Insulins in Diabetes - ECAB
Insulins in Diabetes - ECAB

Author: Rangasamy V. Jayakumar

Publisher: Elsevier Health Sciences

Published: 2012-07-05

Total Pages: 122

ISBN-13: 8131232077

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Decision making in instituting insulin therapy is an important aspect of diabetes management. The appropriate insulin regimen for an individual patient should take into account the patient’s lifestyle, age, motivation, general health, self-management skills, and treatment goals. In addition, a discussion of the newer insulins versus older insulin is a much desired topic in the Indian context. Another area of interest is the insulin delivery mechanism in the intensive care units in hospital settings. This CME module is designed to address such questions with supportive typical clinical scenarios, with which all readers will be able to identify. Thus it provides an excellent opportunity to widen one’s perspective in this area.

Lipids in Diabetes - ECAB
Lipids in Diabetes - ECAB

Author: S V Madhu

Publisher: Elsevier Health Sciences

Published: 2013-07-23

Total Pages: 134

ISBN-13: 8131232131

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Type 2 diabetes mellitus is associated with a greater risk of developing atherosclerotic macrovascular diseases like myocardial infarction, stroke, and peripheral vascular disease. There is 2- to 4-fold increased risk of atherosclerotic heart disease and stroke in diabetic patients compared to non-diabetic patients. As the prevalence of type 2 diabetes is increasing rapidly, this diabetes related atherosclerotic disease is predicted to be a major public health problem. Atherosclerosis is a complex process and in diabetic patients, it behaves differently with increased lesion progression and severity. This accelerated atherosclerotic process in diabetics is explained on the basis of several risk factors like hyperglycemia, dyslipidemia, accelerated formation of advanced glycation end products, increased oxidative stress, and genetic factors. It is difficult to establish precisely the elements responsible for this atherosclerosis in diabetics, but by epidemiological, clinical, and by animal studies, it has been possible to get an idea of this problem in diabetics. Of the several risk factors for atherosclerosis in diabetes, dyslipidemia is the leading one, and an insight into the pathophysiologic relation of isolated triglyceridemia in Indian diabetics with the identification of the targets for control of lipids in diabetes (practical vs. ideal) needs to be well understood by the treating physician. This book is designed to address such issues with supportive typical clinical scenarios, with which the readers will be able to identify. Thus, it provides an excellent opportunity to widen one’s perspective in this area.

Hotspots in Diabetes - ECAB
Hotspots in Diabetes - ECAB

Author: Ambady Ramachandran

Publisher: Elsevier Health Sciences

Published: 2013-07-12

Total Pages: 129

ISBN-13: 8131232174

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Diabetes is one of the most important non-communicable lifestyle diseases. Diabetes is a multifaceted disorder which possibly influences and impacts body pathophysiology by different mechanisms and in varied ways. Diabetes has a very distinguished impact on cardiovascular system and plays a detrimental role in development of cardiovascular disorders. Metabolic memory is used to describe the impact of exposure to glucotoxicity, lipotoxicity and other metabolic disturbances, either as an adverse or a beneficial cell response which determines the later development of vascular complications. Terms such as metabolic imprint, legacy effect, glycemic memory or latent hyperglycemic damage are also used. Diabetes has significant impact on different facets of life. Diabetes has a distinguished but significant impact on development of various cancers. Diabetes has a positive, negative and even neutral impact on pathogenesis and progression of cancer depending upon the tumor site. On the contrary, cancer also has a significant effect on diabetes development and management. These facets tend to get overlooked in the study of diabetes development and management. All these aspects are being thoroughly covered in this project so as to facilitate better management of diabetics.

Unconventional Organ Damage in Diabetes - ECAB
Unconventional Organ Damage in Diabetes - ECAB

Author: Samar Banerjee

Publisher: Elsevier Health Sciences

Published: 2012-09-14

Total Pages: 112

ISBN-13: 813123214X

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Cell health depends on a steady supply of fuel from glucose and free fatty acids. Both these major fuels are regulated by insulin. Cells in the muscle, liver, and fat need insulin to receive glucose, and hence do not become exposed to high blood glucose levels when the blood sugars are high and insulin levels are low. The lack of insulin slows the movement of glucose into these cells, and probably spares them from damage when blood sugars are high. However, other cells such as those in the brain, nervous system, heart, blood vessels and kidneys pick up glucose directly from the blood without using insulin. These cells, except the brain, are more prone to damage from high blood sugars because they become exposed to high internal levels of glucose. This to quite an extent explains why damage tends to occur in specific organs such as in nerve and kidney cells, and in small blood vessels like those in the eyes. This project on the organ damage in diabetes is an attempt to elaborate on the various factors to be considered in managing these patients, the pointers for early diagnosis and prevention of the same.

Microvascular Complications of Diabetes - ECAB
Microvascular Complications of Diabetes - ECAB

Author: V Seshiah

Publisher: Elsevier Health Sciences

Published: 2009-09-15

Total Pages: 146

ISBN-13: 8131232123

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The pathogenesis of microvascular complications is complex and multifactorial. Yet, hyperglycemia emerges as the most important single cause, which has been proved by the Diabetes Control and Complications Trial (DCCT). Thus, the importance of protecting the body from hyperglycemia cannot be overstated; the direct and indirect effects on the human vascular tree are the major source of morbidity and mortality in both type 1 and type 2 diabetes. Generally, the injurious effects of hyperglycemia are separated into macrovascular complications (coronary artery disease, peripheral arterial disease, and stroke) and microvascular complications (diabetic nephropathy, neuropathy, and retinopathy). It is important for physicians to understand the relationship between diabetes and vascular disease because the prevalence of diabetes continues to increase in our country, and the clinical requirements for primary and secondary prevention of these complications are also expanding.

Diabetes and Lifestyle - ECAB
Diabetes and Lifestyle - ECAB

Author: Samar Banerjee

Publisher: Elsevier Health Sciences

Published: 2013-07-12

Total Pages: 124

ISBN-13: 8131232204

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Diabetes management, outcomes and prognosis are majorly affected by the lifestyle exercised by the diabetics. Diabetes has significant impact on the different facets of life. These facets tend to get overlooked in the management. The inter-relation of diabetes and marriage, sleep, travel, commute and uneven working hours seem to be trivial part of managing diabetes but are extremely important for a perfect recovery and management of the patient. Patients travelling with diabetes need to consider how to adapt their treatment programs to unfamiliar foods, irregular schedules, and varying amounts of exercise. Diabetes will be involved at every step of married life including vacations, outings, going to the movies, as well as intimate moments. Sleep and diabetes are interconnected. Sleep disorders have a slight but significant impact on diabetes management and it should be focused while attending a diabetic with sleep disorders. Shift workers make a special segment of diabetics, whose glucose monitoring and control need to be tailored in a special manner. With change in circadian rhythm and sleep pattern, diabetes management needs to be adjudged and adjusted. The main risks that arise in driving from having diabetes are hypoglycemia and the long term complications. All these aspects are being thoroughly covered in this book so as to facilitate better management of diabetes.

Infections in Diabetes - ECAB
Infections in Diabetes - ECAB

Author: Samar Banerjee

Publisher: Elsevier Health Sciences

Published: 2012-07-05

Total Pages: 110

ISBN-13: 8131232069

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Patients with diabetes are predisposed to infections. The risk ratio for infectious disease-related hospitalization for diabetic versus nondiabetic persons is more than 2, and almost 2 for death attributable to infection. Infections in diabetes may precipitate metabolic derangements and, conversely, the metabolic derangements of diabetes may facilitate infection. Abnormalities in the microvascular circulation of individuals with diabetes may result in decreased tissue perfusion, which facilitates the acquisition of infection and impairs response to therapy. The incidence of TB among diabetic patients is 2–5 times higher when compared to the general population, which recently has raised the concern that a combination of DM and HIV infection might lead to a further increased incidence of TB in India and in other developing nations. However, it is unclear whether diabetes is an independent risk for common upper and lower respiratory tract infections. Urinary tract is also reported to be the most prevalent site of infection in patients with diabetes. These infections are known to account for a relatively smaller percentage of reported patients probably due to the fact that most patients, including diabetics, with urinary tract infection are treated as outpatients. A number of long-term effects of diabetes mellitus on the genitourinary system predispose diabetic patients to bacterial urinary tract infections. In addition, complications of urinary tract infection (e.g., bacteremia, renal abscesses, and renal papillary necrosis) are more common in patients with than without diabetes. Rhinocerebral mucormycosis and emphysematous pyelonephritis are some of the less commonly reported conditions seen in diabetics though being important pathologies. The primary goal of this book is to provide a high-quality, evidence-based text on the various aspects of the associations of various infections in diabetics with prime focus on TB and diabetes, rare conditions such as rhinocerebral mucormycosis and emphysematous pyelonephritis and also the various acute infections commonly reported in the condition. The book includes in-depth analysis of the diagnostic and management issues considering the same.

Dietary Considerations in Diabetes - ECAB
Dietary Considerations in Diabetes - ECAB

Author: Anoop Misra

Publisher: Elsevier Health Sciences

Published: 2012-07-05

Total Pages: 111

ISBN-13: 8131232093

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Diet plays an important role in the treatment of diabetes, alone or in combination with insulin or oral hypoglycemic drugs. The diabetic nutrition plan of an individual necessitates to be based upon, excepting the usual parameters, his/her socioeconomic status, ethnicity/religion, and local food habits. It is important that diet plan is individualized and also region based. Since there are a number of artificial sweeteners available now, it is necessary that physicians should take in account scientific data while prescribing any artificial sweetener. This issue in the ECAB Update Series: Diabetology reviews these issues in accordance with the Indian Dietary habits and available evidence to support the clinical decisions.