Diabetes in Elderly People: A guide for the health care team

129 Pages·1990·3.388 MB·English

by  P. V. Knight, C. M. Kesson (auth.), Colin M. Kesson, Paul V. Knight (eds.)

DIABETES IN ELDERLY PEOPLE
DIABETES IN
ELDERLY PEOPLE
A guide for the health care team
Edited by
COLIN M. KESSON,
Consultant Physician and Diabetologist,
Victoria Infirmary,
Glasgow
and
PAUL V. KNIGHT,
Consultant Physician in Geriatric Medicine,
Lightburn General Hospital,
Glasgow
Springer-Science+ Business Media, B.V.
First edition
© 1990 Springer Science+ Business Media Dordrecht
Originally published by Chapman and Hall in 1990
Typeset in 11112 Sabon by Scarborough Typesetting Services
ISBN 978-0-412-32870-1
All rights reserved. No part of this publication may be reproduced or
transmitted, in any form or by any means, electronic, mechanical,
photocopying, recording or otherwise, or stored in any retrieval
system of any nature, without the written permission of the
copyright holder and the publisher, application for which shall be
made to the publisher.
British Library Cataloguing in Publication Data
Diabetes in elderly people.
1. Old persons. Diabetes
I. Kesson, C. M. II. Knight P. v.
618.97' 6462
ISBN 978-0-412-32870-1 ISBN 978-1-4899-3322-5 (eBook)
DOI 10.1007/978-1-4899-3322-5
Library of Congress Cataloging-in-Publication Data available
CONTENTS
CONTRIBUTORS Vll
ACKNOWLEDGEMENTS Vlll
PREFACE IX
FOREWORD X
INTRODUCTION. A short guide to some salient
points 1
P. V. Knight and C. M. Kesson
1. EPIDEMIOLOGY AND
PATHOPHYSIOLOGY. Who, where, what and
why? 5
B. J. Martin and P. V. Knight
2. CLINICAL FEATURES AND CASE
DETECTION. Listening, looking and
investigating 9
B. J. Martin and P. V. Knight
3. EDUCATION OF ELDERLY PEOPLE WITH
DIABETES 15
P. V. Knight
4. DIETARY ASSESSMENT AND THERAPY 25
P. A. Phillips
5. ORAL THERAPY 35
P. V. Knight
vi Contents
6. INSULIN THERAPY 41
C. M. Kesson
7. MONITORING CONTROL OF DIABETES IN 49
THE ELDERL Y PATIENT
B.J.
Martin
8. FOOT CARE 55
K. R. Paterson
9. GENERAL PRESCRIBING PROBLEMS IN
ELDERL Y DIABETIC PATIENTS 65
F. I. Caird
10. HYPERGL YCAEMIA AND
HYPOGL YCAEMIA 69
K. R. Paterson
11. COMPLICATIONS OF DIABETES 83
F. I. Caird
12. MANAGEMENT OF INTERCURRENT
ILLNESS 91
K. R. Paterson
13. THE ROLE OF THE SPECIALIST NURSE 95
M. Roberts
14. SHARED CARE 103
C. M. Kesson
APPENDIX A Dietary guidelines for elderly
diabetic patients 109
APPENDIX B Ten basic instructions for patients 113
APPENDIX C Useful addresses 119
APPENDIX D Further Reading 119
INDEX 123
CONTRIBUTORS
Francis I. Caird MA DM FRCP
(Lond. and Glasg.)
David Cargill Professor of Geriatric Medicine, Univer
sity of Glasgow, Glasgow, UK
Colin M. Kesson MBChB MRCP
Consultant Physician and Diabetologist, Victoria In
firmary, Glasgow, UK
Paul V. Knight MBChB MRCP
Consultant Physician in Geriatric Medicine, Lightburn
Hospital, Glasgow; Visiting Assistant Professor of Medi
cine, North Eastern Ohio Universities College of Medi
cine, USA
Brendan J. Martin MBChB MRCP
Consultant Physician in Geriatric Medicine, Lightburn
Hospital, Glasgow, UK
Kenneth R. Paterson MBChB MRCP
Consultant Physician and Diabetologist, Royal Infirmary
and Southern General Hospital, Glasgow, UK
Patricia A. Phillips SRD
Dietitian, Victoria Infirmary, Glasgow, UK
Maureen Roberts RGN SCM
Diabetic Liaison Sister, Victoria Infirmary, Glasgow, UK
ACKNOWLEDGEMENTS
We are greatly indebted to our secretaries, Miss Lorraine
Mitchell and Mrs Mary Gibb, as well as to all the contributors
for their patience and effort. We would also like to thank our
publishers for their good advice, and Mr John Main of the
medical illustration department of the Victoria Infirmary for
his excellent illustrations.
Colin M. Kesson
Paul V. Knight
PREFACE
This book is intended for all members of the health care team
who look after elderly people with diabetes mellitus. This
includes specialist nurses in diabetes and care of the elderly,
other nurses who might be involved with elderly diabetic
patients, hospital doctors, general practitioners, dietitians,
and other paramedical staff as well as students in these various
disciplines.
It is not an exhaustive text, but includes plenty of back
ground references for those who wish to pursue a topic
further.
FOREWORD
It has been said that old age is not so bad when you consider
the alternative; but, fortunately on occasion symptoms attri
buted to ageing are due to treatable disease. This useful book
draws attention to diabetes mellitus, a common illness in
elderly people, which can cause serious disability and should
be diagnosed promptly and treated correctly. In this text the
facts are well documented that the diagnosis may alarm old
people and thus a full explanation must be given and the likely
benefits of an adequate therapeutic regimen described.
Drs Paul Knight and Colin Kesson are physicians intimately
concerned with the day to day diagnosis and treatment of
diabetes and they have enlisted the assistance of colleagues of
outstanding ability, thus demonstrating the vital importance
of teamwork in the control of this disease.
Modern geriatric practice is proving of inestimable value to
older people and detailed accounts such as this, of the practical
comprehensive management of an illness, show that while
diagnosis is still fundamental, the essential components of
complete empathy with the patient as a whole person and
continuity of care are essential to obtain good results.
Education of elderly people with diabetes, dietary assessment
and therapy, appropriate medication and important compli
c~tions are subjects clearly discussed, with detailed guidance
glven.
We live in a world in which the lifespan of the population is
increasing steadily and the numbers of elderly people growing,
thus knowledge must increase to help every old person to
enjoy these added years. I am therefore delighted to be invited