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181
INDEX
A
Acute kidney injury (AKI), 25
Advanced meal assist (AMA) looping, 155
Aerobic and anaerobic exercise on glucose levels, 116
Afferent inputs, 34
Africa, diabetes in
care gaps, 176
challenges, 177
cultural backgrounds, 176
cultural beliefs and practices, 176
diabetic ketoacidosis, 176
endocrinologists/diabetologists, 176
gestational diabetes, 176
hospital admission, 176
ketosis-prone type 2 diabetes, 175
MRDM, 175
peculiarities, type 1 diabetes, 175
prevalence, 175–177
acute and chronic complications, 177
Universal Health Coverage (UHC) model, 176
Albuminuria, 23
diabetic kidney disease, 23
hyperfiltration and, 25–26
moderately increased, 23
recommendations, 24t
severely increased, 23
Albuminuric diabetic kidney disease (A-DKD), 23
Alpha-glucosidase inhibitors, 69
Ambulatory glucose profile (AGP), 131
American College of Cardiology (ACC), 89
American College of Obstetrics and Gynecology
(ACOG), 9
American Diabetes Association (ADA) Standards of Medical
Care, 93, 94t
2019 American Geriatrics Society (AGS) Beers
Criteria, 112
AndroidAPS, 153
Angiotensin-converting enzyme inhibitors (ACEis), 25–26
Angiotensin receptor blockers (ARBs), 25–26
Anion-gap metabolic acidosis, 20
Anterior-segment complications, 30
Antidiabetes medications
cancer and diabetes management, 105, 105t
insulin, 166
macrovascular complications, 42–43
on CV risk, 41–42
weight gain, 166
Antiobesity medications, weight loss, 167, 168t
Arteriolar hyalinosis, 25
Arteriolar vasodilation and efferent arteriolar
vasoconstriction, 26f
Aspirin role, older adults and diabetes, 115
Atherosclerotic cardiovascular disease (ASCVD), 12, 74.
See also Macrovascular complications
glucose-lowering medications, 89
risk estimation tool, 12
Atypical type 2 diabetes, 8
Autoimmune diabetes, cancer and diabetes management, 106
Automated insulin delivery systems, 150
B
Basal insulin, 59
administration of, 63–66
vs. bolus insulin, 59–60, 77
continuous glucose monitoring, 142–146
dose, hospitalized patients, 124, 126
glycemic targets, 90–91
infusion rates, 148
Beta-cell failure, 7, 9
Bicarbonate therapy
diabetic ketoacidosis, 21
hyperglycemic hyperosmolar syndrome, 21
Bihormonal pump, 150
Blindness, 30. See also Diabetic retinopathy (DR)
Blood glucose (BG) monitoring system, 179
Body mass index (BMI), 165
Bolus insulin, 59
administration of, 63
basal insulin vs., 59–60, 77
continuous glucose monitoring, 146
doses, 148
exercise, 118
initial basal rates and, 147–148
snooze, looping, 154–155
Bolus on board (BOB), 77
Bone health, older adults and diabetes, 113
Bromocriptine, 72
Bruns-Garland syndrome, 35
Burned-out diabetes, 26–27
C
Calorie deficit, weight loss, 166
Cancer and diabetes management
antidiabetic therapy, 105, 105t
autoimmune diabetes, 106
comorbid conditions, 104
compromised immune system, 104
glucose and insulin metabolism, 106
glycemic control importance, 104
glycemic targets, 104–105
hyperglycemia, 104, 107t–108t
hyperglycemia in terminal illness, 110
hyperinsulinemia, 104
inflammatory cytokines, 104
metformin, 105–106
mortality risk, 104
PI3K-Akt-mTOR inhibitors, 109
PI3K pathway inhibitors, 109
prognosis, 104
risks, 104
steroid-induced hyperglycemia, 109–110
Carbohydrate
counting and precise insulin dosing
basics, 78t
bolus on board (BOB) and, 77
Certified Diabetes Care and Education Specialist (CDCES), 78
continuous glucose monitor (CGM), 77
definition, 77–81
Note: Page numbers followed by f indicate figures, t tables, b boxes.
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182 INDEX
high-BG correction factor (CF), 77
meal and correction dose, 77
practice with, 78–81, 79b, 80b, 81b
protocol, 77
counting, simple strategy, 52
exercise, 117, 117t
Carbohydrate-to-insulin ratio, continuous glucose monitoring,
142–146
Cardiorespiratory fitness (CRF), 55. See also Exercise
Cardiovascular (CV) events
and mortality outcomes, diabetic nephropathy, 23–24
noninsulin therapies, 68
sodium-glucose cotransporter 2 (SGLT-2), 28
Cardiovascular outcomes trials (CVOTs), 74
Care gaps, diabetes in Africa, 176
Cataracts, 30
Cerebral edema, 21
Certified Diabetes Care and Education Specialist (CDCES), 78
Checkpoint inhibitor-associated autoimmune diabetes mellitus
(CIADM), 9
A1c level, 106
incidence of, 106
monitoring guidelines, 108
recommended treatment, 108
risk factors, 106–108
vs. T1DM, 108
Chronic kidney disease (CKD)
noninsulin therapies, 68
presence and stage of, 12
Chronic pancreatitis, 9
CIADM. See Checkpoint inhibitor-associated autoimmune diabetes
mellitus (CIADM)
Cognitive impairment, older adults and diabetes, 112
Colesevelam, 69
Concentrated insulin, hospitalized patients, 127
Continuous glucose monitoring (CGM), 77
ambulatory glucose profile (AGP), 131
basal rates, 142–146
bolus doses, 146
carbohydrate-to-insulin ratio, 142–146
correction factor, 142–144, 146
devices, 130
dexcom G6 trend arrows, 133t
features of, 130
fingerstick BG tests, 130–131
freestyle libre arrow figures, 133f
glucose management indicator (GMI), 131
glucose sensor, 130–134
glycemic control in
type 1 diabetes, 134
type 2 diabetes, 134
hospitalized patients, 128, 134
hybrid closed loop, 136, 138, 140–141, 145
insulin pumps, 133–134
interpretation, 136–146
interpretation worksheet, 132t
optimal insulin dosing decisions, 132–133
personal, 130, 131t
professional, 130
standardized approach, 132
time in range (TIR) targets, 131t
Continuous subcutaneous insulin infusion (CSII), 98–99
contraindications, 128t
hospitalized patients, diabetes management, 128
Coronary artery disease (CAD), morbidity and
mortality, 99
Correction factor (CF), 77
carbohydrate counting and precise insulin dosing, 77
continuous glucose monitoring, 142–144, 146
COVID-19 pandemic
diabetic ketoacidosis incidence, 18
hospitalized patients, diabetes management with, 128–129
C-peptide, 6
Critically ill and noncritically ill hospitalized patients, diabetes
management, 122
Cystic fibrosis (CF), diabetes mellitus with, 9
Cytotoxic T lymphocyte-associated antigen-4 (CTLA-4), 106
D
DAPA-CKD trial, 28
Dapagliflozin in Patients With Heart Failure and Reduced Ejection
Fraction (DAPA-HF) trial, 75
Delivery systems, insulin pump and integrated
systems, 149–150
Deprescribing, older adults and diabetes, 114
Detemir, pregnancy and diabetes, 99
Dexcom G6 trend arrows, 133t
Diabetes mellitus
classification, 7–8, 8t
complication of, 30
with cystic fibrosis (CF), 9
diagnostic criteria, 6–9, 7t
GFR, 26–27
nerve damage in. See Neuropathy
prevalence, 6
renal dysfunction, 26
type 1, 6
development of, 6
diagnosis, 6
etiology and pathogenesis, 6
type 2, 6
etiology and pathogenesis, 7
types, 6
Diabetes self-management education and support (DSMES), 14–15
Diabetic amyotrophy, 35
Diabetic autonomic neuropathy (DAN)
features of, 34
manifestations, 35t
Diabetic ketoacidosis (DKA), 8. See also Ketosis-prone type 2
diabetes
anion-gap metabolic acidosis, 20
beta-hydroxybutyrate, 21
bicarbonate therapy, 21
degree of ketosis, 18
diabetes in Africa, 176
diagnostic criteria, 19t
euglycemic, 18
hypercoagulable states, 21
incidence, 18
insulin therapy, 20
IV fluid administration recommendations, 20
mortality rate, 21
pathophysiology, 18, 19f
phosphate therapy, 21
potassium, 20–21
precipitants, 18
precipitating factors, 19t
pregnancy and diabetes, 100
prevalence, 18
resolution criteria, 21
treatment, pitfalls, 21
water and electrolyte deficits, 20
Diabetic kidney disease (DKD)
albuminuria, 23
glucagon-like peptide-1 (GLP-1) receptors, 29
hyalinosis in kidney with, 26f
management goals, 27, 27t
Carbohydrate (Continued)
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INDEX 183
modifiable risk factors, 25
nonmodifiable risk factors, 24
therapeutic interventions, 29
Diabetic macular edema (DME), 30
Diabetic nephropathy (DN)
arteriolar vasodilation and efferent arteriolar
vasoconstriction, 26f
cardiovascular and mortality outcomes, 23–24
clinical diagnosis, 27t
definition, 23–29
glomerular hyperfiltration in, 25
histologic changes, 24f
hyperfiltration, 26f
natural progression, 25, 25f
pathophysiologic changes, 25
pregnancy and diabetes, 99–100
Diabetic neuropathy, cachexia, 34–35. See also Neuropathy
Diabetic radiculoplexus neuropathy (DRPN)
clinical features, 34–35
management, 37
prevalence, 35
Diabetic retinopathy (DR)
benefits, 32t
blindness from, 30
complication, 30
diagnosis, 31
dilated fundus exam, 31–32
indications, 32t
long-term/permanent quiescence, 32
major risk factors, 30
mortality rate, 32
nonproliferative and proliferative disease, 30
ophthalmologist/optometrist, 31
pathogenesis and natural history, 31f
pregnancy and diabetes, 100
prevalence, 26, 30
retinal detachment, 30
risks, 32, 32t
subtypes, 30, 31t
treatment, 32, 32t
Diet therapy
fats, medical nutrition therapy, 52
pregnancy and diabetes, 101–102
Disease multiplier, 23–24
Distal convoluted tubule (DCT), 25
DIY APSs looping, 158
DKA. See Diabetic ketoacidosis (DKA)
DKD. See Diabetic kidney disease (DKD)
Do-it-yourself artificial pancreas systems (DIY APSs), 153
components, 153
DPP-4 inhibitor
alogliptin, 72–74
classes, 90
Duration of insulin action (DIA), 77
Dyslipidemia, 40, 43–44
E
Efferent arteriolar vasoconstriction, 26f
Efferent motor signals, 34
End of life diabetes management, 110t
Endothelial injury, 25
Enteral nutrition (EN), 127
Euglycemic diabetic ketoacidosis, 18
Exenatide, 72–74
Exercise
aerobic and anaerobic on glucose levels, 116
benefits, 55
bolus insulin doses, 118
carbohydrate, 117, 117t
contraindications, 58
and CRF, 56
factors affects, 117, 117t
glucose monitoring, 118
glucose response, aerobic exercise, 116
glycemic control, 57
high-intensity on BG levels, 116
hypoglycemia and, 56
insulin pump
advantages, 57
therapy, 120
intermittent high-intensity, BG levels, 116
intolerance, 56
key elements of diabetes management, 118, 118t
medical nutrition therapy and, 56–57
metabolism during, 116–120
micro- and macrovascular outcomes, 56
modality, 57
nutritional recommendations, 118, 119t
older adults and diabetes with, 112
optimal duration and frequency, 55–56
pathophysiological barriers, 56
performance during, 117, 117t
vs. physical activity, 55
in prevention of T2DM, 55
primary drivers of hypoglycemia, 117, 117t
recommendations, nutritional intake, 118, 118t, 119t
role in pregnancy and diabetes, 97
safety measures, 57–58
time of day, 116
F
FDA-approved hybrid closed-loop systems, 157
Fear Survey-II Worry (HFS-II W) Scale, 13–14, 15t
Fetal surveillance, pregnancy and diabetes, 100
Finerenone, 29
Fingerstick BG tests, continuous glucose monitoring, 130–131
Flatbush diabetes, 8
Focal segmental glomerular sclerosis (FSGS), 25
Food insecurity, medical nutrition therapy, 54
Freestyle libre arrow figures, continuous glucose
monitoring, 133f
G
Geriatrics. See Older adults and diabetes
Gestational diabetes mellitus (GDM), 8–9, 100–101. See also
Pregnancy and diabetes
in Africa, 176
GFR drop, sodium-glucose cotransporter 2, 28
Glargine, pregnancy and diabetes, 99
Glomerular basement membrane (GBM) thickening, 23
GLP-1 receptor agonist, 90, 166
Glucagon and hypoglycemia
advantages, 162–163
role, 161, 162t
side effects, 163
treatment, 162
warnings, 163
Glucagon-like peptide-1 (GLP-1) receptors, 29
Glucose
and insulin metabolism, 106
monitoring
exercise, 118
postpartum, 102
response, aerobic exercise, 116
sensor, 130–134
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184 INDEX
Glucose control
Association of Diabetes Care and Education Specialists
(ADCES), 173
barriers to, 170–174
cost-related barriers, 172–173
healthcare team enhance patients’ motivation, 171
limited health literacy, 172
with nonadherence, 170–171
overcome, 171
overcome therapeutic inertia, 170
patient-provider relationship affect adherence, 171
psychosocial barriers, 173–174
psychosocial factors, 173
SDOH, 172
barriers to, 172
strategies, 173
Glucose-lowering medications, 88, 90t
Glucose management indicator (GMI), 131
Glyburide, 72–74
Glycemic control
continuous glucose monitoring
in type 1 diabetes, 134
in type 2 diabetes, 134
exercise, 57
goals during pregnancy and diabetes, 98
importance, cancer and diabetes management, 104
Glycemic targets
A1c, 91
American Diabetes Association recommendations, 88f, 91f
basal insulin, initiation and titration, 90–91
cancer and diabetes management, 104–105
chronic kidney disease (CKD) patients, 89
factors, 88t
glucose-lowering medications, 88, 90, 90t
hemoglobin A1c recommendations, 87–92
initial combination therapy, 87
nonpregnant adults with diabetes, 88t
for older adults and diabetes, 112–115, 113t
people with heart failure, 89
pregnant hospitalized patients, diabetes management, 122, 123t
recommended first-line treatment, 87
SGLT-2 inhibitors, 89
stringent, 87
type 2 diabetes patients, 89
use of insulin therapy, 87
H
Health literacy, glucose control, 172
Heart failure (HF), 12
noninsulin therapies, 68
Heart failure with preserved ejection fraction (HFpEF), 75
Heart failure with reduced ejection fraction (HFrEF), 75
Hemoglobin A1c level
CIADM, 106
fasting plasma glucose (FPG) levels and, 59
glycemic targets, 87–92
hospitalized patients, diabetes management, 122
improvement
medical nutrition therapy, 53
lowering efficacy, 68
recommendations, glycemic targets, 87–92
Hepatic steatosis, 48
High-intensity exercise on BG levels, 116
Home regimen, hospitalized patients, 128
Hospitalized patients, diabetes management
basal insulin dose, 124, 126
CGM, 128
concentrated insulin, 127
continuous glucose monitoring in, 134
continuous subcutaneous insulin infusion (CSII), 128
with COVID-19, 128–129
critically ill and noncritically ill, 122
enteral nutrition (EN), 127
glycemic targets, pregnant patients, 122, 123t
hemoglobin A1c level, 122
home regimen, 128
hyperglycemia, 122, 123t
hypoglycemia, 126
inpatient setting, 122–129
intensive management, 123
intravenous (IV) infusion/subcutaneous (SQ) injections, 123
IV insulin infusion, critically ill patients, 123, 124t
medications prior to surgery, 128
oral agents/noninsulin injectables, 126–127
parenteral nutrition (PN), 127
point-of-care (POC) BG testing, 122
prandial dose, 124
sliding-scale insulin, 126
steroid-induced hyperglycemia, 127
stress hyperglycemia, 122–123
Hybrid closed-loop system, 133–134, 149
continuous glucose monitoring, 136, 138, 140–141, 145
Hyperfiltration, 25
and albuminuria, 25–26
diabetic nephropathy, 26f
Hyperglycemia, 6
cancer and diabetes management, 104, 107t–108t
hospitalized patients, diabetes management, 122, 123t
macrovascular complications, 40
in terminal illness, 110
Hyperglycemic hyperosmolar syndrome (HHS)
anion-gap metabolic acidosis, 20
bicarbonate therapy, 21
vs. diabetic ketoacidosis, 18
diagnostic criteria, 19t
hypercoagulable states, 21
insulin therapy, 20
IV fluid administration recommendations, 20
mortality rate, 21
pathophysiology, 18, 19f
phosphate therapy, 21
potassium, 20–21
precipitants, 18
precipitating factors, 19t
prevalence, 18
treatment
pitfalls, 21
principles, 20
volume repletion, 20
water and electrolyte deficits, 20
Hyperinsulinemia, cancer and diabetes management, 104
Hyperkalemia, 28
Hypertension
macrovascular complications, 43
pregnancy and diabetes, 99–100
Hypoglycemia
cause of, 159
chocolate use and, 161
classification, 160t
definition, 159
educational points about, 163
elimination, 161
and exercise, 57
glucagon
advantages, 162–163
role, 161, 162t
side effects, 163
treatment, 162
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INDEX 185
warnings, 163
glycemic management, 161
health implications, 159
hospitalized patients, diabetes management, 126
impaired awareness, 161
mild, 62
nonmedication causes, 159
older adults and diabetes, 112
physiologic mechanism, 160–161
primary drivers of, exercise, 117, 117t
quality of life, 159
risk group, 160
role of technology, 163
self-management, 163
symptoms, 159, 161
and physiologic effects, 160f
treatment, 161
unawareness, 62
Hypovolemia, 18
I
Immune system, compromised, 104
Inflammatory cytokines, 104
Inhaled insulin, 66
Inpatient setting, diabetes management, 122–129
Insulin neuritis, 38
Insulin pumps
compatible, 155
continuous glucose monitoring, 133–134
exercise, 120
and integrated systems
automated insulin delivery systems, 150
basal insulin infusion rates, 148
benefits of, 147
bihormonal pump, 150
bolus insulin doses, 148
definition, 147
delivery systems, 149–150
glucose control, 148
hybrid closed-loop system, 149
initial basal rates and bolus dosing, 147–148
insulin delivery, 147
looping, 150
Medtronic MiniMed 670 G and 770 G hybrid closed-loop
systems, 149
self-monitoring of blood glucose (SMBG), 148
tandem t:slim X2 hybrid closed-loop systems, 149
tidepool loop, 150
type of insulin, 147
in United States, 148–149, 149t
loopable, 155
Insulin resistance, 7–9
Insulin therapy, 8
adverse effects, 62
approach of, 62
appropriate storage, 63
availability, 64t–65t
cost of, 67
delivery, 147
inhaled insulin, 66
initiation, 62
intensification, 62
mixed insulin, 66
pharmacodynamic properties, 59–67
pharmacokinetic properties, 59–67
PK/PD profile, 66
pump. See also Continuous subcutaneous insulin infusion (CSII)
during pregnancy and diabetes, 98–99
regimens, older adults and diabetes, 114
self-monitoring of blood glucose (SMBG), 61–62
T1D treatment, 60–62
in United States, 63
U-100 regular insulin, 66
U-500 regular insulin, 66
weight gain, 62
Insurance coverage, looping, 158
Intensive insulin therapy (IIT), 60
Intensive management, hospitalized patients, diabetes manage-
ment, 123
Intermittent high-intensity exercise, BG levels, 116
Interpretation worksheet, continuous glucose monitoring, 132t
Intrauterine environment, pregnancy and diabetes, 97
Intravenous (IV) infusion
critically ill patients, 123, 124t
hospitalized patients, diabetes management, 123
Iris neovascularization, 30
Islet-cell antibodies, 6
Islet-cell autoantibodies, 6
K
Ketosis-prone type 2 diabetes, 6, 8, 175
Kidney disease, 23–24, 27t
L
Lactation, maternal DM and, 102. See also Pregnancy and
diabetes
Latent autoimmune diabetes in adults (LADA), 6, 8
Legal blindness, WHO definition, 30. See also Diabetic retinopathy (DR)
Linagliptin, 72–74
Lipid-lowering medications, 44
Liraglutide 3.0 mg, weight management, 169
Liver fibrosis, 46
Loop, 153
Looping, 150, 154f
advanced meal assist (AMA), 155
algorithm, 153–155
bolus snooze, 154–155
components, 153
definition, 153
diabetes team, 157
DIY APSs, 158
FDA-approved hybrid closed-loop systems, 157
insurance coverage, 158
loopable insulin pump, 155
low-glucose suspend behavior, 154
with new insulin pump, 156–157
new-onset type 1 diabetes mellitus, 156
Nightscout reports, 158
online community, 158
OpenAPS, 154
open reference design zero (oref0), 154
oref1 algorithm, 155
RileyLink breakdown, 156f
safety, 157
troubleshoot, 157
Low-glucose suspend behavior, 154
M
Macroalbuminuria, 23
Macrovascular complications
antidiabetes medications, 42–43
on CV risk, 41–42
antihypertensive medications, 43
complications, 40
dietary and exercise recommendations, 41
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186 INDEX
dyslipidemia evidence, 43–44
hypertension, 43
incidence, 40
lipid-lowering medications, 44
pathophysiology, 40
prevalence, 40
risk estimator, 41
risk factors, 40
statins recommendations and doses, 44t
tobacco cessation and CV risk, 41
treatment of hyperglycemia, 41
Major adverse cardiovascular events (MACEs), 40, 42t, 74.
See also Macrovascular complications
Malnutrition-related/malnutrition-modified diabetes (MRDM), 175
classification, 175
features of, 175
Maori people, diabetes complications, 180
Maternal DM and lactation, 102. See also Pregnancy and diabetes
Maternal-fetal outcomes, pregnancy and diabetes, 101
Maturity-onset diabetes of the young (MODY), 6
characteristics, 9
subtypes, 9t
Meal patterns, 52–53
and correction dose, 77
Medical nutrition therapy (MNT)
A1c improvement, 53
carbohydrate counting, simple strategy, 52
dietary fats, 52
and exercise, 56–57
food insecurity, 54
goals, 52
initial weight-loss goal, 52
meal patterns, 52–53
nonnutritive sweeteners, 53
plate method, meal planning, 53
social determinants of health (SDOH) affect nutrition, 53
sodium goal, 53
Medications-induced diabetes, 6
Medtronic MiniMed 670 G and 770 G hybrid closed-loop
systems, 149
Meglitinides, 69
Metabolic acidosis, 18
anion-gap, 20
Metabolic surgery, weight management, 169
Metabolism, during exercise, 116–120
Metformin
adverse effects, 68–69
cancer and diabetes management, 105–106
contraindication, 87
diabetes prevention, 94
monotherapy, 68
Microalbuminuria, 23
Mixed insulin, 66
N
Naltrexone plus bupropion sustained-release, weight
management, 168
Neovascular glaucoma, 30
Neovascularization (NV), 30
chronic, 30
of iris, 30
Neuropathy, 34
bloodwork, 36–37
clinical manifestations of, 34
compression, 35, 36t
cranial, 36t
diagnostic tools, 37
disease-modifying treatments, 38
distal symmetric polyneuropathy (DSP), 34
electromyography (EMG), 37
entrapment/compression, 35
features of, 34
magnetic resonance imaging (MRI), 37
nerve conduction studies (NCSs), 37
pain medications, 37t
pathophysiology, 38
patterns/syndromes, 34
prediabetes and, 38
prevalence, 34
symptomatic treatment options, 37
symptoms, 34
treatment, 37–38
treatment-induced neuropathy of diabetes (TIND), 38
Neutral protamine Hagedorn (NPH)
insulin, 59
pregnancy and diabetes, 99
New-onset diabetes after transplant (NODAT). See Posttransplant
diabetes
New Zealand, diabetes in
blood glucose (BG) monitoring system, 179
definition, 179–180
ethnic differences, 180
healthcare in, 179
limitations, 179
patterns of complications in Maori people, 180
PHARMAC, 179
prevalence, 179
Virtual Diabetes Register (VDR), 179
Nightscout reports, 158
Nonalbuminuric DKD (NA-DKD), 23
Nonalcoholic fatty liver disease (NAFLD)
bariatric surgery, 50
biopsy, 49
clinical diagnosis, 48–49
definition, 46
Food and Drug Administration (FDA), 49
genetic risk factors, 47
insulin resistance, 48
lifestyle modifications, 49–50
liver fibrosis, 46
liver function tests (LFTs), 48–49
medications, 49
NAFLD Activity Score (NAS), 46
natural progression, 48
prevalence, 46
recommendation, 50
risk factors, 46–47, 47f
and type 2 diabetes, 47
Nonalcoholic steatohepatitis (NASH), 46
Noninsulin therapies
alpha-glucosidase inhibitors, 69
bromocriptine, 72
classes, 72
colesevelam, 69
CV safety testing, 74
dosing recommendations, 71t–72t
DPP-4 inhibitors alogliptin, 72–74
exenatide, 72–74
first-line therapy, T2D, 68–75
glyburide, 72–74
heart failure benefit, 75
linagliptin, 72–74
mechanisms and physiologic actions, 69t
medications, 68
classes of, 75
meglitinides, 69
metformin, adverse effects, 68–69
metformin monotherapy, 68
Macrovascular complications (Continued)
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INDEX 187
oral medications doses, 68
periconception, 99
pregnancy and diabetes, 99
relative costs, 75
renal benefit, 74–75
risk of hypoglycemia, 74
saxagliptin, 72–74
sitagliptin, 72–74
weight impact, 74
Nonnutritive sweeteners, 53
Nutritional intake recommendations and exercise, 118, 118t, 119t
O
Obesity
body mass index (BMI), 165–169
clinical assessment, 165
prevalence, 165
Older adults and diabetes
2019 American Geriatrics Society (AGS) Beers Criteria, 112
blood pressure target in, 114
cognitive impairment, 112
complex insulin regimens, 114
deprescribing, 114
with diabetes exercise, 112
diabetes medications, 113
AGS Beers Criteria, 113
bone health, 113
at end of life, 115
first-line medication therapy, 112
functional abnormalities, 113
functional impairment in, 112
glycemic targets for, 112–115, 113t
hypoglycemia, 112
self-management, 114
SGLT-2 inhibitors, 113
sliding-scale insulin, 112
statins therapy, 114, 114t
weight loss recommendations, 113
OpenAPS looping, 153–154
Open reference design zero (oref0) looping, 154
Optimal insulin dosing decisions, 132–133
Oral agents/noninsulin injectables, hospitalized patients, 126–127
Oral glucose tolerance test (OGTT), 100–101, 101t
one-step approach, 101
two-step approach, 101
Oref1 algorithm looping, 155
Orlistat, weight management, 167
Overweight. See also Obesity
asymptomatic adults, diabetes, 93–94
body mass index (BMI), 165–169
initial weight-loss goal, 52
P
Pancreatic diabetes mellitus (type 3c), 6, 9
Pancreatic insufficiency, 9
Pancreatogenic diabetes mellitus, 9
Pancreatogenous diabetes mellitus, 9
Panretinal photocoagulation, 32
Parenteral nutrition (PN), 127
Patient-centered collaborative care, 12–16
Periconception, 99
Peripheral neuropathy, 34
Personal continuous glucose monitoring, 130, 131t
Person with diabetes (PWD)
assessment and treatment plan, 12
comorbidities, 16
comprehensive medical evaluation, 12
immunizations, 13, 14t
initial care management, 16
lifestyle and social history, 13
medications and vaccinations, 13
past medical and family history, 12–13
physical examination, 15
psychosocial factors, 14–15
referring patients registered dietitian, 16
routine laboratory monitoring, 15, 16t
self-management skills, 14–15
technologies associated with insulin delivery, 14
treatment-associated hypoglycemia, 13–14
Pharmacodynamic (PD) properties
factors, 59
insulin preparations, 60t
insulin therapy, 59–67
Pharmacokinetic (PK) properties
insulin products, 61f
insulin therapy, 59–67
Phentermine plus topiramate extended-release (PHEN/TPM),
167–168
Phentermine, weight management, 167
Physical activity
benefits, 55
demographic factors, 55
exercise vs., 55
guidelines for people with DM, 55
sedentary time role, 55
strategies, 56
PI3K-Akt-mTOR inhibitors
cancer and diabetes management, 109
hyperglycemia, 109, 109f
PI3K pathway inhibitors, 109
Plexopathy, 35
Point-of-care (POC) BG testing, 122
Postpartum
glucose monitoring, 102
period affect, 98
Posttransplant diabetes, 6, 8
Potassium
binders, 28t
diabetic ketoacidosis, 20–21
hyperglycemic hyperosmolar syndrome, 20–21
Prandial dose, hospitalized patients, 124
Precise insulin dosing, carbohydrate counting and
basics, 78t
bolus on board (BOB) and, 77
Certified Diabetes Care and Education Specialist (CDCES), 78
continuous glucose monitor (CGM), 77
definition, 77–81
high-BG correction factor (CF), 77
meal and correction dose, 77
practice with, 78–81, 79b, 80b, 81b
protocol, 77
Preconception counseling, pregnancy and diabetes, 96–102
Prediabetes
definition, 93–95
diagnostic criteria, 6–9, 8t
and neuropathy, 38
weight loss, 165
Pregestational diabetes mellitus, 97. See also Gestational diabetes
mellitus (GDM)
Pregnancy and diabetes
adverse outcomes with T1DM/T2DM, 96
coronary artery disease (CAD) morbidity and mortality, 99
detemir, 99
diabetic nephropathy/hypertension, 99–100
diabetic retinopathy, 100
diet therapy and pharmacologic therapy, 101–102
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188 INDEX
DKA, 100
exercise role, 97
fetal surveillance, 100
GDM, 100–101
glargine, 99
glucose monitoring postpartum, 102
glycemic goals during, 98
insulin pump during, 98–99
intrauterine environment, 97
maternal DM and lactation, 102
maternal-fetal outcomes, 101
metabolic changes
in first trimester, 97
second and third trimesters, 98
neutral protamine Hagedorn (NPH), 99
noninsulin agents, 99
optimal contraception, 96
postpartum period affect, 98
preconception counseling, 96–102
real-time continuous glucose monitoring (RT-CGM) in, 98
short-acting/rapid-acting insulin analogs, 99
White Classification, 96, 97t
Professional continuous glucose monitoring, 130
Programmed cell death protein 1 (PD-1), 106
Proinsulin, 6
Proteinuria, 23
Proximal convoluted tubule (PCT), 25
Proximal diabetic neuropathy, 35
Psychosocial barriers, glucose control, 173–174
R
Radiculopathy, 35
Real-time continuous glucose monitoring (RT-CGM), 98
Renal dysfunction, 26
Renin-angiotensin-aldosterone system (RAAS)
blockade, 23
inhibition, 27–28
Retinopathy. See Diabetic retinopathy (DR)
RileyLink breakdown, 156f
S
Saxagliptin, 72–74
Sedentary time role, 55
Self-monitoring of blood glucose (SMBG), 148
insulin therapy, 61–62
Short-acting/rapid-acting insulin analogs, 99
Sitagliptin, 72–74
Sliding-scale insulin
hospitalized patients, diabetes management, 126
older adults and diabetes, 112
Social determinants of health (SDOH)
affect nutrition, 53
glucose control, 172
barriers to, 172
Sodium-glucose cotransporter 2 (SGLT-2), 25
adverse drug effects, 28
cardiovascular outcomes, 28
DAPA-CKD trial, 28
GFR drop, 28
inhibitor candidates, 29t
inhibitors
glycemic targets, 89
older adults and diabetes, 113
weight loss, 166
kidney outcomes, 28
mechanism of action, 28
mortality, 28
Sodium goal, 53
Statins therapy
older adults and diabetes, 114, 114t
recommendations and doses, macrovascular complications, 44t
Steatosis grades, 46
Steroid-induced hyperglycemia, 8, 109–110
hospitalized patients, diabetes management, 127
treatment strategies, 110
Stress hyperglycemia, 122–123
Subcutaneous (SQ) injections, 123
Symptomatic dysautonomia, 34
T
Tandem t:slim X2 hybrid closed-loop systems, 149
Task-shifting/task-sharing approach, 176
The Newest Vital Sign assessment, 12
Tidepool loop, 150
Time in range (TIR) targets, 131t
Tobacco cessation and CV risk, 41
Treatment-associated hypoglycemia, 13–14
Treatment-induced neuropathy of diabetes
(TIND), 38
Tubuloglomerular feedback (TGF), 25
Type 1 diabetes mellitus (T1DM), 6
development of, 6
diagnosis, 6
etiology and pathogenesis, 6
Type 1.5 diabetes, 8
Type 2 diabetes mellitus (T2DM), 6
in adolescents, 93
in adults, 93
assessment of asymptomatic adults, 94
in children, 93
dietary approaches, 166
etiology and pathogenesis, 7
lifestyle interventions, 94
metabolic surgery, 169
metformin, 94
overweight/obese, asymptomatic adults, 93–94
prevention, 93
risk factors, 93
weight loss, 165
medications in, 167
Type 3c diabetes mellitus, 9
U
Universal Health Coverage (UHC) model, 176
U-100 regular insulin, 66
U-500 regular insulin, 66
V
Vascular endothelial growth factor (VEGF), 30
Virtual Diabetes Register (VDR), 179
Vision loss. See Diabetic retinopathy (DR)
Vitreous hemorrhage, 30
W
Weight
gain
antidiabetes medications, 166
insulin therapy, 62
medications, 166
loss
antiobesity medications, 167, 168t
Pregnancy and diabetes (Continued)
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INDEX 189
calorie deficit, 166
GLP-1 RAs and SGLT-2 inhibitors, 166
glucose-lowering medications, 90
medications in type 2 diabetes, 167
prediabetes, 165
recommendations, older adults and diabetes, 113
strategies, 165
type 2 diabetes, 165
typical course of, 167
management
body mass index (BMI), 165
liraglutide 3.0 mg, 169
metabolic surgery, 169
naltrexone plus bupropion sustained-release, 168
orlistat, 167
phentermine, 167
phentermine plus topiramate extended-release (PHEN/TPM),
167–168
type 2 diabetes mellitus patients, 165
White Classification, 96, 97t
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