Oxford Diabetes Library – serie

Diabetic neuropathy is amongst the most common of the late complications of diabetes, affecting up to 50% of older patients with Type 2 diabetes. It can result in disabling neuropathic pain, lower extremity amputations and troublesome autonomic neuropathies (gastroparesis, erectile dysfunction, sudden cardiac death and so forth). With the rising incidence of diabetes the prevalence of neuropathy is also likely to increase. Over recent years, there have been new advances in our understanding and treatment of diabetic neuropathies and the problems associated with the disease.

While Type 1 diabetes is still predominantly a hospital-based specialty, increasing numbers of patients are being supervised in primary care. This book emphasises both the unique nature of Type 1 diabetes and its fundamental differences from Type 2 diabetes (at least in its 'classic' form), and also draws together the common threads of management - especially in the diagnosis and treatment of microvascular complications, its common coexistence with the insulin resistance syndrome, and the importance of late-onset Type 1 diabetes in older patients. This highly practical volume in the Oxford Diabetes Library is intended for all advanced practitioners in primary and secondary care. Wherever it is available, the limited RCT evidence base for practice in Type 1 diabetes is quoted and put into a practical context.

Diabetes is one of the most common medical conditions to complicate pregnancy. Gestational diabetes (diabetes with onset or first recognition in pregnancy) may complicate between 2 and 20% of pregnancies depending on the criteria used. Type 1 or Type 2 diabetes complicates over 1 in 300 pregnancies, and both have major implications for mother and child. The management of diabetes during pregnancy has seen a number of major innovations in recent years. Insulin analogues have been introduced, and technical innovations include improvements in insulin pumps and the development of continuous glucose monitoring devices. The evidence base for the management of gestational diabetes has improved markedly, and the investigations based around the Hyperglycaemia and Adverse Pregnancy Outcomes (HAPO) study promise to revolutionise our understanding of the risks of adverse outcomes in pregnancy. The Australian Carbohydrate Intolerance Study (ACHOIS) has demonstrated that identification and glycaemic management of gestational diabetes leads to reduction in birth weight, macrosomia and adverse pregnancy outcomes. Finally, recent randomised control trials have explored use of oral hypoglycaemics (metformin, glibenclamide) in pregnancy. Part of the Oxford Diabetes Library series, 'Diabetes in Pregnancy' summarizes the key aspects of the medical management of diabetes during pregnancy with an emphasis on clinical management. The volume is designed for all members of the multidisciplinary team and will act as a practical introduction particularly for obstetricians and endocrinologists in training.