INTRODUCTION
1. THE PHYSIOLOGY OF GLUCOSE METABOLISM
There are two sources of glucose
There are two 'kinds' of insulin - basal and bolus
Other hormones assist with glucose homeostasis
The kidneys also play a crucial role
2. THE PATHOPHYSIOLOGY OF DIABETES
Type 1 diabetes
Type 2 diabetes
Monogenic diabetes
Gestational diabetes
Other types of diabetes
3. MAKING THE DIAGNOSIS OF DIABETES
Criteria for the diagnosis of diabetes
Screening: testing for diabetes in asymptomatic patients
Management following a positive test
4. ORAL MEDICATIONS
5. INSULINS AND INSULIN MANAGEMENT
Insulin pharmacokinetics
Insulin delivery
Insulin dose calculations
Essential teaching points
6. SURGICAL MANAGEMENT OF DIABETES
Metabolic/bariatric surgery
Transplantation
7. CONSIDERATIONS WHEN APPROACHING DIABETES MANAGEMENT
Consider the patient as a whole
Consider underlying pathology when selecting management options
Consider the durability of management
Determining the patient’s type of diabetes and underlying pathologies
8. GLYCAEMIC MANAGEMENT Medical management of glycaemia
Individualisation of HbA1c target
Self-monitoring of blood sugars
Blood glucose management
Remission of diabetes
9. LIFESTYLE MANAGEMENT
Exercise
Foods
10. CARDIOVASCULAR RISK MANAGEMENT
Diabetes
Blood pressure
Cholesterol
Smoking
Weight
Renal protection
Aspirin use
11. PROVIDING PATIENT-CENTRED CARE
Establish a working relationship
Find a common language
Understand the patient
Acknowledge the patient as the expert
Find common ground
Empower the patient
12. EMPOWERING THE PATIENT FOR LIFELONG SELF-MANAGEMENT
Provide opportunity for ongoing education
Ensure supports and safety nets are in place - for both patient and provider
Hand over the controls
PATIENT HANDOUTS
Biography
Janet Titchener, MD, is the Medical Director of GPSI Diabetes Ltd, New Zealand, and provides care for all types of diabetes, across all age groups. Her clinical practice adheres to the principles of patient-centred clinical medicine so that each patient is considered the expert with regard to knowing which management approach will best fit with their life and life’s choices.
This desk reference is a finest succinct reference, offering practical recommendations for behavioral change of the provider concerning this chronic disease. This will greatly increase success in the long term diabetes outcomes of your patients. Dr. Titchener's manual is the quickest and easiest way for you to gather the facts and strategies one needs for the complete patient centered treatment of diabetes.
Alan S. Peterson, MD
Emeritus Director of Community and Environmental Medicine of Lancaster General Health/University of Pennsylvania
