6.4 Insulitis. There is a chronic inflammatory cell infiltrate centre...Figure 6.5 ICA demonstrated by indirect immunofluorescence in a frozen secti...Figure 6.6 Progression to symptomatic Type 1 Diabetes in 585 children with t...Figure 6.7 Potential mechanisms of viral aetiology of autoimmune and non‐aut...Figure 6.8 Proposed mechanisms of β cell death. β cells die through a proces...Figure 6.9 Stages of Type 1 Diabetes as proposed by the Juvenile Diabetes Re...Figure 6.10 Lifetime risk of developing Type 1 diabetes (left axis) compared...
7 Chapter 7Figure 7.1 The relationship between body mass index (BMI) and risk of type 2...Figure 7.2 Rising obesity rates in the USA (2008‐2015) based on self‐reporte...Figure 7.3 The rising Prevalence of type 2 diabetes parallels the rising inc...Figure 7.4 Age‐adjusted prevalence rates of type 2 diabetes in different geo...Figure 7.5 The IDF atlas also monitors the rising prevalence of prediabetes ...Figure 7.6 A league table of countries showing widely different prevalence r...Figure 7.7 Deaths attributable to diabetes are highest in low‐ and middle‐in...Figure 7.8 The relationship between HbA1c and the incidence of cardiovascula...Figure 7.9 Varying prevalence rates of type 2 diabetes by ethnicity/region a...Figure 7.10 Weight gain is a particularly strong driver of type 2 diabetes r...Figure 7.11 Insulin resistance (as assessed by glucose infusion rate (GIR) t...Figure 7.12 Age‐adjusted risk of type 2 diabetes among 5990 men. The figure ...Figure 7.13 The natural history of type 2 diabetes development often begins ...Figure 7.14 Mechanisms of insulin resistance in type 2 diabetes.Figure 7.15 The ‘thrifty phenotype’ hypothesis.Figure 7.16 β‐cell function as measured by the homeostasis model assessment ...Figure 7.17 Plasma concentrations of glucose and insulin in subjects with ty...Figure 7.18 The stages of glucose tolerance and associated β cell function a...Figure 7.19 Pathogenesis of type 2 diabetes. Both genetic and environmental ...
8 Chapter 8Figure 8.1 Rabson–Mendenhall syndrome in a 12‐year‐old boy, showing growth r...Figure 8.2 Acanthosis nigricans on the nape of the neck of a 26–year–old wom...Figure 8.3 Optic atrophy (note white optic disc) in a patient with Wolfram’s...Figure 8.4 Acute pancreatitis. CT scan of the abdomen, showing marked oedema...Figure 8.5 Pancreatic calculi, showing characteristic patterns in alcoholic ...Figure 8.6 A patient with glucagonoma, showing characteristic necrolytic mig...
9 Chapter 9Figure 9.1 Correlation in patients with type 1 diabetes between blood glucos...Figure 9.2 Example of combined blood glucose and blood ketone meter together...Figure 9.3 Urine ketone testing strips. NOTE these detect urinary acetoaceta...Figure 9.4 Continuous Glucose Sensor and Transmitter and associated Meter. T...Figure 9.5 Flash (intermittent) glucose monitoring system. Sensor and transm...Figure 9.6 Clarke error grid showing the density of paired FreeStyle Navigat...Figure 9.7 Computer download of 14 days’ data from continuous glucose monito...Figure 9.8 Computer download of 14 days’ data from flash monitoring device i...Figure 9.9 CGM Target Ranges for different groups of patients as agreed by i...
10 Chapter 10Figure 10.1 Normal plasma glucose and insulin profiles. Shaded areas represe...Figure 10.2 Basal‐bolus insulin regimen.Figure 10.3 Schematic amino acid sequence of native human insulin; porcine a...Figure 10.4 What happens in the subcutaneous tissue after subcutaneous injec...Figure 10.5 Suitable sites for subcutaneous insulin injection.Figure 10.6 Suprapubiclipohypertrophy at habitually used insulin injection s...Figure 10.7 Example of disassembled insulin pen. Insulin dose is selected us...Figure 10.8 Insulin infusion pump, fillable insulin cartridge (left), subcut...Figure 10.9 Insulin infusion pump and glucose sensor fitted on a patient wit...Figure 10.10 Meta regression analysis of mean effect size of insulin pump th...
11 Chapter 11FIGURE 11.1 Management of type 2 diabetes: the initial measures.FIGURE 11.2 Change in weight during energy restriction is similar with high ...FIGURE 11.3 Effect of Orlistat in obese patients with type 2 diabetic.Figure 11.4 Effect of Mysimba in obese patients with type 2 diabetes.FIGURE 11.5 Practical food recommendations for patients with diabetes.FIGURE 11.6 The progressive rise in median HbA1c with time in the convention...Figure 11.7 Pharmacologic Approaches to Glycemic Treatment in type 2 diabete...Figure 11.8 Approach to individualising Hba1c target in people with type 2....Figure 11.9 Mechanism by which glucose and sulfonylureas stimulate insulin s...Figure 11.10 Mechanism of action of TZDs. These agents stimulate the peroxis...Figure 11.11 Mechanism of action of SGLT‐ 2 inhibitor.Figure 11.12 LEADER STUDY. (available free online from https://tracs.unc.edu...Figure 11.13 Summary of glucose lowering therapy in type 2 diabetes.Figure 11.14 (a) Different types of common bariatric surgery procedures (b) t...
12 Chapter 12Figure 12.1 (a) Age distribution of 746 episodes of diabetic ketacidosis (ex...Figure 12.2 Mechanisms of ketacidosis. NEFA, non‐esterified fatty acids.Figure 12.3 Flowchart for the investigation of diabetic ketoacidosis.Figure 12.4 Guide to the initial treatment of diabetic ketacidosis in adults...
13 Chapter 13Figure 13.1 Some consequences of hypoglycaemia in diabetes.Figure 13.2 Major components of the counter‐regulatory and sympathetic nervo...Figure 13.3 Glycemic thresholds for secretion of counterregulatory hormones ...Figure 13.4 In the Diabetes Control and Complications Trial (DCCT, a landmar...Figure 13.5 Risks of severe hypoglycaemia associated with different diabetes...Figure 13.6 Glycaemic thresholds for the release of epinephrine and activati...Figure 13.7 Impairment of counter‐regulatory responses in type 1 diabetes. (...Figure 13.8 The vicious circle of repeated hypoglycaemia.Figure 13.9 Proposed mechanism of linking hypoglycaemia and arrhythmias in p...Figure 13.10 Algorithm for treating acute hypoglycaemia in patients with dia...
14 Chapter 14Figure 14.1 Schematic showing interaction of haemodynamic and cellular facto...Figure 14.2 Prevalence of diabetic neuropathy as a function of duration of d...Figure 14.3 Progression of proliferative retinopathy is related to glycated ...Figure 14.4 Effect of intensive treatment on the onset of retinopathy. Cumul...Figure 14.5 Risk of retinopathy progression and mean glycated haemoglobin in...Figure 14.6 Effect of intensive blood glucose control on microvascular compl...Figure 14.7 The relationship between glycated haemoglobin percentage and car...Figure 14.8 Kaplan–Meier plots of proportions of patients who developed micr...Figure 14.9 Cumulative incidence of a three‐step change in ETDRS retinopathy...Figure 14.10 The polyol pathway. (Left) The pathway is normally inactive, bu...Figure 14.11 Formation of reversible, early, non‐enzymatic glycation product...Figure 14.12 Possible mechanisms of cell damage by interactions of advanced ...Figure 14.13 Activation of protein kinase C by de novo synthesis of diacylgl...Figure 14.14 The hexosamine pathway. Glucosamine‐6‐phosphate, generated from...Figure 14.15 Superoxide links glucose