Diabetes in Hospital (eBook)

Paula Holt, Lecturer, School of Healthcare, University of Leeds.

Diabetes in Hospital: A Practical Approach for Healthcare Professionals 1
Contents 7
Preface 10
Acknowledgements 12
Abbreviations 13
1: Understanding diabetes 15
Aims of the chapter 15
What is diabetes? 15
History of diabetes and insulin 16
Anatomy and physiology in the absence of diabetes 17
Insulin 18
Glucagon 22
Classification of diabetes 23
Type 1 diabetes 25
Type 2 diabetes 28
Signs and symptoms of diabetes 34
Making a diagnosis 36
Conclusion 37
2: Treating diabetes effectively 38
Aims of the chapter 38
Insulin therapy 39
Case study: Charlotte 50
Case study: David 62
Conclusion 63
Further information 64
3: Management and treatment of acute diabetes complications in Accident and Emergency 65
Aims of the chapter 65
Hyperglycaemia and diabetic ketoacidosis 65
Case study: Pippa 68
Hypoglycaemia 75
Case study: Jerry 77
Conclusion 84
4: Diabetes in the medical ward 85
Aims of the chapter 85
Diabetic neuropathy 85
Peripheral vascular disease 89
Treatment of neuropathic foot ulcers 91
Case study: Malcolm 94
Conclusion 105
5: Diabetes and the surgical patient 107
Aims of the chapter 107
Risk of surgery 108
Case study: Julie 109
Surgery in different types of diabetes 124
Conclusion 127
6: Diabetes in coronary care 129
Aims of the chapter 129
Metabolic syndrome 130
Central obesity 132
Inflammatory defects 134
Dyslipidaemia 134
Hyperglycaemia 135
Case study: Maggie 136
Conclusion 148
7: Management of diabetes in the renal unit 149
Aims of the chapter 149
Anatomy and physiology of the normal functioning kidney 150
Diabetic nephropathy 153
Diabetic nephropathy and cardiovascular disease 156
Hypertension 157
Case study: Winston 158
Conclusion 169
8: Diabetes and liver disease 170
Aims of the chapter 170
Alcohol-related liver disease 171
Non-alcoholic fatty liver disease 172
Non-alcoholic steatohepatitis 172
Treatment of non-alcoholic fatty liver disease 173
Hepatitis C 177
Hereditary haemochromatosis 177
Case study: Paul 180
New-onset diabetes following transplantation 184
Conclusion 186
9: Discharging the patient with diabetes from hospital 187
Aims of the chapter 187
National Service Framework 189
Structured education 196
National programmes 198
Information prescription 202
Checklist for discharging the person with diabetes from hospital 205
Conclusion 205
References 206
Index 221