Table Of ContentDIABETES HEAD TO TOE
Note to Reader. This book is not meant to substitute for medical care of people with diabetes, and treatment
should not be based solely on its contents. Instead, treatment must be developed in a dialogue between the
individual and his or her physician. Our book has been written to help with that dialogue.
Drug dosage: The authors and publisher have made reasonable efforts to determine that the selection of
drugs discussed in this text conform to the practices of the general medical community. In view of ongoing
research, changes in governmental regulation, and the constant flow of information relating to drug therapy
and drug reactions, the reader is urged to check the package insert of each drug for any change in
indications and dosage and for warnings and precautions. This is particularly important when the
recommended agent is a new and/or an infrequently used drug.
© 2018 Johns Hopkins University Press
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Library of Congress Cataloging-in-Publication Data
Names: Kalyani, Rita Rastogi, author.
Title: Diabetes head to toe : everything you need to know about diagnosis, treatment, and living with
diabetes / Rita R. Kalyani, MD, MHS, Mark D. Corriere, MD, Thomas W. Donner, MD, Michael W.
Quartuccio, MD.
Description: Baltimore : Johns Hopkins University Press, 2018. | Series: A Johns Hopkins Press health book
| Includes bibliographical references and index.
Identifiers: LCCN 2018000282 | ISBN 9781421426471 (hardcover : alk. paper) | ISBN 1421426471
(hardcover : alk. paper) | ISBN 9781421426488 (paperback : alk. paper) | ISBN 142142648X (paperback
: alk. paper) | ISBN 9781421426495 (electronic) | ISBN 1421426498 (electronic)
Subjects: LCSH: Diabetes—Diagnosis—Popular works. | Diabetes—Treatment—Popular works.
Classification: LCC RA645.D5 K35 2018 | DDC 616.4/62—dc23
LC record available at https://lccn.loc.gov/2018000282
A catalog record for this book is available from the British Library.
Illustrations by Jennifer E. Fairman, MA, CMI, FAMI, and Tim Phelps, MS, FAMI © 2018, Johns Hopkins
University, Art as Applied to Medicine
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Johns Hopkins University Press uses environmentally friendly book materials, including recycled text paper
that is composed of at least 30 percent post-consumer waste, whenever possible.
To the millions of people living with diabetes worldwide whose inspiring stories and determination
give us hope. To my husband, Sachin, and my children, Shaan and Sonia, who are my constant source
of wisdom, joy, and pride, and to my parents for always seeing what is possible.
—RITA R. KALYANI To my wife, Suzy, and children—Dominic, Molly, Sam, and Tommy—for
their constant support and encouragement of my career. To my dad, who was the first person to
pique my interest in diabetes, and the scores of patients I have been honored to treat who have
grown my interest in this field.
—MARK D. CORRIERE
To my wife, Danielle, and my children—Gabriel, Bridget, and Celia—who so enrich my life. And to
my patients who have had the courage and persistence to take on this challenging disease and from
whom I have learned so much.
—Thomas W. Donner To my wife, Katelyn, and son, Benjamin, who have been so supportive of my
career choice. To my parents, who constantly pushed me to achieve my goals. And to all my
patients, who inspire me to work harder every day.
—MICHAEL W. QUARTUCCIO
CONTENTS
Preface
Acknowledgments
1 A Quick Overview of Diabetes
Introduction to Diabetes
The Global Burden of Diabetes
Landmark Studies in Diabetes Care
2 Diagnosis, Screening, and Types of Diabetes
Diagnosing Diabetes
Risk Factors for Type 1 Diabetes
Risk Factors for Type 2 Diabetes
Differences between Type 1 and Type 2 Diabetes
Testing for Prediabetes
Latent Autoimmune Diabetes in Adults
Maturity-Onset Diabetes of the Young
Cystic Fibrosis–Related Diabetes
Diabetes after Pancreatic Surgery
Steroid-Induced Diabetes
3 General Aspects of Diabetes
Monitoring Blood Glucose Levels
Hyperglycemic (High Blood Glucose) Emergencies
Hypoglycemia (Low Blood Glucose)
Routine Care and Vaccinations
Social and Legal Issues
4 Diabetes in Special Populations
Children and Type 2 Diabetes
Older Adults and Diabetes
Diabetes among People Living with HIV
Race and Ethnic Disparities in Diabetes
Diabetes in American Indians
Diabetes Care during Times of Religious Fasting
Diabetes Care during a Hospital Stay
5 Lifestyle and Behavioral Changes in Diabetes
Diabetes Education
Dietary Therapy
Exercise
6 Obesity and Diabetes
Managing Obesity
Bariatric Surgery
7 Diabetes Complications and Other Conditions Common in Diabetes
The Brain
The Eyes
The Ears
The Mouth
The Thyroid
The Heart and Related Conditions (Hypertension and Dyslipidemia)
The Circulation
The Lungs and Breathing
The Stomach, Gut, Liver, and Pancreas
The Kidneys
The Bladder
The Nerves
The Feet
The Muscle, Skin, and Bone
Cancer and Diabetes
Anemia, Infections, and the Immune System
Men’s Health
Women’s Health
8 An Overview of Treatments for Type 1 and Type 2 Diabetes
Type 1 Diabetes: Insulin Treatment
Type 2 Diabetes: Non-insulin Treatment
Type 2 Diabetes: Insulin Treatment
9 Medications Commonly Used to Treat Diabetes
Pills and Non-insulin Injectable Medications
Types of Insulin
Complementary and Alternative Treatments for Diabetes
10 Medications for Conditions Related to Cardiovascular Disease
Medications for High Blood Pressure
Medications for Cholesterol Abnormalities
Medications to Prevent Cardiovascular Disease
11 Diabetes Technology and Equipment
Glucose Meters
Continuous Glucose Monitors
Using an Insulin Pump to Manage Diabetes
Types of Insulin Pump Devices
12 Cutting-Edge and Future Treatments for Diabetes
Pancreas and Islet Transplantation
The Artificial Pancreas
Appendix. Diabetes Medications Currently Available in the United States
Index
About the Author
PREFACE
We wrote this book for you. Chances are that you either know someone who has
diabetes, are at risk of developing diabetes, or have diabetes yourself. The
number of people with diabetes continues to climb dramatically, and the face of
diabetes worldwide is changing rapidly. No two people with diabetes are alike.
There are various types of diabetes, and some people are more likely to develop
diabetes than others. An ever-increasing number of medications are available to
treat this disease. While some people need insulin right away, others do not. The
disease can affect many different organs in the body—from head to toe and
everywhere in between. Not everyone with diabetes develops the same
complications or medical conditions.
The information in these pages represents the best of what we know to date.
We are health professionals who have not only spent many years specializing in
the comprehensive care of people with diabetes but who have also established
clinical guidelines for how all health professionals should care for people with
diabetes. We treat people with diabetes both in the community and in university-
based centers. We are hopeful that patients, family members, teachers,
physicians, nurses, dietitians, pharmacists, specialists, and anyone else who cares
about the health of a person with diabetes will benefit from this book.
Diabetes is a chronic illness that relies heavily on a person’s ability to self-
manage his or her disease. Yet during a routine clinic visit, health care providers
may be limited (for a variety of reasons) in their ability to relay the critical
information that people with diabetes need to optimally manage their disease at
home. Many complications of diabetes are preventable. By reading this book, we
hope that people with diabetes will be better equipped to recognize early
warning signs so that the appropriate measures can be taken. This will help to
avoid difficulties in the future. The goal is attainable, but it starts with you.
In this book, we provide up-to-date information written in simple, easy-to-
grasp sections. We emphasize the key facts that we would want any person who
has diabetes (or who is interested in diabetes) to know—as if we were sitting
face-to-face with you right now. The more than 130 topics in this book cover the
different ways in which diabetes can affect a person from a personal, family,
societal, and legal perspective. This book goes beyond describing the
“traditional” small blood vessel complications (eye disease, kidney disease, and
