SubscribeType 2 diabetes has become one of the major public health problems of modern times. Numbers have increased exponentially in recent decades and this massive increase is now becoming apparent in both the developed and developing worlds.
Globally, there are now more people suffering the consequences of over-nutrition compared with malnutrition. The major reason for this massive increase in numbers relates in part to our ageing populations, but more particularly to the increasing prevalence of obesity in association with urbanisation, changes in diet and much reduced physical activity. The problem of diabetes though, relates not just to numbers of patients but also to their long-term complications.
Twenty-five years ago the emphasis in diabetic medicine was on glycaemic control. Indeed, there was no real evidence base for treatment from the point of view of prevention/amelioration of the long-term vascular complications. It was recognised that coronary heart disease, stroke and peripheral vascular disease were particularly common in association with diabetes, but the reasons for this were not entirely clear.
More recently there has been a major change in the way that diabetes experts look at and understand type 2 diabetes. It is now recognised that around 80% of all patients with diabetes will die, many prematurely from cardiovascular disease and predominantly ischaemic heart disease, and there is also a greatly increased risk of stroke and peripheral vascular disease. In addition, it has become apparent that diabetic nephropathy is not just about the development of renal failure but is itself also associated with massively increased cardiovascular risk. This knowledge has led to the redefinition of type 2 diabetes as part of a syndrome of cardiovascular risk diagnosed on the basis of raised blood glucose. If we are to make a significant impact of type 2 diabetes then it is the area of cardiovascular disease reduction where efforts must be concentrated.
A H Barnett
Professor of Medicine, University of Birmingham, and Consultant Physician, Birmingham Heartlands & Solihull NHS Hospital Trust (Teaching)
Diabetes &… is MEP Ltd’s new series of books for health professionals working in the fields of diabetes and cardiovascular risk management. Titles currently available include:
Diabetes and cardiovascular disease
A H Barnett
Professor of Medicine, University of Birmingham, and Consultant Physician, Birmingham Heartlands and Solihull NHS Trust (Teaching)
and
Dr Geraldine O’Gara,
General Practitioner, Small Heath Medical Practice, Small Health, Birmingham
This book considers type 2 diabetes as part of a syndrome of cardiovascular risk diagnosed on the basis of raised blood glucose. It highlights the scale of the problem, with specific chapters relating type 2 diabetes to each of the major cardiovascular risk factors. The relationship between diabetes and each risk factor is considered, followed by the evidence base for management and management regimens. In the final chapter there is a discussion of multiprofessional care, including the challenges facing health professionals in the provision of such care, systems of care and overcoming obstacles including problems of patient compliance.
Chapters include:
- Epidemiology of diabetes and cardiovascular disease
- Diabetes, obesity and cardiovascular disease
- Diabetes and dyslipidaemia
- Diabetes and hypertension
- Diabetes, hyperglycaemia and cardiovascular disease
- Diabetes and non-classical cardiovascular risk factors
- Organising diabetes care in general practice
Available to purchase for £10 per copy.
Diabetes, obesity & cardiovascular disease
A H Barnett
Professor of Medicine, University of Birmingham, and Consultant Physician, Birmingham Heartlands and Solihull NHS Trust (Teaching)
The increase in the number of people developing type 2 diabetes, one of the biggest public health problems of modern times, is inextricably linked to the global obesity epidemic. Diabetes, Obesity & Cardiovascular Disease considers the epidemiology of diabetes and obesity, which has recently been termed diabesity, and its relationship to cardiovascular disease.
The evidence base for treatment of each of the cardiovascular risk factors in patients with diabetes, including lifestyle, glycaemia, blood pressure and lipid levels, is reviewed in light of their relationship to obesity. Multiple risk factor intervention is then discussed, followed by chapters on the management of obesity as a means of reducing cardiovascular risk, with consideration given to weight management programmes, the use and role of anti-obesity agents, bariatric surgery and other forms of pharmacotherapy.
Chapters include:
- Epidemiology of diabetes and obesity
- Obesity, diabetes and cardiovascular disease
- Evidence base for treatment of cardiovascular risk
- Management of obesity in type 2 diabetes
- Management of dyslipidaemia, hypertension and glycaemic control
- The role of bariatric surgery
- Multiprofessional management in obesity in type 2 diabetes
Available to purchase for £10 per copy.
Diabetes & renal disease
A H Barnett,
Professor of Medicine, University of Birmingham, and Consultant Physician, Birmingham Heartlands and Solihull NHS Trust (Teaching)
Renal disease is one of the most serious consequences of diabetes and will affect between one-quarter and one-third of the growing population of people who have type 2 diabetes.
Diabetes & Renal Disease is an informative and practical guide to diabetic renal disease and its identification and early management in primary care. The book highlights the importance of adequate screening and prompt intervention, and reviews the evidence base underlying current prevention and treatment strategies. The role of newer agents that inhibit the renin angiotension system is highlighted and how they can be used together with other therapies to limit renal damage and reduce overall cardiovascular risk. Although diabetic renal disease is a grave consideration, this is an area of medicine where profound health benefits can be achieved with the correct management.
Chapters include:
- Epidemiology and vascular complications
- Pathogenesis and natural history
- Evidence base for the prevention and treatment
- The role of newer agents
- Risk reduction: an overview
- Multiprofessional management
Available to purchase for £10 per copy.