This book provides a comprehensive guide for all healthcare professionals managing diabetic foot problems including general practitioners, nurses, podiatrists, orthopaedic surgeons, vascular surgeons and endocrinologists. It is also written in an easy to read fashion so that patients and caregivers will also find it useful.It covers a wide range of topics on the Diabetic Foot starting with an Introductory Section on "Overview of Diabetes". Topics include 'What is Diabetes?', 'Complications of Diabetes' and 'Management of Diabetes'. The section on "Basic Science of Diabetic Foot" covers Anatomy, Biomechanics and Pathogenesis: the Diabetes Foot Triad of Neuropathy, Vasculopathy and Immunopathy. Other Sections include Classification, Clinical Presentation and Treatment.A highlight of the book is the large "Guide to Operative Surgery" section. This section covers Major Amputations, Minor Amputation and other Diabetic Foot Surgeries. The latter details Surgical Debridement and Split Skin Grafting - two of the commonest operations performed. This operative manual is also useful to residents and registrars.The section on Wound Care has also been carefully assembled to meet the needs of nurses, podiatrists and general practitioners, performing day to day dressing of diabetic wounds. It focuses on the use of New Generation Dressings including Silver and Iodine Dressings and Advances in Wound Healing. Patients and Care-givers will also find this useful.The last section "A Patient's Guide" is especially written to benefit patients and care-givers. It includes 'Care of Diabetes', 'Care of the Foot', 'Choosing your own Footwear', 'Doing your own Dressing' and 'Rehabilitating your Below Knee Amputation'.Finally, the Appendix includes details of the formation of NUH Diabetic Foot Team, Asia Pacific Association of Diabetic Limb Problems and the ASEAN Plus Expert Group Forum on the Management of Diabetic Foot Wounds.

Diabetes mellitus has become epidemic on a global scale, and millions of new cases are diagnosed every year. The epidemic of diabetes mellitus is expected to result in one of the steepest rises in human morbidity and mortality ever observed outside of wartime. Insulin resistance is a hallmark of pre-diabetes and type 2 diabetes mellitus, and is characterized by impaired insulin- signaling transduction. Authoritative and comprehensive, Lipoproteins in Diabetes Mellitus details the many changes wrought by insulin resistance and diabetes mellitus on lipid and lipoprotein metabolism. The book begins by summarizing the various techniques to measure lipoproteins and their subclasses. The mechanisms by which insulin resistance and diabetes mellitus increase risk for atherosclerosis, diabetic retinopathy, and diabetic nephropathy are then explored in detail. Finally, the effects of lifestyle modification and the results of clinical trials using established and investigational drugs are discussed. An invaluable contribution to the literature, Lipoproteins in Diabetes Mellitus is a comprehensive reference on the clinical and scientific aspects of lipoproteins in diabetes. It will have a long-lasting and significant effect on the medical management of people with diabetes.

This book provides a concise, state-of-the art review of the surgical treatment of metabolic syndrome and diabetes mellitus. The volume reviews what current practices in surgery and metabolic syndrome and diabetes including the biohormonal effects of the different surgeries. Isolating the effects of the different procedures is critical to the decision tree for type of procedure selected for an individual patient. Specifically for diabetes, this textbook will provide a guide for practitioners to a tailored approach to the treatment. Areas of ongoing research that highlight the minimally invasive approach as well as incorporating what we know of the biochemical results of surgery are presented. Results of established weight loss procedures and ongoing trials are juxtaposed against some of the more novel techniques to ascertain a best practice. Metabolic Surgery and the Surgical Treatment of Diabetes serves as a very useful resource for physicians and researchers dealing with, and interested in, this rising epidemic of metabolic syndrome and diabetes. It provides a concise yet comprehensive summary of the current status of the field that will help guide patient management and stimulate investigative efforts.

Prevention and treatment of cardiometabolic disorders by lifestyle management is the most understood and effective applications of this emerging field. The focus of this book on prediabetes, diabetes and cardiometabolic diseases is timely and will be a welcome addition to clinicians who wish to gain more knowledge and competence in the area. This book will focus on the metabolic syndrome, which is the largest non-communicable disease of our time, and lifestyle approaches that drastically reduce the risks and adverse effects of this condition. Presents a detailed review of clinical evidence and guide for implementation. Provides a toolkit to counter both the high cost of medications and the need to address metabolic disorders associated with insulin resistance early, before or simultaneous to when medications are indicated.

This new volume provides a plethora of new information about potential medicinal herbs and their usefulness in treating diabetes and neurological diseases. Most large multinational companies are interested and engaged in the commercialization of herb-based formulations, and consumers continue to seek natural-based therapies. Herbs for Diabetes and Neurological Disease Management provides insight into plant-based novel molecules targeted for diabetes and neurological disorders. It looks at a selection of herbs that have proven effective in the management of diabetes and neurological disorders, including migraine, epilepsy, memory disorders, depression, and more. Divided into ten chapters focusing on diabetes and its macro- and microvascular complications (migraine, epilepsy, memory disorders, depression and other neuropsychiatric disorders), this book is structured to provide a source of reliable information and enrich the knowledge of readers. Each chapter briefly explains the epidemiology and pathophysiology of the disease state and the possible role of herbal drugs in the prevention of the particular disease. The reported pharmacological activities and possible mechanism of action of herbal drugs are also discussed in detail, which makes this book informative and unique. This new volume will be a reliable reference complementing the substantial information on the use of herbal drugs in diabetes and neurological disorders that serve as the pillars of drug discovery and development.

This issue of Medical Clinics devoted to prediabetes and diabetes prevention belongs in the hands of every practicing internist, PCP, hospitalist, nurse practitioner, endocrinologist, and any healthcare provider who is concerned about the diabetes epidemic. The importance of this resides in our ability to prevent diabetes by early identification of individuals with a precursor condition termed prediabetes that affect 54 million adult Americans. This entity has grown globally over the recent decades paralleling the obesity epidemic. No country or region of the world is immune. Overweight and obesity affect approximately 60% of our population and children as well as adolescents are not spared. Approximately 13% of adolescents have prediabetes which has doubled since the year 2000. Both type 2 diabetes and prediabetes are preventable and reversible with lifestyle changes involving weight loss and exercise. This issue gives a historical perspective on diabetes prevention, examines its public health implications, and explores diabetes prevention initiatives. Essential topics covered include prediabetes definition, epidemiology, mechanisms of complications, pathophysiology, diagnosis, and treatment recommendations. Diabetes prevention trials and the economics of prevention are also covered.

This book addresses diabetic retinopathy, an eye disease that remains one of the main causes of vision loss if not diagnosed and managed properly. It aims to cover the entire spectrum of the disease by describing its clinical identification and characterization, pathophysiology, epidemiology, and medical and surgical management. Diabetic Retinopathy also offers a complete overview of the present understanding of diabetic retinopathy, covering current practice but also including original contributions that offer novel perspectives for looking at and addressing this disease.

The author has dedicated his lifetime to the study of diabetic retinal disease and has organized this book around his personal experience but at the same time giving the necessary information for updated management of diabetic retinopathy. Diabetic Retinopathy will be especially useful for postgraduate students in diabetology, retina specialists and researchers.

This book combines the reference material of a nephrology textbook with the everyday relevance of a clinical handbook. This second edition develops and expands upon the success of the first. All the content has been updated and entirely new chapters on acid-base disorders and stone disease have been added. Understanding Kidney Diseases includes over 60 real-life case studies and is illustrated with over 200 figures. Readers can test their knowledge with a bank of multiple-choice questions and put it into practice by answering questions that patients frequently ask. The book provides all that students, residents and fellows need in order to approach a patient with a kidney problem with confidence.

Emphasizing a team approach that includes the practicing podiatrist, endocrinologist, diabetologist, vascular surgeon, orthopedist, and infectious disease specialist, The High Risk Diabetic Foot provides a thorough and detailed resource on the management of complex diabetic foot problems. This comprehensive text is an essential tool that will enable physicians to reduce infections and amputations through careful examination, diagnosis, treatment, and prevention.

Key features in The High Risk Diabetic Foot include:

• A full section devoted to the prevention of amputation
• High-quality images for accurate diagnosis
• Chapters organized by epidemiology, classification and staging, diagnosis, special studies, and medical and surgical management
• Summary tables and flow charts for quick reference
• A discussion of the co-morbidities associated with diabetic foot pathology, including sensory neuropathy, painful neuropathy, peripheral vascular disease, food wounds, and more
• Identification of the level of medical evidence associated with treatment recommendations

Diabetic Neurology offers a unique focus on the broad neurological complications of diabetes, bridging the clinical divide between diabetology and neurology with a practitioner-friendly guide for the recognition, investigation and management of diabetic patients with neurological disease.

This book provides a comprehensive, practical review of the problems encountered at the interface of diabetes and neurology. The point form format facilitates a thorough summary of the diabetological and neurological approach to patients and their related disease states.

The authors of this book bring together their expertise in these shared fields to address the problems neurologists may encounter in diabetic patients and the important neurological issues to consider in diabetes clinics. The emphasis is on adult patients and some topics are deliberately covered in more than one section, depending on the context of the discussion.

The book s three sections provide:

* An overview of diabetes care directed towards neurologists and of neurological basics directed towards diabetologists
* A summary of various neurological presentations, both common and serious, which both specialties must be cognizant of
* A discussion of rare conditions, their neurological and diabetic complications

This book is a comprehensive and useful reference for diabetologists, endocrinologists, internists and neurologists.

Recent research in diabetes has proven Type 1 diabetes is no longer only a juvenile disease. It has been projected adult Type 1 diabetes will increase 40% from 1997-2010, and as our understanding of the pathogenesis of Type 1 and Type 2 diabetes grows - it is apparent that some cases previously classified as Type 2 are actually adult onset Type 1 diabetes. This volume is the first to focus exclusively on Type 1 diabetes in adults, seeks to clarify the complexities by explaining latest concepts in the pathophysiology and management of the disease, and to assist clinicians in the optimal utilization of cutting edge technology, therapeutics, and management strategies available to them.

The incidence and prevalence of type 2 diabetes mellitus have increased dramatically in modernized and developing nations over the past few decades. Thoroughly revised and expanded, this Second Edition responds to the epidemic and supplies a current overview and guide to the management of diabetes in the modern healthcare environment. This Second Edition offers a current perspective on diabetes demographics, epidemiology, pathophysiology, disease monitoring, and approaches to glucose control, and supplies new chapters by world-renowned experts on non-pharmacological management options, complications of the skin and urogenital function, related macrovascular conditions, coronary heart disease, stroke, and peripheral vascular disease, and rare forms of diabetes, PCOS, and NASH.

While nutrition is central to the management of diabetes, there is no one "diabetic diet". Nutritional prescriptions depend on the type of diabetes, food preferences, lifestyle, treatment regimen, comorbidities, state of health, and the route of caloric administration. Nutritional Strategies for the Diabetic/Prediabetic Patient is a comprehensive reference aimed at advancing physicians' knowledge of nutrition in relation to diabetes, allowing them to provide evidence-based recommendations for their diabetic patients. It also provides dietitians and diabetic educators with an in-depth understanding of the pathophysiology and medical treatment of diabetes. Written by scientists, clinicians, registered dietitians, and certified diabetes educators, this book reviews the molecular mechanisms of disease and drug therapy. It also provides recommendations for management with the level of evidence indicated where appropriate. In areas where little research data is available, the editors present recommendations based on extensive clinical experience. The book places particular focus on the synchronization of nutrient intake with medications, and provides unique clinical management tools, along with details of their ability to be replicated for patient use. To facilitate accessibility, it features evidence-based technical reviews of clinical literature and includes numerous tables and figures, with color photos of wound healing stages. Addressing all aspects of nutrition in adult diabetic and prediabetic patients, Nutritional Strategies for the Diabetic/Prediabetic Patient is an important referencefor those concerned with the dietary management of this disease.

Although cardiovascular disease remains the leading proximate cause of death in the United States, it is now estimated that obesity may be equivalent to smoking as the leading cause of preventable death in America. In light of these statistics, this reference presents our current understanding of the epidemiology, pathology, and genetics of the obesity epidemic and its relationship to cardiovascular disease. It provides an evidence-based approach to the topic, as well as emphasizes a combined treatment strategy for patients suffering from both obesity and cardiovascular disease.

Diabetes is a complex disease--but learning about it shouldn't be

A Type 2 diabetes diagnosis can be daunting, but it is also manageable. With this all-in-one guide, you will get expert advice on establishing a healthier lifestyle and getting control of your diabetes. "The Everything Guide to Managing Type 2 Diabetes" provides easy-to-follow advice on all aspects of living with diabetes, and helps you:

• Recognize the symptoms of prediabetes and diabetes
• Monitor your blood glucose levels
• Learn about the types of insulin and insulin-delivery systems
• Understand the importance of nutrition and exercise
• Reduce the short- and long-term effects of diabetes

Gestational Diabetes Mellitus is becoming an increasingly prevalent disease as obesity and other chronic diseases are on the rise. It requires careful and informed clinical management as the care received during pregnancy affects not only perinatal health but the risk of developing type 2 diabetes even decades into the future, in both the mother and the child.From epidemiology and pathophysiology to diagnosis and management, covering recent breakthroughs in research and up-to-date developments in clinical practice, Gestational Diabetes During and After Pregnancy offers the reader a comprehensive and current look at Gestational Diabetes. Anyone involved in the research, public health or clinical aspects of Gestational Diabetes will find this volume a valuable aid in consolidating all recent developments regarding this disease.

(Diabetes Forum Series; Vol. 3)

Last year, the National Audit Office reported that levels of obesity in the UK have tripled over the last 20 years. This makes the British among the fattest nations in Europe and, if nothing is done to halt the epidemic, it is feared that levels will soon reach those in the US where one person in every four is obese. Every year tens of thousands of people in the western world are dying prematurely from heart disease, stroke and diabetes - all of them closely linked to obesity.
Obesity is a disease. It is the expression of a classic interaction between nature and nurture. What are the factors responsible for its development? Are we becoming more and more a nation of couch potatoes, or are we just eating too much? Do fat children become fat adults? Can anything be done to halt the obesity epidemic?
This collection of essays, based on presentations made at a national symposium on obesity, is aimed at the generalist with an interest in managing obesity and its outcomes, whether general practitioner, community nurse, dietician or hospital clinician. Its purpose is to highlight the causes and consequences of obesity and to bring modern understanding to the treatment of a problem that is still heavily stigmatised. The authors offer a wide-ranging perspective of obesity as a global problem and explore its devastating metabolic, social and political impact.
What is increasingly clear is that the seeds of many of these adult diseases are sown in childhood. The prevention of adult obesity has thus become a major challenge for the paediatrician.

Control pre-diabetes with these 200 easy-to-follow, nutritious recipes that take 30 minutes or less and leave you feeling full, satisfied, and one step closer to a healthier life. A pre-diabetes diagnosis can be concerning, but taking action and incorporating a better diet and more activity at an early stage can help you avoid type-2 diabetes altogether. And The Everything Pre-Diabetes Cookbook is here to help on your health journey. This cookbook includes 200 healthy and easy recipes that will help you manage your pre-diabetes. You will enjoy meals like a savory stir fry, chili, pasta, and even sweet baked goods like doughnuts, all while creating positive change and improving your health. In 30 minutes or less you can devour these easy-to-make recipes that you're sure to enjoy. The first step toward a healthier life starts right here!

Contents:
1. What do gap junctions do anyway? 2. Cardiovascular gap junctions: Functional Diversity, complementation and specialization of connexins 3. Endothelium and smooth muscle pathways for conduction along resistance microvessels 4. Membrane potential and calcium responses evoked by acetylcholine in submucosal arterioles of the guinea-pig small intestine 5. The effects of ouabain, 18a-glycyrrhetinic acid and connexin-mimetic peptides on intercellular communication in cells expressing a Cx43-GFP chimeric protein 6. Role of gap junctions in endothelium-dependent hyperpolarizations 7. Heterogeneity of EDHF-type relaxations of rabbit and rat arteries analysed with peptides homologous to the extracelluar loops of connexins 37, 40 and 43 8. Myoendothelial and circumferential spread of endothelium-dependent hyperpolarization in coronary arteries 9. Direct myoendothelial contact in human pulmonary microvessels 10. Role of gap junctional communication in EDHF-mediated responses and mechanisms of K-induced dilatations 11. Comparison of alpha and beta isoforms of glycyrrhetinic acid and carbenoxolone as inhibitors of EDHF-type relaxation 12. Inhibitory effect of 18-beta-glycyrrhetinic acid on the relaxation induced by acetylcholine in the rat aorta 13. A central role for endothelial cell potassium channels in EDHF-mediated responses 14. Could the EDHF be K in porcine coronary arteries? 15. Nitro-L-arginine/indomethacin-resistant relaxations to acetylcholine in small gastric arteries of the rat: Effect of ouabain plus Ba2+ and relation to potassium ions 16. Effects of barium, ouabain and K+ on the resting membrane potential and endothelium-dependent responses in rat arteries 17. EDHF and potassium: Blockade of chloride channels reveals relaxations of rat mesenteric artery to potassium 18. Cytochrome P450 2C is a source of EDHF and reactive oxygen species in the porcine coronary artery 19. Cortisol increases EDHF-mediated relaxations in porcine coronary artery 19. Cortisol increases EDHF-mediated relaxations in porcine coronary arteries and up-regulates the expression of cytochrome P450 2C9 20. An arachidonic acid metabolite(s) produced by the endothelial cytochrome P450 isoform, CYP3A4, relaxes the lingual artery of the monkey via K+ channel opening 21. EDHF-mediated responses induced by bradykinin in the porcine coronary artery 22. Epoxyeicosatrienoic acid release mediates nitric oxide-independent dilatation of rat mesenteric vessels 23. Epoxyeicosatrienoic acid and endothelium-dependent hyperpolarization in porcine coronary arteries 24. Lipoxygenase-derived metabolites of arachidonic acid are not involved in the endothelium-dependent hyperpolarization to acetylcholine in the carotid artery of the guinea-pig 25. Cytochrome P450 isoforms in the brain encode cell specific hyperpolarizing factors with a common mechanism of action 26. Expression of recombinant cytochrome P450 epoxygenase in rat brain 27. Identification of 11, 12, 15-trihydroxyeicosatrienoic acid as the mediator of acetylcholine- and arachidonic acid-induced relaxations in the rabbit aorta 28. Identification of hydrogen peroxide as an endothelium-derived hyperpolarizing factor in mice 29. Components of the potassium currents underlying the actions of endothelium- derived hyperpolarizing factor in arterioles 30. Evidence for relaxation to endothelium-derived hyperpolarizing factor (EDHF) in isolated small mesenteric arteries of the mouse 31. Pharmacological characterization of potassium channels in intact mesenteric arteries and single smooth muscle cells from eNOS-/- and +/+ mice 32. EDHF, which is not NO, is a major endothelium-dependent vasodilator in mice 33. Prostacyclin and iloprost in the isolated carotid artery of the guinea pig 34. Role of charybdotoxin/apamin sensitive K+ Ca channels in pulsatile perfusion- mediated coronary vasodilatation in vivo 35. Essential role of estrogen in the EDHF-mediated responses of mesenteric arteries from middle-aged female rats: Possible contribution of gap junctional protein connexin 43 36. Endothelium-derived hyperpolarizing factor (EDHF) and utero-feto-placental circulation in the rat 37. Endothelium-derived hyperpolarizing factor maintains a normal relaxation to bradykinin despite impairment of the nitric oxide pathway in porcine coronary arteries with regenerated endothelium 38. Mechanisms underlying the vasodilatation caused by bradykinin in essential hypertensive patients 39. Influence of diabetes on endothelium-dependent responses in mesenteric and femoral arteries of rats 40. Folate restores the NO synthase- and cyclooxygenase-resistant renal vasodilator response to acetylcholine in diabetes 41. Resistance of EDHF-mediated relaxations to oxidative stress in human radial arteries 42. Critical limb ischemia results in different types of endothelial dysfunction depending on the vascular bed studied 43. Potentiated EDHF-mediated dilatations in the rat middle cerebral artery following ischemia/reperfusion 44. The EDHF-dependent but not the NO-dependent component of the acetylcholine-induced relaxation of the rabbit aorta is resistant to ionized radiation 45. Inhibition of converting enzyme prevents the age-related decline in endothelium-dependent hyperpolarization 46. Effects of a converting enzyme inhibitor, an AT1-receptor antagonist and their combination on endothelial dysfunction in hypertension 47. EDHF: Gap junction or chemical? And many other questions

Diabetes and hypertension have evolved as two of the modern day epidemics affecting millions of people around the world. These two common co-morbidities lead to substantial increase in cardiovascular disease, the major cause of morbidity and mortality of adults around the world. In Diabetes and Hypertension: Evaluation and Management, a panel of renowned experts address a range of critical topics -- from basic concepts in evaluation and management of diabetes and hypertension, such as dietary interventions, to evaluation and management of secondary hypertension in clinical practice. Other chapters focus on high cardiovascular risk populations such as those with coronary heart disease, chronic kidney disease and minority patients. In addition, evolving concepts and new developments in the field are presented in other chapters, such as prevention of type 2 diabetes and the epidemic of sleep apnea and its implication for diabetes and hypertension evaluation and management. An important title covering two of the most troubling disorders of our time, Diabetes and Hypertension: Evaluation and Management will provide the busy practitioner with cutting edge knowledge in the field as well as practical information that can translate into better care provided to the high-risk population of diabetics and hypertensive patients.

This book is a how-to manual for practicing physicians and health care providers, nurse educators, nutritionists, and physicians in training in the management of persons with diabetes mellitus. Experts with strong clinical and teaching backgrounds provide up-to-date recom-mendations and rationale of the most effective diagnostic and therapeutic approaches to diabetes mellitus and its multiorgan micro- and macrovascular complications for patients of all ages. Gives five practical guidelines for nutrition therapy that supplies realistic recommendations! With contributions from nearly 60 clinicians who reveal a constellation of disorders with different signs, symptoms, clinical characteristics, and therapies, Medical Management of Diabetes Mellitus -reviews the autoimmune process and genetics of type 1 and type 2 diabetes -offers an overview of the medications that impair glucose metabolism causing hypo- or hyperglycemia -covers pathogenesis, clinical presentation, and diagnosis with specialized laboratory tests -surveys therapeutic modalities, their mechanisms of action, and rationale for use -focuses on outcomes and how they are tracked -stresses early detection and therapy of end-organ complications -discusses the effect of intensive diabetes management on reducing retinopathy, nephropathy, and neuropathy -considers incorporating psychiatric techniques into the treatment of diabetes -compares and contrasts diabetes in children, adults, and the elderly -and more! Containing over 850 references, tables, drawings, and photographs, Medical Management of Diabetes Mellitus is a cross-disciplinary reference perfect for family practice physicians, internists, pediatricians, endocrinologists, pharmacologists, nutritionists, physiologists, dietitians, obesity specialists, psychiatrists, and medical school students in these disciplines.

Despite what you might have heard, diabetes is not a lifelong condition.

It does not have to shorten your life span or result in high blood pressure, heart disease, kidney failure, blindness, or other life-threatening ailments. In fact, most diabetics can get off medication and become 100 percent healthy in just a few simple steps. In The End of Diabetes, Dr. Joel Fuhrman shows how you can prevent and reverse diabetes and its related symptoms and lose weight in the process.

The End of Diabetes is a radical idea wrapped in a simple plan: Eat Better, End Diabetes. While the established medical protocol aims to control diabetes by limiting your carbohydrate intake, monitoring glucose levels, and prescribing bottomless doses of medicine, Dr. Fuhrman believes this long-standing approach to fighting diabetes is wrong--and possibly fatal.

Designed for anyone ready to enjoy a healthier and longer life, Dr. Fuhrman's plan is based on a single formula: Your Health Future (H) = Nutrients (N) / Calories (C). Foods with a high nutrient density, according to Dr. Fuhrman, turn our bodies into the miraculous, self-healing machines they can be, which results in significant weight loss, improved health, and, ultimately, the end of diabetes and other diseases.

In engaging, direct, and easy-to-follow language, The End of Diabetes supplies the science and clinical evidence to prove that diabetes, heart disease, and high blood pressure are not inevitable consequences of aging. They are reversible and preventable. This simple and effective plan offers great food, starts working right away, and puts you on a direct path to a longer, better, fuller, disease-free life.

An extremely useful text for research Internationally renowned experts describe the models, provide data obtained with those models, and discuss the relative usefulness of models in relation to the diabetic syndrome in humans. The first section examines the most widely used model, the streptozotocin (STZ) rat, condensing a massive quantity of literature to present both the general effects of of STZ diabetes and the effects on individual organ systems. The second section discusses less well-known and more recent diabetic models, such as the BB rat, the NOD mouse and Zucker and Zucker Diabetic Fatty rat models.
Genetic models of insulin dependent diabetes mellitus (IDDM) are examined and compared to chemically induced IDDM models.