More than 20 million Americans have diabetes, which can lead to blindness, kidney failure, and amputations. This book from the world-renowned Joslin's Diabetes Center in Boston is directed to primary care providers - internists, family practitioners, nurse practitioners, physician assistants, dieticians, counsellors - who manage diabetes in their patients most every day. The authors discuss the pathogenesis of diabetes and its complications, along with the most current thinking and guidelines about diagnosis, prescription, monitoring, nutrition, exercise, medications, insulin, patient education, and many other topics. All chapters have been peer-reviewed.Chapter 1 Diabetes: Definition Pathophysiology Introduction Normal Glucose Homeostasis The Pancreas Insulin Production The Pathophysiology of Diabetes Types of Diabetes Epidemilogy of Diabetes Chapter 2 The Approach to Diagnose and Treatment of Diabetes Mellitus Diagnosing Diabetes Symptoms of Diabetes Standards of Care Treating Diabetes Aggressively Chapter 3 Monitoring Diabetes The Importance of Self-Monitoring of Blood Glucose and Glycohemoglobin Measurements Chapter 4 Adipose tissue as an Endocrine Gland: A Possible Key in Understanding the Metabolic Mysteries Understanding the Endocrine Role of Adipose Tissue Chapter 5 Medical Nutrition Therapy and Diabetes Nutrition Therapy Is Not New Chapter 6 Physical Activity for Fitness Effect of Physical Activity on People without Diabetes Chapter 7 Type 2 Diabetes: Multiple Treatments for a Multicomponent Condition Insulin Resistance Chapter 8 Pharmacotherapy for Type 2 Diabetes: Medications to Match the Pathophysiology Options for Therapy The Classes of Antidiabetes Medicatioins Chapter 9 Using Insulin To Treat Diabetes-General Principles Endogenous Insulin Insulin for Exogenous Therapy Chapter 10 Designing a Conventional Insulin Treatment Program Indications for Inslin Therapy Goals of Insulin Treatment Chapter 11 Physiologic Insulin Treatment Programs What Is Physiologic Insulin Therapy Why Physiologic therapy Makes Sense Chapter 12 Educating the Patient The Emotional Component Evaluation, Negotiation and Goal Setting Chapter 13 Acute Complications Diabetic Ketoacidosis(DKA) Hyperosmolar Hyperglycemic State (HHS) Chapter 15 Macrovascular Complications Hypertension Dyslipidemia Chapter 16 Diabetic Neuopathy Classification Evaluation of Diabetic Peripheral Neuropathy Chapter 17 The Foot: Clinical Care and Problem Prevention Risk Factors for Foot Wounds The Foot Examination Chapter 18 Surgical Management of the Patient with Diabetes General Approach to Surgical Management Preoperative Evaluation Chapter 19 Gender-Specific Issues Women's Health Issues Male Sexual Dysfunction Chapter 20 Pregnancy and Diabetes Metabolic Changes during Pregnancy Gestational Diabetes(GDM) Pregestational Diabetes - Preparing Women with Type 1 or Type 2 Diabetes for Pregnancy Chapter 21 Treatmenr of Children with Diabetes Epidemilogy Team Approach to Patient Care Goals of Treatment Chapter 22 Diabetes in the Older Adult Treatment Goals Screening for and Diagnosing Diabetes Chapter 23 Psychological Issues in the Treatment of Diabetes Diagnosis and Ongoing Support Major Psychological Obstacles to Diabetes Care Chapter 24 Diabetes in Culturally Diverse Populatiions: Facing the Challenge in Clinical Practice Type 2 Diabetes in Culturally Diverse Populations:Genes or Culture? Biological Factors