OF PHYSICAL ACTIVITY
- PRACTICAL CONSIDERATIONS (Fig. 4.8)
  - How Much Exercise?
  - Which is the Best Exercise?
5:Counseling
- INTRODUCTION
  - Steps in Counseling
- CONCLUSION
- CASE STUDIES
- ACKNOWLEDGMENT
6:Oral Antidiabetic Agents
- ROLE OF ORAL ANTIDIABETIC AGENT THERAPY IN TYPE 2 DIABETES MELLITUS
- SULPHONYLUREAS
  - Available Agents
- BIGUANIDES
- MEGLITINIDE
- ALPHA GLUCOSIDASE INHIBITORS
- THIAZOLIDINEDIONES
- INCRETIN EFFECT
- GUIDELINES FOR INITIATING ORAL ANTIDIABETIC AGENTS: (ADA 2007 GUIDELINES, REVISED IN 2012)
7:Parenteral Therapeutic Agents
- PATHOPHYSIOLOGY AND THE BASIS FOR INSULIN REPLACEMENT REGIMENS
- HISTORY
- SOURCES OF INSULIN
- CLASSIFICATION OF INSULIN
- INDICATIONS FOR INSULIN THERAPY
- THERAPEUTIC REGIMENS
  - Augmentation Therapy
  - Replacement Therapy
    - Dosing
- ORAL MEDICATIONS PLUS INSULIN
- INSULIN ANALOGS
- STANDARD INSULIN Vs INSULIN AnalogS
- PROBLEMS WITH REGULAR INSULIN
- INSULIN ANALOGS
  - Rapidly-acting Analogs
  - Long-acting Analogs
- NEW SECRETAGOGUES
8:Insulin Therapy—Practical Aspects
- INTRODUCTION
- INSULIN STORAGE
- INSULIN SYRINGES
- REUSE AND DISPOSAL OF SYRINGES
- SYRINGE ALTERNATIVES
- SITES FOR INSULIN ADMINISTRATION
  - Mixing of Insulin
  - Split-mix and Multiple Dose Regimens
- FACTORS THAT AFFECT RATE OF INSULIN ABSORPTION
- COMPLICATIONS OF INSULIN THERAPY
- SICK DAY MANAGEMENT
  - Sick Day Guidelines
  - Other Instructions
- ALTERNATIVE METHODS OF INSULIN DELIVERY
- DETERMINING EFFECTIVENESS OF SELF-INJECTION EDUCATION
9:Instruments and Gadgets
- INTRODUCTION
10:Peripheral Neuropathy
- INTRODUCTION
- DEFINITION
  - WHO Definition of Neuropathy in Diabetes
- RISK FACTORS
- CLASSIFICATION
- PATHOGENESIS
- CLINICAL PRESENTATION
- CONCLUSION
11:Feet, Footcare and Neuroarthropathy
- INTRODUCTION
12:Footwear
- INTRODUCTION
- FOOT INJURY MECHANISM—DUE TO SENSORY NEUROPATHY
  - Foot Injury Mechanism Due to Motor and Sensory Neuropathy
- FOOT EXAMINATION FOR SELECTING APPROPRIATE FOOT ORTHOTICS
- SELECTION OF FOOTWEAR
- SUMMARY
13:Hypertension
- DEFINITION
- DIAGNOSIS
- CLASSIFICATION
- PREVALENCE OF HYPERTENSION IN DIABETES
- PATHOGENESIS
- TARGET LEVELS OF BLOOD PRESSURE IN PATIENTS WITH DIABETES
- MANAGEMENT OF HYPERTENSION
- EVIDENCE FOR TREATMENT
- WHEN AND HOW TO INVESTIGATE FOR SECONDARY CAUSE FOR HYPERTENSION
  - Renovascular Hypertension
  - Primary Hyperaldosteronism
14:Nephropathy
- INTRODUCTION
- DEFINITIONS
- RISK FACTORS
- CLASSIFICATION
- SURVIVAL IN PATIENTS WITH DIABETIC NEPHROPATHY
- PATHOGENESIS OF NEPHROPATHY
- PATHOLOGY
- SCREENING
- CLINICAL PRESENTATION
- DIFFERENTIATING FROM OTHER CAUSES OF KIDNEY DISEASES
- MANAGEMENT
- INVESTIGATIONS
  - Renal Replacement Therapy (RRT)
- NORMOALBUMINURIC CKD IN DIABETES
- NEWER/EXPERIMENTAL THERAPies FOR DIABETIC NEPHROPATHY
- CONCLUSIONs
15:Cardiovascular Complications and Dyslipidemia
- CARDIOVASCULAR DISEASE-THE IMPACT OF DIABETES
- PATHOGENESIS OF CHD
  - Diabetic Cardiomyopathy
  - Cardiac Autonomic Neuropathy
- CLINICAL MANIFESTATIONS
- SCREENING FOR CORONARY ARTERY DISEASE IN DIABETES
  - Indications for Testing of CAD
  - Cardiac Testing in Symptomatic Diabetic Subject
- CARDIAC TESTING
- ACUTE CORONARY SYNDROME
  - Thrombolysis
  - Coronary Interventions
- CARDIAC FAILURE
- HYPERGLYCEMIA AND BEYOND
- DYSLIPIDEMIA IN DIABETES
- MANAGEMENT
- PRIMARY PREVENTION OF CVD IN PATIENTS AT METABOLIC RISK
16:Ocular Disease and Retinopathy
- INTRODUCTION
- CORNEAL CHANGES
- LENS AND CATARACT
- DIABETES AND GLAUCOMA
- ORBITAL INVOLVEMENT
- NEURO OPHTHALMIC MANIFESTATIONS OF DIABETES
- DIABETIC RETINOPATHY
- MANAGEMENT OF DIABETIC RETINOPATHY
- OPHTHALMOSCOPY
- PROCEDURE
  - Fundus Findings of Diabetic Retinopathy
- RECORDING OF FUNDUS FINDINGS
17:Autonomic Neuropathy
- INTRODUCTION
- EPIDEMIOLOGY OF DAN
- PATHOGENESIS
- CLINICAL MANIFESTATIONS OF DAN
- CURRENT GUIDELINES FOR THE DIAGNOSIS OF DAN
- MANAGEMENT IMPLICATIONS OF DAN
- CONCLUSION
18:Infections in Diabetes
- INTRODUCTION
- SPECIFIC INFECTIONS
- BACTERIURIA AND CYSTITIS IN WOMEN
- EMPHYSEMATOUS PYELONEPHRITIS
  - Abdominal and Gastrointestinal Infections
    - Emphysematous Cholecystitis
    - Enteric Pathogens
  - Skin and Soft Tissue Infections
- DIABETIC FOOT INFECTIONS
  - Meliodosis
  - Immunizations Recommended in Diabetes
- CONCLUSION
  - Common Infections and Suggested Antimicrobial Therapy
19:Emergencies
- INTRODUCTION
- PRECIPITATING FACTORS
- PATHOPHYSIOLOGY OF DKA AND HHS
- CLINICAL RECOGNITION, ESTABLISHING A DIAGNOSIS AND ASSESSMENT OF CO-MORBIDITIES
  - History in DKA and HHS
  - Physical Findings in DKA and HHS
- DIAGNOSTIC EVALUATION AND LABORATORY STUDIES
- CLINICAL MANAGEMENT OF DKA AND RECOGNITION OF COMPLICATIONS
- PROGNOSIS
- HYPOGLYCEMIA IN A PATIENT WITH DIABETES
20:Pregnancy
- INTRODUCTION
- TERMINOLOGY
- GESTATIONAL DIABETES MELLITUS
- PREGESTATIONAL DIABETES
- MANAGEMENT
  - Obstetric Management of GDM
    - Antepartum Management
  - Postpartum Management
- FUTURE RISKS IN MOTHER
- CONCLUSION
21:Diabetes in Childhood and Adolescence
- EPIDEMIOLOGY
- DIAGNOSIS
- CLASSIFICATION
- CLINICAL FEATURES
- MANAGEMENT
- CHRONIC COMPLICATIONS
- ACUTE COMPLICATIONS
  - Hypoglycemia
  - Diabetic Ketoacidosis
- SICK DAY MANAGEMENT
- TYPE 2 DIABETES IN CHILDREN
  - Prediction of Development of Type 1 Diabetes Mellitus
- CONCLUSIONS
22:Secondary Diabetes and Other Specific Types
- CLASSIFICATION OF SECONDARY DIABETES
- CHRONIC COMPLICATIONS IN SECONDARY DIABETES
- CLINICAL CONSIDERATIONS–WHY IS KNOWLEDGE ABOUT SECONDARY DIABETES IMPORTANT?
- MANAGEMENT
- OTHER SPECIFIC TYPES OF DIABETES
23:Perioperative Care
- METABOLISM AT REST
- METABOLIC CHALLENGE OF SURGERY
- PREOPERATIVE MANAGEMENT OF DIABETIC PATIENTS
  - Preoperative Assessment
    - Evaluation of End-Organ Damage
  - Level of Glycemic Control
- CLASSIFICATION OF THE TYPE OF SURGERY
  - Management of Diabetes Depends on
- CHOICE OF ANESTHESIA
- PREMEDICATION
- INTRAOPERATIVE ANESTHETIC MANAGEMENT OF DIABETIC PATIENTS
- MAJOR SURGERY REGIMEN
- MANAGEMENT OF DIABETIC PATIENTS UNDER DIFFERENT MODES OF ANESTHESIA
  - In General Anesthesia
  - In Regional Techniques
- PROBLEMS TO BE ANTICIPATED IN A DIABETIC PATIENT UNDER ANESTHESIA
- EMERGENCY SURGERY IN THE DIABETIC PATIENT
- SPECIAL CLINICAL SCENARIOS
- POSTOPERATIVE MANAGEMENT OF DIABETIC PATIENTS
  - Blood Glucose Monitoring and Control
  - Surgical Wound Management
- SUMMARY
24:Laboratory and Analytical Methods
- INTRODUCTION
- LABORATORY ERRORS
- PREANALYTICAL, ANALYTICAL AND POSTANALYTICAL ERRORS
- ROLE OF LABORATORY IN DIABETES MANAGEMENT
- AVAILABLE ASSAYS
- OTHER TESTS OF RELEVANCE
25:Recent Advances
- SELECTIVE SODIUM-GLUCOSE COTRANSPORTER-2 (SGLT) INHIBITORS
- DRUGS WHICH POTENTIATE INSULIN SECRETION
  - Newer Glucagon-like Peptide-1 Analogs
  - Newer DPP-IV inhibitors
- INSULIN RECEPTOR ACTIVATORS
- NEWER PEROXISOME PROLIFERATOR ACTIVATED RECEPTOR (PPAR) AGONISTS
- NEW HEPATIC TARGETS FOR GLYCEMIC CONTROL IN DIABETES
- MISCELLANEOUS
- ADVANCES IN INSULIN THERAPY
- IMMUNOTHERAPY FOR TYPE 1 DIABETES
  - Immunomodulators
- STEM CELL THERAPY
26:Inhospital Management of Diabetes
- INTRODUCTION
- EFFECTS OF HYPERGLYCEMIA IN HOSPITALIzED PATIENTS AND BENEFITS OF GLYCEMIC CONTROL
- WHICH PATIENT should we ADMIT?
- AIMS AND TARGETS
  - Goals for Blood Glucose Levels*
- THE DIABETES INPATIENT TEAM
- THE PARADOX: BARRIERS TO GLYCEMIC CONTROL IN HOSPITAL
- COMMON ERRORS IN MANAGEMENT
  - Glucose Monitoring
- GLUCOSE CONTROL
27:Integrating Systems
- INTRODUCTION
- DISEASE PREVENTION
- PREVENTION AND ITS IMPORTANCE
  - In The Hospital
  - In The Community
- INTEGRATED DIABETES CLINICS
  - Functionaries of an Integrated Diabetes Clinic and their Role
  - Outreach Activities
- DIABETES SUPPORT GROUPS
- INTRODUCTION
- DESKTOP CONFERENCE—WEB-BASED LEARNING METHOD
- REQUIREMENTS FOR QUALITY TRANSMISSION
- ADMINISTRATIVE CHALLENGES AND ISSUES
  - Impact of Telemedicine on Diabetes and Health
- CONCLUSION
Clinical Case Studies
Final Evaluation
Answers to Self Assessment
Appendices
- WHAT IS DIABETES MELLITUS?
- WHAT ARE THE SYMPTOMS OF DIABETES MELLITUS?
- WHAT DOES THE MANAGEMENT OF DIABETES MELLITUS INVOLVE?
- HOW OFTEN SHOULD ONE CHECK BLOOD SUGARS?
  - Monitoring Blood Sugar Control
- WHAT ARE THE TABLETS UTILIZED IN TREATING DIABETES MELLITUS?
- WHAT ARE THE SYMPTOMS OF A LOW BLOOD SUGAR (“HYPOGLYCEMIC ATTACK”)?
- WHEN SHOULD INSULIN BE USED?
- HOW SHOULD INSULIN BE ADMINISTERED?
- WHAT EXTRA ATTENTION DOES THE FEET REQUIRE IN DIABETES MELLITUS?
- CONCLUSION
- THE IMPORTANCE OF FOOT CARE IN DIABETES MELLITUS

INDEX

TOC
Index

Chapter Notes