Cover -- Contents -- Preface -- Acknowledgments -- 1 Introduction -- 2 Getting to grips with diabetes -- When you first find out you have diabetes -- What happens next? -- Older people -- Teenagers and young adults -- Self-help groups -- Routine check-ups -- Living the life you choose -- 3 Caring for your own diabetes -- Goals for managing diabetes -- How can you achieve these goals? -- Becoming your own expert -- Can you take time off from diabetes? -- Alternative and complementary therapies -- 4 Diabetes: some background -- Type 1 diabetes -- Type 2 diabetes -- Tablets for Type 2 diabetes -- Young people with Type 2 diabetes -- Maturity-onset diabetes of the young (MODY) -- Latent autoimmune diabetes in the adult (LADA) -- How common is diabetes? -- Can you catch diabetes? -- Does eating too much sweet food cause diabetes? -- 5 How your body works -- Insulin -- Your body doesn't realizeit has diabetes -- Your body's anatomy -- Pancreas -- The islets of Langerhans -- Cellular metabolism -- Diabetes, insulin deficiency and insulin resistance -- 6 Regulation of blood glucose -- The liver -- Glucagon -- Glucagon injections -- Adrenaline -- Cortisol -- Growth hormone -- 7 High blood glucose levels -- Insulin resistance - not enough insulin to do the job? -- Early need for insulin in Type 2 diabetes -- What to do with a high blood glucose level -- Ketoacidosis -- Hyperosmolar non-ketotic coma (HONK) -- Blurred eyesight and diabetes -- 8 Nutrition -- Absorption of carbohydrates -- Emptying the stomach -- Sugar content in our food -- Taking fluids with food -- Dietary fats -- Dietary fibre -- Glycaemic index -- Milk -- Vegetables -- Potatoes -- Bread -- Pasta -- Meat and fish -- Pizza -- Salt -- Herbs and spices -- Fruit and berries -- Mealtimes -- Special 'diabetic' food? -- 'Fast food' -- Vegetarian and vegan diets -- Different cultures.

Religious fasting days -- Ramadan: the fasting month -- Sweeteners -- Non-nutritive sweeteners -- Nutritive sweeteners -- Diet drinks and 'light' foods -- 9 Weight control -- What is 'overweight'? -- Is weight always a problem? -- Metabolic syndrome -- Weight loss: the benefits to your health -- Exercise and weight loss -- Are low carbohydrate diets useful? -- Are conventional low fat diets useful? -- Partial meal replacement diets -- Using the glycaemic index (GI) in dietary planning for weight reduction -- Group therapy -- Drugs for weight loss -- 10 Exercise -- What happens during exercise? -- Planning and maintaining exercise -- Exercise and mood -- Exercise and the cardiovascular system -- Exercise and its effects on blood sugar -- Exercise and muscle strength -- 11 Monitoring -- The blood glucose testing dilemma -- Do you need to monitor at all? -- How many tests should you take? -- Urine tests -- 'Good' or 'bad' tests? -- Are some things forbidden? -- Blood glucose -- How to take blood tests -- Self-monitoring around mealtimes -- Continuous glucose monitoring -- Does continuous finger-prickingcause loss of feeling? -- Ketones -- Acting on the information -- 12 Glycosylated haemoglobin (HbA1c) -- What level should HbA1c be? -- Why check your HbA1c? -- How often should you check your HbA1c? -- Can your HbA1c be 'too good'? -- Can the HbA1c measurement give false information? -- Fructosamine -- 13 Tablets for lowering blood sugar -- Tablet treatments for diabetes -- Biguanides (metformin) -- Glitazones (insulin sensitizers) -- Sulphonylureas -- Postprandial glucose regulators (PPGRs) -- Alpha-glucosidase inhibitors -- Gliptins -- Oral treatment pathways for blood glucose: what is the best form of treatment? -- 14 Insulin treatment -- Animal and human insulin -- Rapid-acting insulin -- Basal insulin -- New basal insulins -- Pre-mixed insulin.

Units and insulin concentrations -- Twice-daily treatment -- Multiple injection treatment -- Injections before meals (bolus insulin) -- When should you take your pre-meal dose? -- Can regular short-acting insulin injections be taken just before a meal? -- Can I skip a meal? -- Bedtime insulin -- When should the long-acting injectionbe taken? -- Mixing insulins -- Depot effect -- How accurate is your insulin dose? -- Insulin absorption -- What if you forget to take your insulin? -- What if you take the wrong type of insulin? -- Having a lie-in at weekends -- Staying awake all night -- Shift work -- 15 Administering insulin -- Injection technique -- Rapid-acting and short-acting insulin -- Long-acting insulin -- Is it necessary to disinfect the skin? -- Storage of insulin -- Syringes -- Pen injectors -- Used needles and syringes -- Automatic injectors -- Jet injectors -- Insuflon -- Insulin pumps -- New methods of insulin delivery -- 16 Changing insulin requirements -- Tablets with insulin:what can you expect? -- Moving towards treatment by insulin alone -- Why might an insulin regime need changing? -- Blood glucose goals -- Managing your insulin doses -- 17 Side effects and problems with insulin treatment -- Insulin and weight gain -- Hypoglycaemia -- Why do patients with Type 2 diabetes have to take such large amounts of insulin? -- Reducing the insulin dose -- Problems at the injection sites -- Insulin antibodies -- Anticipating the problems -- 18 Hypoglycaemia -- Blood glucose levels and symptoms of hypoglycaemia -- Severe hypoglycaemia -- Seizures -- Hypoglycaemia unawareness -- Driving and insulin -- Rebound phenomenon -- Too little food or too much insulin? -- Night time hypoglycaemia -- Can you die from hypoglycaemia? -- Why does the blood glucose level at which hypoglycaemia is noticed vary? -- 19 Treating hypoglycaemia.

Which dose of insulin contributed to your hypoglycaemia? -- Timing and hypoglycaemia -- Helping someone with diabetes who is not feeling well -- Glucose -- Fructose -- After hypoglycaemia -- Learning to recognize the symptoms of hypoglycaemia -- 20 Stress -- Stress in daily life -- 21 Coping with sickness -- Nausea and vomiting -- Gastroenteritis -- Wound healing -- Surgery -- Drugs that affect blood glucose -- Teeth -- Vaccinations -- 22 Type 2 diabetes and younger people -- Why me? -- Type 2 diabetes and overweight -- Are the symptoms any different in younger people? -- What can be done? -- Is treatment with insulin inevitable in time? -- What does the future hold? -- Type 2 diabetes in young people who are not overweight -- Finding out more -- 23 Smoking -- The risks -- How do I stop? -- Nicotine replacement therapy -- Passive smoking -- Snuff -- 24 Alcohol and other substances -- Alcohol and the liver -- Why is it dangerous to drink too much if you have diabetes? -- Basic rules -- What if you have had too much to drink? -- Dieting and weight loss -- Illegal drugs -- 25 Sexual problems and Type 2 diabetes -- Problems with your erection -- Medical treatment of erectile dysfunction -- What about women? -- Fertility -- Contraception -- Staying healthy -- 26 Pregnancy and diabetes -- Preparing for pregnancy -- Glucose control -- Blood pressure control -- During the pregnancy -- Gestational diabetes -- Delivery -- Feeding your baby -- 27 Social and employment issues -- Social life -- Diabetes ID -- Being a parent with diabetes -- Diabetes and work -- Diabetes and the Armed Forces -- Driving and diabetes -- 28 Travelling with diabetes -- Travelling with insulin -- Passing through time zones when on insulin -- Travelling if you are taking blood glucose-lowering tablets -- Vaccinations -- Ill while abroad? -- Diarrhoea.

29 Psychological aspects of Type 2 diabetes -- Need for information -- Psychological support -- Anxiety and Type 2 diabetes -- Depression and Type 2 diabetes -- Diabetes and underlying psychiatric illness -- Taking control -- 30 Complications of the cardiovascular system -- What are macrovascular complications? -- Blood glucose levels -- Blood pressure -- Cholesterol levels -- Insulin resistance -- Who needs aspirin treatment? -- New cardiovascular risk markers -- Helping yourself -- 31 Microvascular complications -- Complications affecting the eyes (retinopathy) -- Complications affecting the kidneys (nephropathy) -- Complications affecting the nerves (neuropathy) -- Avoiding complications: the evidence -- 32 Problems with feet -- Why do foot problems happen? -- Minimizing the risk of foot problems -- Treating foot ulcers -- Charcot foot -- 33 Associated diseases -- Insulin resistance -- Problems associated with insulin resistance -- Maturity-onset diabetes of the young (MODY) -- Causes of secondary diabetes -- 34 Type 2 diabetes in later life -- Best possible blood glucose levels -- Glucose-lowering drugs: which is best for you? -- Insulins -- Management of other risk factors if you are older -- Diabetes in a care home -- 35 Support and information -- What should you be getting from your primary care team? -- National Service Frameworks -- The NSF for diabetes -- Structured patient education programmes -- Diabetes UK -- Other useful organizations -- Practical and financial support -- Using the Internet -- 36 Outcome studies in Type 2 diabetes -- UKPDS -- Heart Protection Study -- CARDS -- HOPE -- PROactive -- ASCOT -- Steno-2 study -- DREAM -- ADOPT -- Future outcome studies reporting in the next few years -- Outcome studies: what now? -- 37 Research and new developments -- Newer glitazone-type drugs -- Incretins.

Drugs acting on glucose re-absorption in the kidney.