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Figure 12.1 Incidence of renal replacement therapy RRT is relatively stable for type 1 patients a compared with type 2 populations b , where needs are escalating, particularly in older men. Reproduced with permission from Van Dijk et al. Kidney International 2005 67 1489-99. Pathological mechanisms in diabetic nephropathy are complex, and involve genetic factors as well as glycaemia, lipids, smoking and blood pressure. Microvascular and macrovascular factors conspire in the progression of this...

How To Cure Buminuria

Other ways of reducing cardiovascular risk Smoking cessation Smoking in a person with diabetes is particularly harmful. It not only increases the already raised risk of macrovascular disease, but it also increases microvascular complications, particularly nephropathy and retinopathy. Patients with diabetes who smoke should be actively targeted for smoking cessation interventions. Current evidence suggests that, despite their raised cardiovascular risk, people with diabetes may not in fact...

Dbk

Impaired fasting glycaemia IGF 3 impaired glucose tolerance IGT 3 incretin mimetics 28, 94, 95 infections bone 69, 70 foot 64, 68, 68 urinary tract 56 initial consultation 9, 10 insulin 34-6 administration method sites 35-6,36, 75-6 adverse effects problems 36 allergy 36 animal 34, 37 frequency of glucose self-monitoring 45-6 hypoglycaemia associated 29, 37 illness, concurrent 31, 46 indications 4, 28, 34 inhaled 36 intravenous infusion 32, 32, 33, 82 long-acting analogue 29, 34, 35, 35, 44 in...

Non Proliferative Retinopathy Venous Beading

Proliferative Retinopathy

Figure 13.1 Background retinopathy with a few microaneurysms only. This stage is not likely to threaten vision in the near future but tight control of vascular risk factors is important to reduce progression photograph courtsey of Dr Sailesh Sankar, consultant Physician, University Hospital, Coventry . Figure 13.3 The same eye as in Fig 13.2, showing relative sparing of the macular region, but the retina is generally ischaemic and at risk of progression to sight threatening neovascularisation...

Acknowledgements

This book would not have been possible without the generous support and advice of colleagues at Warwick Medical School and the University Hospital, Coventry. A number are involved as tutors on the Warwick Diabetes courses and are also practising clinicians, both in primary and secondary care, ensuring that this book reflects contemporary UK practice. We are indebted to numerous individuals who have generously provided figures, tables, photographs and offered suggestions during proof-reading. We...