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Clinical Gems

Our clinical gems come from the top selling medical books, and text books because knowledge is everything when it comes to diabetes.

Practical Diabetes Care, 3rd Ed., Excerpt #4: Type 1 Diabetes: Insulin Treatment Part 1 of 2

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David Levy, MD, FRCP Introduction Insulin treatment in type 1 diabetes is substitution/replacement hormone treatment, but replacement is much more variable and difficult to achieve than in other hormone deficiencies (e.g. thyroid, adrenal, gonadal hormones) because of the minute-by-minute variation in insulin secretion by the intact pancreas, which cannot yet be ...

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Practical Diabetes Care, 3rd Ed., Excerpt #3: Management of Inpatient Diabetes Part 2 of 2

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David Levy, MD, FRCP Patients in the Intensive Care Unit Hyperglycemia, whether associated with known diabetes or not, carries a poor prognosis in critically ill patients through multiple mechanisms, including vascular disease, polyneuropathy, an increased tendency to infection, dyslipidemia, and abnormal anti-inflammatory and coagulation responses. Consistent near-normoglycemia has therefore been a ...

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Practical Diabetes Care, 3rd Ed., Excerpt #1: Diabetes in the Emergency Department

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David Levy, MD, FRCP INTRODUCTION Every day many patients with established or newly diagnosed diabetes pass through emergency departments. Few require admission, but all need careful evaluation and management: emergencies in diabetes can develop rapidly, and they carry a risk of mortality. Deciding who needs admission requires clinical skill and experience. ...

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Handbook of Diabetes, 4th Ed., Excerpt #25: Specific Circumstances that Affect Diabetes Control

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Rudy Bilous, MD, FRCP Richard Donnelly, MD, PHD, FRCP, FRACP Exercise Regular physical exercise is an important component of the management and prevention of type 2 diabetes (Figure 26.1). Aerobic exercise, in particular, and resistance exercise improve insulin sensitivity and glycemic control. Blood glucose and lipid profiles improve, as well as insulin ...

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Handbook of Diabetes, 4th Ed., Excerpt #24: Psychological and Psychiatric Problems in Diabetes

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Rudy Bilous, MD, FRCP Richard Donnelly, MD, PHD, FRCP, FRACP Particular groups of patients with diabetes are at risk of different psychological problems (Table 25.1). Many chil­dren show remarkable resilience to the diagnosis of diabetes, but about one-third have some temporary psychological distress, mostly ‘adjustment disorders’ such as difficulty in sleeping, depression, ...

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