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Book Details
Abstract
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.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Front ccver | ||
| Front Matter | ia | ||
| Copyright | id | ||
| ECAB Clinical Update:Diabetology | ie | ||
| Microvascular Complications ofDiabetes | if | ||
| About the Authors | ig | ||
| Contents | ii | ||
| ECAB Clinical Update InformationMICROVASCULAR COMPLICATIONS OFDIABETES | i | ||
| Preface | v | ||
| Diabetic Neuropathy | 1a | ||
| ABSTRACT | 1a | ||
| KEYWORDS | 1a | ||
| Normal Nerve Metabolism and Physiology | 1 | ||
| Etiopathogenesis | 2 | ||
| Metabolic Theory | 2 | ||
| Polyol Pathway | 2 | ||
| Myo-inositol Metabolism | 3 | ||
| Lipids | 3 | ||
| Vascular Theory | 4 | ||
| Pathology | 5 | ||
| Electrophysiological Abnormalities | 7 | ||
| Classification | 8 | ||
| Diabetic Mononeuropathies | 8 | ||
| Cranial Mononeuropathies | 8 | ||
| Truncal Mononeuropathies | 9 | ||
| Isolated and Multiple Mononeuropathies | 10 | ||
| Diabetic Polyneuropathies | 10 | ||
| Acute Sensory Neuropathy | 10 | ||
| Chronic Sensory Motor Neuropathy | 11 | ||
| Proximal Motor Neuropathy | 12 | ||
| Distal Sensorimotor Neuropathy | 13 | ||
| Autonomic Neuropathy | 14 | ||
| Tests to Assess Autonomic Neuropathy | 15 | ||
| Reversibility of Diabetic Neuropathic Syndromes | 18 | ||
| Diagnosis and Treatment | 19 | ||
| Treatment of Hyperglycemia | 19 | ||
| Treatment of Metabolic Abnormalities | 20 | ||
| Aldose Reductase Inhibitors | 20 | ||
| Gangliosides | 21 | ||
| Protein Kinase C Inhibitors | 22 | ||
| Gamma Linoleic Acid | 22 | ||
| Antioxidants | 22 | ||
| Neurotrophins | 22 | ||
| Mecobalamin | 22 | ||
| Nandrolone | 23 | ||
| Treatment of Painful Neuropathy | 23 | ||
| Duloxetine Hydrochloride | 25 | ||
| Pregabalin | 26 | ||
| Normal Saline Therapy | 26 | ||
| Treatment of Autonomic Neuropathy (Table 7) | 26 | ||
| Case Studies Diabetic Neuropathy | 33 | ||
| Case Study 1 | 33 | ||
| Presentation | 33 | ||
| On Examination | 33 | ||
| Diagnosis | 33 | ||
| Laboratory Investigations | 33 | ||
| Treatment | 33 | ||
| Diabetic Nephropathy: Clinical Course, Evaluation, and Follow-up Recommendations | 37a | ||
| ABSTRACT | 37a | ||
| KEYWORDS | 37a | ||
| Clinical Course and Markers for Evaluation | 38 | ||
| Stage I: Stage of Hyperperfusion and Hyperfiltration | 39 | ||
| Stage II: Silent Stage | 39 | ||
| Stage III: Microalbuminuria Stage | 39 | ||
| Stage IV: Overt Diabetic Nephropathy | 40 | ||
| Stage V: End-Stage Renal Failure | 40 | ||
| Risk Factors for Nephropathy in Type 2 DM | 42 | ||
| Detection | 43 | ||
| Microalbuminuria | 43 | ||
| Screening for Albuminuria | 44 | ||
| Recommendations for Screening | 44 | ||
| Markers Other than Microalbuminuria | 44 | ||
| Limitations | 45 | ||
| Recommendations for Follow-Up Care | 46 | ||
| Glycemic Control | 46 | ||
| Blood Pressure Control | 47 | ||
| Role of ACE Inhibitors and AR Blockers | 47 | ||
| Dietary Protein Intake | 47 | ||
| Specific Therapies | 47 | ||
| Case Studies Diabetic Nephropathy: Clinical Course, Evaluation, and Follow-up Recommendations | 50 | ||
| Case Study 1 | 50 | ||
| Presentation | 50 | ||
| Questions | 50 | ||
| Case Study 2 | 51 | ||
| Presentation | 51 | ||
| Questions | 52 | ||
| Case Study 3 | 53 | ||
| Presentation | 53 | ||
| Questions | 53 | ||
| Diabetic Retinopathy | 55 | ||
| Introduction | 55 | ||
| Global Update | 60 | ||
| Update in Indian Context | 66 | ||
| Management | 70 | ||
| Treatment | 73 | ||
| Laser Photocoagulation Therapy | 73 | ||
| Laser Photocoagulation for Diabetic Macular Edema | 74 | ||
| Laser Photocoagulation for Proliferative Diabetic Retinopathy | 74 | ||
| Pars Plana Vitreous Surgery in Diabetic Retinopathy | 76 | ||
| Pharmacotherapy | 76 | ||
| Intravitreal Steroids | 77 | ||
| Intravitreal Anti-VEGF Agents | 77 | ||
| Oral Ruboxistaurin | 77 | ||
| Aspirin | 77 | ||
| Patient Education | 78 | ||
| Follow-Up | 78 | ||
| Concomitant Cataract and Diabetic Retinopathy | 78 | ||
| Conclusion | 81 | ||
| Case Studies Diabetic Retinopathy | 88 | ||
| Sight-Threatening Diabetic Retinopathy Present at the Time of Diagnosis of Diabetes | 88 | ||
| Diabetic Retinopathy in Pregnancy | 88 | ||
| Diabetic Retinopathy with Branch Retinal Vein Occlusion with Macular Edema | 90 | ||
| Sexual Dysfunction in Diabetes | 92a | ||
| ABSTRACT | 92a | ||
| KEYWORDS | 92a | ||
| Introduction | 92 | ||
| Physiology of Penile Erection | 93 | ||
| Etiology | 95 | ||
| Pathogenesis | 96 | ||
| Metabolic | 97 | ||
| Hormonal Causes | 97 | ||
| Spermatogenesis | 97 | ||
| Neurogenic Causes | 99 | ||
| Vascular Causes | 99 | ||
| Drug-Induced Erectile Failure | 100 | ||
| Clinical Features | 100 | ||
| Clinical Evaluation | 101 | ||
| Psychogenic or Organic | 101 | ||
| Clinical Assessment | 101 | ||
| Vascular Assessment | 103 | ||
| Neurological Assessment | 104 | ||
| Hormonal Assessment | 105 | ||
| Treatment of Diabetic Erectile Failure | 106 | ||
| Sildenafil Citrate | 107 | ||
| Tadalafil | 109 | ||
| Vardenafil | 110 | ||
| Vasoactive Agents | 110 | ||
| Medicated Urethral System for Erection (MUSE) | 111 | ||
| Vacuum Constriction Devices | 112 | ||
| Surgical Treatment | 112 | ||
| Microvascular Arterial Bypass and Venous Ligation | 112 | ||
| Prosthesis (Penile Implants) | 113 | ||
| Sexual Problems in Diabetic Women | 113 | ||
| Other Books in This Series | 119 |