Clinical Dilemmas in Diabetes

Edited by Adrian Vella MD is the Earl and Annette R. McDonough Professor of Medicine, and the Research Chair of the Division of Diabetes, Endocrinology & Metabolism in the Department of Medicine, Mayo Clinic College of Medicine, US

List of Contributors, vii

Preface, x

Part I Prediabetes and the Diagnosis of Diabetes

1 “Is Prediabetes a Risk Factor or Is It a Disease?” 3
Jacob Kohlenberg and Adrian Vella

2 Early Diagnosis of Type 1 Diabetes – Useful or a Pyrrhic Victory? 17
Paolo Pozzilli and Silvia Pieralice

3 Reclassifying or Declassifying Diabetes? Can Clinical Characteristics Guide Classification and
Treatment? 37
Adrian Vella

4 How Should Secondary Causes of Diabetes Be Excluded? 45
Tomás P. Griffin, Aonghus O’Loughlin, and Sean F. Dinneen

5 How to Screen Appropriately for Monogenic Diabetes 68
Adrian Vella

Part II Initial Evaluation and Management of Diabetes

6 Managing Gestational Diabetes During and After Pregnancy 75
Aoife M. Egan and Fidelma P. Dunne

7 What Is the Role of Self‐Monitoring in Diabetes? Is There a Role for Postprandial Glucose Monitoring? How Does Continuous Glucose Monitoring Integrate into Clinical Practice? 87
Rami Almokayyad and Robert Cuddihy

8 Does HbA1c Remain the Most Important Therapeutic Target in Outpatient Management of Diabetes? 101
Kristen Gonzales and Steve A. Smith

9 Technology Issues: Continuous Glucose Monitoring, Insulin Pumps, and Closed Loop Control for Patients with Diabetes 115
Ravinder Jeet Kaur, Shafaq R. Rizvi and Yogish C. Kudva

10 Optimizing Diet in Patients with Diabetes 124
Meera Shah

11 Are Insulin Sensitizers Useful Additions to Insulin Therapy? 133
John W. Richard, III and Philip Raskin

12 Incretin‐Based Therapy for the Management of Type 2 Diabetes 146
Kristin Gonzales and Adrian Vella

Part III Diagnosis and Management of Cardiovascular Risk Factors and Cardiovascular Disease

13 Screening Patients with Prediabetes and Diabetes for Cardiovascular Disease 163
Sabreen Ahmed, Saritha Tirumalasetty and Vivian Fonseca

14 Choosing Medications for Type 2 Diabetes – What Weighting Should Be Given to Cardiovascular Risk Reduction? 174
Adrian Vella

15 Choosing Medications for Weight Loss in Type 2 Diabetes Mellitus 187
Shubhada Jagasia, Chase Dean Hendrickson and Alexander J. Williams

16 Are Statins the Optimal Therapy for Cardiovascular Risk in Patients with Diabetes? What Newer Agents Are There for the Treatment for Dyslipidemia in Diabetes? Are Triglycerides an Important Risk Factor for Diabetes? 198
Recie Davern and Timothy O’Brien

17 New Agents for Treatment of Dyslipidemia 211
Vinaya Simha

18 The Role of Bariatric Surgery in Obese Patients with Diabetes: Primary or Rescue Therapy? 220
Praveena Gandikota and Blandine Laferrère

19 Treatment Strategies in Patients with Diabetes Mellitus and Ischemic Heart Disease 228
Madeline K. Mahowald, Chiam Leker Locker, Mandeep Singh and Robert L. Frye

Part IV Management of Disease Complications

20 Diabetes Management in Patients with Critical and Non-Critical Illness 241
Kalpana Muthusamy, Kristin Grdinovac and John M. Miles

21 Diagnosis and Management of Ophthalmic Complications of Diabetes 252
Andrew J. Barkmeier and Konstantin Astafurov

22 Upper Gastrointestinal Manifestations of Diabetes 269
Michael Camilleri

Index 280