References

1. Burrows GD. Depressive disorders. In: MIMS Disease Index (2nd edn). Sydney: IMS Publishing, 1996, 139-141.

2. Davies B. An introduction to clinical psychiatry. University of Melbourne, 1977, 76-77.

3. Serry DK, Serry M. Masked depression and the use of antidepressants in general practice. Med J Aust, 15 February 1969, 35-37.

4. Depression: Masked or missed? Patient Care, Oct 1972, 1(3):6-14.

5. Robinson MJ. Practical paediatrics (2nd edn), Melbourne: Churchill Livingstone, 1990, 552-553.

6. Moulds RFW. Psychotropic drug guidelines (3rd edn), Melbourne: Victorian Medical Postgraduate Foundation, 1996/7, 107-118.

7. Davis A, Bolin T, Ham J. Symptom analysis and physical diagnosis (2nd edn), London: Bailliere Tindall, 1990, 983.

8. Murtagh J. Patient education (2nd edn). Sydney: McGraw-Hill, 1996, 146.

9. Keltner N. Serotonin syndrome: A case of fatal SSRI/MAOI interaction. Perspectives in Psychiatric Care, 1994; 30(4):26-31.

10. Kumar PJ, Clark ML. Clinical medicine (2nd edn), London: Bailliere Tindall, 1990, 983.

11. Rogers I. Guidelines for the management of common emergencies in the emergency department (2nd edn). Auckland Hospital, 1996, 43.

Chapter 17 - Diabetes mellitus

Those labouring with this Disease, piss a great deal more than they drink. Authors who affirm the drink to be little or nothing changed are very far from the truth, because the urine very much differed both from the drink taken in and also in being wonderfully sweet as if it were imbued with honey or sugar.

Thomas Willis (1621-75) The pissing evil

Diabetes comes from a Greek word meaning 'to pass or flow through' (i.e. excessive urination) and mellitus means 'sweet'.

There are two main types of diabetes (see Table 17.1).

• Type I is known as juvenile onset diabetes or insulin dependent diabetes mellitus (IDDM).

• Type II is known as maturity onset diabetes or non-insulin dependent diabetes mellitus (NIDDM).

Table 17.1 Clinical differentiation between type I and type II diabetes

Type I Type II

IDDM NIDDM

Relative frequency (approx)

15%

85%

Peak age incidence

10-30 years

> 40 years

Age of onset

usually < 20

> 40

Onset

rapid

insidious

Weight at onset

low (thin)

high (obese)

Ketoacidosis

yes

no

Familial

weak

strong

Insulin status

deficient

resistant

Complications

yes

yes

Note: These are generalisations and the clinical features may vary, e.g. type II

may be thin and have a rapid onset; type I may exhibit a weak genetic link.

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