By Vivian Fonseca, Merri Pendergrass, Roberta Harrison McDuffie
Diabetes in scientific perform is a realistic guide at the prognosis, remedy and administration of variety 2 diabetes. It covers all parts of the remedy and administration of kind 2 diabetes, from sufferer schooling on matters corresponding to fit consuming and workout to the potential clinical remedies and medicine on hand. As such, this booklet aids in either without delay treating the disorder and dealing in the direction of the prevention of any pointless problems that could come up out of dwelling with this condition.
Concise, but thorough, Diabetes in medical perform is a worthwhile spouse to these kin practitioners and different clinicians who're confronted with this more and more wide-spread disease.
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Additional resources for Diabetes in Clinical Practice
Example text
34 Freemantle N, Blonde L, Duhot D, et al. Availability of inhaled insulin promotes greater perceived acceptance of insulin therapy in patients with type 2 diabetes. Diabetes Care 2005; 28:427–428. 1). 2, that cause tissue damage [1, 2]. 1. Most of these changes can be prevented by good glycemic control which prevents the development of the complications and slows their progression [3]. Eye: Diabetic retinopathy is a specific abnormality: cataract and glaucoma are common. A. g. g. in nerves, lens) Altered protein function and turnover Cytokine activation and inflammation Osmotic effects Activation of protein kinase C Oxidative stress Acute changes in nerve conduction velocity Changes in glomerular filtration rate and renal plasma flow Kidney: Diabetic nephropathy going through various stages of microalbuminuria to overt proteinuria and kidney failure are specific to diabetes, but other conditions, such as urinary tract infections, may be more common in patients with uncontrolled diabetes.
Second generation SUs (glipizide, glyburide, and glimiperide) are frequently used as first-line agents. Sustainedrelease products offer no advantage over generic, immediate-release SUs, and may be associated with increased rates of nocturnal hypoglycemia. Back-to-back comparisons between metformin and SUs reveal similar A1C reductions [10]. The major adverse side effect of sulfonylureas is hypogly- 24 • HANDBOOK OF DIABETES cemia, which appears to occur most frequently in the elderly. Fortunately, severe episodes tend to be rare.
Adapted from reference [5]. Although it has been proposed that pharmacokinetic properties of insulin analogs may translate into improved clinical efficacy, this has not been convincingly demonstrated in clinical trials, especially for type 2 diabetes. Recent meta-analyses of published clinical trials suggest that, compared with human regular insulin, the rapid-acting analogs provide only a small advantage in terms of A1C reductions, and no advantage for hypoglycemia [6–8]. Compared with human NPH insulin, basal analogs (glargine and detemir) have no advantage for A1C and only minor reductions in nocturnal hypoglycemia [8,9].