Rudy Bilous - Handbook of Diabetes

8 Chapter 8Figure 8.1 Rabson–Mendenhall syndrome in a 12‐year‐old boy, showing growth r...Figure 8.2 Acanthosis nigricans on the nape of the neck of a 26–year–old wom...Figure 8.3 Optic atrophy (note white optic disc) in a patient with Wolfram’s...Figure 8.4 Acute pancreatitis. CT scan of the abdomen, showing marked oedema...Figure 8.5 Pancreatic calculi, showing characteristic patterns in alcoholic ...Figure 8.6 A patient with glucagonoma, showing characteristic necrolytic mig...

9 Chapter 9Figure 9.1 Correlation in patients with type 1 diabetes between blood glucos...Figure 9.2 Example of combined blood glucose and blood ketone meter together...Figure 9.3 Urine ketone testing strips. NOTE these detect urinary acetoaceta...Figure 9.4 Continuous Glucose Sensor and Transmitter and associated Meter. T...Figure 9.5 Flash (intermittent) glucose monitoring system. Sensor and transm...Figure 9.6 Clarke error grid showing the density of paired FreeStyle Navigat...Figure 9.7 Computer download of 14 days’ data from continuous glucose monito...Figure 9.8 Computer download of 14 days’ data from flash monitoring device i...Figure 9.9 CGM Target Ranges for different groups of patients as agreed by i...

10 Chapter 10Figure 10.1 Normal plasma glucose and insulin profiles. Shaded areas represe...Figure 10.2 Basal‐bolus insulin regimen.Figure 10.3 Schematic amino acid sequence of native human insulin; porcine a...Figure 10.4 What happens in the subcutaneous tissue after subcutaneous injec...Figure 10.5 Suitable sites for subcutaneous insulin injection.Figure 10.6 Suprapubiclipohypertrophy at habitually used insulin injection s...Figure 10.7 Example of disassembled insulin pen. Insulin dose is selected us...Figure 10.8 Insulin infusion pump, fillable insulin cartridge (left), subcut...Figure 10.9 Insulin infusion pump and glucose sensor fitted on a patient wit...Figure 10.10 Meta regression analysis of mean effect size of insulin pump th...

11 Chapter 11FIGURE 11.1 Management of type 2 diabetes: the initial measures.FIGURE 11.2 Change in weight during energy restriction is similar with high ...FIGURE 11.3 Effect of Orlistat in obese patients with type 2 diabetic.Figure 11.4 Effect of Mysimba in obese patients with type 2 diabetes.FIGURE 11.5 Practical food recommendations for patients with diabetes.FIGURE 11.6 The progressive rise in median HbA1c with time in the convention...Figure 11.7 Pharmacologic Approaches to Glycemic Treatment in type 2 diabete...Figure 11.8 Approach to individualising Hba1c target in people with type 2....Figure 11.9 Mechanism by which glucose and sulfonylureas stimulate insulin s...Figure 11.10 Mechanism of action of TZDs. These agents stimulate the peroxis...Figure 11.11 Mechanism of action of SGLT‐ 2 inhibitor.Figure 11.12 LEADER STUDY. (available free online from https://tracs.unc.edu...Figure 11.13 Summary of glucose lowering therapy in type 2 diabetes.Figure 11.14 (a)Different types of common bariatric surgery procedures (b)t...

12 Chapter 12Figure 12.1 (a) Age distribution of 746 episodes of diabetic ketacidosis (ex...Figure 12.2 Mechanisms of ketacidosis. NEFA, non‐esterified fatty acids.Figure 12.3 Flowchart for the investigation of diabetic ketoacidosis.Figure 12.4 Guide to the initial treatment of diabetic ketacidosis in adults...

13 Chapter 13Figure 13.1 Some consequences of hypoglycaemia in diabetes.Figure 13.2 Major components of the counter‐regulatory and sympathetic nervo...Figure 13.3 Glycemic thresholds for secretion of counterregulatory hormones ...Figure 13.4 In the Diabetes Control and Complications Trial (DCCT, a landmar...Figure 13.5 Risks of severe hypoglycaemia associated with different diabetes...Figure 13.6 Glycaemic thresholds for the release of epinephrine and activati...Figure 13.7 Impairment of counter‐regulatory responses in type 1 diabetes. (...Figure 13.8 The vicious circle of repeated hypoglycaemia.Figure 13.9 Proposed mechanism of linking hypoglycaemia and arrhythmias in p...Figure 13.10 Algorithm for treating acute hypoglycaemia in patients with dia...

14 Chapter 14Figure 14.1 Schematic showing interaction of haemodynamic and cellular facto...Figure 14.2 Prevalence of diabetic neuropathy as a function of duration of d...Figure 14.3 Progression of proliferative retinopathy is related to glycated ...Figure 14.4 Effect of intensive treatment on the onset of retinopathy. Cumul...Figure 14.5 Risk of retinopathy progression and mean glycated haemoglobin in...Figure 14.6 Effect of intensive blood glucose control on microvascular compl...Figure 14.7 The relationship between glycated haemoglobin percentage and car...Figure 14.8 Kaplan–Meier plots of proportions of patients who developed micr...Figure 14.9 Cumulative incidence of a three‐step change in ETDRS retinopathy...Figure 14.10 The polyol pathway. ( Left ) The pathway is normally inactive, bu...Figure 14.11 Formation of reversible, early, non‐enzymatic glycation product...Figure 14.12 Possible mechanisms of cell damage by interactions of advanced ...Figure 14.13 Activation of protein kinase C by de novo synthesis of diacylgl...Figure 14.14 The hexosamine pathway. Glucosamine‐6‐phosphate, generated from...Figure 14.15 Superoxide links glucose and diabetic complications.

15 Chapter 15Figure 15.1 Structure of the retinal microvasculature. The endothelial cells...Figure 15.2 Microaneurysms, the earliest sign of diabetic retinopathy appear...Figure 15.3 Fluorescein angiogram, showing microaneurysms as small white dot...Figure 15.4 Retinal haemorrhages: red ‘blots’.Figure 15.5 Focal diabetic maculopathy with circinate (ring‐shaped) exudate....Figure 15.6 Cotton wool spots around the optic disc. Note also flame and blo...Figure 15.7 Intraretinal microvascular abnormalities (IRMAs) appearing as a ...Figure 15.8 Venous irregularity or ‘beading’ (centre of field) and new vesse...Figure 15.9 More extensive new vessels on the disc, occupying more than half...Figure 15.10 Extensive neovascularisation above the disc, with widespread si...Figure 15.11 Preretinal haemorrhage. Note the settling of the uncoagulated b...Figure 15.12 Fibrous bands that are exerting traction on the retina. The ret...Figure 15.13 Rhegmatogenous retinal detachment: a large retinal tear (red le...Figure 15.14 B‐scan ultrasound image of the eye, showing a retinal detachmen...Figure 15.15 Diffuse macular oedema, with a macular ‘star’. This requires la...Figure 15.16 Left eye of a patient with diffuse diabetic macular oedema. (a)...Figure 15.17 New vessels (arrows) on the iris (rubeosis iridis). There is al...Figure 15.18 Diabetic cataract appearing as pale opacification of the lens....Figure 15.19 Recent panretinal (scatter) laser photocoagulation burns for tr...Figure 15.20 Focal laser photocoagulation scars around the macula following ...

16 Chapter 16Figure 16.1 Classification and prognosis for end stage renal disease based u...Figure 16.2 Hyperfiltration in diabetes and its correction by SGLT‐2 (sodium...Figure 16.3 Relative mortality of patients with diabetes with and without pe...Figure 16.4 Nodular glomerulosclerosis in a patient with type 1 diabetes and...Figure 16.5 Nodular glomerulosclerosis (Kimmelstiel–Wilson lesions) in a pat...Figure 16.6 Electron micrograph of the glomerulus from a patient with diabet...Figure 16.7 Schematic to show how metabolic and haemodynamic factors combine...Figure 16.8 Schematic of changes in selectivity of glomerular capillary to a...Figure 16.9 Prevalence of parental hypertension in type 1 patients with norm...Figure 16.10 (a) Prevalence and (b) cumulative incidence of moderate albumin...Figure 16.11 Effects of antihypertensive treatment on (a) mean arterial bloo...Figure 16.12 Meta‐analysis of the effects of angiotensin‐converting enzyme (...Figure 16.13 (a) Cumulative incidence of death in 160 moderately albuminuric...Figure 16.14 Frequency of monitoring (number of clinic visits per year) base...Figure 16.15 Reciprocal serum creatinine plotted against date for the case h...