Diabetes (eBook)

Kenneth M. Shaw MA, MD, FRCP, is Honorary Consultant Physician, specialising in general medicine, diabetes, endocrinology and metabolism; based at Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust and Emeritus Professor of Medicine, University of Portsmouth. Professor Shaw leads an internationally recognised and award winning, multidisciplinary, professional diabetes team in Portsmouth. Professor Shaw is an Alumna of the University of Cambridge, UK and a Scientific Fellow of the Zoological Society of London. Professor Shaw is Editor-in-Chief of the Wiley journal, Practical Diabetes International and has authored over 200 publications. He is also Chairman of the Professional Support and Development Committee for Diabetes UK. Michael H. Cummings MD, FRCP. is with Portsmouth Hospitals NHS Trust & University of Portsmouth. Professor Cummings was appointed as Consultant in Diabetes and Endocrinology at Queen Alexandra Hospital in 1996. He is also Honorary Professor in Diabetes and Endocrinology at Portsmouth University. Professor Cummings has 44 articles listed on PubMed.

Diabetes Chronic Complications 3
Contents 7
Preface to Diabetic Complications 11
Foreword to Diabetic Complications 13
Preface to the Current Edition 15
List of Contributors 17
1 Diabetes and the Eye 19
1.1 Introduction 19
1.2 Epidemiology of diabetic retinopathy 20
1.3 Retinal anatomy 21
1.4 Classification/clinical and histological features of diabetic retinopathy 24
2 Diabetes and the Kidney 39
2.1 Introduction 39
2.2 Normal renal structure and function 40
2.3 Stages in the development of diabetic renal disease 41
2.4 Prevalence and significance of microalbuminuria 45
2.5 Screening for diabetic renal disease 48
2.6 Initiators and promoters of diabetic renal disease 50
2.7 Renal morphology and diabetic nephropathy 52
2.8 Prevention and treatment of diabetic renal disease 53
2.9 Summary and clinical recommendations 59
3 Diabetes and Foot Disease 67
3.1 Introduction 67
3.2 Diabetic foot ulceration 68
3.3 Charcot foot 76
3.4 The organization of foot care 91
3.5 Conclusion 93
4 Diabetes and Autonomic Neuropathy 97
4.1 Introduction 97
4.2 Causative factors 97
4.3 Tests of autonomic function 99
4.4 Prevalence 100
4.5 Screening for autonomic neuropathy 101
4.6 Clinical syndromes 102
4.7 Conclusion 109
5 Diabetes and Sexual Health 113
5.1 Male erectile dysfunction 113
5.2 Aetiology 114
5.3 Assessment of the diabetic male with ED 118
5.4 Discussion and counselling 122
5.5 Management of ED in the diabetic male 123
5.6 Conclusions 133
5.7 Sexual dysfunction in the female with diabetes 133
6 Diabetes and the Heart 139
6.1 Introduction 139
6.2 Nature of the problem 140
6.3 Primary prevention of heart disease in diabetes 145
6.4 Management of heart disease in diabetes 152
6.5 Secondary prevention of heart disease in diabetes 159
6.6 Conclusions 159
7 Diabetes and the Brain 163
7.1 Introduction 163
7.2 Cerebrovascular disease and diabetes 164
7.3 Primary prevention of stroke in diabetes 166
7.4 Stroke prevention 167
7.5 Management of acute stroke in diabetic patients 170
7.6 Diabetes and cognitive function 171
7.7 Summary 182
8 Diabetes and the Gastrointestinal System 187
8.1 Introduction 187
8.2 Epidemiology 188
8.3 Pathophysiology of GI dysfunction 189
8.4 Oesophageal complications 191
8.5 Stomach complications 194
8.6 Small intestine 201
8.7 Colon 204
8.8 Anorectal function 206
8.9 Pancreatic 207
8.10 Hepatobiliary 208
8.11 Biliary disorders 211
8.12 Diabetic diarrhoea 212
8.13 Conclusion 215
9 Diabetes and Musculoskeletal Disease 221
9.1 Introduction 221
9.2 Pathophysiology 221
9.3 Musculoskeletal conditions associated with diabetes 223
9.4 Upper limb diabetic complications 223
9.5 Generalized conditions involving the skeletal system in diabetes 226
9.6 Functional disability in diabetic patients 228
9.7 Conclusion 229
10 Diabetes and the Skin 233
10.1 Introduction 233
10.2 Necrobiotic disorders 234
10.3 Necrobiosis lipoidica 237
10.4 Acanthosis nigricans 239
10.5 Eruptive xanthomata 241
10.6 Diabetic thick skin 242
10.7 Diabetic dermopathy 244
10.8 Bullosis diabeticorum 245
10.9 Infections 245
10.10 Perforating disorders 246
10.11 Glucagonoma syndrome 247
10.12 Vitiligo 248
10.13 Dermatological definitions 249
10.14 Dermatological therapies 251
Index 259

"Considering the ever increasing number of people afflicted withdiabetes this is a timely update." (E-STREAMS, June 2007)

"...ideal for the healthcare practitioner with limitedexperience in treating patients." (The Annals ofPharmcotherapy, May 2006)

"...easy to read..." (Practical Diabetes International, Vol 22(9), November 2005)