Diabetes
Chronic Complications
Kenneth M. Shaw, Michael H. Cummings, Kenneth M. Shaw, Michael H. Cummings
- English
- ePUB (mobile friendly)
- Available on iOS & Android
Diabetes
Chronic Complications
Kenneth M. Shaw, Michael H. Cummings, Kenneth M. Shaw, Michael H. Cummings
About This Book
This edition of Diabetes: Chronic Complications provides both the experienced and trainee endocrinologist with easy-to-read, up-to-date practical guidance on the management of the many complications that can result from the onset of diabetes, such as kidney failure, cardiovascular disease, retinal failure, and cerebrovascular disease. Reflecting therapid developments currently taking place in the field, the second editionintroduces a brand-new section on liver complications in diabetes, additional material on mental health complications in the section on diabetes and the brain, coverage ofdyslipidaemia and hypertension in the section on diabetes and the heart, fiveMCQ's in each section to help improve clinical skills, and a case study and key points summary box in every chapter.
Frequently asked questions
Information
- Of people with diabetes in the UK 2 per cent are thought to be registered blind.
- Of patients with type 1 diabetes 87–98 per cent have retinopathy seen after 30 years of the disease.
- Eighty-five per cent of those with type 2 diabetes on insulin and 60 per cent on diet or oral agents have retinopathy after 15 years of the disease.
- Optical coherence tomography (OCT) is a technique allowing visualization of retinal layers and assessment of maculopathy.
- New treatments such as intravitreal therapy and vitrectomy are emerging as treatments that maintain or improve vision but laser remains the primary treatment of choice.
- Poor glycaemic control is associated with worsening of diabetic retinopathy and improving glycaemic control improves outcome.
- Systolic hypertension is associated with retinopathy in type 1 and type 2 diabetes; reducing this improves retinopathy.
- Reducing lipid levels with fibrates and statins has been shown to improve retinopathy.
- Intraretinal injections of vascular endothelial growth factor (VEGF) receptor blockers may improve maculopathy.
- Laser therapy remains the primary treatment of choice for sight-threatening diabetic retinopathy, both proliferative disease and maculopathy.
- <2 per cent have any lesions of diabetic retinopathy at diagnosis
- 8 per cent have it by 5 years (2 per cent proliferative)
- 87–98 per cent have abnormalities 30 years later (30 per cent of these having had proliferative retinopathy).
- 20–37 per cent can be expected to have retinopathy at diagnosis
- 15 years later, 85 per cent of those on insulin and 60 per cent of those on diet or oral agents will have abnormalities.
- duration of diabetes
- type of diabetes (proliferative disease in type 1 and maculopathy in type 2)
- poor diabetic/glycaemic control
- hypertension
- diabetic nephropathy
- recent cataract surgery
- pregnancy
- alcohol (variable results which may be related to the type of alcohol involved, e.g. effects are worse in Scotland than in Italy)
- smoking (variable results, but appears worse in young people with exudates and older women with proliferative disease)
- ethnic origin.
- the sclera – the rigid outer covering of the eye, which includes the cornea
- the choroid – the highly vascularized middle layer of the eye, which has the largest blood flow in the entire body.