Diabetes demystified by umesh masharani (257 pages, 2008)

diabetes DeMYSTiFieD Demystified Series Accounting Demystified Advanced Calculus Demystified Advanced Physics Demystified Advanced Statistics Demystified Algebra Demystified Alternative Energy Demystified Anatomy Demystified asp.net 2.0 Demystified Astronomy Demystified Audio Demystified Biology Demystified Biotechnology Demystified Business Calculus Demystified Business Math Demystified Business Statistics Demystified C++ Demystified Calculus Demystified Chemistry Demystified Circuit Analysis Demystified College Algebra Demystified Corporate Finance Demystified Databases Demystified Data Structures Demystified Differential Equations Demystified Digital Electronics Demystified Earth Science Demystified Electricity Demystified Electronics Demystified Engineering Statistics Demystified Environmental Science Demystified Everyday Math Demystified Fertility Demystified Financial Planning Demystified Forensics Demystified French Demystified Genetics Demystified Geometry Demystified German Demystified Home Networking Demystified Investing Demystified Italian Demystified Java Demystified JavaScript Demystified Lean Six Sigma Demystified Linear Algebra Demystified Macroeconomics Demystified Management Accounting Demystified Math Proofs Demystified Math Word Problems Demystified MATLAB ® Demystified Medical Billing and Coding Demystified Medical Terminology Demystified Meteorology Demystified Microbiology Demystified Microeconomics Demystified Nanotechnology Demystified Nurse Management Demystified OOP Demystified Options Demystified Organic Chemistry Demystified Personal Computing Demystified Pharmacology Demystified Physics Demystified Physiology Demystified Pre-Algebra Demystified Precalculus Demystified Probability Demystified Project Management Demystified Psychology Demystified Quality Management Demystified Quantum Mechanics Demystified Real Estate Math Demystified Relativity Demystified Robotics Demystified Sales Management Demystified Signals and Systems Demystified Six Sigma Demystified Spanish Demystified sql Demystified Statics and Dynamics Demystified Statistics Demystified Technical Analysis Demystified Technical Math Demystified Trigonometry Demystified uml Demystified Visual Basic 2005 Demystified Visual C# 2005 Demystified xml Demystified diabetes DeMYSTiFieD Umesh Masharani, M.D New York Chicago San Francisco Lisbon London Madrid Mexico City Milan New Delhi San Juan Seoul Singapore Sydney Toronto Copyright © 2008 by Umesh Masharani All rights reserved Manufactured in the United States of America Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher 0-07-159389-6 The material in this eBook also appears in the print version of this title: 0-07-147795-0 All trademarks are trademarks of their respective owners Rather than put a trademark symbol after every occurrence of a trademarked name, we use names in an editorial fashion only, and to the benefit of the trademark owner, with no intention of infringement of the trademark Where such designations appear in this book, they have been printed with initial caps McGraw-Hill eBooks are available at special quantity discounts to use as premiums and sales promotions, or for use in corporate training programs For more information, please contact George Hoare, Special Sales, at george_hoare@mcgraw-hill.com or (212) 904-4069 TERMS OF USE This is a copyrighted work and The McGraw-Hill Companies, Inc (“McGraw-Hill”) and its licensors reserve all rights in and to the work Use of this work is subject to these terms Except as permitted under the Copyright Act of 1976 and the right to store and retrieve one copy of the work, you may not decompile, disassemble, reverse engineer, reproduce, modify, create derivative works based upon, transmit, distribute, disseminate, sell, publish or sublicense the work or any part of it without McGraw-Hill’s prior consent You may use the work for your own noncommercial and personal use; any other use of the work is strictly prohibited Your right to use the work may be terminated if you fail to comply with these terms THE WORK IS PROVIDED “AS IS.” McGRAW-HILL AND ITS LICENSORS MAKE NO GUARANTEES OR WARRANTIES AS TO THE ACCURACY, ADEQUACY OR COMPLETENESS OF OR RESULTS TO BE OBTAINED FROM USING THE WORK, INCLUDING ANY INFORMATION THAT CAN BE ACCESSED THROUGH THE WORK VIA HYPERLINK OR OTHERWISE, AND EXPRESSLY DISCLAIM ANY WARRANTY, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE McGraw-Hill and its licensors not warrant or guarantee that the functions contained in the work will meet your requirements or that its operation will be uninterrupted or error free Neither McGraw-Hill nor its licensors shall be liable to you or anyone else for any inaccuracy, error or omission, regardless of cause, in the work or for any damages resulting therefrom McGraw-Hill has no responsibility for the content of any information accessed through the work Under no circumstances shall McGraw-Hill and/or its licensors be liable for any indirect, incidental, special, punitive, consequential or similar damages that result from the use of or inability to use the work, even if any of them has been advised of the possibility of such damages This limitation of liability shall apply to any claim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise DOI: 10.1036/0071477950 To Nisha, Vijay, and Hansha This page intentionally left blank For more information about this title, click here CONTENTS Acknowledgments Introduction ix xi PART ONE WHAT DOES A DIAGNOSIS OF DIABETES MEAN FOR YOU? CHAPTER Understanding Diabetes CHAPTER Causes of Diabetes: Genes and Environment 13 CHAPTER Complications of Diabetes 25 PART TWO MANAGING YOUR DIABETES DAY-TO-DAY CHAPTER Assembling Your Treatment Team and Support Network 53 CHAPTER Monitoring Your Diabetes 61 CHAPTER Medicine for Diabetes 75 CHAPTER Hypoglycemia (Low Glucose Reaction) 101 CHAPTER Diabetes and Nutrition 111 CHAPTER Developing a Safe Exercise Program 125 CHAPTER 10 Weight Loss 137 vii viii Contents PART THREE ADDITIONAL CONSIDERATIONS CHAPTER 11 Managing Your Diabetes While Traveling CHAPTER 12 Managing Diabetes While Sick and During Medical Procedures and Hospitalization 155 CHAPTER 13 Diabetes and Pregnancy 165 CHAPTER 14 When Your Child Has Diabetes 175 CHAPTER 15 Diabetes as You Age 191 CHAPTER 16 Putting It All Together 199 Glossary Resources References Index 213 223 227 237 151 ACKNOWLEDGMENTS I would like to thank my colleagues at the University of California, San Francisco, who have helped shape my approach to the practice of diabetes I am indebted to my patients, who over the years have taught me much about diabetes Two of my diabetes educator colleagues, Marlene Bedrich and Gloria Yee, also deserve my thanks for reviewing some of the chapters and providing helpful comments about the manuscript I would like to give a special thank-you to my editor at McGraw Hill, Johanna Bowman, for guiding and encouraging me throughout the writing of this book, and to Terre Stouffer for her careful and meticulous editorial help Lastly, I would like to thank my wife, Hansha, for her love and support ix Copyright © 2008 by Umesh Masharani Click here for terms of use 230 References Takagi T, Yamamuro A, Tamita K, Yamabe K, Katayama M, Mizoguchi S, Ibuki M, et al “Pioglitazone reduces neointimal tissue proliferation after coronary stent implantation in patients with type diabetes mellitus: an intravascular ultrasound scanning study.” Am Heart J 2003 Aug; 146 (2): E5 UK Prospective Diabetes Study (UKPDS) Group “Effect of intensive blood-glucose control with metformin on complications in overweight patients with type diabetes (UKPDS 34).” Lancet 1998 Sep 12; 352 (9131): 854–65 Erratum in: Lancet 1998 Nov 7; 352 (9139): 1558 UK Prospective Diabetes Study (UKPDS) Group “Intensive bloodglucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type diabetes (UKPDS 33).” Lancet 1998 Sep 12; 352 (9131): 837–53 Erratum in: Lancet 1999 Aug 14; 354 (9178): 602 Vanschoonbeek K, Thomassen BJ, Senden JM, Wodzig WK, van Loon LJ “Cinnamon supplementation does not improve glycemic control in postmenopausal type diabetes patients.” J Nutr 2006 Apr; 136 (4): 977–80 Vuksan V, Sievenpiper JL, Xu Z, Wong EY, Jenkins AL, Beljan-Zdravkovic U, Leiter LA, Josse RG, Stavro MP “Konjac-Mannan and American ginseng: emerging alternative therapies for type diabetes mellitus.” J Am Coll Nutr 2001 Oct; 20 (5 Suppl): 370S–80S; discussion 381S–83S Chapter Austin EJ, Deary IJ “Effects of repeated hypoglycemia on cognitive function: a psychometrically validated reanalysis of the Diabetes Control and Complications Trial data.” Diabetes Care 1999 Aug; 22 (8): 1273–77 Briscoe VJ, Davis SN “Hypoglycemia in type and type diabetes.” Physiology, Pathophysiology, and Management Clinical Diabetes 2006; 24: 115–21 de Galan BE, Schouwenberg BJ, Tack CJ, Smits P “Pathophysiology and management of recurrent hypoglycaemia and hypoglycaemia unawareness in diabetes.” Neth J Med 2006; 64: 269–79 Jacobson AM, et al “Effects of intensive and conventional treatment on cognitive function twelve years after the completion of the Diabetes Control and Complications Trial (DCCT).” Abstract Number 750232, presented at the American Diabetes Association’s 66th Annual Scientific Sessions held in Washington, D.C., June 13, 2006 References 231 Chapter American Diabetes Association “Nutrition recommendations and interventions for diabetes.” Diabetes Care 2007 Jan; 30 (Suppl 1): S48–S65 American Diabetes Association Task Force for Writing Nutrition Principles and Recommendations for the Management of Diabetes and Related Complications “American Diabetes Association position statement: evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications.” J Am Diet Assoc 2002 Jan; 102 (1): 109–18 de Lorgeril M, Salen P, Martin JL, Monjaud I, Delaye J, Mamelle N “Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study.” Circulation 1999 Feb 16; 99 (6): 779–85 Foster-Powell K, Holt SHA, and Brand-Miller JC “International table of glycemic index and glycemic load values.” American Journal of Clinical Nutrition 2002; 76 (1): 5–56 Turpeinen O, Karvonen MJ, Pekkarinen M, Miettinen M, Elosuo R, Paavilainen E “Dietary prevention of coronary heart disease: the Finnish Mental Hospital Study.” Int J Epidemiol 1979 Jun; (2): 99–118 Chapter American College of Sports Medicine and American Diabetes Association joint position statement “Diabetes mellitus and exercise.” Med Sci Sports Exerc 1997; 29: i–vi Perkins BA, Riddell MC “Type diabetes and exercise: using the insulin pump to maximum advantage.” Canadian Journal of Diabetes 2006; 30; 72–79 Sigal RJ, Castaneda-Sceppa C, Kenny GP, White RD, Wasserman DH “Physical/ exercise and type diabetes.” Diabetes Care 2006; 29: 1433–38 Walsh J, Roberts R Pumping Insulin 3rd ed San Diego, CA: Torrey Pines Press; 2000 Wasserman DH, Zinman B “Exercise in individuals with IDDM.” Diabetes Care 1994; 17: 924–37 232 References Chapter 10 Bravata DM, Sanders L, Huang J, Krumholz HM, Olkin I, Gardner CD, Bravata DM “Efficacy and safety of low-carbohydrate diets.” JAMA 2003 Apr 9; 289 (14): 1837–50 Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, Schoelles K “Bariatric surgery: a systematic review and meta-analysis.” JAMA 2004; 292: 1724– 37 Review Erratum in: JAMA 2005; 293: 1728 Colquitt J, Clegg A, Loveman E, Royle P, Sidhu MK “Surgery formorbid obesity.” Cochrane Database Syst Rev 2005 Oct 19; 4: CD003641 DPP Research Group “Description of lifestyle intervention.” Diabetes Care 2002; 25: 2165–71 Haddock CK, Poston WS, Dill PL, Foreyt JP, Ericsson M “Pharmacotherapy for obesity: a quantitative analysis of four decades of published randomized clinical trials.” Int J Obes Relat Metab Disord 2002 Feb; 26 (2): 262–73 Heymsfield SB, van Mierlo CA, van der Knaap HC, Heo M, Frier HI “Weight management using a meal replacement strategy: meta and pooling analysis from six studies.” Int J Obes Relat Metab Disord 2003 May; 27 (5): 537–49 James WP, Astrup A, Finer N, Hilsted J, Kopelman P, Rossner S, Saris WH, Van Gaal LF “Effect of sibutramine on weight maintenance after weight loss: a randomised trial STORM Study Group Sibutramine Trial of Obesity Reduction and Maintenance.” Lancet 2000 Dec 23–30; 356 (9248): 2119–25 Lean M, Lara J “ABC of obesity: Strategies for preventing obesity.” BMJ 2006; 333 (7575): 959–62 Li Z, Maglione M, Tu W, Mojica W, Arterburn D, Shugarman LR, Hilton L, et al “Meta analysis: pharmacologic treatment of obesity.” Ann Intern Med 2005 Apr 5; 142 (7): 532–46 Low AK, Bouldin MJ, Sumrall CD, Loustalot FV, Land KK “A clinician’s approach to medical management of obesity.” Am J Med Sci 2006 Apr; 331 (4): 175–82 Maggard MA, Shugarman LR, Suttorp M, Maglione M, Sugerman HJ, Livingston EH, Nguyen NT, et al “Meta-analysis: surgical treatment of obesity.” Ann Intern Med 2005 Apr 5; 142 (7): 547–59 Miffin MD, St Jeor ST, Hill LA, Scott BJ, Daugherty SA, Koh YO “A new predictive equation for resting energy expenditure in healthy individuals.” Am J Clin Nutr 1990; 51: 241–47 References 233 Nordmann AJ, Nordmann A, Briel M, Keller U, Yancy WS, Brehm BJ, Bucher HC “Effects of low-carbohydrate vs low-fat diets on weight loss and cardiovascular risk factors: a meta-analysis of randomized controlled trials.” Arch Intern Med 2006; 166: 285–93 Padwal R, Li SK, Lau DC “Long-term pharmacotherapy for obesity and overweight.” Cochrane Database Syst Rev 2004; 3: CD004094 Rothacker DQ “Five-year self-management of weight using meal replacements: comparison with matched controls in rural Wisconsin.” Nutrition 2000; 16 (5): 344–48 Sjostrom L, Lindroos AK, Peltonen M, Torgerson J, Bouchard C, Carlsson B, Dahlgren S, et al “Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery.” N Engl J Med 2004 Dec 23; 351 (26): 2683–93 Chapter 11 Burnett JC “Long- and short-haul travel by air: issues for people with diabetes on insulin.” J Travel Med 2006 Sep–Oct; 13 (5): 255–60 Chapter 13 American Diabetes Association “Position statement Gestational diabetes mellitus.” Diabetes Care 2003; 26 (Suppl 1): S103–5 American Diabetes Association “Preconception care of women with diabetes.” Diabetes Care 2004; 27 (Suppl 1): S76–78 Coustan DR, Carpenter MW “The diagnosis of gestational diabetes.” Diabetes Care 1998; 21 (Suppl 2): B5–8 Gabbe SG, Graves CR “Management of diabetes mellitus complicating pregnancy.” Obstet Gynecol 2003; 102: 857–68 Jovanovic L, Nakai Y “Successful pregnancy in women with type diabetes: from preconception through postpartum care.” Endocrinol Metab Clin North Am 2006; 35: 79–97 Price N, Bartlett C, Gillmer M “Use of insulin glargine during pregnancy: a casecontrol pilot study.” BJOG 2007 Apr; 114 (4): 453–57 234 References Xiang AH, Peters RK, Kjos SL, Marroquin A, Goico J, Ochoa C, Kawakubo M, Buchanan TA “Effect of pioglitazone on pancreatic beta-cell function and diabetes risk in Hispanic women with prior gestational diabetes.” Diabetes 2006 Feb; 55 (2): 517–22 Zarzycki W, Zieniewicz M “Reproductive disturbances in type diabetic women.” Neuro Endocrinol Lett 2005 Dec; 26 (6): 733–38 Chapter 14 American Association of Diabetes Educators “Management of children with diabetes in the school setting.” Diabetes Educ 2000; 26: 32–35 American Diabetes Association “Diabetes care at diabetes camps.” Diabetes Care 2007 Jan; 30 (Suppl 1): S74–76 American Diabetes Association “Diabetes care in the school and day care setting.” Diabetes Care 2007 Jan; 30 (Suppl 1): S66–73 Bloomgarden ZT “Type diabetes in the young: the evolving epidemic.” Diabetes Care 2004 Apr; 27 (4): 998–1010 Silverstein J, Klingensmith G, Copeland K, Plotnick L, Kaufman F, Laffel L, Deeb L, et al “Care of children and adolescents with type diabetes: a statement of the American Diabetes Association.” Diabetes Care 2005 Jan; 28 (1): 186–212 Chapter 15 Benbow SJ, Walsh A, Gill GV “Diabetes in institutionalised elderly people: a forgotten population?” BMJ 1997 Jun 28; 314 (7098): 1868–69 Gregg EW, Engelgau MM, Narayan V “Complications of diabetes in elderly people.” BMJ 2002 Oct 26; 325 (7370): 916–17 References 235 Chapter 16 Nathan DM, Buse JB, Davidson MB, Heine RJ, Holman RR, Sherwin R, Zinman B “Management of hyperglycemia in type diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes.” Diabetes Care 2006; 29: 1963–72 Sherwin RS, Anderson RM, Buse JB, Chin MH, Eddy D, Fradkin J, Ganiats TG, et al “The prevention or delay of type diabetes.” Diabetes Care 2003; 26 (Suppl 1): S62–69 This page intentionally left blank INDEX Abbott Pharmaceutical glucose monitoring system, 68 A1c See Hemoglobin H1c (HbA1c) Acanthosis nigricans, 41 Acarbose (Precose), 80, 80t Acetohexamide (Dymelor), 77, 78t Acomplia (rimonabant), 147 Actoplus Met (pioglitazone with metformin), 86t ACTOS (pioglitazone), 80–82, 81t, 166 Acute exercise, 126 Addison’s disease, 16, 105 Adolescents See Children with diabetes Adult-onset diabetes See Type diabetes Advil (ibuprofen), 34 Aerobic exercise, 127–28 Aging See also Elderly impact of diabetes on diseases of, 195 management of diabetes and, 193–95 Airplanes, managing diabetes on, 152–53 Albumin, 31 Alcohol, carbohydrate counting and, 121–22 Alendronate (Fosamax), 40 Alpha blockers, 33t Alpha cells, Alpha-linolenic acid, 116 Alprostadil (Muse), 47 Amaryl (glimepiride), 77, 78t American Diabetes Association (ADA) screening guidelines for diabetes of, 6–7, 7t as source for diabetes-related information, 57 American ginseng (Panax quinquefolius), 99 Amitriptyline (Elavil), 35 Anaerobic exercise, 129 Analogs, insulin, 87–88 Angina, 43 Angiotensin converting enzyme (ACE) inhibitors, 32, 33t Angiotensin receptor blockers (ARBs), 32, 33t Antibodies, 15 Antioxidants, 28 Apidra (insulin glulisine), 87 Artificial sweeteners, 114 Aspirin, 44 children and, 44 Atherosclerosis, 42 Athlete’s foot, 41 Atkins diet, 141, 143–44 Autoantibodies, 15 Autoimmune diseases children with diabetes and, 184–85 type diabetes and, 16 Autoimmune injury, Autoimmune thyroid disease, 16 Autonomic neuropathy, 39, 105, 135 Autonomic symptoms, 101, 102t Avandamet (rosiglitazone with metformin), 86t Avandia (rosiglitazone), 80–81, 81t, 166 Avandryl (rosiglitazone with glimepiride), 86t Avastin (bevacizumab), 30 Balanced diets, 140–41 Bariatric surgery, for weight loss, 147–48 Basal insulin, optimal dosage, 202–4 Bell’s palsy, 37 Beta-blocker eyedrops, 31 Beta-blockers, 33t Beta cell injury, 20 Beta cells, Betagan (levobunolol), 31 Betaxolol (Betoptic), 31 Bethanechol (Urecholine), 39 Betoptic (betaxolol), 31 Bevacizumab (Avastin), 30 Bile acid resins, 46t Bisphosphonates, 40 Bladder, injury to nerves to, 39 237 Copyright © 2008 by Umesh Masharani Click here for terms of use 238 Blood glucose body uses of, 3–4 defined, logs, 66f measuring, in urine, 67 recording, 66–67 Blood glucose levels See also Hypoglycemia ADA targets for, 62t determining appropriate, 102–3 monitoring, 61–62, 131, 205 nutritional supplements that lower, 96–100 regulating, during exercise, 129 targets for, 201 targets for, during pregnancy, 167, 167t targets for, in children and adolescents, 179 targets for, in elderly, 192–93 Blood glucose management, during hospitalizations, 161–62 Blood pressure See also High blood pressure children with type diabetes and, 187 medications for, during pregnancies, 168 monitoring, 71 potassium and, 123 salt intake and, 123 Blood vessels, injury to nerves supplying, 39–40 Body mass index (BMI) calculating, 138–39 weight classification by, 139f Bolus insulin, optimal dosage, 204–5 Borg perceived exertion scale, 127, 128 Bowel, nerve injury to, 38 Brain circulation, diabetes and, 43 Breast-feeding, type diabetes and, 171 British Diabetes Association, 57 Byetta (exenatide), 82–83, 83t Calcium channel blockers, 33t Calorie, defined, 115 Canadian Diabetes Association, 57 Capsaicin, 35–36 Carbachol (Isopto Carbachol), 31 Carbohydrate counting, 119, 119t, 205–6 alcohol and, 121–22 Carbohydrate intake, overestimating, hypoglycemia and, 103 Carbohydrates, 112–15 exercise and, 133–34, 133t Carbonic anhydrase inhibitors, 31 Carpal tunnel syndrome, 37 Catapres (clonidine), 37 Cataracts, 30 CB1 receptors, 147 Celiac disease, 16 children with diabetes and, 184–85 Central alpha agonists, 33t Certified diabetes educators (CDEs), 55 Charcot’s arthropathy, 40, 135 Children with diabetes See also Diabetes aspirin and, 44 camps for, 189 type 1, 176–85 challenges at different ages of, 176–79 fear of needles and, 182 glucose targets for, 179 Index identification bracelets and, 182–83 illnesses and, 183–84 insulin therapy for, 180–82 role as parent and, 175–76 symptoms leading to diagnosis of type 1, 176 testing for autoimmune diseases and, 184–85 type 2, 185–88 blood pressure and, 187 diet and, 185–86 exercise and, 186 lipid profile and, 187 medications and, 186–87 screening for, 185 screening for complications and, 188 Chlorpropamide (Diabinese), 77, 78t Cholesterol, 45, 117 foods high in, 117t monitoring, 72 Chromium, for lowering glucose levels, 98–99 Chronic exercise, 126 Chylomicrons, 45 Cialis (tadalafil), 47 Cinnamon, for lowering glucose levels, 98 Circulatory problems diabetes and, 42–43 preventing, 43–46 Clinical social workers, 56 Clonidine (Catapres), 37 Coma, hyperosmolar, 27 Complications, of diabetes, 105 for elderly, 196 long-term, 27–29 managing, while traveling, 153–54 short-term, 25–27 Congenital malformations, risk of, HbA1c levels and, 167, 168t Continuous glucose monitoring systems, 67–69 See also Glucose meters Abbott Pharmaceutical system, 68 DexCom system, 68–69 GlucoWatch system, 69 Medtronic MiniMed system, 68–69 Coronary artery disease, 39 Cortisol deficiency, 105 Counterregulatory systems, failure of, 104–5 Creatinine, 31 CSIRO (Commonwealth Scientific and Industrial Research Organization) Total Wellbeing Diet, 141 Cymbalta (duloxetine), 35 Cystic fibrosis, Detrol (tolterodine), 39 DexCom glucose monitoring system, 68–69 Diabeta (glyburide), 78t Diabetes, 19f See also Children with diabetes; Diabetes mellitus; Diet; Gestational diabetes; Pregnancy; Type diabetes; Type diabetes brain circulation and, 43 circulation to legs and, 43 circulatory problems and, 42–46 due to pancreatic damage, 0–10 gestational, 171–72 heart and, 43 Index impact of, on diseases of aging, 195 induced by medications, 10 institutional aspects for elderly of, 195–96 obesity and, 18 related to excessive hormone production, 10 screening for, 6–7 short-term complications of, 25–27 symptoms of, testing for, 56 tests for evaluating, 69–70 types of, 8–11 Diabetes mellitus, defined, Diabetes Prevention Program (DPP), 21 Diabetes self-management education (DSME), 54 Diabetic amyotrophy, 40 Diabetic dermopathy, 41 Diabetic ketoacidosis (DKA), 26–27, 129, 130 Diabetic kidney disease, 31–34, 168 Diabetic nerve diseases, 34–40 to bladder, 39 to blood vessels, 39–40 to bowel, 38 to eye muscles, 37 to face, 37 to feet, 35–37 to hands, 37 to heart, 39 to penis, 39 to stomach, 38–39 Diabetic retinopathy, 29–30, 168 Diabetic supplies, for traveling, 151–52 Diabinese (chlorpropamide), 78t Dialysis, 34 Diaries See Logs Diet See also Weight-loss diets carbohydrates, 112–15 children with type diabetes and, 185–86 in diabetes, 111–12 fats, 115–17 food labels and, 120–21, 121f during pregnancy, 170 proteins, 118, 118t for type diabetes, 118–22 for type diabetes, 122–23 Diphenoxylate with atropine (Lomotil), 39 Diseases, diabetic eye, 29–31 kidney, 31–34 Ditropan (oxybutynin), 39 Diuretics, 32, 33t Docosahexaenoic acid, 116 Dorzolamide (Trusopt), 31 Dot hemorrhages, 29 Driving, hypoglycemia and, 108–9 Duetact (pioglitazone with glimepiride), 86t Duloxetine (Cymbalta), 35 Dupuytren’s contractures, 40–41 Dymelor (acetohexamide), 78t eDiets, 140 Eicosapentaenoic acid, 116 Elavil (amitriptyline), 35 239 Elderly See also Aging blood glucose targets in, 192–93 diabetes complications and, 196 institutional aspects of diabetes for, 195–96 Emergency hospitalizations, managing diabetes during, 162–63 Endocrinologists, 55–56 Environment type diabetes and, 15–16 type diabetes and, 20–21 Erec-Aid System (external vacuum therapy), 48 Erectile dysfunction, 39, 47–48 See also Female sexual dysfunction Exenatide (Byetta), 82–83, 83t Exercise acute vs chronic, 126 aerobic, 127–28 anaerobic, 129 benefits of, 125–26 children with type diabetes and, 186 eating carbohydrates and, 133–34, 133t failure to adjust for, hypoglycemia and, 103–4 flexibility, 128 moderate, 127 regulating glucose levels during, 129 resistance, 128 type diabetes and, 129–34 type diabetes and, 134–35 External vacuum therapy (Erec-Aid System), 48 Exubera (inhaled insulin), 91 Eye diseases, diabetic, 29–31 cataracts, 29 children with type diabetes and, 188 diabetic retinopathy, 29–30 glaucoma, 29, 30–31 monitoring, 72 Eye muscles, injuries to nerves of, 37 Eyedrops beta-blocker, 31 miotic, 31 Ezetimibe (Zetia), 46t Face, injuries to nerves of, 37 Fast-acting insulin preparations, 86–88 Fasting blood glucose test, Fat-restricted diets, 141 Fats, 115–17 monounsataurated, 115–16 Omega-3 fatty acids, 116–17 polyunsaturated, 115–16 saturated, 115–16 trans-fatty, 116 Feet diabetes and, 40–41 nerve injury to, 35–37 Female sexual dysfunction, 48 See also Erectile dysfunction Fetal surveillance, during pregnancy, 170 Fiber, 113–14 food labels and, 120 Fibrates, 46t Finnish Mental Health Study, 116 First-generation sulfonylureas, 77 Flexibility exercise (stretching), 128–29 240 Flights, managing diabetes on, 152–53 Florinef (fludrocortisone), 40 Fludrocortisone (Florinef), 40 Food labels, 120–21, 121f fiber and, 120 Foot disease, monitoring, 73 Foot drop, 40 Foot problems, children with type diabetes and, 188 Foot ulcers, 36 Fosamax (alendronate), 40 Frozen shoulder, 41 Fructosamine level, 70 Gabapentin (Neurontin), 35 Gangrene, 43 Gastroparesis, 38, 105 pregnancies and, 169 Genes type diabetes and, 14 type diabetes and, 18–20 Gestational diabetes, 10 labor and delivery and, 172 risk factors for, 171 risk for type nongestational diabetes and, 172 testing for, 171, 172t treatment of, 172 Glaucoma, 30–31 Gliclazide, 77, 78t Glimepiride (Amaryl), 77, 78t Glipizide, 77 Glipizide (Glucotrol), 78t Glipizide (Glucotrol XL), slow-release, 78t Glucagon, 4, injection of, 106–7 Glucophage (metformin), 78–79, 79t, 166, 186–87 Glucose See Blood glucose Glucose meters See also Continuous glucose monitoring systems how they work, 64 using, 63–66 Glucotrol (glipizide), 78t Glucotrol XL (slow-release glipizide), 78t Glucovance (glyburide with metformin), 86t GlucoWatch system, 69 Glutamic acid decarboxylase (GAD) antibody, 15 Glyburide, 77 Glyburide (Diabeta, Micronase), 78t Glyburide (Glynase), slow-release, 78t Glycemic index, 112–13, 113t Glynase (slow-release glyburide), 78t Glyset (miglitol), 80, 80t Good cholesterol See High-density lipoproteins (HDL) (good cholesterol) Graves’ disease, 16 Gustatory sweating, 37 Hands diabetes and, 40–41 nerve injury to, 37 Hard exudates, 29 Hashimoto’s thyroiditis, 16 HbAlc See Hemoglobin H1c (HbA1c) Index Heart diabetes and, 43 injury to nerves supplying, 39–40 Heart attacks, 43 Heart disease, 169 elderly and, 193 Heart failure, 43 Hemochromatosis, Hemoglobin H1c (HbA1c) controlling, during pregnancy, 167 monitoring, 69–70, 70t risk of fetal malformation with elevated, 168t High blood pressure See also Blood pressure medicines for treating, 33t treating, and kidneys, 32 High-density lipoproteins (HDL) (good cholesterol), 45 trans fats and, 116 High-protein diets, 141 HMG-CoA reductase inhibitors, 46t Honeymoon phase, of type diabetes, 16 drugs for prolonging, 17 Hormones, Hospitalizations, managing diabetes during emergency, 162–63 planned, 159–62 Humalog (insulin lispro), 87, 90 Human leukocyte antigen (HLA), 14 Humanized OKT3, 17 Hydrochlorothiazide (HCTZ), 32 Hyperosmolar coma, 27 Hypoglycemia, 101–2 See also Blood glucose levels causes of, 103–5 complications of, 107–8 driving and, 108–9 elderly and, 194 preventing, 107 risk of, 205 treating, 106–7 typical symptoms of, 102t Hypoglycemic unawareness, 102 Ibuprofen (Advil, Motrin), 34 Ideal body weight (IBW), calculating, 138 Identification bracelets, children with diabetes and, 182–83 Illnesses preventing, while traveling, 154 procedures to follow during, 156–57 Imodium (loperamide), 39 Impaired fasting glucose (IFG), Impaired glucose tolerance (IGT), Indocin (indomethacin), 34 Indomethacin (Indocin), 34 Infusion sets, choosing, 93–94 Inhaled insulin (Exubera), 91 Insulin, 4–5, 86–96 adjusting, before exercise, 131–32 amounts needed, at different ages, 200–201, 201t analogs, 87–88 effects of on liver cells, muscle cells, and fat cells, 5, 5f fast-acting preparations of, 86–88 inhaled, 91 long-acting preparations of, 88–89 Index preparations available in United States, 90 regular, 87–88 release patterns of, 86 “stacking,” 104 tips for, 89–90 types of, 86 Insulin antibody, 15 Insulin aspart (Novolog), 87 Insulin-dependent diabetes milletus See Type diabetes Insulin detemir (Levemir), 88–89 Insulin glargine (Lantus), 88 Insulin glulisine (Apidra), 87 Insulin lispro (Humalog), 87 Insulin pumps, 91–92 advantages/disadvantages of, 93t for children, 182 choosing, 94 choosing infusion set for, 93–94 living with, 96 self-management skills for, 93 setting up, 94–95 starting therapy with, 95–96 Insulin resistance, 8, 20 Insulin sensitivity, 18 genes and, 18–20 Insulin therapy, for children, 180–82 Intermittent claudication, 43 Islet cell antibody (ICA), 15 Islet transplantation, 97 Islets of Langerhans, Isopto Carbachol (carbachol), 31 Isopto Carpine (pilocarpine), 31 Janumet (sitagliptin with metformin), 86t Januvia (sitagliptin), 83–84, 84t Jenny Craig diet, 140 Joints, diabetes and, 40–41 Journals See Logs Ketoacidosis, 167 Ketones guidelines for treatment of, 71t measuring, 70–71 Kidney failure, 105 Kidney functions classification of, using urinary albumin measurements, 32t monitoring, 72 Kidneys sensitivity to injury of, 34 treating high blood pressure and, 32 Kilocalorie, defined, 115 Lactic acidosis, 79 Lancets, 65 Lantus (insulin glargine), 88 Laser therapy, 30 Legs circulation to, diabetes and, 43 nerve injuries to, 40 Levemir (insulin detemir), 88–90 Levitra (vardenafil), 47 Levobunolol (Betagan), 31 241 Lipohypertrophy, 41 Lipid-lowering medicines, 45, 46t Lipid profiles children with type diabetes and, 187 improving, 44–45 Lipid therapy, 169 Lipids, monitoring, 72 Lipoprotein particles, 45 Liver, Logs blood glucose, 66f exercise, 130, 131f Lomotil (diphenoxylate with atropine), 39 Long-acting insulin preparations, 88–89 Loperamide (Imodium), 39 Low-calorie diets with partial meal replacement with liquid meals, 144 Low-carbohydrate diets, 143 Low-density lipoprotein (LDL) cholesterol, 45 trans fats and, 116 Low glucose reaction See Hypoglycemia Lyon Heart Study, 116 Lyrica (pregabalin), 35 Macroalbuminuria, 32 Macrosomia, 167 Macular edema, 30 Malformations, congenital, risk of, HBA1c levels and, 167, 168t Maturity onset diabetes of the young (MODY), McDougall diet, 141 Medical procedures, managing diabetes during, 157–59 Medical teams certified diabetes educators, 55 choosing, 56–57 clinical social workers, 56 endocrinologists, 55–56 nutritionists, 54–55 ophthalmologists, 55 podiatrists, 55 primary care physicians, 54 psychiatrists, 56 psychologists, 56 MedicAlert bracelets, 152 for children with diabetes, 182–83 Medications, diabetes combinations of, 85, 86t introduction to, 75–77 metabolism of elderly and, 193 Medications, diabetes induced by, 10 Medtronic MiniMed glucose monitoring system, 68–69 Meridia (sibutramine), 146 Metabolism, Metaglip (glipizide with metformin), 86t Metformin (Glucophage), 78–79, 79t, 166, 186–87 Microalbuminuria, 31–32 screening for, children with type diabetes and, 188 Microaneurysms, 29 Micronase (glyburide), 78t Midodrine (ProAmatine), 40 Miglitol (Glyset), 80, 80t Miotic eyedrops, 31 MODY 2, 242 Monitoring glucose levels, 61–62 understanding home, 62–63 Motrin (ibuprofen), 34 Myocardial infarction, 43 N-acetylcysteine, 34 Nails, diabetes and, 41 Naprosyn (naproxen), 34 Naproxen (Naprosyn), 34 Nateglinide (Starlix), 77, 78t National Institutes of Health, 17 Navigator system See Abbott Pharmaceutical glucose monitoring system Necrobiosis lipoidica diabeticorium, 41 Needles, fear of, children and, 182 Neuroglycopenic symptoms, 101–2, 102t Neurontin (gabpentin), 35 Neuropathy, 34 Niacin, 46 Non-insulin-dependent diabetes mellitus See Type diabetes Nonsteroidal anti-inflammatories, 34 Novolog (insulin aspart), 87, 90 NPH insulin, 88, 89, 90 Nutrition See Diet Nutritional supplements, for lowering glucose levels, 96–100 American ginseng, 99 chromium, 98–99 cinnamon, 98 selenium, 99 Nutritionists, 54–55 Obesity diabetes and, 18, 19f type diabetes and, 20 Octreotide (Sandostatin), 39 Omega-3 fatty acids, 46, 116–17 Onychomycosis, 41 Ophthalmologists, 55 Oral diabetes medications, 77, 78t Oral glucose tolerance test (OGTT), Orinase (tolbutamide), 78t Orlistat (Xenical, Tetrahydrolipostatin), 146 Ornish diet, 141, 144 Outpatient procedures, managing diabetes during, 157–59 Oxybutynin (Ditropan), 39 Pamidronate, 40 Panax quinquefolius (American ginseng), 99 Pancreas, diabetes due to damage of, 9–10 Pancreas transplants, 97 Pancreatitis, 46 Papaverine, 47 Papaverine with phentolamine, 47–48 Partially hydrogenated vegetable oils, 118 PDE5 enzyme inhibitors, 47 Penis, injury to nerves to, 39 Phentermine, 145–46 Pilocarpine (Isopto Carpine), 31 Pima Indians, 19 Pioglitazone (ACTOS), 80–81, 81t, 166 Index Planned hospitalizations, managing diabetes during, 159–62 Plantar fasciitis, 41 Plaque buildup, 42, 42f Podiatrists, 55 Polycystic ovary syndrome (PCOS), 166 Polyhydramnios, 167 Postural hypotension, 39 Potassium, blood pressure and, 123 Pramlintide (Symlin), 84–85, 85t Precose (acarbose), 80, 80t Prediabetes, 206–7 Preeclampsia, 168 Pregabalin (Lyrica), 35 Pregnancy, 20 diabetes complications during, 167–69 fetal surveillance during, 170 glucose targets during, 167, 167t labor and delivery in, 170 nutrition during, 170 planning, with preexisting diabetes, 165–69 treatment of diabetes during, 169–70 Priapism, 47 Primary care physicians, 54 Pritikin diet, 141 ProAmatine (midodrine), 40 Proliferative retinopathy, 29 Proprioception, 40 Proteins, 118, 118t Psychiatrists, 56 Psychologists, 56 Pumps See Insulin pumps Reactive oxygen species, 28 Regular insulin, 87–88 Repaglinide (Prandin), 77, 78t Resistance exercise, 128 Resting energy expenditure (REE), calculating, 139–40 Restrictive surgery, 147 Retinal detachment, 30 Rimonabant (Acomplia), 147 Rosiglitazone (Avandia), 80–82, 81t, 166 Roux-en-Y gastric bypass procedure, 147–48 Salt intake, blood pressure and, 123 Sandostatin (octreotide), 39 Scleredema diabeticorum, 41 Second-generation sulfonylureas, 77 Selenium, for lowering glucose levels, 99 Shin spots, 41 Sibutramine (Meridia), 146 Sildenafil (Viagra), 47 Sitagliptin (Januvia), 83–84, 84t Skin, diabetes and, 41 South Beach diet, 141 “Stacking” insulin, 104 Statins, 46t Steroids, 20–21 Stomach, injury to nerves of, 38 Strength training, 128 Stretching (flexibility exercise), 128–29 Stroke, 43 243 Index Sugar alcohols, 114–15 Sulfonylureas, 77, 78t Supplies, diabetic, for traveling, 151–52 Support networks, setting up, 58–59 Surgery, bariatric, for weight loss, 147–48 Swedish Obesity Surgery Study, 21 Sweeteners, artificial, 114 Symlin (pramlintide), 84–85, 85t Tadalafil (Cialis), 47 Teams See Medical teams Teenagers See Children with diabetes Tests fasting blood glucose, oral glucose tolerance, Tetrahydrolipostatin (orlistat), 146 Thalassemia major, 9–10 Thiazolidinediones, for children, 186–87 Thyroid disease children with diabetes and, 184 pregnancies and, 169 Thyroid disease, screening for, 73 Time changes, adjusting insulin for, 153 Timolol (Timoptic), 31 Timoptic (timolol), 31 Tolazamide (Tolinase), 77, 78t Tolbutamide (Orinase), 77, 78t Tolinase (tolazamide), 78t Tolterodine (Detrol), 39 Tramadol (Ultram), 36 Trans-fatty acids (trans fats), 116 Transient ischemic attack (TIA), 43 Transplants, pancreas, 97 Traveling adjusting insulin for time changes, 153 managing diabetes complications while, 153–54 managing diabetes on flights, 152–53 managing diabetes supplies and, 151–52 preventing illness while, 154 TrialNet, 17 Tricyclic antidepressants, 35 Trigger finger, 40–41 Triglycerides, 4–5, 45–46 Trusopt (dorzolamide), 31 Type diabetes, 8, 13–17 autoimmune diseases and, 16 causes of, 14–16 in children, 176–85 cure for, 97 diet for, 118–22 environment and, 15–16 established, 200–1 exercise and, 129–34 fertility and, 166 genetics and, 14–15 honeymoon phase of, 16 increasing incidence of, 14 newly diagnosed, 199–200 research into preventing, 17 risk of parents transmitting, to their children, 166 short-term complications of, vs type diabetes, 28t treating, 16 Type diabetes, 8–9, 18–22, 206–11 breast-feeding and, 171 causes of, 18 in children, 185–88 circulatory problems, 42 diet for, 122–23 environment and, 20–21 exercise and, 134–35 gestational diabetes and, 172 getting diagnosed, 207 medicines for, 77–96, 201t obesity and, 20 reasons for increase in, 18 research into preventing, 21 risk of parents transmitting, to their children, 166 short-term complications of, vs type diabetes, 28t treating, 22, 207–11 Ulcers, foot, 36 Ultram (tramadol), 36 United Kingdom Prospective Diabetes Study (UKPDS), 79, 208 Urecholine (bethanechol), 39 Urine, measuring glucose in, 67 Vardenafil (Levitra), 47 Vascular endothelium growth factor (VEGF), 29 Very low calorie diets, 144 Very low-density lipoproteins (VLDL), 45 Viagra (sildenafil), 47 Visceral fat, 20 Weight classifications, by body mass index, 139f Weight loss bariatric surgery for, 147–48 basic concepts about, 137–38 drugs for, 145–47 Weight-loss diets, 140–45 balanced, 140–41 changing behavior for, 142–43 fat-restricted, 141 high-protein, 141 increasing exercise/physical activity for, 143 low-calorie diets with partial meal replacement with liquid meals, 144 low-carbohydrate diets, 143–44 reducing calories for, 142 very low calorie diets, 144–45 WeightWatchers, 140 Xenical (orlistat), 146 Zetia (ezetimibe), 46t Zone diet, 141 Zostrix, 35 ABOUT THE AUTHOR Dr Umesh Masharani is a clinical professor of medicine in the division of endocrinology and metabolism and associate chief in the diabetes clinic at the University of California at San Francisco (UCSF) In addition to seeing patients and teaching, he does clinical research in diabetes Dr Masharani got his medical degree at the Middlesex Hospital, London, and completed his fellowship in endocrinology at UCSF Copyright © 2008 by Umesh Masharani Click here for terms of use ... Demystified diabetes DeMYSTiFieD Umesh Masharani, M.D New York Chicago San Francisco Lisbon London Madrid Mexico City Milan New Delhi San Juan Seoul Singapore Sydney Toronto Copyright © 2008 by Umesh Masharani. .. your diabetes xi Copyright © 2008 by Umesh Masharani Click here for terms of use This page intentionally left blank PART ONE WHAT DOES A DIAGNOSIS OF DIABETES MEAN FOR YOU? Copyright © 2008 by Umesh. .. categorized the different kinds of diabetes into four main groups: • Type diabetes • Type diabetes • Other specific types of diabetes • Gestational diabetes TYPE DIABETES In type diabetes (formerly referred