Improving Diabetes Care in the Clinic

Description

In providing care to diabetic patients, education to patient and family members is one of the most important aspects of management. The informed decisions about self-monitoring of blood glucose (SMBG), nutrition, exercise, weight control, eye and foot care, use of oral medications and insulin, prevention of micro- and macrovascular complications cannot be effectively managed without knowledge of diabetes. Also, the factors such as desire to learn, cognitive abilities, attitudes, depression, family support, barrios to care and cultural and ethnic back ground influence the learning process. Obviously, physicians and other health care professionals play a pivotal role in providing education and care to patients with this chronic devastating disease. Most of the care of diabetes and steps to prevent its complications occurs in the institutional or private clinics. There is vast amount of literature, often confusing and contradictory, is available on multitude of topics concerning diabetes and its complications. This book has made a sincere effort to provide new and futuristic information in diabetes management, which is not overwhelming. Chapters are written as easy to understand clear information and practical guidelines by expert international clinicians and scientists. Also, the chapters in this book have made an attempt to provide unbiased and evidence-based information in a comprehensive yet concise manner to be a useful guide for practicing primary care physicians, endocrinologists and other health care providers in their quest of providing excellent care to their diabetic patients. The authors have taken meticulous efforts to provide current practice recommendation. In many chapters the tables and figures stipulate clear and concise guidance which can be used as ready reference material by busy practitioners. Unique chapter on Diabetes Registry discuss and provide guidelines how diabetes registry can help institutions, private practice clinics and individual clinicians to manage the patients with this chronic disease and its complications. The chapter on epidemiology enhances the understanding of multifaceted nature of pathophysiology and risk factors of diabetes and importance of this understanding in overall management of diabetes. The chapter on self-monitoring of blood glucose (SMBG) explores controversies and provides guidance on how parsimonious and structured use of SMBG can lead to improved glycemic control and health outcomes in diabetic patients. Easy to understand and clear guidelines on the management of pregnant diabetic patient from pre-partum to post-partum and treatment of congestive cardiac failure and hypertension in diabetic patient are outlined in specific chapters. A new concept in health care delivery 'Medical Home' for diabetes which leverages resources and improves outcomes while holding down cost is discussed in clear and concise manner in the chapter 'management of diabetes in primary care'. The book also describes state-of-art and evidence based information for management of diabetic neuropathy, erectile dysfunction, and diabetic foot and eye disorders. Utility of food frequency questionnaire and motivational interview, the key aspects of nutritional management are discussed in specific chapters. A clear understanding of pathophysiology and treatment of type 2 diabetes in youth as well as guidelines for management of diabetic patients during religious fasting, international travelling and shift work are described in dedicated chapters.