With the advent of the knowledge-based assessment for specialist trainees in diabetes and endocrinology there is a need for an easy-to-read, comprehensive and up-to-date textbook on diabetes. While searching for this mythical text, I recently picked up a copy of ABC of Diabetes, 5th edition (2003) by Peter Watkins that was, at the time, the most recent installment in a franchise originally based on a series of review articles published in the British Medical Journal. Despite initially appearing like a promising candidate, closer inspection revealed that the 5th edition was a little dated and I decided against parting with my hard-earned cash. But the 5th edition has recently been given a complete overhaul by Tim Holt and Sudhesh Kumar – apparently basing the content on the University of Warwick’s Medical School teaching programme – and is now available as ABC of Diabetes, 6th edition (2010).
The new edition has an emphasis on the promotion of patient-centred care and the management of diabetes in primary care. New chapters cover the organisation of diabetes care in general practice, early detection and prevention and self-management of diabetes. Other additions include advice for the healthcare professional on supporting people living with diabetes, as well as psychological issues related to diabetes. Gone are the chapters on practical problems in diabetes, the person with unstable type 1 diabetes and the three neuropathy chapters have been amalgamated into one.
The content is as up-to-date as possible. Recent recommendations on the use of HbA1c for the diagnosis of diabetes and the new International Federation of Clinical Chemistry HbA1c units – mmol/mol – are both included. The most recently updated NICE clinical guideline (2009) on the use of antidiabetes agents in type 2 diabetes are also summarised. Where available, evidence-based recommendations are discussed. Newer technologies (e.g. continuous glucose monitoring) and emerging therapies (e.g. the incretin mimetic-based agents and pramlintide) are adequately covered. Islet cell transplantation is mentioned briefly, while bariatric surgery is not discussed at all.
With the increased focus on patient-centred care in general practice, the importance of structured patient education and self-efficacy is well highlighted. The utility of diabetes registers and the pros and cons of the Quality and Outcomes Framework are also covered. Despite the emphasis on management in the community, a chapter still remains on the management of hyperglycaemic emergencies and people with diabetes in hospital, although I am sure it is a simple error that a diabetic ketoacidosis protocol is referred to when discussing management of people with type 2 diabetes undergoing surgery!
The presentation and layout has been significantly improved from the previous edition. As in the 5th edition, topics are presented in short, manageable chapters, but page space is used more effectively – with two columns of text enhanced by tables, diagrams and summary boxes. Each chapter begins with an overview box and ends with a helpful list of further reading – both new features.
With the majority of diabetes care now taking place in the community this new edition has been targeted at primary care practitioners and nurses, as well as medical students. As such, the authors are to be commended for an excellent, up-to-date and readable overview of most aspects relating to diabetes care. However, in aiming at this market some of the detail covered in earlier editions has been lost. For example, there was little mention of mononeuropathies, which – although rare – were previously afforded their own chapter. Likewise, in the section on hypoglycaemia, contributing pathologies (e.g. hypoadrenalism) were not considered. The dermatological manifestations (e.g. cheiroarthropathy) of diabetes are also not covered, and the section on diabetic renal disease has been curtailed.
The 6th edition of ABC of Diabetes has been well written and is an attractively presented and up-to-date book that fills an important niche in the reference market for primary care practitioners, specialist nurses, medical students and junior hospital doctors. My own search for the elusive diabetes text aimed at specialist trainees continues.
ABC of Diabetes, 6th edition
Authors Tim Holt and Sudhesh Kumar
Publisher Wiley–Blackwell, Chichester
Date 2010
ISBN 978-1-4051-7784-9
Paperback: 112 pages
Price £25.99
Attempts to achieve remission, or at least a substantial improvement in glycaemic control, should be the initial focus at type 2 diabetes diagnosis.
9 May 2024