The title of each chapter is in the form of a question—emphasizing, we
believe, the considerable doubts and uncertainty that pervade clinical diabetology,
despite significant scientific advances in our understanding of the
disease. It is interesting that even how to diagnose diabetes remains controversial,
and the first chapters discuss such issues, including the problems of
impaired glucose tolerance (IGT) and gestational diabetes. We have, however,
given the most space to management issues, both in type 1 and type 2
diabetes. A strong case for considering surgical options in obesity is presented.
A view of oral agent usage is given which is contrary to much routine
clinical practice, but which is, the authors argue, based on available evidence.
Other hot topics covered in the management sections include hypoglycaemia
unawareness, insulin regimens, brittle diabetes, glycaemic control in adolescence,
and the evidence base for foot ulcer management. Surgeons from both
sides of the Atlantic debate whether sole pancreatic transplantation (without
kidney) can be justified in certain sub-groups of type 1 diabetes. In the last