Staged Diabetes Management: A Systematic Approach

by Roger Mazze, Ellie S. Strock, Gregg D. Simonson, Richard M. Bergenstal

Overview

Using evidence-based medicine, this title addresses the prominent issues of primary care diabetes management. It provides practical solutions to the detection and treatment of diabetes, its complications and such new areas as metabolic syndrome, pre-diabetes and diabetes in children. The text reviews the fundamental basis of diabetes management and then addresses treatment of each type of diabetes and the major micro- and macrovascular complications.

This Revised Second Edition uniquely focuses on advanced technologies and advanced therapeutics. Key changes include: Integration of incretin hormones in the basic pathophysiology of type 2 diabetes; Incretin mimetics and potentiators; Revised clinical decision paths with new medications and advanced insulin algorithms; New section on continuous glucose monitoring.

Staged Diabetes Management: A Systematic Approach, Second Edition, Revised presents a clear set of clinical algorithms consistent with the EASD/ADA recommended algorithms. It provides a means of applying the principles using a proven methodology and one that has been applied internationally.

• Based on the highly successful diabetes programmes for primary care developed by the world-renowned International Diabetes Center in Minneapolis, USA
• Features Decision Paths and Practice Guidelines to facilitate clinical decision making
• Clearly written and illustrated: each chapter may be read alone but complements the others to give a broad view of diabetes care

This title is an invaluable guide for healthcare professionals, particularly primary care physicians, diabetes specialist nurses, and for all those with an interest in diabetes. It is also useful for all Diabetes educators and medical students.

Product Details

ISBN-13:	9780470061268
Publisher:	Wiley
Publication date:	01/23/2007
Edition description:	2nd Edition, Revised
Pages:	448
Product dimensions:	8.75(w) x 11.25(h) x 1.27(d)

About the Author

Roger S. Mazze, PhD, Chief Academic Officer, International Diabetes Center, Vice President, Park Nicollet Institute. Director, World Health Organization Collaborating Center at International Diabetes Center and Clinical Professor of Family Practice and Community Health, University of Minnesota Medical School. Formerly, Professor of Biostatistics, Epidemiology and Community Health, and Executive Director and Co-Principal Investigator of the Diabetes Research and Training Center, Albert Einstein College of Medicine and Distinguished Visiting Scientist to the United States Centers for Disease Control. Past Co-Chairperson, American Diabetes Association Council on Health Care Delivery.

Ellie S. Strock, RN, BC, ANP, CDE, Chief of Professional Services, International Diabetes Center, Vice President, Park Nicollet Institute. Chief Education Director, World Health Organization Collaborating Center at International Diabetes Center. Board Certified Adult Nurse Practitioner, Department of Endocrinology, Park Nicollet Health Services.

Gregg D. Simonson, PhD, Director, Program Research and Implementation and Chief Research Officer, World Health Organization Collaborating Center at International Diabetes Center. Adjunct Assistant Professor, Department of Family Practice and Community Health, University of Minnesota Medical School. Formerly, Post-Doctoral Fellow, Juvenile Diabetes Foundation, Department of Pediatrics, University of Wisconsin.

Richard M. Bergenstal, MD, Executive Director, International Diabetes Center and Clinical Professor of Medicine in Endocrinology, University of Minnesota Medical School. Consultant, Department of Endocrinology, Park Nicollet Health Services. Formerly, Assistant Professor of Medicine, University of Chicago. Past Member, National Board of Directors, American Diabetes Association.

Table of Contents

About the Authors.

Acknowledgements.

PART ONE STAGED DIABETES MANAGEMENT IN PRACTICE.

1 Introduction to Staged Diabetes Management.

The development of Staged Diabetes Management.

The structure of Staged Diabetes Management.

Practice guidelines.

Master DecisionPaths.

Specific DecisionPaths.

Criteria for adjusting and changing therapy.

Diabetes Management Assessment DecisionPaths.

Metabolic syndrome, complications, and hospitalization DecisionPaths.

The patient and Staged Diabetes Management.

The diabetes care team.

The changing perspective of diabetes care: DCCT and UKPDS.

Metabolic syndrome (insulin resistance syndrome).

Children and adolescents with type 2 diabetes and/or metabolic syndrome.

Common diagnostic criteria.

Diabetes management improvement initiatives.

References.

2 The Implementation of Staged Diabetes Management.

Community diabetes care needs assessment.

Group formation.

Orientation to Staged Diabetes Management.

Customization of Staged Diabetes Management.

Evaluation of Staged Diabetes Management.

References.

3 Therapeutic Principles for the Treatment of Diabetes.

Medical nutrition therapy stage.

Oral agent stage.

Insulin stage.

Combination therapies.

Evaluating blood glucose control.

References.

PART TWO THE TREATMENT OF DIABETES.

4 Type 2 Diabetes.

Etiology.

Overview of treatment options for type 2 diabetes.

Prevention of type 2 diabetes.

Type 2 diabetes detection and treatment.

Type 2 Diabetes Practice Guidelines.

Type 2 Diabetes Master DecisionPath.

New treatment alternatives.

Management of acute complications.

Type 2 diabetes and pregnancy.

Patient education.

Behavioral issues and assessment.

References.

5 Type 2 Diabetes and Metabolic Syndrome in Children and Adolescents.

Etiology.

Prevention of type 2 diabetes.

Major studies.

Overview of treatment options for children and adolescents with type 2 diabetes.

Obesity and weight management in children and adolescents.

Type 2 diabetes in children and adolescents.

Metabolic syndrome in children and adolescents.

References.

6 Type 1 Diabetes.

Etiology.

Type 1 diabetes detection and treatment.

Type 1 Diabetes Practice Guidelines.

Screening and Diagnosis DecisionPath.

Type 1 Diabetes Master DecisionPath.

Management of acute complications.

Type 1 diabetes and pregnancy.

Patient education.

Behavioral issues and assessment.

References.

7 Pregestational and Gestational Diabetes.

Etiology of GDM and hyperglycemia.

Adverse fetal and perinatal outcome.

Preventing gestational diabetes and subsequent type 2 diabetes.

Pregestational diabetes.

Gestational diabetes detection and treatment.

Gestational diabetes practice guidelines.

Gestational Diabetes Master DecisionPath.

Pregestational (type 1 and type 2) diabetes treatment options.

Fetal and maternal assessment.

References.

PART THREE INSULIN RESISTANCE AND DIABETES COMPLICATIONS.

Overview.

Metabolic syndrome (insulin resistance syndrome) and complications.

Hospitalization overview.

8 Macrovascular Disease.

Diabetes and the risk of cardiovascular disease.

Role of inflammation in macrovascular disease.

Prevention of cardiovascular disease in diabetes: importance of a multifactorial approach.

Insulin resistance, hypertension, and cardiovascular disease.

Detection and treatment of hyperglycemia, hypertension, and dyslipidemia.

Practice guidelines: hypertension and dyslipidemia.

Staged management of hypertension.

Staged management of hyperlipidemia and dyslipidemia.

Additional therapeutic options for prevention and treatment of cardiovascular disease.

References.

9 Microvascular Complications.

Detection and treatment of diabetic nephropathy.

Detection and treatment of eye complications.

Detection and treatment of diabetic neuropathy.

Detection and treatment of foot complications.

Detection and treatment of dermatological, connective tissue, and oral complications.

Polycystic ovary syndrome (PCOS).

References.

10 Hospitalization.

The current impact of diabetes related hospitalizations.

Hospitalization practice guidelines.

Hospitalization for problems related to glycemic control.

Hospitalization for illness.

Hospitalization for surgery.

Reference.

Appendix.

Index.

Editorial Reviews

Reviewer: Siu-Ling Ma, MD (University of Chicago Medical Center)
Description: Since it was first published in 1999, this book has provided primary care physicians with a comprehensive set of guidelines for managing diabetes. The DecisionPaths in the book cover issues ranging from gestational diabetes to type 1 and type 2 diabetes in both children and adults, and include all aspects of care from nutrition to diabetic neuropathy.
Purpose: In response to primary care providers' desire for diabetes management guidelines, the authors have successfully created a set of evidence-based algorithms. Their goal is to provide a more consistent approach to the screening and treatment of diabetes and its complications.
Audience: The authors write in a simple, easy to understand style that is appropriate for all primary care providers, medical students, and even the lay public who have an interest in diabetes.
Features: The book is thorough in its coverage. Traditional topics are addressed, such as oral hypoglycemic agents and insulin therapy, as well as broader topics, with guidelines for such issues as hospitalizations, oral fungal infections, exercise planning, and assessment for psychological issues. The book is especially noteworthy for the many algorithms that address such relevant issues as how to titrate the doses of oral hypoglycemic agents, when to initiate insulin therapy, and how to specifically adjust dietary items to achieve a particular glycemic goal.
Assessment: The evidence-based guidelines provided here will quickly help primary care providers in caring for patients with all aspects of diabetes. The revised second edition provides information on the most up-to-date therapies.

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