Alan J. Sinclair is a former Professor of Medicine at the University of Bedfordshire and Dean of the Beds & 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. Ahmed H. Abdelhafiz is 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.

• Contributors xxviiForeword xxxiiiPreface xxxvAbout the Companion Website xxxviiCharacteristics and Care Needs xxxixAhmed H Abdelhafiz, Ann Middleton and Alan J Sinclair1 Epidemiology and Pathophysiology 1Sarah L Sy2 Screening and Diagnosis 11Isabelle Bourdel-Marchasson3 Lifestyle Interventions 21Abdiazizi Yusuf and Ahmed H Abdelhafiz4 Oral Hypoglycaemic Therapy 31Nahian Kazi and Ahmed H Abdelhafiz5 Insulin Therapy 41Giuseppe Maltese6 Use of Continuous Glucose Monitoring in Older People with Diabetes 49Giuseppe Maltese7 Education: Key Features for Achieving Success 57Kirsty Winkley and Angus Forbes8 Carers and Care Needs 71Puja Merwaha and Ahmed H Abdelhafiz9A Macrovascular Complications: Peripheral Arterial Disease 81Leocadio Rodríguez-Mañas, Rubí E Sandoval-Santoyo and Marta Castro-Rodríguez9B Macrovascular Complications: Coronary Arterial Disease 89Leocadio Rodríguez-Mañas, Rubí E, Sandoval-Santoyo and Marta Castro Rodríguez9C Macrovascular Complications: Cerebrovascular Disease 97Abubakhr Subkhan, Arshad Majid and Ali Ali10A Microvascular Complications: Diabetic Eye Disease 109Archith Kamath and Nachiketa Acharya10B Microvascular Complications: Diabetic Kidney Disease 119Mohsen El Kossi10C Microvascular Complications: Peripheral Neuropathy 129Mitra Tavakoli11A Vascular Risk Factors: Hypertension 141Pann Ei Hnynn Si and Ahmed H Abdelhafiz11B Vascular Risk Factors: Dyslipidaemia 153Pann Ei Hnynn, Si and Ahmed H Abdelhafiz12A Metabolic Decompensation: Hyperglycaemic Crisis 165Puja Merwaha and Ahmed H Abdelhafiz12B Metabolic Decompensation: Hypoglycaemia 178Srikanth Bellary, Ahmed H Abdelhafiz and Alan J Sinclair13A Management of Diabetes in Hospital 189Julie Lewis and Chris Cottrell13B Management of Diabetes in Care Homes 201Lynne Reedman and Alan J Sinclair14 Nutrition 215Rihan Said and Grace Zaman15 Sexual Health 229Pann Ei Hnynn Si and Ahmed H Abdelhafiz16A Special Issues in Old Age: Frailty 241Alan J Sinclair and Ahmed H Abdelhafiz16B Special Issues in Old Age: Multimorbidity 266Alan J Sinclair and Ahmed H Abdelhafiz16C Special Issues in Old Age: Type 1 Diabetes Mellitus 275Alex M Summerbell and Ahmed H Abdelhafiz16D Special Issues in Old Age: Cognitive Health Agility, Cognitive Dysfunction, Dementia and Diabetes 285Tali Cukierman-Yaffe16E Special Issues in Old Age: Depression 299Sara-Louise Wylie16F Special Issues in Old Age: Foot Care 313Solomon Muzulu16G Special Issues in Old Age: Skin Care 326Grace Keegan and Sarah Mahmoud16H Special Issues in Old Age: Falls and Bone Health 336Nandkishor V Athavale16I Special Issues in Old Age: Avoiding Hospitalisation 347Demelza Emmerton and Ahmed H Abdelhafiz16J Special Issues in Old Age: Use of Technology 357Anna Kahkoska, Aastha Dubal, Josh Weinstein and Ruth S Weinstock16K Special Issues in Old Age: Annual Reviews 371Puja Merwaha and Ahmed H Abdelhafiz16L Special Issues in Old Age: Mouth Care 381Nali Ahmed and Ahmed H Abdelhafiz16M Special Issues in Old Age: Pain Management 392Pann Ei Hnynn Si and Ahmed H Abdelhafiz17 Deintensification of Therapy 405Antoine Christiaens18 Diabetes in End-of-Life Care 413June JamesAnswers to Clinical Practice Questions 429Index 445

Alan J. Sinclair is a former Professor of Medicine at the University of Bedfordshire and Dean of the Beds & 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. Ahmed H. Abdelhafiz is 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.

• Contributors xxviiForeword xxxiiiPreface xxxvAbout the Companion Website xxxviiCharacteristics and Care Needs xxxixAhmed H Abdelhafiz, Ann Middleton and Alan J Sinclair1 Epidemiology and Pathophysiology 1Sarah L Sy2 Screening and Diagnosis 11Isabelle Bourdel-Marchasson3 Lifestyle Interventions 21Abdiazizi Yusuf and Ahmed H Abdelhafiz4 Oral Hypoglycaemic Therapy 31Nahian Kazi and Ahmed H Abdelhafiz5 Insulin Therapy 41Giuseppe Maltese6 Use of Continuous Glucose Monitoring in Older People with Diabetes 49Giuseppe Maltese7 Education: Key Features for Achieving Success 57Kirsty Winkley and Angus Forbes8 Carers and Care Needs 71Puja Merwaha and Ahmed H Abdelhafiz9A Macrovascular Complications: Peripheral Arterial Disease 81Leocadio Rodríguez-Mañas, Rubí E Sandoval-Santoyo and Marta Castro-Rodríguez9B Macrovascular Complications: Coronary Arterial Disease 89Leocadio Rodríguez-Mañas, Rubí E, Sandoval-Santoyo and Marta Castro Rodríguez9C Macrovascular Complications: Cerebrovascular Disease 97Abubakhr Subkhan, Arshad Majid and Ali Ali10A Microvascular Complications: Diabetic Eye Disease 109Archith Kamath and Nachiketa Acharya10B Microvascular Complications: Diabetic Kidney Disease 119Mohsen El Kossi10C Microvascular Complications: Peripheral Neuropathy 129Mitra Tavakoli11A Vascular Risk Factors: Hypertension 141Pann Ei Hnynn Si and Ahmed H Abdelhafiz11B Vascular Risk Factors: Dyslipidaemia 153Pann Ei Hnynn, Si and Ahmed H Abdelhafiz12A Metabolic Decompensation: Hyperglycaemic Crisis 165Puja Merwaha and Ahmed H Abdelhafiz12B Metabolic Decompensation: Hypoglycaemia 178Srikanth Bellary, Ahmed H Abdelhafiz and Alan J Sinclair13A Management of Diabetes in Hospital 189Julie Lewis and Chris Cottrell13B Management of Diabetes in Care Homes 201Lynne Reedman and Alan J Sinclair14 Nutrition 215Rihan Said and Grace Zaman15 Sexual Health 229Pann Ei Hnynn Si and Ahmed H Abdelhafiz16A Special Issues in Old Age: Frailty 241Alan J Sinclair and Ahmed H Abdelhafiz16B Special Issues in Old Age: Multimorbidity 266Alan J Sinclair and Ahmed H Abdelhafiz16C Special Issues in Old Age: Type 1 Diabetes Mellitus 275Alex M Summerbell and Ahmed H Abdelhafiz16D Special Issues in Old Age: Cognitive Health Agility, Cognitive Dysfunction, Dementia and Diabetes 285Tali Cukierman-Yaffe16E Special Issues in Old Age: Depression 299Sara-Louise Wylie16F Special Issues in Old Age: Foot Care 313Solomon Muzulu16G Special Issues in Old Age: Skin Care 326Grace Keegan and Sarah Mahmoud16H Special Issues in Old Age: Falls and Bone Health 336Nandkishor V Athavale16I Special Issues in Old Age: Avoiding Hospitalisation 347Demelza Emmerton and Ahmed H Abdelhafiz16J Special Issues in Old Age: Use of Technology 357Anna Kahkoska, Aastha Dubal, Josh Weinstein and Ruth S Weinstock16K Special Issues in Old Age: Annual Reviews 371Puja Merwaha and Ahmed H Abdelhafiz16L Special Issues in Old Age: Mouth Care 381Nali Ahmed and Ahmed H Abdelhafiz16M Special Issues in Old Age: Pain Management 392Pann Ei Hnynn Si and Ahmed H Abdelhafiz17 Deintensification of Therapy 405Antoine Christiaens18 Diabetes in End-of-Life Care 413June JamesAnswers to Clinical Practice Questions 429Index 445

Alan J. Sinclair is a former Professor of Medicine at the University of Bedfordshire and Dean of the Beds & 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. Ahmed H. Abdelhafiz is 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.

• Contributors xxviiForeword xxxiiiPreface xxxvAbout the Companion Website xxxviiCharacteristics and Care Needs xxxixAhmed H Abdelhafiz, Ann Middleton and Alan J Sinclair1 Epidemiology and Pathophysiology 1Sarah L Sy2 Screening and Diagnosis 11Isabelle Bourdel-Marchasson3 Lifestyle Interventions 21Abdiazizi Yusuf and Ahmed H Abdelhafiz4 Oral Hypoglycaemic Therapy 31Nahian Kazi and Ahmed H Abdelhafiz5 Insulin Therapy 41Giuseppe Maltese6 Use of Continuous Glucose Monitoring in Older People with Diabetes 49Giuseppe Maltese7 Education: Key Features for Achieving Success 57Kirsty Winkley and Angus Forbes8 Carers and Care Needs 71Puja Merwaha and Ahmed H Abdelhafiz9A Macrovascular Complications: Peripheral Arterial Disease 81Leocadio Rodríguez-Mañas, Rubí E Sandoval-Santoyo and Marta Castro-Rodríguez9B Macrovascular Complications: Coronary Arterial Disease 89Leocadio Rodríguez-Mañas, Rubí E, Sandoval-Santoyo and Marta Castro Rodríguez9C Macrovascular Complications: Cerebrovascular Disease 97Abubakhr Subkhan, Arshad Majid and Ali Ali10A Microvascular Complications: Diabetic Eye Disease 109Archith Kamath and Nachiketa Acharya10B Microvascular Complications: Diabetic Kidney Disease 119Mohsen El Kossi10C Microvascular Complications: Peripheral Neuropathy 129Mitra Tavakoli11A Vascular Risk Factors: Hypertension 141Pann Ei Hnynn Si and Ahmed H Abdelhafiz11B Vascular Risk Factors: Dyslipidaemia 153Pann Ei Hnynn, Si and Ahmed H Abdelhafiz12A Metabolic Decompensation: Hyperglycaemic Crisis 165Puja Merwaha and Ahmed H Abdelhafiz12B Metabolic Decompensation: Hypoglycaemia 178Srikanth Bellary, Ahmed H Abdelhafiz and Alan J Sinclair13A Management of Diabetes in Hospital 189Julie Lewis and Chris Cottrell13B Management of Diabetes in Care Homes 201Lynne Reedman and Alan J Sinclair14 Nutrition 215Rihan Said and Grace Zaman15 Sexual Health 229Pann Ei Hnynn Si and Ahmed H Abdelhafiz16A Special Issues in Old Age: Frailty 241Alan J Sinclair and Ahmed H Abdelhafiz16B Special Issues in Old Age: Multimorbidity 266Alan J Sinclair and Ahmed H Abdelhafiz16C Special Issues in Old Age: Type 1 Diabetes Mellitus 275Alex M Summerbell and Ahmed H Abdelhafiz16D Special Issues in Old Age: Cognitive Health Agility, Cognitive Dysfunction, Dementia and Diabetes 285Tali Cukierman-Yaffe16E Special Issues in Old Age: Depression 299Sara-Louise Wylie16F Special Issues in Old Age: Foot Care 313Solomon Muzulu16G Special Issues in Old Age: Skin Care 326Grace Keegan and Sarah Mahmoud16H Special Issues in Old Age: Falls and Bone Health 336Nandkishor V Athavale16I Special Issues in Old Age: Avoiding Hospitalisation 347Demelza Emmerton and Ahmed H Abdelhafiz16J Special Issues in Old Age: Use of Technology 357Anna Kahkoska, Aastha Dubal, Josh Weinstein and Ruth S Weinstock16K Special Issues in Old Age: Annual Reviews 371Puja Merwaha and Ahmed H Abdelhafiz16L Special Issues in Old Age: Mouth Care 381Nali Ahmed and Ahmed H Abdelhafiz16M Special Issues in Old Age: Pain Management 392Pann Ei Hnynn Si and Ahmed H Abdelhafiz17 Deintensification of Therapy 405Antoine Christiaens18 Diabetes in End-of-Life Care 413June JamesAnswers to Clinical Practice Questions 429Index 445