Diabetes in Old Age, Second Edition

Content material:
Chapter 1 Diabetes Mellitus and Impaired Glucose rules in previous Age: the size of the matter (pages 1–16): Paul Finucane and Phil Popplewell
Chapter 2 Pathophysiology of Diabetes within the aged (pages 17–23): Graydon S. Meneilly
Chapter three setting up the prognosis (pages 25–39): P. Jean Ho and John R. Turtle
Chapter four Screening and remedy recommendations for Diabetes problems within the aged (pages 41–49): Lea Sorenson and Dennis ok. Yue
Chapter five Metabolic Decompensation (pages 52–66): Simon C. M. Croxson
Chapter 6 The Diabetic Foot (pages 67–87): Matthew J. younger and Andrew J. M. Boulton
Chapter 7 Erectile disorder (pages 89–102): Aaron Vinik and Donald Richardson
Chapter eight Mortality and its Predictors in variety 2 Diabetes (pages 103–117): M. Muggeo, G. Zoppini, E. Brun, E. Bonora and G. Verlato
Chapter nine visible Loss (pages 119–131): Amanda Butcher and Paul Dodson
Chapter 10 Hypoglycaemia (pages 133–152): Vincent McAulay and Brian M. Frier
Chapter eleven matters within the preliminary administration of sort 2 Diabetes (pages 154–164): Alan J. Sinclair
Chapter 12 Insulin remedy (pages 165–176): Tim Hendra
Chapter thirteen coping with surgical procedure within the aged Diabetic sufferer (pages 177–185): Geoffrey Gill and Susan Benbow
Chapter 14 Metabolic threat elements and their therapy (pages 187–198): Hosam ok. Kamel and John E. Morley
Chapter 15 Drug remedy: present and rising brokers (pages 199–214): Joe M. Chehade and Arshag D. Mooradian
Chapter sixteen Rehabilitation (pages 215–227): Paul Finucane and Maria Crotty
Chapter 17 forthcoming basic Care (pages 229–239): Klaas Reenders
Chapter 18 Diabetes in Care houses (pages 241–251): Alan J. Sinclair and Roger Gadsby
Chapter 19 smooth views and up to date Advances (pages 253–261): Christopher J. Turnbull and Alan J. Sinclair

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Example text

It is increasingly recognized, too, that a subset of middle-aged patients with Type 2 diabetes have a form of diabetes characterized by beta-cell failure, and these patients often have high titres of islet-cell antibodies and antibodies to GAD, similar to younger patients with Type 1 diabetes. It has been suggested that screening for anti-GAD antibodies and other autoimmune parameters should be routine in middle-aged patients, since the presence of these antibodies will predict patients destined to require insulin therapy (Zimmet 1999).

Recently, metabolic factors have been characterized in lean and obese elderly patients with diabetes (Arner, Pollare and Lithell 1991; Meneilly et al 1996). These studies have found some surprising differences in the metabolic pro®les of middle-aged and elderly subjects. In contrast to younger subjects, fasting hepatic glucose production is normal in both lean and obese elderly subjects (Figure 2). As in younger subjects, lean elderly patients have a profound impairment in pancreatic insulin secretion, but in contrast to the young these patients have minimal resistance to insulinmediated glucose disposal (Figures 3 and 4).

A Swedish community study estimated that 15% of people aged over 65 years had diabetes (Andersson, Svardsudd and Tibblin 1991) and similar prevalence rates have been reported from Denmark (Agner, Thorsteinsson and Eriksen 1982). 5% in French people aged over 65 years (Bourdel-Marchasson et al 1997). However, as the French study largely relied on self-reporting, the true prevalence rate is likely to be substantially higher. Australia and New Zealand National studies on the epidemiology of diabetes are lacking in both countries.

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