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Textbook of Diabetes

Wiley (Verlag)
6. Auflage
Erschienen am 11. Januar 2024
1232 Seiten
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978-1-119-69743-5 (ISBN)
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Textbook of Diabetes

Classic textbook providing diabetologists and endocrinologists with illustrated and clinically focused content on diabetes

Now in its sixth edition, the Textbook of Diabetes has established itself as the modern, international guide to diabetes. Sensibly organized and easy to navigate, with exceptional illustrations, the textbook hosts an unrivalled blend of clinical and scientific content. Written by highly experienced editors and international contributors all of whom have provided insight on new developments in diabetes care. These include the most recent guidelines from the European Association for the Study of Diabetes (EASD), the American Diabetes Association (ADA), Diabetes UK, and the National Institute for Health and Care Excellence (NICE) and information on the latest treatment modalities used around the world.

The textbook includes free access to the Wiley Digital Edition which provides easy-to-use searching across the book, the full reference list with web links, illustrations and photographs, and post-publication updates.

Sample topics covered in Textbook of Diabetes include:

* Diabetes in its historical and social context, covering the history of diabetes, past classification and diagnosis of diabetes and the global burden of diabetes

* Normal physiology, covering glucose homeostasis, islet function and insulin secretion, and
glucagon in islet and metabolic regulation

* Pathogenesis of diabetes, covering genetics of diabetes and obesity, autoimmune type 1 diabetes
and other disorders with type 1 diabetes phenotype

* Other types of diabetes, covering endocrine disorders that cause diabetes, pancreatic diseases and diabetes and drug-induced diabetes

Beautifully illustrated with a clinical focus, Textbook of Diabetes provides endocrinologists and diabetologists, both consultants/specialists and those in training, with a fresh and comprehensive clinical resource to consult time and time again. The text is also of value to specialist diabetes nurses and researchers in the field.
Richard I.G. Holt, Professor in Diabetes and Endocrinology, University of Southampton, UK and Honorary Consultant Physician, University Hospital Southampton NHS Foundation Trust. Professor Holt is also Chair of the EASD Committee for Clinical Affairs.

Allan Flyvbjerg, Former CEO at Steno Diabetes Center Copenhagen and Clinical Professor at University of Copenhagen, Denmark. Further, professor Flyvbjerg was President of the Danish Diabetes Association from 2000-2011 and is presently member of the Board of Directors of EASD, Chairman of the EASD Postgraduate Education Committee and Chairman of the Board of Directors of The Danish Diabetes and Endocrine Academy (DDEA).
  • Cover
  • Title Page
  • Copyright Page
  • Contents
  • List of Contributors
  • Preface
  • List of Abbreviations
  • Part 1 Diabetes in its Historical and Social Context
  • Chapter 1 The History of Diabetes Mellitus
  • Ancient times
  • Seventeenth and eighteenth centuries
  • Nineteenth century
  • Clinical diabetes in the nineteenth century
  • Twentieth century
  • Discovery of insulin
  • The post-insulin era
  • Causes and natural history of diabetes
  • Chronic diabetic complications
  • Physiology
  • Management of diabetes
  • Insulin
  • Other anti-diabetes agents
  • Glucose management and treatment targets
  • Diabetes-related complications
  • Diabetic ketoacidosis
  • Diabetes in pregnancy
  • Delivery of care for people with diabetes
  • References
  • Chapter 2 Classification and Diagnosis of Diabetes
  • Definition
  • Diagnosis and classification of diabetes
  • Methods and criteria for diagnosing diabetes
  • Diagnostic thresholds
  • Number of abnormal tests required
  • Further considerations of method of diagnosis
  • Analytical considerations
  • Classification of diabetes types
  • Type 1 diabetes
  • Type 2 diabetes
  • Other specific types
  • Gestational diabetes
  • Conclusion
  • References
  • Chapter 3 The Global Burden of Diabetes
  • Prevalence
  • Type 1 diabetes
  • Type 2 diabetes
  • Sub-Saharan Africa
  • Europe
  • Middle East and North Africa
  • North America and Caribbean
  • South and Central America
  • South-East Asia
  • Western Pacific
  • Gestational diabetes mellitus
  • Incidence of type 2 diabetes
  • Trends in diabetes-related complications
  • Macrovascular complications
  • Lower-extremity amputations
  • Microvascular complications
  • End-stage renal disease
  • Retinopathy
  • Neuropathy
  • Acute complications
  • Mortality
  • Emerging complications
  • Cancer
  • Mental health disorders
  • Cognitive impairment
  • Disability
  • Infections
  • Economic costs of diabetes
  • Socioeconomic costs of diabetes
  • Gaps and future directions
  • References
  • Chapter 4 Epidemiology of Type 1 Diabetes
  • Occurrence of type 1 diabetes by age, sex, place, and time
  • Occurrence of type 1 diabetes by age
  • Incidence by sex
  • Incidence by country
  • Trends in incidence over time
  • Variation in incidence within countries including by ethnicity
  • Seasonal variation in diagnosis of type 1 diabetes
  • Familial clustering and twin studies
  • Environmental risk factors for type 1 diabetes: clues from epidemiological studies
  • Specific putative environmental factors
  • Mortality
  • Conclusion
  • Acknowledgements
  • References
  • Chapter 5 Epidemiology of Type 2 Diabetes
  • Risk factors for type 2 diabetes
  • Emerging risk factors
  • Sugar-sweetened beverages
  • Decreased sleep
  • Depression and treatment of depression
  • Drug-induced metabolic changes
  • Environmental toxins
  • Low birth weight and fetal malnutrition
  • Maternal obesity, maternal hyperglycaemia, and other factors in early development
  • Methodological issues in the epidemiology of type 2 diabetes
  • Effects of changes in the definition of diabetes
  • Emerging data on the incidence of type 2 diabetes
  • Regional and ethnic patterns of type 2 diabetes worldwide
  • Africa
  • North America
  • Central and South America
  • Europe
  • South-East Asia
  • Middle East
  • Western Pacific region
  • Impact of diabetes
  • Mortality and morbidity
  • Healthcare burden and economic costs
  • Prevention of type 2 diabetes
  • Remission of type 2 diabetes
  • Conclusion
  • References
  • Part 2 Normal Physiology
  • Chapter 6 Overview of Glucose Metabolism
  • Pancreatic islets of langerhans
  • Insulin
  • Effect on glucose metabolism
  • Effect on lipid metabolism
  • Effect on protein metabolism
  • Glucagon
  • Liver
  • Skeletal muscle and adipose tissue
  • Gastrointestinal tract
  • Incretin hormones
  • Microbiome
  • Brain
  • Kidney
  • Other hormones involved in glucose metabolism
  • Catecholamines
  • Corticosteroids
  • Growth hormones and insulin-like growth factor I
  • References
  • Chapter 7 Islet Function and Insulin Secretion
  • Islet structure and function
  • Islet anatomy
  • Intra-islet interactions
  • Insulin biosynthesis and storage
  • Regulation of insulin secretion
  • Nutrient-induced insulin secretion
  • Regulation of insulin secretion by non-nutrients
  • Conclusions
  • References
  • Chapter 8 Glucagon in Islet and Metabolic Regulation
  • Anatomy and development of cells
  • Proglucagon gene transcription, translation, and peptide processing
  • Regulation of -cell secretion
  • Glucagon actions in the liver: glucose and lipid metabolism
  • Glucagon actions in the liver: amino acid metabolism and the hepatic--cell axis
  • Glucagon intra-islet communication and insulin secretion
  • Effects of glucagon on energy intake and energy expenditure
  • Production of glucagon-like peptide 1 by cells
  • Abnormalities of glucagon secretion andaction in diabetes
  • Pharmacology based on glucagon action
  • References
  • Chapter 9 Mechanism of Insulin Action
  • Insulin
  • Insulin receptor
  • Extracellular domain of the insulin receptor
  • Receptor tyrosine kinase
  • Insulin signalling cascade
  • IRS proteins couple the insulin receptor to the downstream signalling cascade
  • Phosphatidylinositol 3-kinase AKT cascade
  • Insulin-regulated glucose transport
  • Heterologous regulation and insulin resistance
  • Transcriptional control of IRS1
  • Transcriptional control of IRS2
  • miRNA-mediated post-transcriptional regulation
  • Regulation of IRS signalling by Ser/Thr phosphorylation
  • Regulation of IRS degradation
  • Regulation by protein and lipid phosphatases
  • Mouse genetics reveal tissue-integrated insulin signalling
  • Systemic insulin receptor signalling cascade
  • Hepatic insulin receptorFOXO1 signalling
  • Insulin signalling and glucose homeostasis in skeletal muscle
  • Adipose insulin signalling
  • IRS2 as a gateway to -cell function
  • References
  • Chapter 10 Central Control of Glucose Homeostasis
  • Evolutionary considerations
  • Overview of brain control of glucose homeostasis in normal physiology
  • Autonomic control of pancreatic islet function
  • Circadian control of metabolism
  • How does the brain sense physiological changes in blood glucose?
  • Glucose sensing and brain control of energy balance
  • Glucose transporters and brain glucose uptake
  • Evidence supporting indirect blood glucose sensing by the brain
  • Parallels to brain control of thermoregulation
  • Integration of glucose homeostasis, energy homeostasis, and thermoregulation
  • Brain responses to perceived glucose deficiency
  • Hypothesis: reduced brain glucose sensing predisposes to hyperglycaemia in type 2 diabetes
  • The transition from obesity to type 2 diabetes
  • Roles of insulin-dependent and -independent glucose lowering by the brain
  • Clinical evidence supporting altered brain blood glucose handling in individuals with diabetes
  • Targeting the brain to restore normoglycaemia
  • Current and future anti-diabetes drugs that target central pathways
  • Conclusion
  • References
  • Chapter 11 Control of Body Weight: How and Why Do We Gain Weight Easier Than We Lose It?
  • Body weight regulation
  • Energy homeostasis: control of appetite and body weight
  • Physiological regulators of body weight
  • Gut hormones
  • Hypothalamus and neurotransmitters
  • Adipose tissue
  • Intestinal microbiome
  • Beyond homeostasis: hedonic pathways
  • Metabolic alterations with weight gain
  • Compensatory mechanisms in response to weight loss
  • Weight loss maintenance insights from bariatric surgery
  • Genetic factors
  • Evolutionary perspectives
  • Monogenic obesity
  • Polygenic susceptibility to obesity
  • Epigenetic factors
  • Environmental and behavioural factors
  • Circadian rhythms, sleep patterns, and obesity
  • The effect of dietary composition
  • Medications and toxins
  • Weight stigma and adverse impact on biology
  • Effects of societal factors and policy
  • Conclusion
  • References
  • Part 3 Pathogenesis of Diabetes
  • Chapter 12 The Genetics of Diabetes
  • Increase in diabetes prevalence
  • Diabetes spectrum
  • Diabetes heterogeneity
  • Heritability of type 1 diabetes and type 2 diabetes
  • Genetic architecture of type 1 diabetes and type 2 diabetes
  • Genetic loci for type 1 diabetes
  • Linkage studies for type 2 diabetes
  • Candidate genes for type 2 diabetes
  • Genome-wide association studies identify common variants associated with type 2 diabetes
  • Rare variants with stronger effects are often rare
  • Protective variants
  • Gene-gene and gene-environment interactions
  • Parent-of-origin effects
  • Epigenetics
  • Non-coding RNAs - MicroRNAs and LincRNAs
  • Difficulties in assigning functions to associated genes
  • Genotype-based treatment
  • Little common genetic basis for type 1 diabetes and type 2 diabetes
  • A holistic view: systems genetics
  • Conclusion
  • References
  • Chapter 13 Genetics of Obesity
  • Evidence for the genetic contribution to obesity
  • Finding the genes that regulate body weight
  • Obesity with developmental delay
  • Prader-Willi syndrome
  • Albright hereditary osteodystrophy
  • Ciliary disorders
  • BDNF, TRKB, and SH2B1 deficiency
  • Obesity without developmental delay
  • Leptin and leptin receptor deficiency
  • POMC and PCSK1 deficiency
  • MC4R deficiency
  • SIM1 deficiency
  • Rare variants in multiple genes associated with obesity
  • Conclusion
  • References
  • Chapter 14 Autoimmune Type 1 Diabetes
  • Epidemiology
  • Natural history and staging type 1 diabetes
  • Islet autoantibodies as biomarkers
  • Genetic and environmental aetiology to initiate islet autoimmunity
  • Genetic aetiology
  • Environmental aetiology
  • Virus aetiology
  • Biomarkers of triggers
  • Pathogenesis
  • Cellular autoimmunity
  • Humoral autoimmunity
  • Biomarkers of pathogenesis
  • Diabetes diagnosis
  • Screening for islet autoimmunity and diabetes
  • References
  • Chapter 15 Other Disorders with Type 1 Diabetes and Atypical Phenotypes
  • Ketosis-prone diabetes
  • Autoimmune diabetes in adults
  • Fulminant type 1 diabetes
  • Autoimmune type 1 diabetes and immune checkpoint inhibitors
  • Young-onset diabetes, maturity-onset diabetes of the young, and monogenic diabetes
  • Maturity-onset diabetes of the young
  • Mitochondrial gene mutations
  • Pancreatic amyloidosis and other pancreatic diseases
  • Interpretation of genetic variants in the era of sequencing
  • Conclusion
  • References
  • Chapter 16 Abnormalities of Insulin Secretion and -Cell Defects in Type 2 Diabetes
  • Physiological insulin secretion
  • Natural history of ß-cell failure
  • Genetic predisposition
  • Early -cell dysfunction
  • Factors that accelerate the rate of loss of ß-cell function
  • how insulin secretion progressively worsens after development of type 2 diabetes
  • Diabetes treatments
  • ß-cell dysfunction: exhaustion or insufficient mass?
  • Conclusion
  • References
  • Chapter 17 Insulin Resistance in Type 2 Diabetes
  • Definition and measurement of insulin resistance in humans
  • Insulin resistance as a risk factor for type 2 diabetes
  • Insulin resistance in skeletal muscle
  • Insulin resistance in the liver
  • Insulin resistance in adipose tissue
  • Stepwise development of tissue-specific insulin resistance
  • Conclusion
  • Acknowledgements
  • References
  • Chapter 18 Obesity and Diabetes
  • Obesity: definitions and phenotypes
  • The obesity and diabetes syndemic
  • Pathophysiology of obesity and diabetes
  • Treatment
  • Diabetes reversal and remission
  • Very low-energy diets and reversal or remission of diabetes
  • Anti-obesity medications
  • Bariatric surgery
  • Management of obesity in type 1 diabetes
  • Convergence of obesity and diabetes treatments
  • References
  • Chapter 19 The Microbiome and Diabetes
  • The microbiome
  • The intestinal microbiome is associated with body mass
  • Composition of the intestinal microbiome is altered in type 2 diabetes
  • The intestinal microbiome can influence intestinal permeability
  • Metabolic endotoxaemia
  • Metabolic endotoxaemia in type 2 diabetes
  • Modulation of the intestinal microbiome can alter in insulin sensitivity
  • The microbiome contributes to type 2 diabetes risk via innate immune pathways
  • The microbiome contributes to type 2 diabetes risk via modulation of enteroendocrine cell function
  • The microbiome contributes to type 2 diabetes risk via modulation of bile acids
  • Type 1 diabetes
  • Conclusion and perspectives
  • References
  • Part 4 Other Types of Diabetes
  • Chapter 20 Monogenic Causes of Diabetes
  • Maturity-onset diabetes of the young
  • Prevalence of MODY variants
  • Strategies to improve case finding
  • Use of diagnostic and pre-symptomatic molecular testing in monogenic diabetes
  • Glucokinase MODY
  • Clinical features
  • Differentiating from type 1 diabetes and 2 diabetes
  • Management
  • Glucokinase MODY and pregnancy
  • Clinical features
  • Genetic testing for GCK variants in pregnancy
  • Management
  • HNF1A and HNF4A (Transcription factor MODY)
  • Clinical features
  • Diabetes
  • Extra-pancreatic clinical features
  • Differentiating from type 1 diabetes
  • Differentiating from type 2 diabetes
  • Management
  • Management in pregnancy
  • Special considerations in HNF4A pregnancies
  • Rare subtypes of MODY
  • Neonatal diabetes and diabetes diagnosed within six months of life
  • Permanent neonatal diabetes
  • Transient neonatal diabetes
  • Genetic testing in neonatal diabetes
  • Diabetes with extra-pancreatic features
  • Maternally inherited diabetes and deafness
  • Renal cysts and diabetes (HNF1B MODY)
  • Other monogenic -cell diabetes with extra-pancreatic features
  • Wolfram syndrome
  • Thiamine-responsive megaloblastic anaemia syndrome
  • Wolcott-Rallison syndrome
  • Monogenic diabetes with pancreatic exocrine dysfunction
  • Primrose syndrome
  • Insulin resistance
  • Insulin receptor gene variants
  • Inherited lipodystrophies
  • Other monogenic conditions associated with insulin resistance
  • Conclusion
  • References
  • Chapter 21 Drug-Induced Diabetes
  • Glucocorticoids
  • Second-generation antipsychotics
  • Oral contraceptive agents
  • Menopause hormone therapy
  • Thiazide diuretics
  • ß-adrenoceptor antagonists
  • HMG CoA reductase inhibitors
  • Antiretroviral therapy for human immunodeficiency virus
  • Pentamidine
  • Fluoroquinolones
  • Calcineurin inhibitors
  • Diazoxide
  • Prevention and treatment strategies
  • References
  • Chapter 22 Diabetes in Hypersecreting Endocrine Disorders
  • Acromegaly
  • Clinical presentation
  • Glucose intolerance
  • Diagnosis and treatment
  • Glucose tolerance and acromegaly treatment
  • Cushing syndrome
  • Origin and clinical features
  • Disturbance to glucose tolerance
  • Diagnosis and treatment
  • Glucose tolerance following treatment of Cushing syndrome
  • Phaeochromocytoma and paraganglioma
  • Epidemiology, clinical features, and genetics
  • Glucose intolerance
  • Diagnosis and treatment
  • Glucose tolerance in response to treatment of phaeochromocytomas and paragangliomas
  • Glucagonomas
  • Somatostatinomas
  • Vasoactive intestinal peptide-producing tumours
  • Hyperthyroidism
  • Primary hyperaldosteronism
  • Primary hyperparathyroidism
  • Polycystic ovarian syndrome
  • Glucose intolerance in hyposecreting endocrine disorders
  • Other endocrine disorders associated with diabetes
  • References
  • Chapter 23 Pancreatic Disease and Diabetes
  • Acute pancreatitis
  • Chronic pancreatitis
  • Epidemiology
  • Pathological features
  • Clinical features and diagnosis
  • Investigations
  • Diabetes in chronic pancreatitis
  • Tropical chronic pancreatitis
  • Hereditary haemochromatosis
  • Aetiology and pathology
  • Clinical features
  • Diabetes in primary haemochromatosis
  • Investigations and diagnosis
  • Treatment
  • Secondary haemochromatosis
  • Pancreatic neoplasia
  • Pancreatic surgery and diabetes
  • Management of diabetes caused by pancreatic surgery
  • Cystic fibrosis
  • Diabetes in cystic fibrosis
  • Management
  • Conclusion
  • Acknowledgements
  • References
  • Chapter 24 Clinical Presentations of Diabetes
  • Clinical considerations at presentation
  • Types of diabetes
  • Thirst, polydipsia, and polyuria
  • Weight loss
  • Blurred vision
  • Infections
  • Diabetic ketoacidosis
  • Hyperosmolar hyperglycaemic syndrome
  • Macrovascular presentations
  • Acute coronary syndromes
  • Acute stroke
  • Microvascular presentations
  • Eye presentations
  • Diabetes kidney disease
  • Neuropathic syndromes
  • Diabetes-related foot disease
  • Pregnancy
  • Screening
  • Covid-19 and diabetes
  • Other presentations
  • Conclusion
  • References
  • Part 5 Managing the Person with Diabetes
  • Chapter 25 The Aims of Diabetes Care
  • St Vincent declaration
  • Diabetes care team
  • Improving the outcome of the consultation
  • Following diagnosis
  • Issues relating to diagnosis
  • Diabetes education
  • Ongoing clinic visits
  • Glycaemic management
  • Assessment of cardiovascular risk
  • Microvascular complications
  • Diabetes emergencies
  • Lifestyle issues
  • Psychological issues
  • Sexual health
  • Inpatient diabetes care
  • Involving people with diabetes in the planning of healthcare and service development
  • Conclusion
  • References
  • Chapter 26 Education to Empower the Person with Diabetes
  • The foundation of diabetes self-management education and support
  • Modalities of education
  • Values, competencies, and tools
  • The role of the healthcare professional: how do we guide people with diabetes to self-management behaviours?
  • Working with dialogue and participation
  • A framework to guide selection of education methods
  • Supporting the behaviour change process
  • Empowerment through language and the flourishing mindset
  • Outcomes must mirror biomedical as well as behavioural and emotional challenges
  • Diabetes self-management education and support in the social context
  • The final step: using health education tools to promote and support change and self-management
  • Evaluation of diabetes education
  • Conclusion
  • References
  • Chapter 27 Dietary Management of Diabetes
  • Energy balance and body weight
  • Remission of type 2 diabetes
  • Carbohydrate and diabetes
  • Quantity
  • Adjustment of insulin to carbohydrate intake
  • Carbohydrate in the treatment of mild to moderate hypoglycaemia
  • Carbohydrate quality
  • Dietary fibre
  • Dietary mono- and disaccharides
  • Non-nutritive sweeteners
  • Dietary fat
  • Saturated fat
  • Polyunsaturated fat
  • Monounsaturated fat
  • Trans fats
  • Dietary cholesterol
  • Protein
  • Micronutrients
  • Salt or sodium
  • Sterols and stanols
  • Alcohol
  • Diet in special circumstances
  • Diet in pregnancy
  • Diet in children with diabetes
  • Exercise and insulin-treated diabetes
  • References
  • Chapter 28 Physical Activities and Diabetes
  • Defining exercise, type of exercise, and intensity
  • Type 1 diabetes and exercise
  • Prevention of type 1 diabetes
  • Treatment of type 1 diabetes
  • Type 2 diabetes and exercise
  • Prevention of type 2 diabetes
  • Treatment of type 2 diabetes
  • Physical activity and gestational diabetes
  • Prevention of gestational diabetes
  • Treatment of gestational diabetes
  • Exercise advice for people with type 1 diabetes or type 2 diabetes
  • Exercise guidelines
  • Minimizing risk of exercise-related adverse events
  • Specific exercise considerations for people with type 1 diabetes
  • Specific considerations for people with type 2 diabetes
  • Conclusion
  • References
  • Chapter 29 Monitoring Diabetes
  • Why monitor?
  • Tests and their characteristics
  • Glycated haemoglobin
  • Clinical drivers for standardization of HbA1c
  • Diagnosis of type 2 diabetes using HbA1c
  • Assays for measurement of HbA1c
  • Point-of-care HbA1c
  • Factors affecting HbA1c measurement
  • Fructosamine and glycated albumin
  • Measurement of blood glucose
  • Point-of-care test devices for blood glucose
  • Self-monitoring blood glucose devices
  • Continuous glucose monitoring
  • Estimated average glucose
  • Measurement of glucose in urine
  • Measurement of ketones
  • Clinical approaches to monitoring in diabetes
  • Self-monitoring of blood glucose
  • Monitoring in type 1 diabetes
  • Monitoring in type 2 diabetes
  • Diabetes in pregnancy
  • Monitoring of diabetes in special situations
  • Bariatric surgery
  • Low-resource settings
  • Conclusion
  • References
  • Chapter 30 Biomarkers and Precision Medicine in Diabetes
  • Introduction
  • Neonatal diabetes
  • Maturity-onset diabetes of the young
  • Precision medicine in type 1 diabetes and type 2 diabetes
  • Oral anti-diabetes drugs
  • Metformin
  • Sulfonylurea derivatives
  • Dipeptidyl peptidase-4 inhibitors
  • Glucagon-like peptide-1 receptor agonists
  • Sodium glucose cotransporter-2 inhibitors
  • Blood pressure-lowering drugs
  • Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers
  • Lipid-lowering drugs
  • HMG-CoA reductase inhibitors - statins
  • Personalized medicine: implementation in clinical practice and future research directions
  • References
  • Part 6 Treatment of Diabetes
  • Chapter 31 Insulin and Insulin Treatment
  • Discovery and early days of insulin therapy
  • Modern insulin formulations to reproduce physiological insulin delivery
  • Short-acting formulations
  • Intermediate and long-acting formulations
  • Biosimilars
  • Concentration
  • Insulin administration
  • Subcutaneous insulin injections
  • Continuous subcutaneous insulin infusion
  • Alternative routes of insulin administration
  • Complications of subcutaneous insulin therapy
  • Importance of education and assessment of glycaemia
  • Place of insulin therapy in people with different types of diabetes
  • Absence of endogenous insulin secretion, including type 1 diabetes
  • Insulin resistance and relative insulin deficiency, including type 2 diabetes
  • Selecting the most appropriate insulin regimen: towards a personalized approach
  • Basal only
  • Basal plus
  • Insulin mixtures: premix insulins, combination insulins
  • Basal bolus
  • More practical tips on starting and titrating insulin
  • Future perspectives: route, hepatoselectivity, glucose-dependent action
  • References
  • Chapter 32 New Technologies for Glucose Monitoring
  • Self-monitoring of capillary blood glucose
  • Measurement method and frequency
  • Systems and measurement quality
  • Continuous glucose monitoring
  • Continuous glucose monitoring measurement method
  • Intermittently scanned continuous glucose monitoring
  • Minimal requirements for continuous glucose monitoring performance
  • Clinical efficiency of continuous glucose monitoring
  • Practical issues with the use of continuous glucose monitoring
  • Calibrating the sensor
  • Physiological lag between blood and interstitial glucose
  • Trend arrows
  • Setting of glucose alarms
  • Skin issues with continuous glucose monitoring
  • Use of capillary blood glucose monitoring and continuous glucose monitoring to guide management and assess outcomes
  • Visualization, analysis, and documentation of key capillary blood glucose monitoring metrics
  • Assessment of glucose variability
  • Time in range
  • Ambulatory glucose profile
  • Future perspectives for continuous glucose monitoring
  • Transition from capillary blood glucose monitoring to continuous glucose monitoring
  • Using continuous glucose monitoring in the virtual diabetes clinic
  • Using continuous glucose monitoring for automated insulin dosing
  • References
  • Chapter 33 New Technologies for Insulin Administration
  • Insulin pens
  • i-Port
  • Continuous subcutaneous insulin infusion
  • Features of continuous subcutaneous insulin infusion
  • Evidence base for pumps
  • Types of pumps
  • Types of cannulas
  • Insulin pump-associated adverse events
  • Intraperitoneal pumps
  • Future prospects
  • Conclusion
  • References
  • Chapter 34 Whole Pancreas and Islet Cell Transplantation
  • What is the problem?
  • ß-cell replacement therapies: a potential solution for diabetes
  • Whole pancreas transplantation
  • History
  • Procedural considerations
  • Indications
  • Islet cell transplantation
  • History
  • Procedural considerations
  • Indications
  • Clinical outcomes: state of the art
  • Whole pancreas transplantation
  • Islet cell transplantation
  • Whole pancreas and islet cell transplantation: competing or complementary therapies?
  • Whole pancreas and islet cell transplantation: challenges and potential solutions
  • Organ or tissue source and preservation
  • Peri-procedural care
  • Chronic immunosuppression
  • Conclusion
  • References
  • Chapter 35 Oral Glucose-Lowering Agents
  • Pathophysiological considerations
  • Guidelines and algorithms
  • Biguanides
  • Mode of action
  • Pharmacokinetics
  • Indications and contraindications
  • Efficacy
  • Adverse effects
  • Sulfonylureas
  • Mode of action
  • Pharmacokinetics
  • Indications and contraindications
  • Efficacy
  • Adverse effects
  • Meglitinides (short-acting prandial insulin releasers)
  • Mode of action
  • Pharmacokinetics
  • Indications and contraindications
  • Efficacy
  • Adverse effects
  • Thiazolidinediones
  • Mode of action
  • Pharmacokinetics
  • Indications and contraindications
  • Efficacy
  • Adverse effects
  • Dipeptidyl peptidase 4 inhibitors
  • Mode of action
  • Pharmacokinetics
  • Indications and contraindications
  • Efficacy
  • Adverse effects
  • Sodium-glucose cotransporter-2 inhibitors
  • Mode of action
  • Pharmacokinetics
  • Indications and contraindications
  • Efficacy
  • Adverse effects
  • Oral glucagon-like peptide-1 receptor agonist
  • a-Glucosidase inhibitors
  • Mode of action
  • Pharmacokinetics
  • Indications and contraindications
  • Efficacy
  • Adverse effects
  • Bromocriptine
  • Mode of action
  • Pharmacokinetics
  • Indications and contraindications
  • Efficacy
  • Adverse effects
  • Colesevelam
  • Mode of action
  • Pharmacokinetics
  • Indications and contraindications
  • Efficacy
  • Adverse effects
  • Anti-obesity therapies
  • Fixed-dose combinations
  • Conclusions
  • References
  • Chapter 36 Non-insulin Parenteral Therapies
  • Glucagon-like peptide 1, the GLP-1 receptor, and GLP-1 receptor agonists
  • Historical overview
  • GLP-1 physiology and anti-diabetes effects
  • Proglucagon distribution, GLP-1 release, and metabolism
  • GLP-1 receptor distribution and physiological effects of GLP-1
  • GLP-1 receptor agonists for the treatment of diabetes
  • Short-acting GLP-1RAs
  • Continuous-acting GLP-1RA
  • Cardiovascular outcome trials with GLP-1RA in diabetes
  • Safety Issues
  • Amylin and amylin analogues
  • Historical overview
  • Amylin physiology
  • Amylin analogues for the treatment of diabetes
  • Perspectives for non-insulin parenteral therapies
  • References
  • Chapter 37 How to Use Type 2 Diabetes Treatments in Clinical Practice
  • Therapeutic options
  • Metformin
  • Sulfonylureas
  • Meglitinides
  • Pioglitazone
  • a-glucosidase inhibitors
  • Dipeptidyl-peptidase 4 inhibitors
  • Glucagon-like peptide 1 receptor agonists
  • Sodium-glucose cotransporter 2 inhibitors
  • Dual glucose-dependent insulinotropic polypeptide/glucagon-like peptide 1 receptor agonists
  • Insulin
  • Rationale for treatment selection
  • Glycaemic management
  • Management for prevention of complications
  • Management of obesity and associated comorbidities
  • Precision medicine-based approach
  • Therapeutic decision making in the clinical setting
  • References
  • Chapter 38 Weight Management and Metabolic Surgery
  • Diet, lifestyle, and psychological support
  • Pharmacotherapy
  • Anti-obesity medications
  • Anti-diabetes medications
  • Bariatric surgery
  • Types of bariatric surgery
  • Sleeve gastrectomy
  • Adjustable gastric banding
  • Roux-en-Y gastric bypass
  • One anastomosis gastric bypass
  • Biliopancreatic diversion and duodenal switch
  • Efficacy of bariatric surgery
  • Long-term complications of bariatric surgery
  • Bariatric surgery referral pathways
  • Conclusion
  • References
  • Chapter 39 In-Hospital Treatment and Surgery in People with Diabetes
  • Known diabetes in hospital
  • Undiagnosed diabetes and stress hyperglycaemia in hospital
  • Pathophysiology of hyperglycaemia in acute illness
  • Evidence of harm from in-hospital hyperglycaemia and effect of glucose lowering
  • Glycaemic targets for individuals with diabetes in hospital
  • Intensive care unit
  • General wards
  • Current recommended standards of hospital care for people with diabetes
  • Minimizing length of stay
  • Patient safety
  • Diabetes self-management
  • Patient satisfaction
  • The role of the diabetes specialist team
  • Staff education
  • Management of in-hospital hyperglycaemia
  • Medication to manage in-hospital hyperglycaemia
  • Technology
  • Subcutaneous and intravenous insulin protocols
  • Preparation and delivery of an intravenous insulin infusion
  • Transition from intravenous to subcutaneous insulin
  • Avoiding and treating in-hospital hypoglycaemia
  • Frequency of hypoglycaemia in hospital
  • Causes of in-hospital hypoglycaemia
  • Mortality and length of stay associated with in-hospital hypoglycaemia
  • Management of in-hospital hypoglycaemia
  • Evidence for treatment options
  • Surgery in people with diabetes
  • Potential mechanisms of beneficial effects of glucose lowering in surgical settings
  • The role of primary care in supporting diabetes care before elective surgery
  • Preoperative assessment
  • Hospital admission
  • In the operating theatre and recovery
  • Postoperative period
  • Hospital discharge
  • Emergency surgery
  • Continuous subcutaneous insulin infusions (pumps)
  • Glucocorticoid use
  • Steroid therapy: impact on blood glucose
  • Monitoring
  • Medication options for people taking steroid therapy
  • Hospital discharge
  • Steroid treatment in end-of-life care
  • Hospital readmission
  • Foot care
  • Conclusions
  • References
  • Chapter 40 Hypoglycaemia in Diabetes
  • Overview of the clinical problem
  • Hypoglycaemia and the brain
  • Responses to hypoglycaemia
  • Clinical manifestations of hypoglycaemia
  • Counter-regulation during hypoglycaemia
  • Pathophysiology of glucose counter-regulation in diabetes
  • Insulin excess
  • Defective glucose counter-regulation
  • Impaired awareness of hypoglycaemia
  • Mechanisms of counter-regulatory failure and impaired awareness
  • Experimental limitations in studying the mechanisms contributing to hypoglycaemia in diabetes
  • Risk factors for hypoglycaemia in diabetes
  • Absolute or relative insulin excess
  • Compromised defences against hypoglycaemia
  • Magnitude of the clinical problem of hypoglycaemia in diabetes
  • Frequency of hypoglycaemia
  • Impact of hypoglycaemia
  • Hypoglycaemia and cardiovascular disease
  • Clinical definition and classification of hypoglycaemia
  • Prevention and treatment of hypoglycaemia in diabetes: hypoglycaemia risk factor reduction
  • Hypoglycaemia in children and adolescents
  • Definition of hypoglycaemia in children and young people
  • Prevalence and incidence of hypoglycaemia in children and young people
  • Signs and symptoms
  • Physiological responses in children and adolescents
  • Impact and consequences of hypoglycaemia in children and young people
  • Risk factors for hypoglycaemia in children and young people
  • Hypoglycaemia treatment in children and young people
  • Diabetes technology and hypoglycaemia in children and young people
  • Perspective on hypoglycaemia in diabetes
  • Acknowledgements
  • Disclosures
  • References
  • Chapter 41 Acute Metabolic Complications of Diabetes: Diabetic Ketoacidosis and the Hyperosmolar Hyperglycaemic State in Adults
  • Diabetic ketoacidosis
  • Definitions
  • Pathogenesis and pathophysiology
  • Hyperglycaemia
  • Ketogenesis and ketoacidosis
  • Fluid and electrolyte disturbance
  • Sodium-glucose cotransporter 2 inhibitor-induced ketoacidosis
  • Precipitating factors
  • Clinical presentation and diagnosis
  • Management
  • Fluid therapy
  • Insulin therapy
  • Electrolyte considerations
  • Complications
  • Resolution and prevention
  • Hyperosmolar hyperglycaemic state
  • Pathophysiology
  • Precipitating factors
  • Clinical presentation and diagnosis
  • Management
  • Complications
  • Prevention
  • References
  • Part 7 Microvascular Complications in Diabetes
  • Chapter 42 Pathogenesis of Microvascular Complications
  • Diabetic angiopathy: definition and clinical features
  • Pathogenesis of microvascular complications: the role of hyperglycaemia
  • Differences in cell response to hyperglycaemia
  • Glycaemic memory or legacy effect
  • Determinants of individual susceptibility to hyperglycaemia-induced damage
  • Beyond hyperglycaemia
  • Metabolic factors
  • Haemodynamic factors
  • Growth factors/cytokines
  • Intracellular factors
  • Innate immune system
  • The potential mechanisms behind the renoprotective effects of incretin drugs and sodium-glucose cotransporter 2 inhibitors
  • Conclusion
  • References
  • Chapter 43 Diabetic Retinopathy
  • Nomenclature
  • Pathophysiology
  • Development
  • Early changes with no vision loss
  • Vision-threatening diabetic retinopathy
  • Epidemiology
  • Prevention
  • Screening
  • Diagnosis
  • Treatment
  • Retinal photocoagulation
  • Intravitreal angiostatic treatment
  • Treatment guidelines
  • Investigation of diabetic retinopathy
  • References
  • Chapter 44 Diabetic Nephropathy
  • Definitions
  • Screening for and classification of chronic kidney disease
  • Natural history and histopathology
  • Classical diabetic nephropathy
  • Non-classical diabetic kidney disease
  • Changing epidemiology of kidney disease in diabetes
  • Type 1 diabetes
  • Type 2 diabetes
  • Risk factors and markers for chronic kidney disease in diabetes
  • Hyperglycaemia
  • Blood pressure
  • Other metabolic factors
  • Hyperfiltration
  • Genetic factors
  • Ethnicity
  • Type 2 diabetes developing in young people
  • Albuminuria and estimated glomerular filtration rate
  • Other risk factors
  • Association of diabetic kidney disease with cardiovascular disease
  • Type 1 diabetes
  • Type 2 diabetes
  • Microvascular complications
  • Investigation of kidney disease in diabetes
  • Excluding other treatable causes of kidney disease
  • Monitoring kidney disease
  • Prevention and management of diabetic kidney disease
  • Glucose management
  • Glucose-lowering medications and organ protection
  • Blood pressure management
  • Endothelin receptor antagonists
  • Low-protein diet
  • Lipids
  • Cardiovascular risk: other factors
  • Weight loss
  • Further management of chronic kidney disease stages 3-5
  • Monitoring anaemia and bone chemistry
  • Monitoring glucose levels
  • Glucose-lowering agents
  • Anaemia
  • When to refer to nephrology
  • Organization of care
  • Pregnancy in women with diabetes and chronic kidney disease
  • References
  • Chapter 45 Diabetic Neuropathy
  • Classification of diabetic neuropathy
  • Epidemiology and clinical impact of diabetic sensorimotor polyneuropathy
  • Clinical manifestations of diabetic neuropathy
  • Diabetic sensorimotor polyneuropathy
  • Acute painful neuropathy
  • Focal and multifocal neuropathies
  • Central nervous system abnormalities in structure and function
  • Pathogenesis of diabetic sensorimotor polyneuropathy
  • Diagnosis of diabetic sensorimotor polyneuropathy
  • Diagnostic definitions
  • Neuropathy symptoms
  • Quantitative sensory testing
  • Vibration perception threshold
  • Nerve conduction studies
  • Skin biopsy
  • Corneal confocal microscopy
  • Optical coherence tomography
  • Sudoscan
  • Laser doppler imaging FLARE
  • Management
  • Intensive diabetes therapy and metabolic factors
  • Diet and behavioural interventions
  • Weight loss
  • Disease-modifying treatment
  • Treatment based on pathogenetic concepts
  • Treatment of painful diabetic neuropathy
  • Diabetic autonomic neuropathy
  • Cardiac autonomic neuropathy
  • Gastrointestinal dysfunction
  • Urogenital system
  • References
  • Part 8 Macrovascular Complications in Diabetes
  • Chapter 46 Pathogenesis of Macrovascular Complications in Diabetes
  • Epidemiology of diabetic macrovascular complications
  • Pathogenesis of diabetic macrovascular disease
  • Role of hyperglycaemia
  • Clinical trials and hyperglycaemia
  • Direct and indirect glycotoxicity
  • Insulin resistance
  • Advanced glycation end-product formation
  • Direct effects of vascular advanced glycation end-product accumulation
  • Interaction with the renin-angiotensin-aldosterone system
  • Role of vasoactive hormones in diabetes-related atherosclerosis
  • Classic renin-angiotensin-aldosterone system
  • Novel aspects of the renin-angiotensin-aldosterone system: ACE2
  • Angiotensin receptors
  • Role of the renin-angiotensin-aldosterone system in macrovascular disease
  • Renin-angiotensin-aldosterone system and regenerative endothelial cell repair
  • Role of AT-(1-7) and ACE2 in endothelial dysfunction
  • Renin-angiotensin-aldosterone system activation and atherosclerosis
  • ACE2 and diabetes-accelerated atherosclerosis
  • Renin-angiotensin-aldosterone system and oxidative stress
  • Therapeutic implications
  • Endothelin system
  • Role of endothelin in diabetes-related macrovascular complications
  • Urotensin II
  • Role of urotensin II in atherosclerosis
  • Oxidative stress
  • Role of reactive oxygen species in diabetes-accelerated atherosclerosis
  • Nicotinamide adenine dinucleotide phosphate oxidase production of reactive oxygen species
  • Inflammation and immune responses
  • Tumour necrosis factor-related apoptosis-inducing ligand and osteoprotegerin
  • Complement activation
  • Interventions to reduce diabetes-associated macrovascular complications
  • Glucose management
  • Hypertension
  • Choice of antihypertensive treatment
  • Renal denervation
  • Dyslipidaemia
  • Hypercoagulability
  • Novel therapies
  • Multifactorial approaches
  • References
  • Chapter 47 Hypertension and Diabetes
  • Size of the problem
  • Causes of hypertension in diabetes
  • Hypertension in the metabolic syndrome
  • Hypertension and diabetic nephropathy
  • Impact of hypertension in diabetes
  • Screening for hypertension in diabetes
  • Measurement of blood pressure
  • Diagnosis of hypertension in diabetes
  • Investigation of hypertension in diabetes
  • Management of hypertension in diabetes
  • Non-pharmacological treatment
  • Antihypertensive drug therapy
  • Treatment strategies
  • Hypertension in type 1 diabetes
  • Hypertension in type 2 diabetes
  • Combination therapy
  • Special considerations in ethnic groups
  • Outcome of treating hypertension in diabetes
  • Conclusions
  • References
  • Chapter 48 Dyslipidaemia and Diabetes
  • Cardiovascular disease risk factors in diabetes
  • Glucose
  • Dyslipidaemia
  • Treatment options
  • Dietary treatments
  • Statins
  • Cholesterol absorption and resorption inhibitors
  • Proprotein convertase subtilisin kexin-9 inhibitors
  • Fibrates
  • Niacin
  • Omega-3 fatty acids
  • Other triglyceride-reducing agents
  • Agents to increase high-density lipoprotein cholesterol
  • Cardiovascular risk guidelines
  • Future drug developments and drug targets
  • Non-alcoholic fatty liver disease
  • Conclusion
  • References
  • Chapter 49 Ischaemic Heart Disease in Diabetes
  • Epidemiology
  • Pathophysiological perspective
  • How can cardiovascular risk be reduced in people with diabetes?
  • Cardiovascular risk categorization
  • Glucose lowering
  • Lipid management
  • Blood pressure management
  • Aspirin and anticoagulation
  • Multimodal therapy of cardiovascular risk factors in type 2 diabetes
  • References
  • Chapter 50 Heart Failure and Diabetes
  • Two epidemics: diabetes and heart failure
  • Epidemiology of diabetes and heart failure
  • Diabetes is a risk factor for heart failure and subclinical abnormalities
  • Diabetes and other heart failure risk factors
  • Pathophysiology of heart failure in diabetes
  • Risk prediction and prevention of heart failure in diabetes
  • Heart failure risk assessment
  • Preventive therapies for heart failure
  • Outcomes in people with comorbid diabetes and heart failure
  • Treatment considerations for heart failure and diabetes
  • Heart failure with reduced ejection fraction therapies among people with diabetes
  • Heart failure with preserved ejection fraction therapies among people with diabetes
  • Anti-diabetes medications among people with or at high risk for developing heart failure
  • Conclusion
  • References
  • Chapter 51 Cerebrovascular Disease and Diabetes
  • Epidemiology of stroke in general
  • Diabetes as a risk factor for stroke
  • Stroke in people with diabetes
  • Pre-diabetes and other risk factors
  • Pathophysiology of ischaemic stroke in diabetes
  • Primary prevention of stroke in people with diabetes
  • Treatment of acute stroke in persons with diabetes
  • Secondary prevention of stroke in diabetes
  • Conclusions
  • References
  • Chapter 52 Peripheral Vascular Disease
  • Peripheral arterial disease
  • Incidence
  • Pathophysiology
  • Diagnosis
  • Prognosis
  • Treatment
  • Acute lower-limb ischaemia
  • Atherosclerosis of renal and mesenteric arteries
  • Ischaemia of the arm
  • Aortic aneurysmal disease (abdominal aortic aneurysm)
  • Peripheral aneurysms
  • Carotid artery disease
  • Prognosis
  • Diagnosis
  • Treatment
  • Carotid stenting
  • References
  • Part 9 Other Complications of Diabetes
  • Chapter 53 Foot Problems in People with Diabetes
  • Epidemiology and economic aspects of diabetes-related foot disease
  • Health economics of diabetes-related foot disease
  • Aetiopathogenesis of diabetes-related foot lesions
  • Diabetic neuropathy
  • Peripheral arterial disease
  • Long-term risk factors for foot ulceration
  • Pathway to ulceration
  • Plantar callus
  • Elevated foot pressures
  • Foot deformities
  • Prevention of diabetes-related foot ulcers
  • Footwear
  • Skin temperature
  • Foot ulcer classification
  • Wound healing in the diabetic foot
  • Offloading
  • Dressings
  • Management of infection
  • Negative pressure
  • Hyperbaric oxygen
  • Surgical management
  • Charcot neuroarthropathy
  • Management
  • Conclusion
  • References
  • Chapter 54 Sexual Function in Men and Women with Diabetes
  • Male erectile dysfunction
  • Physiology of erectile function
  • Clinical aspects of erectile dysfunction in diabetes
  • Erectile dysfunction as a risk factor for cardiovascular disease
  • Smoking and alcohol consumption
  • Quality-of-life issues
  • Assessment and investigation of erectile dysfunction in diabetes
  • General advice
  • Treatment options
  • Organization of the management of erectile dysfunction
  • Female sexual dysfunction
  • Physiology of sexual function
  • Physiology of sexual dysfunction
  • Pathophysiology of female sexual dysfunction in diabetes
  • Clinical aspects of sexual dysfunction for women with diabetes
  • Sexual dysfunction as a risk factor for cardiovascular disease in women with diabetes
  • Sexual dysfunction and peripheral neuropathy in women with diabetes
  • Smoking and alcohol consumption
  • Quality of life and psychological issues
  • Assessment and investigation of sexual dysfunction in diabetes
  • General advice
  • Treatment options
  • Psychological interventions
  • Organization of the management of sexual dysfunction
  • Management of female sexual dysfunction
  • Genitourinary infections in women with diabetes
  • Contraception
  • Contraindications to pregnancy
  • Method of contraception
  • Hormone replacement therapy
  • Hormone replacement therapy and glucose tolerance
  • Hormone replacement therapy and lipids
  • Hormone replacement therapy and blood pressure
  • Hormone replacement therapy and ischaemic heart disease
  • Hormone replacement therapy and osteoporosis
  • References
  • Chapter 55 Gastrointestinal Manifestations of Diabetes
  • Epidemiology of diabetes-related enteropathy
  • Pathophysiology
  • Normal gastrointestinal motor functions
  • Pathophysiology of diabetes-related enteropathy: insights from animal studies
  • Modulation of M2 macrophages and oxidative stress in gastroparesis
  • Pathophysiology of diabetes-related enteropathy in humans
  • Gastric dysfunction
  • Neuropathy
  • Hyperglycaemia
  • Iatrogenic gastroparesis: opioids and glucagon-like peptide 1 receptor agonists
  • Diabetic diarrhoea
  • Faecal incontinence
  • Constipation
  • Clinical manifestations
  • Dysphagia and heartburn
  • Dyspepsia and gastroparesis
  • Diarrhoea and constipation
  • Abdominal pain
  • Diagnostic tests
  • Suspected gastric dysfunction
  • Investigation of constipation
  • Management
  • Gastroparesis and dyspepsia
  • Diabetic diarrhoea
  • Constipation
  • Acknowledgement
  • References
  • Chapter 56 Diabetes and Oral Health
  • Gingivitis and periodontitis
  • Gingivitis
  • Periodontitis
  • Association of diabetes with gingivitis and periodontitis
  • Pathogenic mechanisms linking diabetes and periodontitis
  • Periodontitis and late diabetes-related complications
  • Significance of periodontal treatment for the course of diabetes
  • Caries
  • Hyposalivation
  • Candidal infection
  • Oral cancer
  • Guidelines for physicians and other medical health professions for use in practice
  • Collaboration in healthcare for the benefit for persons with diabetes
  • Conclusion
  • References
  • Chapter 57 Diabetes and Non-alcoholic Fatty Liver Disease
  • Non-alcoholic fatty liver disease definition, epidemiology, and diagnosis
  • Definition
  • Non-alcoholic fatty liver disease epidemiology in type 2 diabetes
  • Diagnosis
  • Diagnosis of liver fat (steatosis)
  • Diagnosis of liver fibrosis
  • Aetiology and pathogenesis of non-alcoholic fatty liver disease
  • Genetic factors predisposing to more severe non-alcoholic fatty liver disease
  • Obesity and insulin resistance
  • Non-alcoholic fatty liver disease as a multisystem disease
  • Risk of type 2 diabetes
  • Worsening of glycaemic levels in individuals with type 2 diabetes and non-alcoholic fatty liver disease
  • Risk of worsening fibrosis and cirrhosis in individuals with type 2 diabetes
  • Risk of cardiovascular disease, arrhythmias, and cardiac diseases
  • Risk of microvascular complications
  • Treatment for non-alcoholic fatty liver disease in individuals with type 2 diabetes
  • Lifestyle modifications
  • Bariatric surgery
  • Metformin
  • Peroxisome proliferator-activated receptor- agonists
  • Glucagon-like peptide 1 receptor agonists
  • Sodium-glucose cotransporter 2 inhibitors
  • Lipid-lowering drugs
  • Antihypertensive drugs
  • New drugs for non-alcoholic fatty liver disease
  • Conclusion
  • References
  • Chapter 58 The Skin in Diabetes
  • Metabolic manifestations
  • Acanthosis nigricans
  • Achrochordons (skin tags)
  • Diabetic bullae (bullosis diabeticorum)
  • Diabetic thick skin
  • Scleroedema of diabetes
  • Yellow skin
  • Eruptive xanthomas
  • Vascular changes
  • Diabetic dermopathy (shin spots)
  • Necrobiosis lipoidica diabeticorum
  • Rubeosis faciei
  • Periungual telangiectasia
  • Lower-limb vascular changes
  • Calcific uraemic arteriolopathy (calciphylaxis)
  • Infections
  • Bacterial infections
  • Fungal/yeast infections
  • Associated conditions
  • Vitiligo
  • Lichen planus
  • Pruritus
  • Perforating dermatoses
  • Clear-cell syringomas
  • Glucagonoma
  • Disseminated granuloma annulare
  • Psoriasis
  • Iatrogenic
  • Reactions to insulin
  • Reaction to oral anti-diabetes agents
  • References
  • Chapter 59 Bone and Rheumatic Disorders in Diabetes
  • Musculoskeletal disease in diabetes
  • Fibroproliferative disorders of soft tissue
  • Disorders of joints
  • Skeletal disease in diabetes
  • References
  • Chapter 60 Diabetes and Cancer: Risk, Outcomes, and Clinical Implications
  • Interpretation of the epidemiological evidence
  • Diabetes and cancer: potential confounding
  • Diabetes and cancer: potential biases
  • Diabetes and cancer risk: epidemiological evidence
  • Cancer incidence
  • Type 1 diabetes and cancer risk
  • Gestational diabetes and cancer risk
  • Diabetes and cancer mortality: evidence
  • Cancer mortality
  • Cancer as the leading cause of death in diabetes
  • Hyperglycaemia and hyperinsulinaemia in cancer
  • Pharmaco-epidemiology: anti-diabetes agents and cancer risk
  • Interpretation
  • Anti-diabetes drugs and cancer risk
  • Metformin and cancer risk
  • Insulins and cancer risk
  • Pioglitazone and bladder cancer risk
  • Impact of diabetes on outcome after cancer diagnosis
  • Clinical implications
  • Cancer screening
  • Commencing new anti-diabetes drugs
  • The onco-diabetes clinic
  • Conclusion
  • Acknowledgements
  • References
  • Chapter 61 Diabetes and Infections
  • Diabetes, the immune system, and host factors
  • Host immune response
  • Other host-related factors
  • Diabetes-related complications
  • Organism-specific factors
  • Bidirectionality: the effect of infections on diabetes
  • Hepatitis C
  • HIV/AIDS
  • Hepatitis B
  • Specific infections either strongly associated with diabetes or in which the presence of diabetes is important
  • Infections involving the head and neck
  • Endophthalmitis
  • Periodontal disease
  • Respiratory tract infections, coronavirus, and tuberculosis
  • Infections of the urinary tract
  • Emphysematous cystitis and emphysematous pyelonephritis
  • Intra-abdominal infections other than those within the urinary tract
  • Skin and superficial soft tissue infections
  • Bone and joint infections
  • Iatrogenic and surgical site infections
  • Principles of treatment, prevention, and general care
  • General principles
  • Glycaemic management
  • References
  • Chapter 62 Sleep and Diabetes
  • Sleep problems
  • Sleep disorders
  • Insomnia
  • Sleep apnoea
  • Restless leg syndrome
  • Sleep duration (long and short sleep)
  • Sleep timing and consistency
  • Sleep problems or disorders and diabetes
  • Sleep duration and type 1 diabetes
  • Sleep quality and type 1 diabetes
  • Obstructive sleep apnoea and type 1 diabetes
  • Type 2 diabetes and insomnia
  • Type 2 diabetes and sleep apnoea
  • Type 2 diabetes and sleep duration
  • Type 2 diabetes and sleep timing and consistency
  • Type 2 diabetes, sleep problems, and depression
  • Type 2 diabetes, sleep duration, and mortality
  • Type 2 diabetes, sleep disorders, and cardiovascular outcomes
  • Type 2 diabetes, sleep disorders, and renal function
  • Type 2 diabetes, sleep disorders, and neuropathy
  • Type 2 diabetes, sleep disorders, and retinopathy
  • Sleep and diabetes self-management
  • Clinical implications
  • Conclusion
  • References
  • Part 10 Psychosocial Aspects of Diabetes
  • Chapter 63 Psychosocial and Behavioural Aspects of Diabetes
  • Psychological risk factors for developing diabetes
  • Psychological risk factors for type 2 diabetes
  • Psychological risk factors for type 1 diabetes
  • Psychosocial impact of living with diabetes and its complications
  • Psychological distress shortly after diagnosis
  • Psychological reactions emerging in the course of diabetes
  • Psychosocial impact of diabetes-related complications
  • Social stigma and discrimination
  • Quality of life
  • Impact of psychosocial factors on diabetes self-management
  • Psychological traits and glycaemic state
  • Psychological states and glycaemic state
  • Family characteristics, interactions, and glycaemia
  • Impact of behaviour on diabetes management
  • Behavioural factors: self-monitoring of blood glucose
  • Methodological issues in self-care assessment
  • Interventions to reduce psychological distress and improve self-management, glycaemic outcomes, and quality of life
  • Reducing depression and diabetes distress
  • Empowerment-based approaches
  • Structured training and educational approaches
  • Technological approaches
  • Cognitive behavioural approaches to improve outcomes
  • Psychotherapeutic and family-focused approaches
  • Conclusion
  • References
  • Chapter 64 Role of Cognitive Function in Managing People with Diabetes
  • Cognition
  • Definition of cognition function
  • Assessing and measuring cognitive function
  • Cognitive impairment and dementia
  • Dementia and diabetes
  • Impact of dementia as a comorbidity in a person with diabetes
  • Differences in cognitive function between type 1 diabetes and type 2 diabetes
  • Pathogenic mechanisms linking diabetes with dementia
  • Clinical management of people with cognitive impairment and diabetes
  • Self-management
  • Self-management and dementia
  • Collaborative approach
  • Targeted management plans
  • Case studies
  • Conclusion
  • References
  • Chapter 65 Mental Disorders and Diabetes
  • Depression
  • Case definition
  • Epidemiology
  • Depressive disorders as a risk factor for diabetes
  • Which people with diabetes are likely to develop depression?
  • Proposed mechanisms linking depression and diabetes
  • Consequences of depression in diabetes
  • Management of people with diabetes and depression
  • Anxiety disorders
  • Case definition
  • Epidemiology
  • Who is likely to develop an anxiety disorder?
  • Anxiety disorders as a risk factor for diabetes
  • Proposed mechanisms linking anxiety and diabetes
  • Consequences of anxiety in diabetes
  • Management of people with diabetes and anxiety disorders
  • Eating disorders
  • Case definitions
  • Epidemiology
  • Aetiology
  • Impact on diabetes outcomes
  • Clinical features
  • Management of eating disorders
  • Psychotic disorders
  • Case definitions
  • Epidemiology
  • Diabetes and severe mental illness
  • Acknowledgements
  • References
  • Chapter 66 Social Aspects of Diabetes
  • Driving
  • Hypoglycaemia
  • Visual impairment
  • Statutory requirements for drivers with diabetes
  • Aircraft pilot licences
  • Employment
  • Unemployment, sickness, and diabetes
  • Prison and custody
  • Insurance
  • Alcohol
  • Alcohol consumption and risk of diabetes
  • Alcohol and glycaemic levels
  • Alcohol and the complications of diabetes
  • Recommended alcohol intake
  • Recreational drugs
  • Regulation
  • Prevalence of recreational drug use
  • Impact of recreational drug use on diabetes
  • Advice on recreational drug use in diabetes
  • Travel
  • Preparation for travel
  • Long flights and crossing time zones
  • Insulin treatment in hot climates
  • Food and drink
  • Intercurrent illness
  • Recreational activities
  • Leaving home
  • Students with diabetes
  • References
  • Chapter 67 Social Determinants of Diabetes
  • How do macro-level factors and meso-level factors shape health behaviours that influence the risk of conditions like type 2 diabetes?
  • Scope of social inequities in type 2 diabetes in select former British colonies
  • Colonization as a frame for examining social determinants of type 2 diabetes
  • Type 2 diabetes among First Nations communities in Canada
  • Burden of type 2 diabetes among First Nations communities in Canada
  • History of colonization and the development of a fiduciary relationship
  • History of the diabetes epidemic in Northwestern Ontario
  • Legacy of colonialism and burden of diabetes in First Nations communities
  • Type 2 diabetes among African Americans in the USA
  • Geographical separation and exploitation in US Housing
  • How political and social systems narrow options for individual choice
  • Understanding within-group variability to enhance the tailoring of prevention efforts
  • Relationship between social determinants of health and diabetes healthcare
  • Conclusion
  • Reconsidering the role of individual-level factors in the type 2 diabetes epidemic
  • Postscript
  • Acknowledgement
  • References
  • Part 11 Diabetes in Special Groups
  • Chapter 68 Ethnic, Cultural, and Religious Aspects to the Management of Diabetes
  • Defining race, ethnicity, and religion
  • Epidemiology
  • South Asian diaspora
  • Religion
  • Diabetes
  • Diabetes-related outcomes in South Asian people
  • Macrovascular complications
  • Microvascular complications
  • Cultural sensitivity and cultural competence
  • Taboos and barriers
  • The impact of ethnicity and health inequalities
  • What has the Covid-19 pandemic taught us in relation to ethnic minority groups?
  • The relationship between culture, discrimination, and impact on diabetes care
  • Specific cultural considerations when considering diabetes management
  • Dietary habits
  • Exercise and physical activity
  • Structured education
  • Impact of religious rituals on diabetes management
  • Fasting and feasting
  • Pilgrimage
  • Research priorities
  • Conclusion
  • References
  • Chapter 69 Diabetes in Childhood
  • Spectrum of diabetes in children
  • Manifestation, diagnosis, and initial treatment
  • Clinical presentation and diagnosis
  • Monogenic diabetes
  • Diabetic ketoacidosis
  • Paediatric ambulatory diabetes care
  • Initial education
  • Continuing education
  • Telemedicine delivery of outpatient diabetes care
  • Diabetes management in school
  • Insulin treatment
  • Subcutaneous insulin injection regimens
  • Insulin pump therapy
  • Nutrition
  • Exercise
  • Preventing hypoglycaemia
  • Delayed hypoglycaemia
  • Ketones and exercise
  • Hypoglycaemia
  • Signs and symptoms
  • Treatment
  • Glucagon
  • Mini-dose glucagon
  • Dextrose
  • Hypoglycaemia unawareness
  • Prevention
  • Sick-day management
  • Monitoring and goals of diabetes management
  • Continuous glucose monitoring metrics
  • Psychological care
  • Screening and early treatment of risk factors for complications and associated conditions
  • Dyslipidaemia
  • Microalbuminuria
  • Elevated blood pressure
  • Retinopathy
  • Neuropathy
  • Coeliac disease
  • Thyroid disease
  • Addison disease
  • References
  • Chapter 70 Adolescence and Emerging Adulthood: Diabetes in Transition
  • Demographic information about diabetes
  • Physical changes during adolescence
  • Developmental stages
  • Adolescence (age 13-18 years)
  • Emerging adulthood
  • Changes in family involvement
  • Diabetes technologies
  • Type 2 diabetes in adolescence and transition
  • Acute and chronic complications in young adults diagnosed with diabetes in childhood
  • What is transition?
  • Problems with transition
  • Existing transition programmes/interventions
  • Conclusion
  • References
  • Chapter 71 Diabetes in Pregnancy
  • Epidemiology
  • Physiology
  • Pathophysiology and its implications
  • Classification
  • Adverse pregnancy outcomes
  • Risk factors for mother and baby
  • Rationale for pregnancy planning
  • Components of a prepregnancy service
  • Challenges associated with prepregnancy care
  • Adverse fetal outcomes
  • Congenital malformations
  • Miscarriage
  • Stillbirth
  • Accelerated fetal growth
  • Shoulder dystocia
  • Neonatal hypoglycaemia
  • Other neonatal complications
  • Maternal diabetes complications
  • Maternal hypoglycaemia
  • Diabetic ketoacidosis
  • Retinopathy
  • Hypertension
  • Diabetic nephropathy
  • Antihypertensive drugs
  • Renal transplantation
  • Neuropathy
  • Ischaemic heart disease
  • Bariatric surgery
  • Management of diabetes in pregnancy
  • Glycaemic targets before and during pregnancy
  • Relation of glycated haemoglobin and pre- and post-prandial glucose levels to maternal fetal outcome
  • Continuous glucose monitoring systems in pregnancy
  • Monitoring of diabetes-related complications
  • Retinal assessment
  • Hypertension/nephropathy
  • Drug cessation
  • Obesity
  • Autoimmune disease
  • Insulin management
  • Insulin regimens
  • Continuous subcutaneous insulin infusion
  • Sick-day rules
  • Type 2 diabetes versus type 1 diabetes
  • Obstetric surveillance
  • Labour and delivery
  • Management of diabetes postpartum
  • Breastfeeding
  • Neonatal care
  • Contraception
  • Gestational diabetes mellitus
  • Overt diabetes during pregnancy
  • GDM: disease entity or risk factor?
  • Diagnosis in the first trimester (timing of screening)
  • Screening tests
  • Two-step test
  • One-step universal approach
  • Fasting plasma glucose screening test
  • Glycated haemoglobin as a screening test
  • Selective versus universal screening
  • Risk engine
  • Cost-effectiveness of screening
  • Management of gestational diabetes
  • Diet and lifestyle modification
  • Pharmacological treatment
  • Delivery
  • Postpartum management
  • Maternal obesity
  • Malformations
  • Effects on neonatal complications
  • Long-term outcomes for the mother
  • Long-term outcomes for the offspring
  • Lifestyle intervention trials during pregnancy
  • Postnatal intervention trials
  • Probiotics
  • Future work
  • References
  • Chapter 72 Diabetes in Old Age
  • Epidemiology
  • Pathogenesis
  • Increased insulin resistance
  • Decreased insulin secretion
  • Diabetes phenotype in old age
  • Comorbidity burden
  • Geriatric syndromes
  • Frailty
  • Clinical presentation
  • Diagnosis
  • Management
  • Health behaviour modifications
  • Hyperglycaemia
  • Hypertension
  • Dyslipidaemia
  • Aspirin therapy
  • Multiple risk intervention
  • Reverse metabolism
  • Special considerations in old age
  • Hypoglycaemia
  • Dementia
  • Hypoglycaemia-dementia interaction
  • Management of diabetes
  • Glycaemic targets
  • Polypharmacy
  • Care homes
  • Conclusion
  • Future perspectives
  • References
  • Chapter 73 Diabetes at the End of Life
  • Dying with diabetes
  • End of life
  • Early identification of people entering the end-of-life phase
  • Management of diabetes at the end of life
  • Glycaemic targets
  • Medicines management during the last year of life
  • Other non-diabetes medications
  • Insulin
  • Continuous subcutaneous infusion of insulin-insulin pumps
  • Nutrition
  • Managing diabetes in people treated with glucocorticosteroids
  • Withdrawing diabetes and other medication
  • Workforce
  • Acknowledgements
  • References
  • Part 12 Delivery and Organization of Diabetes Care
  • Chapter 74 The Role of the Multidisciplinary Team across Primary and Secondary Care
  • Upskilling of primary or community care professionals in multidisciplinary teams
  • Multidisciplinary team support in structured diabetes self-management education
  • Multidisciplinary teams in diabetes care models
  • Multidisciplinary teams in the management of complexities in cardiovascular risk prevention
  • Multidisciplinary teams in the care of people with diabetic retinopathy
  • Multidisciplinary teams in the care of people with diabetes-related foot ulcers
  • Multidisciplinary teams in the care of diabetes in pregnancy
  • Multidisciplinary teams in the care of people with young-onset type 2 diabetes
  • Multidisciplinary teams in the care of older people with diabetes
  • Staff composition of a multidisciplinary diabetes team
  • General or family practitioners
  • Community pharmacists
  • Practice nurses
  • Diabetes specialists
  • Dietitians
  • Community health workers
  • Conclusion
  • References
  • Chapter 75 Models of Diabetes Care in Low- and Middle-Income Countries
  • What are the current challenges of managing diabetes in low- and middle-income country settings?
  • Human resources, information, and medical products
  • Delivering diabetes care
  • Financing and leadership
  • The health response cannot only focus on diabetes
  • What are the ways forward?
  • Integration as a solution
  • Continuity in addressing the needs of the individual and continuity of care
  • Universality in access
  • Quality and responsiveness as driving principles
  • A focus on the individual
  • How can this be achieved?
  • Innovation and new technologies = new opportunities?
  • Conclusion
  • References
  • Part 13 Future Directions
  • Chapter 76 Immunotherapies for Type 1 Diabetes
  • Type 1 diabetes as an autoimmune disease
  • Definition of the natural history, staging, and how to evaluate disease progression by different biomarkers
  • Prevention of type 1 diabetes
  • Immunotherapy approaches
  • Targeting T cells
  • Targeting B cells
  • Targeting inflammation
  • Antigen-specific therapy
  • Current status of immunomodulatory therapies
  • Type 1 diabetes as a heterogeneous disease
  • When to intervene?
  • Future strategies
  • Conclusion
  • References
  • Chapter 77 Stem Cell Therapy in Diabetes
  • Why use stem cells in people with diabetes?
  • What is a stem cell?
  • Stem cells for insulin replacement
  • Healing the heart
  • Creating new vessels
  • Stem cell-based therapy for kidney disease
  • Conclusion
  • References
  • Chapter 78 Gene Therapy for Diabetes
  • Viral vectors
  • Gene therapy for diabetes
  • Gene therapy for type 1 diabetes
  • Gene therapy for type 2 diabetes
  • Conclusion and perspectives
  • References
  • Chapter 79 Future Drug Treatments for Type 2 Diabetes
  • Development of new glucose-lowering agents
  • Dietary supplements and intestinal agents
  • Supporting pancreatic -cell function
  • Glucokinase activators
  • Fatty acid receptor agonists
  • Imeglimin
  • Incretins
  • Peptide mixtures
  • Modifiers of glucagon secretion and action
  • Insulin mimetic agents
  • Insulin action potentiators
  • Adipokines
  • Peroxisome proliferator-activated receptor agonists
  • Hydroxysteroid dehydrogenase 1 inhibitors
  • Sodium-glucose cotransporter inhibitors
  • Modifiers of nutrient metabolism
  • Tissue selective and smart insulins
  • Anti-obesity agents
  • Epigenetic and pharmacogenomic factors
  • Safety
  • Conclusion
  • References
  • Index
  • EULA

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