Diabetes E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 574

Veröffentlichungsjahr: 2012

Beschreibung

This edition of Diabetes: Chronic Complications provides both the experienced and trainee endocrinologist with easy-to-read, up-to-date practical guidance on the management of the many complications that can result from the onset of diabetes, such as kidney failure, cardiovascular disease, retinal failure, and cerebrovascular disease. Reflecting the rapid developments currently taking place in the field, the second edition introduces  a brand-new section on liver complications in diabetes, additional material on mental health complications in the section on diabetes and the brain, coverage of  dyslipidaemia and hypertension in the section on diabetes and the heart, five MCQ's in each section to help improve clinical skills, and a case study and key points summary box in every chapter.

Leseprobe

Table of Contents

Cover

Title page

Copyright page

Contributors

Preface to Third Edition

CHAPTER 1 Diabetes and the Eye

1.1 Introduction

1.2 Epidemiology of diabetic retinopathy

1.3 Retinal anatomy

1.4 Pathophysiology and anatomical changes of diabetic retinopathy

1.5 Diagnosis and clinical investigation

1.6 Screening for diabetic retinopathy

1.7 Management: Risk factor reduction, medical and surgical management

1.8 Conclusion

CHAPTER 2 Diabetic Chronic Kidney Disease

2.1 Introduction

2.2 Epidemiology and natural history

2.3 Pathophysiology

2.4 Management

2.5 Conclusion

CHAPTER 3 Diabetes and the Liver

3.1 Introduction

3.2 Epidemiology

3.3 Natural history

3.4 Pathogenesis

3.5 Diagnosis of NAFLD

3.6 Conclusions

CHAPTER 4 Diabetes and the Gastrointestinal Tract

4.1 Introduction

4.2 Epidemiology

4.3 Pathophysiology

4.4 Oesophageal dysfunction

4.5 Gastric dysfunction

4.6 Small intestine

CHAPTER 5 Diabetes and Foot Disease

5.1 Epidemiology

5.2 Pathophysiology

5.3 Management

5.4 The organization of foot care

CHAPTER 6 Diabetes and Autonomic Neuropathy

6.1 Introduction

6.2 Epidemiology

6.3 Pathophysiology

6.4 Management

6.5 Conclusion

CHAPTER 7 Diabetes and Sexual Health

7.1 Introduction

7.2 Male erectile dysfunction

7.3 Sexual dysfunction in the female with diabetes

CHAPTER 8 Diabetes and the Heart

8.1 Introduction

8.2 Epidemiology

8.3 Pathophysiology

8.4 Management

8.5 Conclusions

CHAPTER 9 Diabetes and the Brain

9.1 Introduction

9.2 Cerebrovascular disease and diabetes

9.3 Primary prevention of stroke in diabetes

9.4 Secondary stroke prevention

9.5 Management of acute stroke in patients with diabetes

9.6 Diabetes and cognitive function

9.7 Conclusion

CHAPTER 10 Diabetes and Mental Health

10.1 Introduction

10.2 Epidemiology and description of clinical conditions

10.3 Other common mental disorders

10.4 Management of common mental disorders

10.5 Severe mental illnesses

10.6 Severe mental illnesses and diabetes

10.7 Management

10.8 Severe mental illnesses and other cardiovascular risk factors

10.9 Conclusion

CHAPTER 11 Musculoskeletal Complications of Diabetes Mellitus

11.1 Introduction

11.2 Pathophysiology

11.3 Soft-tissue syndromes in patients with diabetes

11.4 Articular manifestations

11.5 Systemic musculoskeletal conditions

11.6 Concluding comments

CHAPTER 12 Diabetes and Oral Health

12.1 Introduction

12.2 Epidemiology of periodontal diseases

12.3 Pathophysiology of periodontitis

12.4 Management of periodontitis

12.5 Other common oral complications of diabetes

12.6 Impact of periodontitis on other systemic diseases

12.7 The role of the medical practitioner in managing oral conditions

12.8 Conclusions

CHAPTER 13 Diabetes and the Skin

13.1 Introduction

13.2 Dermatological definitions

13.3 Infections

13.4 Necrobiotic disorders

13.5 Eruptive xanthomas

13.6 Acanthosis nigricans

13.7 Diabetic dermopathy

13.8 Diabetic bullae (bullosis diabeticorum)

13.9 Diabetic stiff skin

13.10 Perforating disorders

13.11 Skin reactions to diabetic treatments

13.12 Dermatological therapeutics

CHAPTER 14 Diabetes and Cancer

14.1 Introduction

14.2 Associations between diabetes and specific cancer sites

14.3 Hyperinsulinaemia and cancer risk

14.4 IGF-I and its binding proteins and risk of cancer

14.5 Diabetes treatment and cancer

14.6 Treatment of cancer among diabetics

14.7 Conclusions

Multiple Choice Questions

Answers

Index

Color Plates

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Library of Congress Cataloging-in-Publication Data

Diabetes : chronic complications / edited by Kenneth M. Shaw, Michael H.

Cummings. – 3rd ed.

p. ; cm.

 Includes bibliographical references and index.

 ISBN 978-0-470-65618-1 (hard cover : alk. paper)

 ISBN 978-1-118-36747-6 (epdf)

 ISBN 978-1-118-36748-3 (epub)

 ISBN 978-1-118-36746-9 (mobi)

 I. Shaw, K. (Kenneth) II. Cummings, Michael H.

 [DNLM: 1. Diabetes Complications. WK 835]

 616.4'62–dc23

2011035461

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

Contributors

Amita Bansal MBBS, MD

Clinical Fellow, Department of Dermatology, St Mary’s Hospital, Portsmouth, UK

Stratos Christianakis MD

Assistant Professor of Clinical Medicine, Division of Rheumatology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

Hywel L Cooper BM BMedSci MRCP Int Dip Acu

Consultant Dermatologist, Department of Dermatology, St Mary’s Hospital, Portsmouth, UK

Steven S Coughlin PhD

Senior Epidemiologist, Epidemiology Program, Office of Public Health, Department of Veterans Affairs, Washington, DC; Adjunct Professor, Department of Epidemiology, Rollins School of Public Health Emory University, Atlanta, GA, USA

Iain Cranston FRCP

Consultant Physician (Diabetes and Endocrinology), Academic Department of Diabetes and Endocrinology, Portsmouth NHS Trust, Queen Alexandra Hospital, Portsmouth, UK

Michael H Cummings MD, FRCP

Professor of Diabetes and Endocrinology, Academic Department of Diabetes and Endocrinology, Portsmouth NHS Trust, Queen Alexandra Hospital, Portsmouth, UK

Nigel Davies MA, PhD, FRCOphth

Consultant Ophthalmologist, Chelsea and Westminster Hospital, London, UK

Anna Mae Diehl MD

Chief, Division of Gastroenterology, Duke University Hospital, Durham, NC, USA

Miles Fisher MD, FRCP

Consultant Physician, Glasgow Royal Infirmary; Honorary Professor, University of Glasgow, Glasgow, UK

Edward L Giovannucci MD, PhD

Professor of Epidemiology, Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

Adam E Haworth MB BChir, MRCPI, FRCP

Consultant Dermatologist, Department of Dermatology, St Mary’s Hospital, Portsmouth, UK

Richard IG Holt MA, MB BChir, PhD, FRCP, FHEA

Professor in Diabetes and Endocrinology, Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK

George Jerums MD, FRACP

Endocrinologist and Professorial Fellow, Endocrine Centre, Austin Health and University of Melbourne, Melbourne, Victoria, Australia

Lisa Jones MD, MPH

Gastroenterology Fellow, Duke University Hospital, Durham, NC, USA

Richard J MacIsaac BSc(Hons), PhD, MBBS, FRACP

Director and Professorial Fellow, Department of Endocrinology and Diabetes, St Vincent’s Hospital and University of Melbourne, Melbourne, Victoria, Australia

Andrew F Macleod MA, MD, FRCP

Consultant Endocrinologist, Royal Shrewsbury Hospital, Shrewsbury, UK

Kate Marsden RGN, BSc

Diabetes Specialist Nurse, Academic Department of Diabetes and Endocrinology, Queen Alexandra Hospital, Portsmouth, UK

Darryl Meeking MB, ChB, MRCP

Senior Lecturer, University of Portsmouth; Senior Lecturer, University of Southampton; Academic Department of Diabetes and Endocrinology, Portsmouth Hospitals NHS Trust, Portsmouth, UK

Minh Chau Nguyen MD

Post-doctoral Fellow, Division of Rheumatology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

David P Osborn BA, MA, MSc, PhD, MRCPsych, FHEA

Reader and Consultant Psychiatrist, UCL Mental Health Sciences Unit, UCL, London, UK

Richard S Panush MD, MACP, MACR

Professor of Medicine, Division of Rheumatology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

Henry P Parkman MD

Professor of Medicine, Gastrointestinal Section, Temple University School of Medicine, Philadelphia, PA, USA

Philip M Preshaw BDS, PhD, FDS RCS(Edin), FDS(Rest Dent) RCS(Edin)

Professor of Periodontology and Consultant in Restorative Dentistry, School of Dental Sciences and Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK

Zeeshan Ramzan MD

Gastroenterology Fellow, Gastrointestinal Section, Temple University School of Medicine, Philadelphia, PA, USA

Kenneth M Shaw MD, FRCP

Honorary Consultant Physician, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust; Emeritus Professor of Medicine, University of Portsmouth, Portsmouth, UK

Kevin Shotliff MD, FRCP, DCH

Consultant Physician and Honorary Senior Lecturer (Imperial College), Chelsea and Westminster Hospital, London, UK

Sharon Tuck BSc(Hons), PG Cert

Podiatry Pathway Lead – At Risk Foot, Podiatry Service, Solent NHS, St James Hospital, Portsmouth, UK

Gerald F Watts DSc, DM, PhD, FRACP, FRCP

Winthrop Professor of Medicine, Head of Metabolic Research Centre and Lipid and Hypertension Services, Royal Perth Hospital, School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia

Preface to Third Edition

For the individual person diagnosed with diabetes today, we believe that the prospects of future good health are substantially better than they were a generation ago. Greater scientific understanding of underlying molecular and metabolic mechanisms, innovative technologies and new therapies, along with expanding evidence-based clinical management, have all contributed to a major risk reduction to the individual in terms of developing long-term complications of diabetes. However, for the population as a whole with escalating numbers of people developing diabetes within the current global pandemic of ‘diabesity’, the overall prevalence of diabetic complications has not diminished. Indeed, the consequences of diabetes now so predominate present-day health-care services and costs that changing concepts in the way prevention and clinical care of such need to be addressed. It is also evident that complication risk differs from one individual to another for a variety of reasons. How much differences are due to genetic susceptibility or to metabolic variation is unclear, but recognizing that some people with diabetes are more at risk than others does lead to the principle of risk stratification and personalized individual clinical management.

A large number of substantive clinical trials in recent years have consolidated a firm evidence base for the treatment of diabetes aimed at reducing long-term complications, not forgetting the parallel need to ensure the present day-to-day quality of life as well. Treatment guidelines derived from expert bodies and consensus opinion have defined important surrogate markers of risk, particularly hypertension, dyslipidaemia and hyperglycaemia (in that order), and the defining of ‘quality’ target-based standards has been associated with significant progress in risk factor management. Research studies indicate that good blood pressure control, optimal lipid status and improved glycaemia will all contribute to a substantial reduction in long-term microangiopathic diabetic complications, and the positive expectation is that this will be replicated in the real world of the diabetes population as a whole. With the current pattern of diabetes complications changing towards a greater emphasis on macroangiopathy, particularly coronary heart disease, the importance of early metabolic control and its potential, beneficial, long-term ‘legacy’ effect have highlighted the significance of early detection of diabetes through screening and ensuring optimal control in the early years after diagnosis.

Providing clinical support for people with diabetes has become almost as complex as the nature of diabetes itself. Most diabetes care these days is well provided within a primary care community setting, but, for those identified with higher risk or when developing complications are detected, involvement of a multidisciplinary team and liaison with specialist services will be needed. Integrated models of diabetes care are evolving to meet overall clinical needs according to local circumstances, with the configuration of clinical care pathways enabling those at highest risk to be individually managed. The epidemiology of long-term diabetes complications is changing, with greater understanding of underlying causative mechanisms and improved metabolic control arising from better therapeutic regimens and more structured models of care. The development of diabetic complications should not be seen as inevitable, but sadly the consequences of diabetes are still prevalent and it is evident that some are more at risk than others. Significant strides have been made towards mitigating the more classic complications of retinopathy and nephropathy, whereas other diabetes-related issues, such as mental health and certain cancers, are becoming increasingly clinically significant. In our preface to the previous edition of this book, we conceded that there was still much more to be done to reduce the considerable burden of diabetes both to the individual and to society, but we also recognized that many advances had been made. Much progress has indeed been made in the understanding of how complications arise and how they can be prevented, while ensuring that in today’s world such knowledge is shared between professionals and people with diabetes alike.

With this new edition of Diabetes: Chronic Complications, we have extensively revised earlier chapters on traditional complications, providing the latest science and current therapeutic guidance. In addition, as other long-term problems related to diabetes continue to emerge, we have introduced a number of new chapters, including mental health, disorders of the mouth, cancer and problems of the liver. Illustrative case histories and a selection of multiple choice questions have also been included. We are most grateful to all of the authors who have contributed their expertise and experience. Although, for the purpose of this book, these complications of diabetes are considered separately, the reality is that development of one complication will signal increased susceptibility to other problems. Most of the complications discussed have issues specific to the particular organ or tissue concerned, but equally all have shared generic components and common management considerations.

Even today the discussion of diabetic complications can still be emotive and subject to misunderstanding, but with the substantial knowledge and evidence base that are now available to everyone involved in diabetes care, much wisdom is in place to secure a life with diabetes but very positive moves towards a life without complications. In this book we have endeavoured to provide a practical analysis and reflection on current issues related to the prevention and management of long-term diabetic complications, knowledge that we trust will be found useful by all involved in the clinical practice of diabetes care, and importantly knowledge that can be shared to advantage with the many individuals now living with diabetes who wish to enjoy long-term good health free of complications.

Kenneth M. Shaw

Michael H. Cummings