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Reproduced with permission from Coulter A, The Autonomous Patient, 2002. Reproduced with permission from Coulter A, The Autonomous Patient, 2002. must be prepared to discuss personal values and preferences. Both accept shared responsibility for the treatment decisions. A successful clinician-patient relationship built on mutual trust allows the model to be adapted flexibly to the situation. Development of a serious acute illness might shift the emphasis towards Professional choice, whilst the...

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...