Diabetes Secrets

240 Pages·2022·4.29 MB·english

by  Michael T. McDermott MD Author

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MICHAEL T. MCDERMOTT, MD
JENNIFER M. TRUJILLO, PharmD
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DIABETES
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DIABETES SECRETS ISBN: 978-0-323-79262-2
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Notices
Knowledge and best practice in this field are constantly changing. As new research and experience broaden our
understanding, changes in research methods, professional practices, or medical treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any
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Last digit is the print number: 9 8 7 6 5 4 3 2 1
We dedicate this book to our patients, who work so hard to control and
overcome diabetes; to our colleagues, who join us in this battle; to our
students, whose curiosity and eagerness to learn continually challenge us; and
to our families, who support us and keep us focused on the priorities of life.
FOREWORD
Approximately 34.2 million Americans and 463 million people worldwide are living with diabetes. It is the leading
cause of kidney failure, acquired blindness, and nontraumatic amputations in the United States. Although the numbers
of patients affected with this chronic disease continue to grow in this country and around the globe, we have seen a
decline in the chronic complications of diabetes in the United States. Although diabetes can cause significant damage
throughout the body, it cannot defeat the human spirit. We see and know of countless people affected with diabetes
who daily face this disease head-on with determination and courage. They modify their diets. They count their calories
and their carbohydrates. They often take multiple oral and/or injectable medications daily to control their glucose levels.
And they monitor their blood glucose levels meticulously with painful fingersticks or with emerging technology. Although
we have not found a cure for diabetes, these brave individuals defeat diabetes daily in a most inspiring way.
Knowledge is power. We have gained a great deal of knowledge about diabetes pathophysiology, diagnosis, and
monitoring, along with measures to control blood glucose levels and the other metabolic features of diabetes. The pur-
pose of this book is to empower providers, fellows, residents, students, and even patients to overcome this formidable
adversary through knowledge of the foe. Although every basic and clinical aspect of diabetes could not be covered in
this short book, we hope to have provided our readers with the most up-to-date information available regarding the
classification, pathophysiology, diagnosis, complications, monitoring, medications, technology, and overall management
of diabetes, with the hope that this will improve the lives of people suffering from diabetes and will inspire some indi-
viduals to pursue critical research to strengthen our armamentarium in the fight against diabetes mellitus.
Diabetes has different demographics and clinical features in different parts of the world, and management prac-
tices vary greatly across the globe. To supplement the information in our book, which is based mainly on data from the
United States and Europe, we have invited colleagues from Ethiopia and New Zealand to write chapters about diabetes
as it presents, progresses, and is managed in their parts of the world. We found their chapters to be intriguing and
compelling, and we greatly appreciate their generosity in sharing their stories with us.
vi
CONTENTS
TOP 100 SECRETS 1
Michael T. McDermott and Jennifer M. Trujillo
1. DIABETES MELLITUS: CLASSIFICATION, ETIOLOGY, AND PATHOGENESIS 6
Michael T. McDermott and Jennifer M. Trujillo
2. COMPREHENSIVE MEDICAL EVALUATION OF PERSONS WITH DIABETES 12
Jennifer M. Trujillo, Elizabeth Ko, and Shasta Tall Bull
3. DIABETIC KETOACIDOSIS AND HYPERGLYCEMIC HYPEROSMOLAR SYNDROME 18
Michael T. McDermott
4. DIABETIC KIDNEY DISEASE 23
Sophia Ambruso and Isaac Teitelbaum
5. DIABETIC RETINOPATHY 30
Jesse M. Smith and Naresh Mandava
6. DIABETIC NEUROPATHIES 34
David Stevens and Dianna Quan
7. PREVENTION OF MACROVASCULAR COMPLICATIONS 40
Stuart T. Haines
8. DIABETES AND NONALCOHOLIC FATTY LIVER DISEASE 46
Thomas Jensen, Mark Lindsay, Amanda Wieland, and Emily Folz
9. DIABETES MANAGEMENT: LIFESTYLE MEASURES—NUTRITION 52
Shannon Lynn Christen
10. EXERCISE AND DIABETES 55
Layla A. Abushamat and Jane E.B. Reusch
11. DIABETES MANAGEMENT: INSULIN THERAPY 59
Lindsay A. Courtney and Jennifer M. Trujillo
12. DIABETES MANAGEMENT: NONINSULIN THERAPIES 68
Sarah L. Anderson and Jennifer M. Trujillo
13. CARBOHYDRATE COUNTING AND PRECISE INSULIN DOSING 77
Michael T. McDermott
14. TYPE 2 DIABETES MANAGEMENT: SELECTING GLYCEMIC TARGETS AND CHOOSING THE RIGHT THERAPY 87
Joshua J. Neumiller
15. DIABETES PREVENTION 93
Kayce M. Shealy
16. DIABETES AND PREGNANCY 96
Layla A. Abushamat and Linda A. Barbour
17. DIABETES MANAGEMENT IN PATIENTS WITH CANCER 104
Elizabeth Tupta
18. DIABETES IN OLDER ADULTS 112
Scott M. Pearson
vii
viii CONTENTS
19. DIABETES MANAGEMENT DURING EXERCISE, SPORTS, AND COMPETITION 116
Michael T. McDermott
20. DIABETES MANAGEMENT IN HOSPITALIZED PATIENTS 122
Stacey A. Seggelke and R. Matthew Hawkins
21. CONTINUOUS GLUCOSE MONITORING 130
Michael T. McDermott
22. CONTINUOUS GLUCOSE MONITORING INTERPRETATION: PRACTICE CASES 136
Michael T. McDermott
23. INSULIN PUMPS AND INTEGRATED SYSTEMS 147
Michael T. McDermott
24. LOOPING 153
Gregory Schleis
25. HYPOGLYCEMIA 159
Diana Isaacs
26. WEIGHT MANAGEMENT IN PATIENTS WITH TYPE 2 DIABETES 165
Christina Ramirez Cunningham and David Saxon
27. IDENTIFYING AND OVERCOMING BARRIERS TO ACHIEVING GLUCOSE CONTROL 170
Sara Wettergreen and Jennifer M. Trujillo
28. DIABETES IN AFRICA 175
Abdurezak Ahmed Abdela and Helen Yifter Bitew
29. DIABETES DIAGNOSIS AND MANAGEMENT IN NEW ZEALAND 179
Nic Crook
INDEX 181