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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.

Handbook of Diabetes, 4th Ed., Excerpt #13: Control and Complications

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Rudy Bilous, MD, FRCP Richard Donnelly, MD, PHD, FRCP, FRACP   Much of the impact of chronic diabetes results from the development of tissue complications, mainly microvascular (retinopathy, nephropathy and neuropathy) and macrovascular disease (atherosclerosis). Microangiopathy is characterized by progressive occlusion of the capillary lumen with subsequent impaired tissue perfusion, increased vascular ...

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Handbook of Diabetes, 4th Edition, Excerpt #11: Diabetic Ketoacidosis, Hyperglycaemic Hyperosmolar State and Lactic Acidosis

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Rudy Bilous, MD, FRCP Richard Donnelly, MD, PHD, FRCP, FRACP Diabetic ketoacidosis (DKA) is a state of severe uncontrolled diabetes caused by insulin deficiency. It is characterised by hyperglycaemia, hyperketonaemia and metabolic acidosis, and has been somewhat arbitrarily divided into mild, moderate and severe based upon biochemical and clinical features (Table 12.1)….

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Handbook of Diabetes, 4th Edition, Excerpt #10: Management of Type 2 Diabetes

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Rudy Bilous, MD, FRCP Richard Donnelly, MD, PHD, FRCP, FRACP   Lifestyle modification The starting points and mainstays of treatment for type 2 diabetes are diet and other modifications of lifestyle, such as increasing exercise and stopping smoking (Figure 11.1). The major aims are to reduce the weight of obese patients and ...

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Handbook of Diabetes, 4th Edition, Excerpt #9: Management of Type 1 Diabetes

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Rudy Bilous, MD, FRCP Richard Donnelly, MD, PHD, FRCP, FRACP   Modern management of type 1 diabetes comprises a package of measures including multiple daily injections for a more physiological insulin replacement; assessment of glycaemic control using blood glucose self-monitoring as well as clinic tests such as glycated haemoglobin (HbA1c); insulin dosage ...

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Handbook of Diabetes, 4th Edition, Excerpt #6: Epidemiology and Aetiology of Type 2 Diabetes

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Rudy Bilous, MD, FRCP Richard Donnelly, MD, PHD, FRCP, FRACP   Epidemiological studies of diabetes prevalence are often based upon age and self-reported diagnosis. Consequently differentiating type 1 and type 2 patients in population studies is difficult. The most recent authoritative review of global prevalence published by the International Diabetes Federation (IDF) ...

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