By Ian N. Scobie

Diabetes mellitus is a very universal disorder that's achieving epidemic proportions due to significant raises within the occurrence of weight problems and the propensity for a sedentary existence. the necessity for physicians to familiarize themselves with all different types of diabetes is key and the Atlas of Diabetes Mellitus is going far towards making the duty more straightforward for either certified physicians and people in education.

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Extra info for Atlas of Diabetes Mellitus, Third Edition (Encyclopedia of Visual Medicine)

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ASSESSMENT OF GLYCEMIC CONTROL The treatment of type 2 DM continues to be a major therapeutic challenge. Our knowledge of the efficacy of treatment strategies was informed by the landmark intervention study, the United Kingdom Prospective Diabetes Study (UKPDS). 9% lower than conventional treatment, was associated with significant reductions in the risk of microvascular endpoints. The UKPDS has demonstrated the progressive nature of type 2 diabetes and the need to employ combination treatments and insulin to achieve target goals.

Unfortunately, finger pricking to produce an aliquot of blood for self-monitoring is an unpleasant procedure, certainly associated with more discomfort than insulin injections. This may inhibit the performance of testing using current technology. Blood glucose measurements are taken before and after meals and, on the basis of a profile of several days’ readings, a decision is made regarding the need to alter the insulin dosages. In practice, however, although most patients become reasonably adept at blood glucose measurement, only a minority of patients acquire the skill of appropriate adjustment of insulin dosages.

Originally developed for multiple-dose regimens using short-acting soluble insulin, they are now available with cartridges of intermediate-acting isophane or fixed mixtures of insulins for injection twice-daily. The particular advantages of these pens are convenience, speed and ease of injection as well as less pain owing to the development of very fine tipped needles. Disposable insulin pens are also available. Also shown is the Innovo® insulin doser device that allows the patient to dial-up the correct dose of insulin and displays the previous dose and the time passed since its delivery 46 Scobie Chapter 03 28/7/06 14:32 Page 47 TREATMENT Figure 53 Insulin pens with preloaded cartridges are a popular method of insulin administration.

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