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The Quality Chasm: Diabetes Mellitus
Over the past several decades there has been much interest in refining the definition of quality of health care, moving the definition beyond an individual’s perception of quality. A pivotal article by Avedis Donabedian in 1988 introduced the concept that…
Disparities in Diabetes Risk, Cardiovascular Consequences, and Care: Women, Ethnic Minorities, and the Elderly
Disparities in Diabetes Risk Type 2 diabetes is a growing problem that closely parallels the obesity epidemic and places a severe burden on health care resources in the United States (see also Chapter 1 ). Diabetes currently affects 25.8 million…
Cardiovascular Autonomic Neuropathy
Cardiovascular autonomic neuropathy (CAN) is defined as the impairment of autonomic control of the cardiovascular system in the setting of diabetes after exclusion of other causes. CAN is usually detected at a subclinical stage by means of several cardiovascular autonomic…
Cerebrovascular Disease in Patients with Diabetes
Stroke—in particular the ischemic subtype—is one of the major vascular manifestations of diabetes, together with coronary heart disease (CHD), peripheral arterial occlusive disease, and diabetic retinopathy. The relationship between hyperglycemia and stroke is bidirectional: on the one hand, diabetic patients…
Peripheral Artery Disease in Diabetes
Peripheral artery disease (PAD) is generally defined as partial or complete obstruction of one or more arteries affecting the lower extremities and is usually caused by atherosclerosis. Symptoms of PAD include pain with ambulation, resulting from an inadequate blood supply…
Treatment of Heart Failure in Diabetes : Systolic Dysfunction, Diastolic Dysfunction, and Post-Acute Coronary Syndrome
Diabetes and heart failure commonly occur together in a patient. Up to a quarter of patients with diabetes also have heart failure, and approximately a third of patients with heart failure also have diabetes. In this chapter we review the…
Prevention of Heart Failure in Patients with Diabetes
Chronic heart failure (HF) is increasing in prevalence, affecting over 5 million patients in the United States, and it is estimated that more than 20 million individuals have HF globally. , An ageing population, improved survival after myocardial infarction (MI),…
Diabetic Cardiomyopathy: Mediators and Mechanisms
Acknowledgments This work was supported by grants from the NIH (HL-075173, JAH; HL-080144, JAH; HL-090842, JAH), AHA (0640084 N, JAH; 12POST9030041, PKB; 10POST4320009, ZVW), ADA mentor-based postdoctoral fellowship (7-08-MN-21-ADA, JAH and PKB), the AHA-Jon Holden DeHaan Foundation (0970518 N, JAH).…
Epidemiology of Heart Failure in Diabetes
Multiple epidemiologic studies have demonstrated that diabetes mellitus (DM) is associated with increased risk for the development of heart failure (HF). The mechanisms contributing to this greater risk are likely multifactorial and include the often accelerated comorbid conditions such as…