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Clinical Challenges in Diabetes by Anthony H. Barnett

By Anthony H. Barnett

Proposing a brand new method of healing decision-making and offering solutions to questions that busy clinicians face each day. In a delicately selected sequence of discussions, the contributors,internationally acknowledged experts of their fields, provide their very own concepts for handling difficult difficulties in treating diabetes.

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Saudi Med J 2008; 29:1414–1418. Agha A, Bashir K, Anwar E. Use of losartan in reducing microalbuminuria in normotensive patients with type-2 diabetes mellitus. Nepal Med Coll J 2007; 9:79–83. Kubba S, Agarwal SK, Prakash A, Puri V, Babbar R, Anuradha S. Effect of losartan on albuminuria, peripheral and autonomic neuropathy in normotensive microalbuminuric type 2 diabetics. Neurol India 2003; 51:355–358. Patel A, Chalmers J, Poulter N. ADVANCE: action in diabetes and vascular disease. J Hum Hypertens 2005; 19:S27–S32.

Studies in patients with varying stages of nephropathy have shown that protein restriction helps slow the progression of albuminuria; GFR decline; and occurrence of ESRD [100–103]. Protein restriction should be considered particularly in patients whose nephropathy seems to be progressing despite optimal glucose and blood pressure control with the use of ACE-Is or ARBs [103]. 8 g/ kg per day [2]. Smoking cessation Development of macroalbuminuria decreased in patients with type 2 DM who were former smokers or who had never smoked compared with patients with type 2 DM who were active smokers.

Fetal origins of adult disease: strength of effects and biological basis. Int J Epidemiol 2002; 31:1235–1239. Shiell AW, Campbell DM, Hall MH, Barker DJ. Diet in late pregnancy and glucose-insulin metabolism of the offspring 40 years later. Br J Obstet Gynaecol 2000; 107:890–895. Scott DA, Loveman E, McIntyre L, Waugh N. Screening for gestational diabetes: a systematic review and economic evaluation. Health Technol Assess (Rockv) 2002; 6:1–161. Crowther CA, Hiller JE, Moss JR, McPhee AJ, Jeffries WS, Robinson JS.

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