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Author: Samar Banerjee
Publisher: Elsevier Health Sciences
ISBN: 8131232069
Category : Medical
Languages : en
Pages : 110
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Book Description
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.
Author: Samar Banerjee
Publisher: Elsevier Health Sciences
ISBN: 8131232069
Category : Medical
Languages : en
Pages : 110
Get Book
Book Description
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.
Author: Gita Ganguly Mukherjee
Publisher: Elsevier Health Sciences
ISBN: 8131232212
Category : Medical
Languages : en
Pages : 147
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Book Description
The insulin resistance syndrome can be defined as insulin resistance, compensatory hyperinsulinemia, and their associated co-morbidities. Clinically, the term insulin resistance syndrome describes a constellation of abnormalities such as obesity, hypertension, dyslipidemia, type 2 diabetes/hyperglycemia, and coronary artery disease. Insulin is responsible for glucose uptake into the body cells and tissues. The response of the cells to insulin varies from individual to individual. In some individuals, the tissue response to insulin may be diminished. This means that even with adequate levels of insulin, the glucose uptake into the cells and tissues is not optimal. This results in a compensatory over-secretion of insulin from the pancreas. The persistence of high levels of insulin in the blood or hyperinsulinemia is thought to be responsible for some of the abnormalities associated with this condition. However, the exact causal association of the condition with these disorders and the pathophysiology of their evolution are unclear. The most common underlying mechanism proposed is increased free fatty acids from abdominal fat in individuals with central obesity. This leads to deranged insulin signaling, reduced muscular glucose uptake, increased triglyceride synthesis, and hepatic gluconeogenesis. A genetic basis of the disease as well as several other factors such as tumor necrosis factor-α, adiponectin, leptin, Interleukin-6, and some adipokines have also been implicated. Insulin resistance syndrome is of clinical significance because of its association with potentially debilitating conditions that contribute to long-term morbidity and even mortality of the individual. People with insulin resistance syndrome are at an increased risk of developing type 2 diabetes, hypertension, dyslipidemia, myocardial infarction, polycystic ovarian disease, and fatty liver. In this book, we have tried to collate the experiences of the pioneers of this field on the subject and provide the reader a comprehensive view on the topic along with practical management points, which we are sure will benefit the physicians in their clinical practice. The contributors have focused on the condition as is prevalent in our subcontinent and have tried to give an insight on the issues pertaining to the same with a topical flavor.
Author: K V Dakshinamurty
Publisher: Elsevier Health Sciences
ISBN: 8131232026
Category : Medical
Languages : en
Pages : 223
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Book Description
The prevalence of Diabetes Mellitus is increasing rapidly all over the world and more so in the developing countries. The global burden of diabetes is expected to double between 2000 and 2030, with the greatest increases in prevalence occurring in the Middle East, sub-Saharan Africa and India. Moreover, the development of type 2 diabetes during the childbearing years is also likely to increase, primarily in the developing countries. It has already been established that Diabetes is the most common primary cause leading to end stage renal disease (ESRD) and Diabetic Nephropathy is the leading cause of chronic kidney disease (CKD) in India. The cornerstones of management of Diabetic Kidney Diseases include early diagnosis of diabetic nephropathy, prevention of its progression and treatment of the co-morbid conditions. Substantial under-diagnosis of both diabetes and chronic kidney disease leads to lost opportunities for prevention. An inadequate or inappropriate care of patients with diabetic kidney disease contributes to disease progression eventually up to a stage that requires renal replacement therapy, which is not a feasible option for many on a long-term basis, especially in a developing country like ours. This book covers various aspects of diabetic kidney disease in detail and attempts to familiarize the reader with the existing aspects of the conditions as well as touch upon the new advances in the field. The first chapter outlines the extent to which the condition affects the population globally as well as in our country. The second chapter explores the underlying mechanism by which the disease starts and progresses and the pathological markers of the same. The third chapter delineates the clinical and diagnostic markers of the condition. The fourth and fifth chapters speak of the non-diabetic glomerular and non-glomerular diseases in diabetics. The sixth chapter addresses the most important and desirable goal of preventing the progression and ideally the onset of the disease. The seventh chapter puts together the various treatment modalities available and the subsequent chapter explores the management options for cases requiring renal replacement. In addition to the emphasis to Indian literature at the end of each chapter, the ninth chapter is specially included to highlight the salient aspects of this condition from the Indian perspective. This book will be beneficial not only for the nephrologists, but also for the epidemiologists, medical students, diabetologists and every doctor who deals with diabetes mellitus.
Author: Samar Banerjee
Publisher: Elsevier Health Sciences
ISBN: 813123214X
Category : Medical
Languages : en
Pages : 112
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Book Description
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.
Author: Anoop Misra
Publisher: Elsevier Health Sciences
ISBN: 8131232093
Category : Medical
Languages : en
Pages : 111
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Book Description
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.
Author: S V Madhu
Publisher: Elsevier Health Sciences
ISBN: 8131232131
Category : Medical
Languages : en
Pages : 134
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Book Description
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.
Author: V Seshiah
Publisher: Elsevier Health Sciences
ISBN: 8131232123
Category : Medical
Languages : en
Pages : 187
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Book Description
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.
Author: Samar Banerjee
Publisher: Elsevier Health Sciences
ISBN: 8131232522
Category : Medical
Languages : en
Pages : 132
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Book Description
Gestational diabetes mellitus (GDM) is classically seen in about 5–8% of the pregnant women. The condition appears to be caused by the same broad spectrum of physiological and genetic peculiarities that characterize diabetes outside of pregnancy. These women with GDM are also otherwise at high risk of having or developing diabetes even when not pregnant. The controversies regarding the diagnosis, management, and prevention of diabetes in pregnancy pose specific problems in clinical practice such as how to clinch the diagnosis, when to introduce therapy, what therapy to introduce, and how to predict the future course of the condition. This book 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.
Author: Rangasamy V. Jayakumar
Publisher: Elsevier Health Sciences
ISBN: 8131232115
Category : Medical
Languages : en
Pages : 96
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Book Description
Diabetes is a chronic disease that is reaching an epidemic proportion in many parts of the world. Despite the high incidence of diabetes, individuals diagnosed with the disorder are only 50%. The main challenge of medical professionals in diagnosing and treating the diabetic patients is the lack of understanding of the disease, which usually leads to problems with treatment compliance and monitoring. There is strong evidence to show that an effective intensive glycemic control reduces various microvascular and neuropathic complications of diabetes mellitus. The Diabetes Control and Complications Trial (DCCT) showed that the intensive glycemic control prevented diabetic complications in type 1 diabetic patients, and the HbA1c levels reduced by 1.5–2.0%. In the UKPDS study, a modest improvement in HbA1c (a difference of 0.9 %) in the intensively treated group than in the control group brought about a 25% reduction in microvascular complications and a 12% reduction in all diabetes related events. There are several methods with differing utilities and limitations existing for monitoring glycemic status in individuals. Diabetes care in India leaves much to be desired and suggested, and there is a need for efforts to increase awareness of both the patients and the doctors for better treatment and monitoring.
Author: Abdul Hamid Zargar
Publisher: Elsevier Health Sciences
ISBN: 8131232166
Category : Medical
Languages : en
Pages : 111
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Book Description
Even though we have many advances in the development of oral hypoglycemic agents, an ideal drug for treating type 2 diabetes is still a distant reality. Today, physicians can choose from a variety of medications targeting numerous facets of disease, but each drug class poses some limitations. The age-old molecules, such as sulfonylureas and biguanides, are still valued because of their well-studied mode of action, safety, tolerability, and predictable pharmacodynamic effects. This book attempts to describe the historical aspects and advances in the arena of oral hypoglycemic agents, extended- and sustained-release formulations of glipizide and metformin (both of which have great promise in the treatment of type 2 diabetes mellitus) as well as evaluates the role of the group in diabetic foot infections.
