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Surgery

Surgery Options and Outcomes for Diabetes Patients: Diabetes in Control answers key questions about the use of surgery in diabetes management and treatment, including:
– Surgical options for weight loss
– How/when a healthcare professional might recommend surgery for a diabetes patient
– What a healthcare professional needs to know about the spectrum of diabetes related surgeries

Circulating Progenitor Cells Predict Microvascular Outcomes in Type 2 Patients

A low CD34+ count also diminished the protective effects of ACE inhibitors/ARBs on microalbuminuria progression… Low circulating progenitor cells have been shown to predict future cardiovascular events and mortality in patients with CKD and low levels in diabetic patients may indicate microvascular complications. Diabetes lowers the levels of circulating and …

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Practical Diabetes Care, 3rd Ed., Excerpt #16: Diabetic Renal Disease Part 5 of 5

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David Levy, MD, FRCP Renal replacement therapy The decision to start dialysis is often difficult. The clinical decision is based on many factors, including the presence of uremic symptoms and weight loss, and biochemical measurements including serum creatinine (e.g. serum creatinine 700–800 μmol/L(small mu), eGFR < 12–14 mL/min, falling albumin, hyperkalemia). …

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Practical Diabetes Care, 3rd Ed., Excerpt #11: Infections in Diabetes Part 3 of 3

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David Levy, MD, FRCP Diabetic foot infections (see also Chapter 10) Multidisciplinary teamwork with specialist podiatrists is crucial. Patients in primary care must be referred for specialist wound débridement and dressing, which are as important as antibiotic treatment. Worsening clinical features of infection are associated with increasing rates of hospitalization and …

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Practical Diabetes Care, 3rd Ed., Excerpt #9: Infections in Diabetes Part 1 of 3

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David Levy, MD, FRCP Introduction Infections in patients with diabetes are a persistent trap for both the inexperienced and world-wise physician. Whenever someone with diabetes presents unwell, always consider the possibility of infection. High blood glucose levels predispose to some acute infections, especially postoperatively, but other mechanisms are involved, for example …

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Practical Diabetes Care, 3rd Ed., Excerpt #9: Pharmacological Treatment of Hyperglycemia Part 2 of 2

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David Levy, MD, FRCP Drugs acting on the incretin system (entero-insular axis) (Fig. 6.2) The incretin effect Bayliss and Starling inferred the existence of gut-derived substances affecting carbohydrate metabolism more than a century ago, but the incretin effect was not described until 1969: the observation that for a given achieved level …

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