Everyday Diabetes in Primary Care

Foreword vii
Preface ix
Acknowledgments xi
Chapter 1 Clinical Presentation 1
Case 1. Type 2 Diabetes in Adults . . . . . . . . . . . . . . . . . . . . . . . 2
Case 2. Type 2 Diabetes in Adolescents . . . . . . . . . . . . . . . . . . 6
Case 3. Type 1 Diabetes in Children . . . . . . . . . . . . . . . . . . . . . 10
Case 4. Latent Autoimmune Diabetes in Adults (LADA)
Clinical Presentation . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Case 5. Monogenic Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Case 6. Ketosis- Prone Type 2 Diabetes . . . . . . . . . . . . . . . . . 23
Case 7. Pregestational Diabetes . . . . . . . . . . . . . . . . . . . . . . . 26
Case 8. Gestational Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . 28
Case 9. Secondary Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Chapter 2 Initial Approach to the Patient 37
Case 1. Type 2 Adult . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Case 2. Type 2 Adolescent . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Case 3. Type 1 Child . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Case 4. Type 1 Young Adulthood . . . . . . . . . . . . . . . . . . . . . . . . 61
Case 5. Developing an Engaged Family Approach . . . . . . . . . 65
Chapter 3 Key Aspects of Treatment 69
Case 1. Type 2 Is Progressive . . . . . . . . . . . . . . . . . . . . . . . . . 70
Case 2. Develop Your Diabetes Care Team . . . . . . . . . . . . . . 75
Case 3. Older Adults With Health Problems and Diabetes . . . 80
Case 4. It Is About the Process Not Result . . . . . . . . . . . . . . . 85
Case 5. Reengaging Your Patient . . . . . . . . . . . . . . . . . . . . . . 89
Case 6. Handling Serious Comorbid Illness . . . . . . . . . . . . . . . 92
Chapter 4 Navigating Diabetes Treatments 95
Case 1. Therapeutic Lifestyle Change . . . . . . . . . . . . . . . . . . 96
Case 2. Best Practices With Metformin Therapy . . . . . . . . . . 103
Case 3. How to Select a Diabetes Medication . . . . . . . . . . . . 108
Case 4. Extraglycemic Effects of Medications . . . . . . . . . . . . 114
ContentsCase 5. Best Practices in Starting Insulin . . . . . . . . . . . . . . . . 121
Case 6. Effective Correction Insulin . . . . . . . . . . . . . . . . . . . . 126
Case 7. Intensive Insulin Therapy . . . . . . . . . . . . . . . . . . . . . . 130
Chapter 5 Hypoglycemia 134
Case 1. Reactive Hypoglycemia . . . . . . . . . . . . . . . . . . . . . . . 135
Case 2. Defensive Eating . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138
Case 3. Somogyi Effect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142
Case 4. Dawn Phenomenon . . . . . . . . . . . . . . . . . . . . . . . . . . 146
Case 5. Hypoglycemic Unawareness . . . . . . . . . . . . . . . . . . . 150
Chapter 6 Anticipating and Responding to
Major Life Changes 155
Case 1. Prediabetes and Diabetes Prevention . . . . . . . . . . . . 156
Case 2. Increasing Responsibility in Self- Care . . . . . . . . . . . . 161
Case 3. Young Adult With Type 1 Diabetes . . . . . . . . . . . . . . . 166
Case 4. Genetics of Diabetes Types . . . . . . . . . . . . . . . . . . . . 171
Case 5. Older Adult . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174
Chapter 7 Technology in Diabetes 179
Case 1. How to Make Your Diabetes Office
Visits More Efficient . . . . . . . . . . . . . . . . . . . . . . . . . . 180
Case 2. Targeted Glucose Monitoring . . . . . . . . . . . . . . . . . . . 195
Case 3. Introducing Glucose Sensors . . . . . . . . . . . . . . . . . . . 199
Case 4. Benefits of Glucose Sensing . . . . . . . . . . . . . . . . . . 205
Case 5. Drawbacks of Glucose Sensing . . . . . . . . . . . . . . . . . 211
Case 6. Introduction to Insulin Pumps . . . . . . . . . . . . . . . . . . . 213
Chapter 8 Diabetes Potpourri 220
Case 1. Identifying Lipohypertrophy . . . . . . . . . . . . . . . . . . . . 221
Case 2. Glucose Testing and Diabetes Supply Snafus . . . . . 225
Case 3. Make a Sick Day Plan . . . . . . . . . . . . . . . . . . . . . . . . 229
Case 4. Steroid- Associated Hyperglycemia . . . . . . . . . . . . . 232
Case 5. Diabetes Complications—Microvascular—
Retinopathy, Nephropathy, Neuropathy . . . . . . . . . . 234
Case 6. Nonalcoholic Fatty Liver Disease . . . . . . . . . . . . . . . 238
Index 245