Table of Contents
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1 |
Overview of
Diabetes Mellitus |
3 |
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Description |
4 |
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Prevalence |
4 |
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Classification |
6 |
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Type 1 Diabetes |
6 |
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Type 2 Diabetes |
6 |
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Gestational Diabetes |
8 |
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Other Types of Diabetes |
8 |
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Other Disorders of
Glucose Regulation |
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Presentation |
10 |
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Screening for
Diabetes |
11 |
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Diagnosis |
11 |
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Management of
Diabetes |
11 |
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Natural History and
Prognosis |
12 |
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2 |
Metabolic
Syndrome, Insulin Resistance, Prevention of Type 2 Diabetes |
14 |
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Metabolic Syndrome |
14 |
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Insulin Resistance |
15 |
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Prevention of Type 2
Diabetes |
21 |
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3 |
Overview of
Treatment of Type 2 Diabetes |
29 |
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Clinical Evaluation |
29 |
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Glycemic Control |
29 |
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Goals of Therapy |
31 |
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Assessment of Glycemic Control |
32 |
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Self-Monitoring of
Blood Glucose |
32 |
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Hemoglobin A1c |
33 |
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Types of Therapy |
34 |
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Other Therapeutic Considerations |
35 |
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Patient Education |
35 |
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4 |
Therapeutic
Lifestyle Changes (TLC) |
37 |
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Medical Nutritional
Therapy |
37 |
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Improving
Postprandial |
43 |
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Mediterranean-Style
Diet |
44 |
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Recommendations |
46 |
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Physical Activity |
49 |
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Amount of Exercise |
50 |
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Evaluation Prior to
Exercise |
51 |
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Coronary Heart
Disease |
51 |
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Diabetic Retinopathy |
51 |
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Other Considerations |
52 |
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Preparing for
Exercise |
53 |
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Weight Control |
53 |
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Smoking Cessation |
57 |
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Psychosocial Risk
Reduction |
60 |
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5 |
Glycemic Control in Type 2 Diabetes |
63 |
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Intensive Glycemic Control |
63 |
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Rationale |
63 |
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Disadvantages |
63 |
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Clinical Trials |
64 |
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Patient Selection |
66 |
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General Approach to Glycemic Control |
67 |
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Therapeutic
Lifestyle Changes |
68 |
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Pharmacologic Therapy |
68 |
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Drug Classes for Glycemic Control |
69 |
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Insulin Secretagogues |
69 |
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Metformin |
76 |
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Thiazolidinediones (TZDs) |
77 |
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Alpha-Glucosidase Inhibitors |
80 |
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DPP-4 Inhibitors |
82 |
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Incretin Mimetics |
83 |
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Amylin Analogs |
84 |
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Insulin |
84 |
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Glycemic Control in Type 2
Diabetes |
86 |
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Special Patient
Populations |
91 |
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Elderly |
91 |
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Acute MI |
91 |
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Gestational Diabetes
Mellitus |
92 |
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Severe/Frequent
Hypoglycemia |
92 |
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6 |
Prevention and Treatment of
Complications of Type 2 Diabetes |
93 |
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Macrovascular Disease |
93 |
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Cardiovascular
Disease |
94 |
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Cerebrovascular Disease |
94 |
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Peripheral Arterial
Disease |
94 |
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Treatment of Macrovascular Disease |
96 |
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Diabetic Retinopathy |
98 |
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Treatment |
99 |
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Diabetic Nephropathy |
99 |
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Types |
100 |
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Stages |
100 |
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Treatment |
101 |
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Diabetic Neuropathy |
102 |
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Diabetic Foot Ulcers |
103 |
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Infections |
103 |
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Diabetic Ketoacidosis |
104 |
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Hyperosmolar Coma |
105 |
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Hypoglycemia |
105 |
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Other Complications |
106 |
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7 |
Control of Dyslipidemia in Type 2 Diabetes |
108 |
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Overview of Diabetic
Dyslipidemia |
108 |
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Lipid Profile |
108 |
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Lipid Therapy and
the New CHD Paradigm |
109 |
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Intensive LDL Lowering |
110 |
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Dyslipidemia Trials in the
General Population |
110 |
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Placebo-Controlled
Trials |
110 |
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Statin vs. Statin Trials |
113 |
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Imaging Trials |
114 |
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Statin Trials in Type 2
Diabetes |
115 |
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Fibrate Trials in Type 2
Diabetes |
116 |
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Therapeutic
Implications |
117 |
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Goals of Therapy |
119 |
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Treatment of
Elevated LDL Cholesterol |
119 |
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Treatment of Low HDL
Cholesterol |
122 |
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Treatment of
Elevated Triglyceride |
123 |
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Drug Therapy for Dyslipidemia |
126 |
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Statin Therapy |
126 |
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Adjuncts to Statin Therapy |
127 |
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Ezetimibe |
127 |
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Niacin |
127 |
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Omega-3 Fatty |
127 |
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Fibrates |
128 |
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Bile Acid Sequestrants |
128 |
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8 |
Control of
Hypertension in Type 2 Diabetes |
132 |
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Diagnosis of
Hypertension |
133 |
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Treatment of
Hypertension |
133 |
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Blood Pressure Goals |
134 |
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Therapeutic Lifestyle
Changes |
134 |
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Drug Therapy |
135 |
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Initial Therapy |
135 |
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Rapidity of Blood
Pressure Lowering and Intensification of Therapy |
137 |
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Use of Specific
Drug Therapy |
138 |
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ACE Inhibitors |
138 |
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ARBs |
139 |
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Renin Inhibitors |
140 |
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Diuretics |
141 |
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Beta Blockers |
141 |
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Calcium Antagonists |
143 |
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Vasodilators |
145 |
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9 |
Other
Measures to Reduce Atherothrombosis |
146 |
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Antiplatelet Therapy |
146 |
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Aspirin |
146 |
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Clopidogrel |
149 |
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Aspirin Plus Clopidogrel |
151 |
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Glycoprotein llb/llla Inhibitors |
152 |
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ACE Inhibitors/ARBs |
153 |
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Fish Oil |
156 |
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Alcohol |
156 |
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Influenza and Pneumococcal Vaccines |
157 |
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10 |
Clinical
Trials |
158 |
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Diabetes Care Trials |
158 |
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Diabetes
Epidemiology Studies |
164 |
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11 |
Diabetes
Drug Summaries |
169 |
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Acarbose |
169 |
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Colesevelam |
169 |
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Exenatide |
170 |
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Glimepiride |
171 |
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Glipizide |
171 |
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Glipizide/Metformin Combination |
172 |
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Glyburide |
173 |
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Glyburide/Metformin Combination |
174 |
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Metformin |
175 |
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Miglitol |
176 |
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Nateglinide |
176 |
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Pioglitazone |
177 |
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Pioglitazone/Glimepiride Combination |
178 |
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Pioglitazone/Metformin Combination |
178 |
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Pramlintide |
180 |
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Repaglinide |
181 |
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Rosiglitazone |
182 |
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Rosiglitazone/Glimepiride Combination |
183 |
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Rosiglitazone/Metformin Combination |
184 |
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Sitagliptin |
185 |
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Sitagliptin/Metformin Combination |
186 |
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Insulin |
187 |
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Index |
189 |
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