Articles: Vol 34.6 July / August 2017

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‘Type 3’ diabetes: a brain insulin-resistant state linked to Alzheimer’s disease

Identifying novel sub-type variants of diabetes has always provided an engaging area for debate and discussion. Having established the classification of type 1 and type 2 diabetes, it was perhaps inevitable that a further category of type 3 diabetes would emerge. In this article, Ken Shaw discusses the intriguing proposal that the term type 3 diabetes could be appropriately applied to an association between a state of brain insulin resistance and dementia. 

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Severe insulin resistance: pathologies

In parallel with the increasing prevalence of obesity, rates of insulin resistance and its associated complications have increased; however, insulin resistance is not only a disease of the overweight and obese. This review discusses the differing pathologies mediating insulin resistance that may be seen in clinical practice, and outlines the phenotypic characteristics that may allow their differentiation.

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Diagnosis and management of diabetes in older people

Older people with diabetes have more than double the risk of cardiovascular disease compared to their non-diabetic peers, and the risk of diabetes-related major lower limb amputation is twice as high in those over 75 years compared with the 40–64 age group. In this article, Anne Kilvert and Charles Fox discuss the ways in which treatment targets for glycaemic control, blood pressure and cholesterol should be individualised in the care of older people. 

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