Type 2 Diabetes, Pre-Diabetes, and the Metabolic Syndrome
Diagnosing and managing type 2 diabetes presents an enormous challenge to the primary care provider confronted with multiple emerging scientific insights, therapeutic strategies and risk reduction principles. In Type 2 Diabetes, Pre-Diabetes, and the Meta
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Current Clinical Practice Neil S. Skolnik, Series Editor
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Type 2 diabetes, pre-diabetes, and the metabolic syndrome Second Edition by
ronald a. codario, md, facp University of Pennsylvania Health System Clinical Instructor in Medicine Thomas Jefferson University Hospital Philadelphia, Pennsylvania USA
Ronald A. Codario, MD, FACP Clinical Instructor in Medicine Thomas Jefferson University Hospital 111 South 11th Street Philadelphia, PA 19107
Ronald A. Codario, MD, FACP Diplomate American Board of Internal Medicine Diplomate American Board of Clinical Lipidology Diplomate American Board of Vascular Medicine Clinical Hypertension Specialist (American Society of Hypertension Certified) Vascular Ultrasound (American Registry of Diagnostic Sonography Certified)
ISBN 978-1-60327-440-1 e-ISBN 978-1-60327-441-8 DOI 10.1007/978-1-60327-441-8 Springer New York Dordrecht Heidelberg London © Springer Science+Business Media, LLC 2011 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Humana Press, c/o Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. Printed on acid-free paper Humana Press is part of Springer Science+Business Media (www.springer.com)
Dedication This book is dedicated to Rocco Fiorentino, a truly courageous young man and role model for determination, who lost his sight shortly after birth, to his parents Tina and Rocco who have established The Little Rock Foundation bringing joy to the visually impaired and deprived, and to all those who have lost their vision due to diabetes. Hopefully this book will inspire further research and investigation to prevent vision loss and enable many to appreciate this precious gift. Special appreciation and acknowledgements: To my wife, Celeste and my four children, Ron, Jr., Maria, Christiana and Joseph for their words of encouragement and inspiration. A special thank you to Noreen and Bill Conroy for transcribing the revisions of this text from my dictation.
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Preface Diabetes has become an ever-increasing problem throughout the world with an estimated 300 million people worldwide to be diagnosed with the disease in the next 10 years and 370 million by 2030. Currently, 240 million people in the world (a prevalence of 5.9%) and 20.8 million people in the United States are currently afflicted (17.2 million with type-2 diabetes), with an additional 5.2 million undiagnosed, and
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