Rajeev Chawla MD FRCP (Edin.) UK
Senior Consultant Diabetologist Director, North Delhi Diabetes Center,
New Delhi, India
Foreword
SV Madhu
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Manual of Diabetes Care / Rajeev Chawla
First Edition: 2014
9789351520047
Printed at
5Dedicated to
My Parents, as their blessings have made this book possible My wife Dr Rachna Chawla for her unconditional and endless patience and spirit behind me and
My Children Aastha and Aastik for their encouragement and understanding; forgiving me for having stolen precious time which was their due
7Foreword
SV Madhu md dm
Professor and Head
Department of Medicine and Division of Endocrinology and Metabolism
University College of Medical Sciences and GTB Hospital, Delhi, India.
The burden of diabetes mellitus has been increasing over the last few decades and managing this disease effectively is a major challenge for all physicians and diabetologists in our country. Diabetes related illness accounts for a significant number of hospitalized patients and is the underlying factor in several patients admitted with cardiovascular or kidney disease. The practicing physician must be empowered to meet this challenge of recognizing and managing diabetes and its complications. An easy to read and concise manual of diabetes for all physicians is the need of the hour.
I must congratulate Dr Rajeev Chawla for responding to the current scenario of diabetes in our country and writing this impressive manual. The book will be very useful to physicians as well as students and would serve as a ready reference for management of diabetes. The book is written in simple language that is easily understood and has tables and charts for quick reference and should be liked by one and all. Importantly, this will be an invaluable contribution that seeks to enhance knowledge and skills that are required to confidently manage diabetes.
9Preface
Rising prevalence of diabetes mellitus, especially type 2 diabetes in urban population, is a concern to the entire medical fraternity. India has the dubious distinction of being the world capital of diabetes. The countries with the largest number of people with diabetes are and will also be in the year 2025, India, China, and the USA.
Diabetes is common, has existed since antiquity, and is becoming more common with ever changing life style and other environmental factors, apart from genetic factors, and a host of other influences.
With the increasing prevalence of diabetes, especially in the middle age group population, who are commonly affected in India, the chances of developing micro- and macrovascular complications are very high and it is going to bring enormous burden on the family, society, and the health care providers involved in the management of diabetes.
Hyperglycemia is a well known risk factor for vascular complications both microvascular and macrovascular in diabetes. However unlike the clear and linear relationship of hyperglycemia with microvascular disease, relationship with macrovascular disease and mortality is clouded by many confounding risk factors like obesity, hypertension, dyslipidemia and hyperinsulinemia.
Unfortunately, many type 2 diabetics present with various micro- and macrovascular complications right at the time of diagnosis. This deprives these patients from primary prevention of microvascular complications. Hence, intervention is likely to be more effective in primary than in secondary prevention.
This book is designed to offer a balanced overview of not only the pathophysiology but also the management of diabetes for both beginners and those seeking to research in detail. Every attempt is made to highlight keynotes and Fast Facts in each chapter to break the monotony of text.
This book, hence is a humble effort to sensitize all physicians involved in management of diabetic patients to pick up these simple tips so as to enable them to rationalize their practice more judiciously.
Rajeev Chawla
11Acknowledgments
At the outset, I would express my sincere gratitude to Mr JP Vij, CEO, Jaypee Brothers Medical Publishers and his publication team for putting their tireless efforts to make this project possible.
I must express my sincere gratitude to Dr Neeraj Choudhary, Senior Medical Editor who actually prompted me to write this book and served as the catalyst through out. He provided me the editorial support and helped me to shape my writings in to a concrete book; without which this book would not have seen the light of the day. He has put enormous effort at every stage of the execution of this book. His commitment and dedication to this endeavor is praiseworthy.
I am also thankful to Mr Manoj Kumar for his technical support in beautifully shaping this book.
I am also indebted to my daughter Aastha Chawla for helping me write 5 chapters on basics and pathophysiology of type 1- and 2 diabetes. But for her encouragement my long cherished desire of writing a book would not have been a reality. I thank my son Aastik Chawla from core of my heat who has throughout helped me in procuring many important images from literature and also drawing others in simple format.