DIABETES HEAD TO TOE Note to Reader. This book is not meant to substitute for medical care of people with diabetes, and treatment should not be based solely on its contents. Instead, treatment must be developed in a dialogue between the individual and his or her physician. Our book has been written to help with that dialogue. Drug dosage: The authors and publisher have made reasonable efforts to determine that the selection of drugs discussed in this text conform to the practices of the general medical community. In view of ongoing research, changes in governmental regulation, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert of each drug for any change in indications and dosage and for warnings and precautions. This is particularly important when the recommended agent is a new and/or an infrequently used drug. © 2018 Johns Hopkins University Press All rights reserved. Published 2018 Printed in Canada on acid-free paper 9 8 7 6 5 4 3 2 1 Johns Hopkins University Press 2715 North Charles Street Baltimore, Maryland 21218-4363 www.press.jhu.edu Library of Congress Cataloging-in-Publication Data Names: Kalyani, Rita Rastogi, author. Title: Diabetes head to toe : everything you need to know about diagnosis, treatment, and living with diabetes / Rita R. Kalyani, MD, MHS, Mark D. Corriere, MD, Thomas W. Donner, MD, Michael W. Quartuccio, MD. Description: Baltimore : Johns Hopkins University Press, 2018. | Series: A Johns Hopkins Press health book | Includes bibliographical references and index. Identifiers: LCCN 2018000282 | ISBN 9781421426471 (hardcover : alk. paper) | ISBN 1421426471 (hardcover : alk. paper) | ISBN 9781421426488 (paperback : alk. paper) | ISBN 142142648X (paperback : alk. paper) | ISBN 9781421426495 (electronic) | ISBN 1421426498 (electronic) Subjects: LCSH: Diabetes—Diagnosis—Popular works. | Diabetes—Treatment—Popular works. Classification: LCC RA645.D5 K35 2018 | DDC 616.4/62—dc23 LC record available at https://lccn.loc.gov/2018000282 A catalog record for this book is available from the British Library. Illustrations by Jennifer E. Fairman, MA, CMI, FAMI, and Tim Phelps, MS, FAMI © 2018, Johns Hopkins University, Art as Applied to Medicine Special discounts are available for bulk purchases of this book. For more information, please contact Special Sales at 410-516-6936 or [email protected]. Johns Hopkins University Press uses environmentally friendly book materials, including recycled text paper that is composed of at least 30 percent post-consumer waste, whenever possible. To the millions of people living with diabetes worldwide whose inspiring stories and determination give us hope. To my husband, Sachin, and my children, Shaan and Sonia, who are my constant source of wisdom, joy, and pride, and to my parents for always seeing what is possible. —RITA R. KALYANI To my wife, Suzy, and children—Dominic, Molly, Sam, and Tommy—for their constant support and encouragement of my career. To my dad, who was the first person to pique my interest in diabetes, and the scores of patients I have been honored to treat who have grown my interest in this field. —MARK D. CORRIERE To my wife, Danielle, and my children—Gabriel, Bridget, and Celia—who so enrich my life. And to my patients who have had the courage and persistence to take on this challenging disease and from whom I have learned so much. —Thomas W. Donner To my wife, Katelyn, and son, Benjamin, who have been so supportive of my career choice. To my parents, who constantly pushed me to achieve my goals. And to all my patients, who inspire me to work harder every day. —MICHAEL W. QUARTUCCIO CONTENTS Preface Acknowledgments 1 A Quick Overview of Diabetes Introduction to Diabetes The Global Burden of Diabetes Landmark Studies in Diabetes Care 2 Diagnosis, Screening, and Types of Diabetes Diagnosing Diabetes Risk Factors for Type 1 Diabetes Risk Factors for Type 2 Diabetes Differences between Type 1 and Type 2 Diabetes Testing for Prediabetes Latent Autoimmune Diabetes in Adults Maturity-Onset Diabetes of the Young Cystic Fibrosis–Related Diabetes Diabetes after Pancreatic Surgery Steroid-Induced Diabetes 3 General Aspects of Diabetes Monitoring Blood Glucose Levels Hyperglycemic (High Blood Glucose) Emergencies Hypoglycemia (Low Blood Glucose) Routine Care and Vaccinations Social and Legal Issues 4 Diabetes in Special Populations Children and Type 2 Diabetes Older Adults and Diabetes Diabetes among People Living with HIV Race and Ethnic Disparities in Diabetes Diabetes in American Indians Diabetes Care during Times of Religious Fasting Diabetes Care during a Hospital Stay 5 Lifestyle and Behavioral Changes in Diabetes Diabetes Education Dietary Therapy Exercise 6 Obesity and Diabetes Managing Obesity Bariatric Surgery 7 Diabetes Complications and Other Conditions Common in Diabetes The Brain The Eyes The Ears The Mouth The Thyroid The Heart and Related Conditions (Hypertension and Dyslipidemia) The Circulation The Lungs and Breathing The Stomach, Gut, Liver, and Pancreas The Kidneys The Bladder The Nerves The Feet The Muscle, Skin, and Bone Cancer and Diabetes Anemia, Infections, and the Immune System Men’s Health Women’s Health 8 An Overview of Treatments for Type 1 and Type 2 Diabetes Type 1 Diabetes: Insulin Treatment Type 2 Diabetes: Non-insulin Treatment Type 2 Diabetes: Insulin Treatment 9 Medications Commonly Used to Treat Diabetes Pills and Non-insulin Injectable Medications Types of Insulin Complementary and Alternative Treatments for Diabetes 10 Medications for Conditions Related to Cardiovascular Disease Medications for High Blood Pressure Medications for Cholesterol Abnormalities Medications to Prevent Cardiovascular Disease 11 Diabetes Technology and Equipment Glucose Meters Continuous Glucose Monitors Using an Insulin Pump to Manage Diabetes Types of Insulin Pump Devices 12 Cutting-Edge and Future Treatments for Diabetes Pancreas and Islet Transplantation The Artificial Pancreas Appendix. Diabetes Medications Currently Available in the United States Index About the Author PREFACE We wrote this book for you. Chances are that you either know someone who has diabetes, are at risk of developing diabetes, or have diabetes yourself. The number of people with diabetes continues to climb dramatically, and the face of diabetes worldwide is changing rapidly. No two people with diabetes are alike. There are various types of diabetes, and some people are more likely to develop diabetes than others. An ever-increasing number of medications are available to treat this disease. While some people need insulin right away, others do not. The disease can affect many different organs in the body—from head to toe and everywhere in between. Not everyone with diabetes develops the same complications or medical conditions. The information in these pages represents the best of what we know to date. We are health professionals who have not only spent many years specializing in the comprehensive care of people with diabetes but who have also established clinical guidelines for how all health professionals should care for people with diabetes. We treat people with diabetes both in the community and in university- based centers. We are hopeful that patients, family members, teachers, physicians, nurses, dietitians, pharmacists, specialists, and anyone else who cares about the health of a person with diabetes will benefit from this book. Diabetes is a chronic illness that relies heavily on a person’s ability to self- manage his or her disease. Yet during a routine clinic visit, health care providers may be limited (for a variety of reasons) in their ability to relay the critical information that people with diabetes need to optimally manage their disease at home. Many complications of diabetes are preventable. By reading this book, we hope that people with diabetes will be better equipped to recognize early warning signs so that the appropriate measures can be taken. This will help to avoid difficulties in the future. The goal is attainable, but it starts with you. In this book, we provide up-to-date information written in simple, easy-to- grasp sections. We emphasize the key facts that we would want any person who has diabetes (or who is interested in diabetes) to know—as if we were sitting face-to-face with you right now. The more than 130 topics in this book cover the different ways in which diabetes can affect a person from a personal, family, societal, and legal perspective. This book goes beyond describing the “traditional” small blood vessel complications (eye disease, kidney disease, and