Book review: Type 2 Diabetes in Adults of All Ages

This is the second edition of the popular book written by the well-respected authors Dr Charles Fox and Dr Anne Kilvert for adults with type 2 diabetes. It is a big book – in more ways than one.

Physically it is a large tome, but the subtitle states “Become your own Diabetes Expert” and that is quite a big task. Indeed, there is a lot of information contained within the covers that I am willing to bet many health professionals do not know. Did you know that the kidney can produce glucose in the same way as the liver? See page 27 if not!

With this in mind, I would be delighted if the people with type 2 diabetes that I see were to read this and come armed with questions. Type 2 diabetes is becoming more complex. This book helps dispel myths.

The lengthy contents pages allow easy navigation through the book and many salient points are repeated in relevant chapters so they won’t be missed. As the authors point out, it is not a book to be read cover to cover in one sitting but for gleaning knowledge in meaningful chunks. The text speaks directly to the reader and feels inclusive.

There is also plenty of scientific content for those that want it. It puts a positive slant on the value of self-care. In places it is also highly optimistic about the level of service a person with type 2 diabetes may expect in their own neighbourhood. Health professionals reading it, take note.

As with any publication, it is impossible to keep up with all developments, and some of the content is now a little out of date. In many parts, HbA_1c is quoted as a percentage, which is fine for those of us who have worked in diabetes for some time, or for people with diabetes who have lived with it for many years, but the newer International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) results are not always given. I feel that the target range for HbA_1c itself could be better explained, with the “legacy” effect and need for early, tight glycaemic control being key. Strangely, although maybe this is with some non-UK readers in mind, “mg/dL” units are frequently included in relation to self-monitoring.

I am pleased to see that the authors have included some excellent profiles relating to insulin and blood glucose monitoring, but I’m not so sure on the “sick day rules” for titration of insulin in type 2 diabetes (page 161). The authors suggest that high blood glucose levels can be corrected using 1 unit of insulin to reduce the blood glucose by 3 mmol/L. Surely doses need to take account of how many units are taken normally? However, overall there is some salient advice on what to do when unwell, which will prove valuable.

Several other areas are addressed, including type 2 diabetes in younger people, pregnancy, driving, alcohol and a very small section on Ramadan. There is also a useful chapter on support and information. Now, such lists could always be added to, but there are some notable exceptions. NICE is there, but not SIGN. The American Diabetes Association is there but not the European Association for the Study of Diabetes. Why?

Overall, this is an excellent book for people with type 2 diabetes and their families or carers. It is written in such a way that it will appeal to those who want a basic understanding or require more advanced scientific knowledge.

Authors: Charles Fox, Anne Kilvert
Publisher: Class Publishing (London)
Publication year: 2013
Format: Paperback (320 pages)
ISBN 13: 9781859593745
Price: £24.99