CHAPTER 1: Diagnosing Diabetes
- Introduction
- Prevalence of diabetes
- Types of diabetes
- Risk factors for diabetes
- Glucose tolerance test
- Interpretation of the oral glucose tolerance test results
- Identifying patients in need of insulin or urgent referral to hospital
- Metabolic syndrome
- Delaying the onset of type 2 diabetes
- Further reading and references
CHAPTER 2: Types of Diabetes
- Introduction
- Type 1 diabetes
- Type 2 diabetes
- Maternally inherited diabetes with deafness (MIDD)
- Special forms of diabetes
- Lipodystrophies
- Other insulin-resistant syndromes
- Further reading
CHAPTER 3: Helping People Live with Diabetes
- Introduction
- Patient-centred priority setting
- Shared decision-making
- Targets
- Main issues to cover in the first consultation
- Keeping on the same side
- How can we help patients change their lifestyles?
- Structured education
- ‘Yo-yoing’
- Semantics
- Summary
- Further reading and references
CHAPTER 4: Early Detection and Prevention of Diabetes
- Introduction
- Changes in population demography
- Type 2 diabetes in the young
- Impacting on the diabetes epidemic
- Pre-diabetes and macrovascular disease
- The tip of the iceberg
- Silent damage
- Should we screen the population for diabetes?
- Screening for raised cardiovascular risk
- Preventing diabetes in those at risk
- The ‘missing population’ with diabetes
- Summary
- Further reading and references
CHAPTER 5: Obesity
- Introduction
- Diagnostic criteria
- Medical management of obesity in diabetic patients
- Further reading and references
CHAPTER 6: Cardiovascular Disease
- Introduction
- ‘Buying in’ to polypharmacy
- Blood glucose control
- Tight glycaemic control in older patients – balancing risks and benefits
- Blood pressure control
- Renal impairment and albuminuria
- Lipid lowering in people with diabetes
- Other ways of reducing cardiovascular risk
- Multifactorial interventions in diabetes care
- Summary
- Further reading and references
CHAPTER 7: Management of Blood Glucose in Type 2 Diabetes
- Introduction
- Initial management
- Drug therapy options
- Starting insulin in general practice
- Hypoglycaemia
- Difficulties in achieving targets
- Further reading and references
CHAPTER 8: Hyperglycaemic Emergencies and Management of Diabetes in Hospital
- Introduction
- Preventing diabetic ketoacidosis (DKA)
- Clinical features of ketoacidosis
- Diagnosis
- Treatment
- ‘Brittle diabetes’
- Hyperosmolar hyperglycaemic syndrome
- Management of hospitalised type 2 diabetic patients
- Management of diabetes for major elective surgery and type 1 diabetic patients
- The role of technology in improving inpatient diabetes care
- Further reading
CHAPTER 9: Insulin Therapy
- Introduction
- Types of insulin
- Insulin regimens
- Administering insulin
- Summary
- Further reading
CHAPTER 10: Hypoglycaemia
- Introduction
- Causes
- Recognising the hypoglycaemic patient: the clinical picture
- Hypoglycaemia unawareness
- Treatment of the acute episode in adults
- Hypoglycaemia in children
- Long-term management of the patient
- Further reading
CHAPTER 11: Self-Management of Diabetes
- Introduction
- What should I eat?
- Should I self-monitor?
- How should I use my blood glucose results to improve control?
- Advice based on the retrospective approach
- Maintaining an active lifestyle
- Summary
- Further reading and references
CHAPTER 12: Surveillance for Complications
- Introduction
- Structure of a basic surveillance programme
- Summary
- Further reading
CHAPTER 13: Kidney Disease in Diabetes
- Introduction
- Epidemiology
- Clinical presentation
- Investigation of suspected nephropathy
- Histological features of diabetic nephropathy
- Primary prevention
- Treatment of diabetic nephropathy
- Other problems
- Prescribing issues in people with renal impairment
- Summary
- Further reading and references
CHAPTER 14: Eye Disease in Diabetes
- Introduction
- Screening techniques
- Pathogenesis
- Background retinopathy
- Pre-proliferative retinopathy
- Proliferative retinopathy
- Further assessment of established retinopathy
- Treatment options
- Other eye problems in diabetes
- Living with diabetic retinopathy
- Summary
- Further reading and references
CHAPTER 15: The Diabetic Foot
- Introduction
- The three key risk factors
- Patterns of presentation
- Regular surveillance
- Charcot’s joint
- Treatment of diabetic foot complications
- Antibiotic therapy
- Conservative management
- Surgical intervention
- Further reading and references
CHAPTER 16: Diabetic Neuropathy
- Introduction
- Peripheral neuropathy
- Autonomic neuropathy
- Erectile dysfunction
- Further reading
CHAPTER 17: Psychological Issues Related to Diabetes Care
- Introduction
- Adjusting behaviourally to the diagnosis
- Needle phobia
- ‘Food addiction’
- Depression and diabetes
- ‘Self-defeating’ behaviour
- Eating disorders in diabetes
- Therapeutic inertia
- Summary
- Further reading and references
CHAPTER 18: Diabetes and Pregnancy
- Introduction
- Preconceptual management in women with pre-existing diabetes
- Gestational diabetes vs. diabetes in pregnancy
- Monitoring of the pregnant patient with diabetes
- Managing diabetic complications during pregnancy
- Monitoring the foetus during pregnancy
- Management in labour
- Managing hyperglycaemia during labour
- Postnatal follow-up of gestational diabetes
- Summary
- Further reading
CHAPTER 19: Organisation of Diabetes Care in General Practice
- Introduction
- Diabetes Register
- Case finding for diabetes
- Organising care following the diagnosis
- Assessing the quality of diabetes care
- Summary
- Further reading
CHAPTER 20: New and Emerging Therapies for Diabetes
- Introduction
- Key limitations of current therapeutic approaches
- Incretins and other hormone-based therapies
- Obesity
- The future
- Further reading and references
CHAPTER 21: Support for People Living with Diabetes
- Introduction
- Patient support organisations
- Diabetes UK
- The International Diabetes Federation (IDF)
- The American Diabetes Association
- Patient.co.uk
- Summary
- Further reading
