{"product_id":"care-of-older-people-with-diabetes-a-manual-for-healthcare-practice","title":"Care of Older People with Diabetes: A Manual for Healthcare Practice","description":"\u003cdiv data-cel-widget=\"bookDescription_feature_div\" data-csa-c-id=\"7y9w7h-rgk3d4-2xixgp-6jetc1\" data-csa-c-is-in-initial-active-row=\"false\" data-csa-c-asin=\"0993745598\" data-csa-c-slot-id=\"bookDescription_feature_div\" data-csa-c-content-id=\"bookDescription\" data-csa-c-type=\"widget\" data-feature-name=\"bookDescription\" class=\"celwidget\" id=\"bookDescription_feature_div\"\u003e\n\u003cdiv class=\"a-expander-collapsed-height a-row a-expander-container a-spacing-base a-expander-partial-collapse-container\" data-a-expander-collapsed-height=\"280\" data-a-expander-name=\"book_description_expander\"\u003e\n\u003cdiv class=\"a-expander-content a-expander-partial-collapse-content\" aria-expanded=\"false\"\u003e\n\u003cp\u003e\u003cspan class=\"a-text-bold\"\u003eA concise and accessible overview to the treatment of diabetes in older patients\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eCare of older people is rapidly becoming one of the most important components of the healthcare profession. An ageing population provides new challenges for the healthcare industry and drives new demand for healthcare professionals with dedicated elder care experience and training. Few aspects of care for older patients are more important than diabetes, a condition characterized by its unique challenges and clinical heterogeneity.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan class=\"a-text-italic\"\u003eCare of Older People with Diabetes\u003c\/span\u003e\u003cspan\u003e offers a concise and readable introduction to the essentials of this vital clinical practice. Building on the knowledge contained within the successful \u003c\/span\u003e\u003cspan class=\"a-text-italic\"\u003eDiabetes in Old Age\u003c\/span\u003e\u003cspan\u003e textbook series, this book brings to bear the work of global experts in the field to provide a working reference for students and early career healthcare professionals alike. Anyone with an interest in caring for older patients with diabetes should find this a lucid and invaluable resource.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan class=\"a-text-italic\"\u003eCare of Older People with Diabetes\u003c\/span\u003e\u003cspan\u003e readers will also find:\u003c\/span\u003e\u003c\/p\u003e\n\u003cul class=\"a-unordered-list a-vertical\"\u003e\n\u003cli\u003e\u003cspan class=\"a-list-item\"\u003e\u003cspan\u003eOne to two clinical case questions per chapter with model answers\u003c\/span\u003e\u003c\/span\u003e\u003c\/li\u003e\n\u003cli\u003e\u003cspan class=\"a-list-item\"\u003e\u003cspan\u003eClear and easy-to-follow division into Background, Key Facts, and Key Management aspects\u003c\/span\u003e\u003c\/span\u003e\u003c\/li\u003e\n\u003cli\u003e\u003cspan class=\"a-list-item\"\u003e\u003cspan\u003eA minimum of 10 key references per chapter\u003c\/span\u003e\u003c\/span\u003e\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp\u003e\u003cspan class=\"a-text-italic\"\u003eCare of Older People with Diabetes\u003c\/span\u003e\u003cspan\u003e is ideal for medical and nursing students, early career doctors, senior nurses, and all other members of the healthcare team.\u003c\/span\u003e\u003c\/p\u003e\n\u003cul class=\"a-unordered-list a-vertical\"\u003e\u003c\/ul\u003e\n\u003c\/div\u003e\n\u003c\/div\u003e\n\u003c\/div\u003e\n\u003cdiv data-csa-c-id=\"e48qwb-36wm3s-vb6e8j-pnxs9b\" data-cel-widget=\"aplus-module-12\" class=\"celwidget aplus-module module-12 aplus-standard\"\u003e\n\u003cdiv class=\"aplus-module-wrapper apm-spacing apm-floatnone apm-fixed-width\"\u003e\n\u003cdiv class=\"apm-sidemodule aplus-module-content\"\u003e\u003cbr\u003e\u003c\/div\u003e\n\u003cdiv class=\"apm-sidemodule aplus-module-content\"\u003e\n\u003cdiv class=\"aboutauthors-section\" id=\"aboutauthors-section\"\u003e\n\u003cdiv class=\"page-section\"\u003e\n\u003cdiv class=\"section-title collapsed\" data-toggle=\"collapse\"\u003e\u003cstrong\u003eAbout the Author\u003c\/strong\u003e\u003c\/div\u003e\n\u003cdiv class=\"section-content collapsed\"\u003e\n\u003cp\u003e\u003cb\u003eAlan J. Sinclair\u003c\/b\u003e\u003cspan\u003e \u003c\/span\u003eis a former Professor of Medicine at the University of Bedfordshire and Dean of the Beds \u0026amp; Herts Postgraduate Medical School. He was the first England national clinical lead for diabetes in older people and has established the Foundation for Diabetes Research in Older People (fDROP). He has led national and international clinical guideline development and advised organisations such as the UK government, Diabetes UK, ABCD, IDF, IAGG and many more.\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003eAhmed H. Abdelhafiz\u003c\/b\u003e\u003cspan\u003e \u003c\/span\u003eis a consultant geriatrician with a subspeciality interest in diabetes in older people based at Rotherham General Hospital, UK. He has written widely in the area of diabetes, ageing, and frailty. He has sat on several national and international writing groups on care home diabetes.\u003c\/p\u003e\n\u003c\/div\u003e\n\u003c\/div\u003e\n\u003c\/div\u003e\n\u003cdiv class=\"permissions-section\" id=\"permissions-section\"\u003e\n\u003cdiv class=\"page-section\"\u003e\n\u003cdiv class=\"section-content collapsed\"\u003e\n\u003cdiv class=\"permissions-content\"\u003e\u003c\/div\u003e\n\u003cdiv class=\"permissions-content\"\u003e\u003c\/div\u003e\n\u003c\/div\u003e\n\u003c\/div\u003e\n\u003c\/div\u003e\n\u003cdiv class=\"tableofcontents-section\" id=\"tableofcontents-section\"\u003e\n\u003cdiv class=\"page-section\"\u003e\n\u003cdiv class=\"section-title collapsed\" data-toggle=\"collapse\"\u003e\u003cstrong\u003eTable of Contents\u003c\/strong\u003e\u003c\/div\u003e\n\u003cdiv class=\"section-content collapsed\"\u003e\n\u003cp\u003eContributors xxvii\u003c\/p\u003e\n\u003cp\u003eForeword xxxiii\u003c\/p\u003e\n\u003cp\u003ePreface xxxv\u003c\/p\u003e\n\u003cp\u003eAbout the Companion Website xxxvii\u003c\/p\u003e\n\u003cp\u003eCharacteristics and Care Needs xxxix\u003cbr\u003e\u003ci\u003eAhmed H Abdelhafiz, Ann Middleton and Alan J Sinclair\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction xxxix\u003c\/p\u003e\n\u003cp\u003eCharacteristics xli\u003c\/p\u003e\n\u003cp\u003eCare Needs xliii\u003c\/p\u003e\n\u003cp\u003ePhysical Function xliii\u003c\/p\u003e\n\u003cp\u003eMental Function xliii\u003c\/p\u003e\n\u003cp\u003eCare Delivery xlvi\u003c\/p\u003e\n\u003cp\u003eFamily Support xlvi\u003c\/p\u003e\n\u003cp\u003eCare Organisation xlvii\u003c\/p\u003e\n\u003cp\u003eContinuity of Care xlvii\u003c\/p\u003e\n\u003cp\u003eCare Homes xlviii\u003c\/p\u003e\n\u003cp\u003eConclusion xlix\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question xlix\u003c\/p\u003e\n\u003cp\u003eReferences xlix\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e1 Epidemiology and Pathophysiology 1\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eSarah L Sy\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 1\u003c\/p\u003e\n\u003cp\u003eEpidemiology 2\u003c\/p\u003e\n\u003cp\u003ePathophysiology of Diabetes in Older Adults 3\u003c\/p\u003e\n\u003cp\u003eAge- related Alterations in Glucose Metabolism 3\u003c\/p\u003e\n\u003cp\u003eGenetics 5\u003c\/p\u003e\n\u003cp\u003eLifestyle and Environmental Factors 5\u003c\/p\u003e\n\u003cp\u003eOther Factors 6\u003c\/p\u003e\n\u003cp\u003eWhat Are the Key Issues? 6\u003c\/p\u003e\n\u003cp\u003ePrevention of Diabetes in Older Adults 6\u003c\/p\u003e\n\u003cp\u003eHypoglycaemia 7\u003c\/p\u003e\n\u003cp\u003eManagement 7\u003c\/p\u003e\n\u003cp\u003eSummary 7\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 9\u003c\/p\u003e\n\u003cp\u003eReferences 9\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e2 Screening and Diagnosis 11\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eIsabelle Bourdel- Marchasson\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 11\u003c\/p\u003e\n\u003cp\u003eBackground 12\u003c\/p\u003e\n\u003cp\u003eKey Issues 14\u003c\/p\u003e\n\u003cp\u003eScreening 14\u003c\/p\u003e\n\u003cp\u003eDiagnosis 16\u003c\/p\u003e\n\u003cp\u003eClinical Practice Questions 17\u003c\/p\u003e\n\u003cp\u003eReferences 18\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e3 Lifestyle Interventions 21\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eAbdiazizi Yusuf and Ahmed H Abdelhafiz\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 21\u003c\/p\u003e\n\u003cp\u003eImpact of Lifestyle Changes 22\u003c\/p\u003e\n\u003cp\u003eLifestyle Intervention 23\u003c\/p\u003e\n\u003cp\u003eNutrition 24\u003c\/p\u003e\n\u003cp\u003eExercise 25\u003c\/p\u003e\n\u003cp\u003eSynergy Between Nutrition and Exercise 27\u003c\/p\u003e\n\u003cp\u003eCare Homes 27\u003c\/p\u003e\n\u003cp\u003eSummary 28\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 28\u003c\/p\u003e\n\u003cp\u003eReferences 29\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e4 Oral Hypoglycaemic Therapy 31\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eNahian Kazi and Ahmed H Abdelhafiz\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 31\u003c\/p\u003e\n\u003cp\u003eHypoglycaemic Agents 32\u003c\/p\u003e\n\u003cp\u003eLow Hypoglycaemia- Risk Agents 32\u003c\/p\u003e\n\u003cp\u003eMetformin 32\u003c\/p\u003e\n\u003cp\u003eDipeptidyl Peptidase- 4 Inhibitors 34\u003c\/p\u003e\n\u003cp\u003eSodium Glucose Transporter- 2 Inhibitors 34\u003c\/p\u003e\n\u003cp\u003eGlucagon- like Peptide- 1 Receptor Agonists 35\u003c\/p\u003e\n\u003cp\u003eThiazolidinediones 35\u003c\/p\u003e\n\u003cp\u003eAlpha- glucosidase Inhibitors 36\u003c\/p\u003e\n\u003cp\u003eHigh Hypoglycaemia Risk Agents 36\u003c\/p\u003e\n\u003cp\u003eSulfonylureas 36\u003c\/p\u003e\n\u003cp\u003eMeglitinides 37\u003c\/p\u003e\n\u003cp\u003eTherapeutic Approach 37\u003c\/p\u003e\n\u003cp\u003eSummary 38\u003c\/p\u003e\n\u003cp\u003eFuture Perspectives 39\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 39\u003c\/p\u003e\n\u003cp\u003eReferences 40\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e5 Insulin Therapy 41\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eGiuseppe Maltese\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 41\u003c\/p\u003e\n\u003cp\u003eBasal Insulin Analogues 42\u003c\/p\u003e\n\u003cp\u003eRapid- acting Analogues 44\u003c\/p\u003e\n\u003cp\u003eTreatment Regimens 45\u003c\/p\u003e\n\u003cp\u003eSummary 47\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 47\u003c\/p\u003e\n\u003cp\u003eReferences 47\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e6 Use of Continuous Glucose Monitoring in Older People with Diabetes\u003c\/b\u003e\u003cb\u003e\u003cspan\u003e \u003c\/span\u003e49\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eGiuseppe Maltese\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 50\u003c\/p\u003e\n\u003cp\u003eContinuous Glucose Monitoring 50\u003c\/p\u003e\n\u003cp\u003ePatient Assessment 52\u003c\/p\u003e\n\u003cp\u003eChallenges 54\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 54\u003c\/p\u003e\n\u003cp\u003eReferences 55\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e7 Education: Key Features for Achieving Success 57\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eKirsty Winkley and Angus Forbes\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 57\u003c\/p\u003e\n\u003cp\u003eKey Issues 58\u003c\/p\u003e\n\u003cp\u003eDiabetes Complications 59\u003c\/p\u003e\n\u003cp\u003eOther Comorbidities Not Specific to Diabetes 60\u003c\/p\u003e\n\u003cp\u003ePolypharmacy 60\u003c\/p\u003e\n\u003cp\u003eAnti- diabetes Oral and Injectable Agents 60\u003c\/p\u003e\n\u003cp\u003eHypoglycaemia 62\u003c\/p\u003e\n\u003cp\u003eRisk of Falls and Fractures 63\u003c\/p\u003e\n\u003cp\u003eCognitive Impairment 63\u003c\/p\u003e\n\u003cp\u003eNutrition 64\u003c\/p\u003e\n\u003cp\u003eManagement 64\u003c\/p\u003e\n\u003cp\u003eDetermine Frailty Risk 64\u003c\/p\u003e\n\u003cp\u003eDeprescribing and Optimisation 65\u003c\/p\u003e\n\u003cp\u003eGlucose Monitoring and Insulin Delivery Technologies 66\u003c\/p\u003e\n\u003cp\u003ePhysical Exercise 66\u003c\/p\u003e\n\u003cp\u003eHealthy Diet 67\u003c\/p\u003e\n\u003cp\u003eDiabetes Self- management Education for Older People 67\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 68\u003c\/p\u003e\n\u003cp\u003eReferences 68\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e8 Carers and Care Needs 71\u003cbr\u003e\u003c\/b\u003e\u003ci\u003ePuja Merwaha and Ahmed H Abdelhafiz\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 71\u003c\/p\u003e\n\u003cp\u003eCare Needs 72\u003c\/p\u003e\n\u003cp\u003eCarer Groups 73\u003c\/p\u003e\n\u003cp\u003eRole of Carers 73\u003c\/p\u003e\n\u003cp\u003eBenefit of Care on Outcomes 74\u003c\/p\u003e\n\u003cp\u003eCaring for Carers 74\u003c\/p\u003e\n\u003cp\u003eCarers’ Burden 75\u003c\/p\u003e\n\u003cp\u003eSupporting Carers 75\u003c\/p\u003e\n\u003cp\u003eSummary 76\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 78\u003c\/p\u003e\n\u003cp\u003eReferences 78\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e9a Macrovascular Complications: Peripheral Arterial Disease\u003c\/b\u003e\u003cb\u003e\u003cspan\u003e \u003c\/span\u003e81\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eLeocadio Rodríguez- Mañas, Rubí E Sandoval- Santoyo and Marta Castro-Rodríguez\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eEpidemiology 81\u003c\/p\u003e\n\u003cp\u003eRisk Factors 81\u003c\/p\u003e\n\u003cp\u003ePrevalence 82\u003c\/p\u003e\n\u003cp\u003ePathogenesis 82\u003c\/p\u003e\n\u003cp\u003eConsequences of Peripheral Arterial Disease 83\u003c\/p\u003e\n\u003cp\u003eInvestigations 83\u003c\/p\u003e\n\u003cp\u003eAnamnesis 83\u003c\/p\u003e\n\u003cp\u003ePhysical Examination 84\u003c\/p\u003e\n\u003cp\u003eNon- invasive Tests 84\u003c\/p\u003e\n\u003cp\u003eInvasive Tests 85\u003c\/p\u003e\n\u003cp\u003eManagement 85\u003c\/p\u003e\n\u003cp\u003eRisk Factor Modification 85\u003c\/p\u003e\n\u003cp\u003eExercise Rehabilitation 85\u003c\/p\u003e\n\u003cp\u003eFoot Care 86\u003c\/p\u003e\n\u003cp\u003ePharmacological Therapy 86\u003c\/p\u003e\n\u003cp\u003eAntiplatelet Therapy 86\u003c\/p\u003e\n\u003cp\u003eCilostazol 86\u003c\/p\u003e\n\u003cp\u003eRevascularisation 86\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 86\u003c\/p\u003e\n\u003cp\u003eReferences 87\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e9b Macrovascular Complications: Coronary Arterial Disease 89\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eLeocadio Rodríguez-Mañas, Rubí E., Sandoval-Santoyo and Marta Castro Rodríguez\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eEpidemiology 89\u003c\/p\u003e\n\u003cp\u003ePathogenesis 90\u003c\/p\u003e\n\u003cp\u003eMedical Treatment 90\u003c\/p\u003e\n\u003cp\u003eIndications for Revascularisation 91\u003c\/p\u003e\n\u003cp\u003eManagement of Cardiovascular Risk Factors According to Baseline Functional and Cognitive Status 92\u003c\/p\u003e\n\u003cp\u003eEffect of Glycaemic Control on Cardiovascular Events 92\u003c\/p\u003e\n\u003cp\u003eEffect of Blood Pressure Control 92\u003c\/p\u003e\n\u003cp\u003eLipid Monitoring 93\u003c\/p\u003e\n\u003cp\u003ePhysical Exercise and Diet 93\u003c\/p\u003e\n\u003cp\u003eFrailty Management 93\u003c\/p\u003e\n\u003cp\u003eManagement 93\u003c\/p\u003e\n\u003cp\u003eSummary 95\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 95\u003c\/p\u003e\n\u003cp\u003eReferences 96\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e9c Macrovascular Complications: Cerebrovascular Disease 97\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eAbubakhr Subkhan, Arshad Majid and Ali Ali\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 97\u003c\/p\u003e\n\u003cp\u003eEpidemiology 98\u003c\/p\u003e\n\u003cp\u003eRisk Factors 98\u003c\/p\u003e\n\u003cp\u003eAetiology and Pathophysiology 99\u003c\/p\u003e\n\u003cp\u003ePresentation 99\u003c\/p\u003e\n\u003cp\u003eStroke and Transient Ischaemic Attack 101\u003c\/p\u003e\n\u003cp\u003eCerebral Small Vessel Disease and Dementia 101\u003c\/p\u003e\n\u003cp\u003eManagement of Cerebrovascular Disease 102\u003c\/p\u003e\n\u003cp\u003eAcute Stroke 102\u003c\/p\u003e\n\u003cp\u003eManagement of Risk Factors 104\u003c\/p\u003e\n\u003cp\u003ePrognosis 105\u003c\/p\u003e\n\u003cp\u003eSummary 106\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 106\u003c\/p\u003e\n\u003cp\u003eReferences 107\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e10a Microvascular Complications: Diabetic Eye Disease 109\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eArchith Kamath and Nachiketa Acharya\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 110\u003c\/p\u003e\n\u003cp\u003eEpidemiology 110\u003c\/p\u003e\n\u003cp\u003ePresentation 110\u003c\/p\u003e\n\u003cp\u003ePathophysiology 111\u003c\/p\u003e\n\u003cp\u003eManagement 113\u003c\/p\u003e\n\u003cp\u003ePrimary Care 113\u003c\/p\u003e\n\u003cp\u003eSecondary Care 115\u003c\/p\u003e\n\u003cp\u003eSummary 117\u003c\/p\u003e\n\u003cp\u003eClinical Practice Questions 117\u003c\/p\u003e\n\u003cp\u003eReferences 118\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e10b Microvascular Complications: Diabetic Kidney Disease 119\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eMohsen El Kossi\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 119\u003c\/p\u003e\n\u003cp\u003eDiabetic Kidney Disease 120\u003c\/p\u003e\n\u003cp\u003eDefinitions and Diagnoses 120\u003c\/p\u003e\n\u003cp\u003eManagement 121\u003c\/p\u003e\n\u003cp\u003eLifestyle 121\u003c\/p\u003e\n\u003cp\u003eGlycaemic Control 122\u003c\/p\u003e\n\u003cp\u003eBlood Pressure Control 122\u003c\/p\u003e\n\u003cp\u003eLipid Control 123\u003c\/p\u003e\n\u003cp\u003eDiabetic Kidney Disease- related Complications 124\u003c\/p\u003e\n\u003cp\u003eAnaemia 124\u003c\/p\u003e\n\u003cp\u003eMineral Bone Disorder 124\u003c\/p\u003e\n\u003cp\u003eMetabolic Acidosis and Fluid Retention 125\u003c\/p\u003e\n\u003cp\u003eNephrology Referral 125\u003c\/p\u003e\n\u003cp\u003eSummary 126\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 127\u003c\/p\u003e\n\u003cp\u003eReferences 127\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e10c Microvascular Complications: Peripheral Neuropathy 129\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eMitra Tavakoli\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 130\u003c\/p\u003e\n\u003cp\u003ePrevalence and Risk Factors 130\u003c\/p\u003e\n\u003cp\u003eClinical Manifestations and Complications 131\u003c\/p\u003e\n\u003cp\u003eDiagnosis and Assessment 132\u003c\/p\u003e\n\u003cp\u003eManagement of Diabetic Neuropathy 135\u003c\/p\u003e\n\u003cp\u003eDiabetes Foot Care in Care Homes 136\u003c\/p\u003e\n\u003cp\u003eSummary 138\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 138\u003c\/p\u003e\n\u003cp\u003eReferences 139\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e11a Vascular Risk Factors: Hypertension 141\u003cbr\u003e\u003c\/b\u003e\u003ci\u003ePann Ei Hnynn Si and Ahmed H Abdelhafiz\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 141\u003c\/p\u003e\n\u003cp\u003eAge- related Blood Pressure Changes 142\u003c\/p\u003e\n\u003cp\u003eDefinition 142\u003c\/p\u003e\n\u003cp\u003eDiagnosis 144\u003c\/p\u003e\n\u003cp\u003eTypes 144\u003c\/p\u003e\n\u003cp\u003eManagement 145\u003c\/p\u003e\n\u003cp\u003eRecommended Targets 145\u003c\/p\u003e\n\u003cp\u003eMedications 146\u003c\/p\u003e\n\u003cp\u003eConsiderations in Older People 147\u003c\/p\u003e\n\u003cp\u003eOrthostatic Hypotension 147\u003c\/p\u003e\n\u003cp\u003eFalls 148\u003c\/p\u003e\n\u003cp\u003eSystolic Hypertension 148\u003c\/p\u003e\n\u003cp\u003eFrailty 148\u003c\/p\u003e\n\u003cp\u003eDementia 149\u003c\/p\u003e\n\u003cp\u003eComorbidity 149\u003c\/p\u003e\n\u003cp\u003ePolypharmacy 149\u003c\/p\u003e\n\u003cp\u003eSummary 149\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 151\u003c\/p\u003e\n\u003cp\u003eReferences 151\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e11b Vascular Risk Factors: Dyslipidaemia 153\u003cbr\u003e\u003c\/b\u003e\u003ci\u003ePann Ei Hnynn, Si and Ahmed H Abdelhafiz\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 153\u003c\/p\u003e\n\u003cp\u003eAgeing and Lipid Profile 154\u003c\/p\u003e\n\u003cp\u003eDiabetes and Lipid Profile 154\u003c\/p\u003e\n\u003cp\u003eDiabetes and Risk of Atherosclerotic Cardiovascular Disease 155\u003c\/p\u003e\n\u003cp\u003eAtherosclerotic Cardiovascular Disease Risk Reduction 156\u003c\/p\u003e\n\u003cp\u003eLipid- lowering Agents 157\u003c\/p\u003e\n\u003cp\u003eGoals of Therapy in Old Age 160\u003c\/p\u003e\n\u003cp\u003eRecommendations from Guidelines 160\u003c\/p\u003e\n\u003cp\u003eGoals in Frailty 162\u003c\/p\u003e\n\u003cp\u003eSummary 162\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 162\u003c\/p\u003e\n\u003cp\u003eReferences 164\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e12a Metabolic Decompensation: Hyperglycaemic Crisis 165\u003cbr\u003e\u003c\/b\u003e\u003ci\u003ePuja Merwaha and Ahmed H Abdelhafiz\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 165\u003c\/p\u003e\n\u003cp\u003eEpidemiology 166\u003c\/p\u003e\n\u003cp\u003ePrecipitating Factors 166\u003c\/p\u003e\n\u003cp\u003ePathogenesis 168\u003c\/p\u003e\n\u003cp\u003eClinical Presentation 168\u003c\/p\u003e\n\u003cp\u003eDiagnosis 169\u003c\/p\u003e\n\u003cp\u003eManagement 171\u003c\/p\u003e\n\u003cp\u003eCorrection of Hypovolaemia 172\u003c\/p\u003e\n\u003cp\u003eCorrection of Hyperglycaemia 173\u003c\/p\u003e\n\u003cp\u003eCorrection of Acidosis 174\u003c\/p\u003e\n\u003cp\u003eCorrection of Electrolytes 175\u003c\/p\u003e\n\u003cp\u003eComplications 175\u003c\/p\u003e\n\u003cp\u003ePrevention 176\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 176\u003c\/p\u003e\n\u003cp\u003eReferences 177\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e12b Metabolic Decompensation: Hypoglycaemia 178\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eSrikanth Bellary, Ahmed H Abdelhafiz and Alan J Sinclair\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 179\u003c\/p\u003e\n\u003cp\u003eDefinition 179\u003c\/p\u003e\n\u003cp\u003eRecognition 179\u003c\/p\u003e\n\u003cp\u003eEpidemiology 180\u003c\/p\u003e\n\u003cp\u003ePathophysiology 180\u003c\/p\u003e\n\u003cp\u003eClinical Consequences 181\u003c\/p\u003e\n\u003cp\u003eImpact on Cognition 182\u003c\/p\u003e\n\u003cp\u003eImpact on Frailty 182\u003c\/p\u003e\n\u003cp\u003eManagement 183\u003c\/p\u003e\n\u003cp\u003eSummary 185\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 185\u003c\/p\u003e\n\u003cp\u003eReferences 186\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e13a Management of Diabetes in Hospital 189\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eJulie Lewis and Chris Cottrell\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 189\u003c\/p\u003e\n\u003cp\u003eFundamentals of Care 190\u003c\/p\u003e\n\u003cp\u003eKey Considerations for Effective Inpatient Care for Older People with Diabetes 192\u003c\/p\u003e\n\u003cp\u003eThe Inpatient Setting 192\u003c\/p\u003e\n\u003cp\u003ePressure Damage and Footcare Assessment 193\u003c\/p\u003e\n\u003cp\u003ePlanning Care 193\u003c\/p\u003e\n\u003cp\u003eKey Considerations to Reduce Unscheduled Admission to Hospital 193\u003c\/p\u003e\n\u003cp\u003eMonitoring Requirements 196\u003c\/p\u003e\n\u003cp\u003eEducation and Training 196\u003c\/p\u003e\n\u003cp\u003eSummary 197\u003c\/p\u003e\n\u003cp\u003eClinical Practice Questions 198\u003c\/p\u003e\n\u003cp\u003eReferences 199\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e13b Management of Diabetes in Care Homes 201\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eLynne Reedman and Alan J Sinclair\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 201\u003c\/p\u003e\n\u003cp\u003eImportant Considerations for Diabetes Care 203\u003c\/p\u003e\n\u003cp\u003eImportance of Monitoring Glucose Levels 207\u003c\/p\u003e\n\u003cp\u003eOther Management Issues 207\u003c\/p\u003e\n\u003cp\u003eHypoglycaemia 208\u003c\/p\u003e\n\u003cp\u003eDiabetes Foot Disease 209\u003c\/p\u003e\n\u003cp\u003eNutritional Deficiency and Weight Loss 209\u003c\/p\u003e\n\u003cp\u003eFrailty 210\u003c\/p\u003e\n\u003cp\u003eEducation 210\u003c\/p\u003e\n\u003cp\u003eCommunication and Collaboration 211\u003c\/p\u003e\n\u003cp\u003eUse of Audit 211\u003c\/p\u003e\n\u003cp\u003eMeasuring Outcomes 212\u003c\/p\u003e\n\u003cp\u003eSummary 212\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 213\u003c\/p\u003e\n\u003cp\u003eReferences 214\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e14 Nutrition 215\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eRihan Said and Grace Zaman\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 215\u003c\/p\u003e\n\u003cp\u003eNutritional Deficiencies 216\u003c\/p\u003e\n\u003cp\u003eCauses of Malnutrition in the Elderly 216\u003c\/p\u003e\n\u003cp\u003eRecommendations 217\u003c\/p\u003e\n\u003cp\u003eSpecific Recommendations for Older People with Diabetes 218\u003c\/p\u003e\n\u003cp\u003ePractical Steps for Nutritional Care in the Elderly 218\u003c\/p\u003e\n\u003cp\u003eScreening 218\u003c\/p\u003e\n\u003cp\u003eAssessment 219\u003c\/p\u003e\n\u003cp\u003eIntervention 219\u003c\/p\u003e\n\u003cp\u003eEnteral Nutrition 221\u003c\/p\u003e\n\u003cp\u003eTypes of Enteral Tubes 221\u003c\/p\u003e\n\u003cp\u003eTypes of Feeds 221\u003c\/p\u003e\n\u003cp\u003eEnteral Feed Delivery Options 221\u003c\/p\u003e\n\u003cp\u003eManagement of Blood Glucose 221\u003c\/p\u003e\n\u003cp\u003eParenteral Nutrition 222\u003c\/p\u003e\n\u003cp\u003eManagement of Blood Glucose 223\u003c\/p\u003e\n\u003cp\u003eGeneral Considerations for Patients on Nutritional Support 224\u003c\/p\u003e\n\u003cp\u003eSummary 224\u003c\/p\u003e\n\u003cp\u003eClinical Practice Questions 225\u003c\/p\u003e\n\u003cp\u003eReferences 226\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e15 Sexual Health 229\u003cbr\u003e\u003c\/b\u003e\u003ci\u003ePann Ei Hnynn Si and Ahmed H Abdelhafiz\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 229\u003c\/p\u003e\n\u003cp\u003eAgeing and Sexual Function 230\u003c\/p\u003e\n\u003cp\u003eDiabetes and Sexual Dysfunction 230\u003c\/p\u003e\n\u003cp\u003eSexual Dysfunction in Men 231\u003c\/p\u003e\n\u003cp\u003eAetiology and Pathogenesis 231\u003c\/p\u003e\n\u003cp\u003eDiagnosis 232\u003c\/p\u003e\n\u003cp\u003eTreatment 233\u003c\/p\u003e\n\u003cp\u003eSexual Dysfunction in Women 236\u003c\/p\u003e\n\u003cp\u003eAetiology and Pathogenesis 236\u003c\/p\u003e\n\u003cp\u003eDiagnosis 237\u003c\/p\u003e\n\u003cp\u003eTreatment 237\u003c\/p\u003e\n\u003cp\u003eSummary 238\u003c\/p\u003e\n\u003cp\u003eClinical Practice Questions 238\u003c\/p\u003e\n\u003cp\u003eReferences 239\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e16a Special Issues in Old Age: Frailty 241\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eAlan J Sinclair and Ahmed H Abdelhafiz\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 241\u003c\/p\u003e\n\u003cp\u003eFrailty–diabetes Inter- relationship 242\u003c\/p\u003e\n\u003cp\u003eEffect of Diabetes on Frailty 244\u003c\/p\u003e\n\u003cp\u003eEffects of Frailty on Diabetes 245\u003c\/p\u003e\n\u003cp\u003eOutcome Effects 249\u003c\/p\u003e\n\u003cp\u003eMetabolic Effects 249\u003c\/p\u003e\n\u003cp\u003eSarcopenic Obese Phenotype 254\u003c\/p\u003e\n\u003cp\u003eAnorexic Malnourished Phenotype 254\u003c\/p\u003e\n\u003cp\u003ePrevention and Management 255\u003c\/p\u003e\n\u003cp\u003eScreening 255\u003c\/p\u003e\n\u003cp\u003eNon- pharmacological Therapy 256\u003c\/p\u003e\n\u003cp\u003ePharmacological Therapy 257\u003c\/p\u003e\n\u003cp\u003eSpecial Considerations 259\u003c\/p\u003e\n\u003cp\u003eGlycaemic Control 259\u003c\/p\u003e\n\u003cp\u003eChoice of Hypoglycaemic Agent 260\u003c\/p\u003e\n\u003cp\u003eSarcopenic Obese Phenotype 260\u003c\/p\u003e\n\u003cp\u003eAnorexic Malnourished Phenotype 260\u003c\/p\u003e\n\u003cp\u003eGoals of Therapy 261\u003c\/p\u003e\n\u003cp\u003eSummary 262\u003c\/p\u003e\n\u003cp\u003eFuture Perspectives 262\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 263\u003c\/p\u003e\n\u003cp\u003eReferences 264\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e16b Special Issues in Old Age: Multimorbidity 266\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eAlan J Sinclair and Ahmed H Abdelhafiz\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 266\u003c\/p\u003e\n\u003cp\u003eMultimorbidity 267\u003c\/p\u003e\n\u003cp\u003eMultimorbidity–Frailty Interaction 268\u003c\/p\u003e\n\u003cp\u003eMultimorbidity Effects on Diabetes 268\u003c\/p\u003e\n\u003cp\u003eClusters of Multimorbidity 269\u003c\/p\u003e\n\u003cp\u003eClinical Implications 270\u003c\/p\u003e\n\u003cp\u003eSummary 272\u003c\/p\u003e\n\u003cp\u003eFuture Perspectives 272\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 273\u003c\/p\u003e\n\u003cp\u003eReferences 273\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e16c Special Issues in Old Age: Type 1 Diabetes Mellitus 275\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eAlex M Summerbell and Ahmed H Abdelhafiz\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 275\u003c\/p\u003e\n\u003cp\u003eEpidemiology and Diagnosis 276\u003c\/p\u003e\n\u003cp\u003eManagement 276\u003c\/p\u003e\n\u003cp\u003eInsulin Therapy 278\u003c\/p\u003e\n\u003cp\u003eMonitoring 279\u003c\/p\u003e\n\u003cp\u003eReducing Hypoglycaemia 280\u003c\/p\u003e\n\u003cp\u003eGoals of Therapy 282\u003c\/p\u003e\n\u003cp\u003eSummary 282\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 282\u003c\/p\u003e\n\u003cp\u003eReferences 283\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e16d Special Issues in Old Age: Cognitive Health Agility, Cognitive Dysfunction, Dementia and Diabetes\u003c\/b\u003e\u003cb\u003e\u003cspan\u003e \u003c\/span\u003e285\u003c\/b\u003e\u003cbr\u003e\u003ci\u003eTali Cukierman- Yaffe\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 286\u003c\/p\u003e\n\u003cp\u003ePopulation Studies Demonstrating the Relationship Between Cognitive Dysfunction, Dementia and Diabetes 286\u003c\/p\u003e\n\u003cp\u003eImplications of the Relationship Between Diabetes and Cognitive Dysfunction 287\u003c\/p\u003e\n\u003cp\u003eThe Effect of Cognitive Dysfunction on Self- care Capacity in Older People with Diabetes 288\u003c\/p\u003e\n\u003cp\u003eAssessment of Cognitive Health Agility in Older People with Diabetes 290\u003c\/p\u003e\n\u003cp\u003ePrevention and Treatment of Cognitive Dysfunction in Older People with Diabetes 291\u003c\/p\u003e\n\u003cp\u003eThe Effect of Current Diabetes Pharmacological Agents on Cognitive Dysfunction 291\u003c\/p\u003e\n\u003cp\u003eGlucose Control 292\u003c\/p\u003e\n\u003cp\u003eInsulin 293\u003c\/p\u003e\n\u003cp\u003eDipeptidyl Peptidase- 4 Inhibitors 294\u003c\/p\u003e\n\u003cp\u003eGlucagon- like Peptide- 1 Receptor Analysts 294\u003c\/p\u003e\n\u003cp\u003eThe Multidomain Approach 295\u003c\/p\u003e\n\u003cp\u003eSummary, Knowledge Gaps and Future Research 296\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 296\u003c\/p\u003e\n\u003cp\u003eReferences 298\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e16e Special Issues in Old Age: Depression 299\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eSara- Louise Wylie\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 299\u003c\/p\u003e\n\u003cp\u003eDepression and Diabetes 300\u003c\/p\u003e\n\u003cp\u003ePresentation 300\u003c\/p\u003e\n\u003cp\u003eEvaluation 302\u003c\/p\u003e\n\u003cp\u003eScreening 302\u003c\/p\u003e\n\u003cp\u003eDiagnosis 303\u003c\/p\u003e\n\u003cp\u003eAssessment 304\u003c\/p\u003e\n\u003cp\u003eManagement 307\u003c\/p\u003e\n\u003cp\u003eLifestyle 307\u003c\/p\u003e\n\u003cp\u003ePharmacological Therapy 308\u003c\/p\u003e\n\u003cp\u003ePsychotherapy 309\u003c\/p\u003e\n\u003cp\u003eCollaborative Care 310\u003c\/p\u003e\n\u003cp\u003eSummary 310\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 310\u003c\/p\u003e\n\u003cp\u003eReferences 311\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e16f Special Issues in Old Age: Foot Care 313\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eSolomon Muzulu\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 313\u003c\/p\u003e\n\u003cp\u003eEpidemiology 314\u003c\/p\u003e\n\u003cp\u003ePathogenesis 314\u003c\/p\u003e\n\u003cp\u003eAgeing and Diabetic Foot Ulcer Disease 315\u003c\/p\u003e\n\u003cp\u003eAssessment of a Diabetic Foot 316\u003c\/p\u003e\n\u003cp\u003eTesting for Peripheral Sensory Neuropathy 316\u003c\/p\u003e\n\u003cp\u003e10- g Monofilament Test 317\u003c\/p\u003e\n\u003cp\u003e128- Hz Tuning Fork 318\u003c\/p\u003e\n\u003cp\u003eIpswich Touch Test 318\u003c\/p\u003e\n\u003cp\u003eChecking for Peripheral Vascular Disease 318\u003c\/p\u003e\n\u003cp\u003eManagement 318\u003c\/p\u003e\n\u003cp\u003eOffloading 320\u003c\/p\u003e\n\u003cp\u003eDebridement 320\u003c\/p\u003e\n\u003cp\u003eDressings 320\u003c\/p\u003e\n\u003cp\u003eInfection Control 320\u003c\/p\u003e\n\u003cp\u003eIschaemia Relief 321\u003c\/p\u003e\n\u003cp\u003eGlycaemic Control 322\u003c\/p\u003e\n\u003cp\u003ePrevention 322\u003c\/p\u003e\n\u003cp\u003eSummary 323\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 323\u003c\/p\u003e\n\u003cp\u003eReferences 324\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e16g Special Issues in Old Age: Skin Care 326\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eGrace Keegan and Sarah Mahmoud\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 326\u003c\/p\u003e\n\u003cp\u003eAge- related Skin Changes 327\u003c\/p\u003e\n\u003cp\u003eDiabetes Mellitus- related Skin Conditions 327\u003c\/p\u003e\n\u003cp\u003ePrimary Skin Conditions 328\u003c\/p\u003e\n\u003cp\u003eAcanthosis Nigricans 328\u003c\/p\u003e\n\u003cp\u003eNecrobiosis Lipoidica 328\u003c\/p\u003e\n\u003cp\u003eDiabetic Dermopathy 329\u003c\/p\u003e\n\u003cp\u003eBullous Eruption of Diabetes Mellitus 329\u003c\/p\u003e\n\u003cp\u003eDiabetes- related Skin Infections 330\u003c\/p\u003e\n\u003cp\u003eBacterial Infections 330\u003c\/p\u003e\n\u003cp\u003eFungal Infections 331\u003c\/p\u003e\n\u003cp\u003eDiabetes Medications- related Skin Adverse Effects 334\u003c\/p\u003e\n\u003cp\u003eInsulin 334\u003c\/p\u003e\n\u003cp\u003eSodium Glucose Transporter- 2 Inhibitors 334\u003c\/p\u003e\n\u003cp\u003eSummary 334\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 335\u003c\/p\u003e\n\u003cp\u003eReferences 335\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e16h Special Issues in Old Age: Falls and Bone Health 336\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eNandkishor V Athavale\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 336\u003c\/p\u003e\n\u003cp\u003eEpidemiology 337\u003c\/p\u003e\n\u003cp\u003ePathophysiology of Fracture Risk in Diabetes 337\u003c\/p\u003e\n\u003cp\u003ePathophysiology and Risk Factors for Falls in Diabetes 338\u003c\/p\u003e\n\u003cp\u003eAssessment of the Risk of Falls in the Community 339\u003c\/p\u003e\n\u003cp\u003eAssessment of Bone Health in Community 340\u003c\/p\u003e\n\u003cp\u003eManagement and Prevention 344\u003c\/p\u003e\n\u003cp\u003eFalls 344\u003c\/p\u003e\n\u003cp\u003eFractures 345\u003c\/p\u003e\n\u003cp\u003eSummary 345\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 345\u003c\/p\u003e\n\u003cp\u003eReferences 346\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e16i Special Issues in Old Age: Avoiding Hospitalisation 347\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eDemelza Emmerton and Ahmed H Abdelhafiz\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 347\u003c\/p\u003e\n\u003cp\u003eRisk Factors for Hospitalisation 348\u003c\/p\u003e\n\u003cp\u003eAvoiding Hospitalisation 349\u003c\/p\u003e\n\u003cp\u003ePatient- Related Interventions 349\u003c\/p\u003e\n\u003cp\u003ePhysical Function 349\u003c\/p\u003e\n\u003cp\u003eMental Function 351\u003c\/p\u003e\n\u003cp\u003ePolypharmacy 351\u003c\/p\u003e\n\u003cp\u003eHealthcare System- related Interventions 352\u003c\/p\u003e\n\u003cp\u003eCommunity Setting 352\u003c\/p\u003e\n\u003cp\u003eCare- home Setting 353\u003c\/p\u003e\n\u003cp\u003eEmergency Setting 353\u003c\/p\u003e\n\u003cp\u003eSummary 355\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 355\u003c\/p\u003e\n\u003cp\u003eReferences 356\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e16j Special Issues in Old Age: Use of Technology 357\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eAnna Kahkoska, Aastha Dubal, Josh Weinstein and Ruth S Weinstock\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 358\u003c\/p\u003e\n\u003cp\u003eWhat Is Diabetes Technology? 358\u003c\/p\u003e\n\u003cp\u003eWhat Is Remote Patient Monitoring? 359\u003c\/p\u003e\n\u003cp\u003eDiabetes Technology and Remote Patient Monitoring in Older Adults 360\u003c\/p\u003e\n\u003cp\u003eManagement 362\u003c\/p\u003e\n\u003cp\u003eContinuous Glucose Monitoring 362\u003c\/p\u003e\n\u003cp\u003eWhat Is Continuous Glucose Monitoring? 362\u003c\/p\u003e\n\u003cp\u003eWhat Is the Evidence for Continuous Glucose Monitoring as Part of Management for Older Adults with Diabetes? 362\u003c\/p\u003e\n\u003cp\u003eWhat Are Challenges for Continuous Glucose Monitoring Use in Older Adults? 363\u003c\/p\u003e\n\u003cp\u003eAutomated Insulin Delivery Systems 363\u003c\/p\u003e\n\u003cp\u003eWhat Is Automated Insulin Delivery? 363\u003c\/p\u003e\n\u003cp\u003eEvidence on Automated Insulin Delivery for Older Adults 364\u003c\/p\u003e\n\u003cp\u003eClinical Guidelines for Automated Insulin Delivery Usage among Older Adults with Type 1 Diabetes 364\u003c\/p\u003e\n\u003cp\u003eWhat Are Challenges for Automated Insulin Delivery Use in Older Adults? 364\u003c\/p\u003e\n\u003cp\u003eIntegration of Diabetes Technologies with Remote Patient Monitoring 365\u003c\/p\u003e\n\u003cp\u003eWhat Are the Key Issues? 366\u003c\/p\u003e\n\u003cp\u003eClinical Practice Questions 368\u003c\/p\u003e\n\u003cp\u003eReferences 369\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e16k Special Issues in Old Age: Annual Reviews 371\u003cbr\u003e\u003c\/b\u003e\u003ci\u003ePuja Merwaha and Ahmed H Abdelhafiz\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 371\u003c\/p\u003e\n\u003cp\u003eDiabetes Phenotype in Older People 372\u003c\/p\u003e\n\u003cp\u003eMultimorbidity 372\u003c\/p\u003e\n\u003cp\u003eGeriatric Syndromes 373\u003c\/p\u003e\n\u003cp\u003eFrailty 373\u003c\/p\u003e\n\u003cp\u003eFunctional Implications 373\u003c\/p\u003e\n\u003cp\u003eAnnual Review Contents 374\u003c\/p\u003e\n\u003cp\u003eDemographics 374\u003c\/p\u003e\n\u003cp\u003eHistory 374\u003c\/p\u003e\n\u003cp\u003ePhysical Examination 374\u003c\/p\u003e\n\u003cp\u003eVascular Complications 376\u003c\/p\u003e\n\u003cp\u003eSexual Function 376\u003c\/p\u003e\n\u003cp\u003eCognition and Mood 376\u003c\/p\u003e\n\u003cp\u003ePhysical Function and Frailty 377\u003c\/p\u003e\n\u003cp\u003eFoot Care 377\u003c\/p\u003e\n\u003cp\u003eDiet and Nutrition 377\u003c\/p\u003e\n\u003cp\u003eMedication Review 377\u003c\/p\u003e\n\u003cp\u003eInfection Prevention 378\u003c\/p\u003e\n\u003cp\u003eSummary 378\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 378\u003c\/p\u003e\n\u003cp\u003eReferences 380\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e16l Special Issues in Old Age: Mouth Care 381\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eNali Ahmed and Ahmed H Abdelhafiz\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 381\u003c\/p\u003e\n\u003cp\u003eAge- related Oral Changes 382\u003c\/p\u003e\n\u003cp\u003eDiabetes- related Oral Changes 382\u003c\/p\u003e\n\u003cp\u003eCommon Oral Conditions in Older People with Diabetes 384\u003c\/p\u003e\n\u003cp\u003ePeriodontal Disease 384\u003c\/p\u003e\n\u003cp\u003eDental Caries 384\u003c\/p\u003e\n\u003cp\u003eDry Mouth 385\u003c\/p\u003e\n\u003cp\u003eCandida 386\u003c\/p\u003e\n\u003cp\u003eOral Cancer 386\u003c\/p\u003e\n\u003cp\u003eTaste Impairment 387\u003c\/p\u003e\n\u003cp\u003eMouth Care 387\u003c\/p\u003e\n\u003cp\u003eEducation 387\u003c\/p\u003e\n\u003cp\u003eGlycaemic Control 388\u003c\/p\u003e\n\u003cp\u003ePreventative Measures 388\u003c\/p\u003e\n\u003cp\u003eSummary 389\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 390\u003c\/p\u003e\n\u003cp\u003eReferences 390\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e16m Special Issues in Old Age: Pain Management 392\u003cbr\u003e\u003c\/b\u003e\u003ci\u003ePann Ei Hnynn Si and Ahmed H Abdelhafiz\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 392\u003c\/p\u003e\n\u003cp\u003eAetiology 393\u003c\/p\u003e\n\u003cp\u003eAssessment 393\u003c\/p\u003e\n\u003cp\u003ePain in Care- home Residents 396\u003c\/p\u003e\n\u003cp\u003eManagement 397\u003c\/p\u003e\n\u003cp\u003eNon- pharmacological Therapy 397\u003c\/p\u003e\n\u003cp\u003ePharmacological Therapy 398\u003c\/p\u003e\n\u003cp\u003ePrevention 401\u003c\/p\u003e\n\u003cp\u003eClinical Practice Question 401\u003c\/p\u003e\n\u003cp\u003eReferences 402\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e17 Deintensification of Therapy 405\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eAntoine Christiaens\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 405\u003c\/p\u003e\n\u003cp\u003eKey Issues 407\u003c\/p\u003e\n\u003cp\u003eManagement 407\u003c\/p\u003e\n\u003cp\u003eIdentifying Patients Who Might Benefit 407\u003c\/p\u003e\n\u003cp\u003eDeintensifying Glucose- lowering Treatment in Older Patients 409\u003c\/p\u003e\n\u003cp\u003eImplementing Deintensification in Daily Clinical Practice 410\u003c\/p\u003e\n\u003cp\u003eClinical Practice Questions 411\u003c\/p\u003e\n\u003cp\u003eReferences 412\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e18 Diabetes in End- of- Life Care 413\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eJune James\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003eIntroduction 413\u003c\/p\u003e\n\u003cp\u003eBackground 414\u003c\/p\u003e\n\u003cp\u003eWhat is End of Life and How is the Need for End- of- life Care Identified? 414\u003c\/p\u003e\n\u003cp\u003eManagement of Diabetes in End- of- Life Care 419\u003c\/p\u003e\n\u003cp\u003eMedicines Management and De- escalation of Therapies 419\u003c\/p\u003e\n\u003cp\u003eSteroids and Cancer 422\u003c\/p\u003e\n\u003cp\u003eNutrition and Enteral Feeding 424\u003c\/p\u003e\n\u003cp\u003eAdvanced Care Planning 424\u003c\/p\u003e\n\u003cp\u003eTreatment Withdrawal 424\u003c\/p\u003e\n\u003cp\u003eWorkforce Training and Competencies 424\u003c\/p\u003e\n\u003cp\u003eSummary 425\u003c\/p\u003e\n\u003cp\u003eClinical Practice Questions 425\u003c\/p\u003e\n\u003cp\u003eReferences 426\u003c\/p\u003e\n\u003cp\u003eAnswers to Clinical Practice Questions 429\u003c\/p\u003e\n\u003cp\u003eIndex 445\u003c\/p\u003e\n\u003c\/div\u003e\n\u003c\/div\u003e\n\u003c\/div\u003e\n\u003c\/div\u003e\n\u003cdiv class=\"apm-sidemodule aplus-module-content\"\u003e\u003c\/div\u003e\n\u003c\/div\u003e\n\u003c\/div\u003e\n\u003cdiv\u003e\n\u003cdiv 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