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Update on diabetes

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Contents

Foreword: Diabetes in 2005 – what’s the scoresheet?

PAT J PHILLIPS, JOHN ALOIZOS

Individualising initial therapy for hyperglycaemia in type 2 diabetes

STEPHEN TWIGG

The clinical context and severity of hyperglycaemia at presentation of type 2 diabetes help guide appropriate therapy.

When and how to start insulin therapy in type 2 diabetes

STEVEN C BOYAGES

Although many patients with type 2 diabetes will need insulin, the initiation of this therapy is often one of the most difficult decisions that patients and clinicians have to make.

Insulin delivery devices: which one is best for your patient?

MICHELLE ROBINS

The availability of insulin pens and other delivery devices has revolutionised the way insulin is prescribed and administered. Here is a guide to help you navigate through the maze of options.

Postprandial glucose in diabetes: role ofrapid acting insulin analogues

RICHARD C O’BRIEN

There is evidence that postprandial hyperglycaemia is an important therapeutic target, particularly for the prevention of macrovascular complications.

Unstable type 1 diabetes in adolescence

WARREN KIDSON

One of the most worthwhile exercises in medical practice can be the improvement of glucose control in patients with chronic unstable type 1 diabetes.

Long acting insulin analogues in type 1diabetes: do we need them?

PAUL C BARTLEY

The new long acting insulins are superior to isophane insulin in controlling overnight and early morning blood glucose.

Diabetes, doctors and quality of life

PAT J PHILLIPS, JOHN ALOIZOS

Psychosocial issues are common in people with diabetes and adversely affect quality of life and metabolic control. Psychosocial assessment is important and should become part of the annual ‘diabetes first’ review.

Does your patient have glucose intolerance?

PAUL ZIMMET, JONATHAN SHAW

Intervention at an early stage of impaired glucose regulation may dramatically reduce the risk of future diabetes and cardiovascular disease.

Guessing glycaemia

PAT J PHILLIPS

In this 64-year-old woman with type 2 diabetes, how would you check the apparent discrepancy in her blood glucose test result?

A different approach to the care of the diabetic foot

GRACE WARREN

The diabetic foot is often insensate, hence trauma can occur without the patient being aware and healing can be delayed by inadvertent retraumatisation. Daily and acute care of the foot with sensory neuropathy are described.

Priorities in diabetes care

PAT J PHILLIPS

Controlling blood pressure and cholesterol in patients with diabetes is now considered more important than controlling glycaemia.

The ulcer that wouldn’t go away

PAT J PHILLIPS

Patients with diabetes should understand the significance of the risk posed by undetected and painless injury to the foot.

Visible manifestations of diabetic retinopathy

PAT J PHILLIPS

Detection and treatment of retinopathy before vision is affected can prevent much of the blindness associated with diabetes.

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