By Edith W.M.T. ter Braak MD, PhD, Aline M.E. Stades (auth.), Geert Jan Biessels, Jose A. Luchsinger (eds.)
Diabetes, fairly sort 2, has develop into progressively more universal all over the world. as a result, the influence of diabetes at the mind has accomplished huge, immense public wellbeing and fitness significance. A surge in pre-clinical and scientific learn on issues starting from administration of hyperglycemia in acute stroke to disturbances in insulin signaling in Alzheimer's sickness has resulted in enormous development within the box. Written via a panel of foreign specialists, Diabetes and the Brain offers extensive reports at the cerebral problems of diabetes, and gives introductory chapters on present insights at the pathophysiology and scientific administration of diabetes, in addition to neuropsychological overview and dementia. This correct and simply obtainable e-book explains the cerebral problems of diabetes, with an replace on diabetes for neurologists, psychiatrists, and psychological overall healthiness prone and researchers in general,and on stroke and dementia for these occupied with study and medical perform in diabetes.
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Additional resources for Diabetes and the Brain
Molitch ME, DeFronzo RA, Franz MJ, et al. Nephropathy in diabetes. Diabetes Care 2004; 27(Suppl 1):S79–S83. 30. Freedman BI, Bostrom M, Daeihagh P, Bowden DW. Genetic Factors in Diabetic Nephropathy. Clin J Am Soc Nephrol 2007; 2(6):1306–1316. 31. The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulindependent diabetes mellitus. N Engl J Med 1993; 329(14):977–986. 32. Freedman BI, Bostrom M, Daeihagh P, Bowden DW.
Freedman BI, Bostrom M, Daeihagh P, Bowden DW. Genetic Factors in Diabetic Nephropathy. Clin J Am Soc Nephrol 2007; 2(6):1306–1316. 31. The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulindependent diabetes mellitus. N Engl J Med 1993; 329(14):977–986. 32. Freedman BI, Bostrom M, Daeihagh P, Bowden DW. Genetic Factors in Diabetic Nephropathy. Clin J Am Soc Nephrol 2007; 2(6):1306–1316.
The dose of long- or intermediate-acting insulin is adjusted according to the fasting glucose concentration, but is limited by nocturnal hypoglycemia. In contrast, some patients show high fasting glucose concentration, which may be attributed to the so-called dawn phenomenon: the physiological early morning cortisol peak results in increased insulin resistance. Another pitfall Table 8 Typical algorithm for insulin dosage adjustment aiming at near normal glycemia Blood Glucose (BG, mmol/L) target level Preprandial dose of rapid/short acting insulin Fasting BG 4–6 Preprandial BG 4–6 Postprandial BG (2 hours after) BG at bedtime 5–7 7–9 Bedtime dose of intermediate/long acting insulin Increase if BG > 6 (unless nocturnal hypoglycemia) Increase dose before previous meal if BG > 6 Increase if BG > 7 Small extra bolus if BG > 9, review evening snacks 24 ter Braak and Stades is a rebound high fasting glucose after undetected nocturnal hypoglycemia, especially in MDI.