This book is dedicated to all people with diabetes and their families who continue to be a source of inspiration; valued research colleagues and participants, and to all the health professionals who shared their wisdom and experience with us.
5th Edition
This edition first published 2020
© 2020 by John Wiley & Sons Ltd
Edition History [4e, 2014]
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Library of Congress Cataloging‐in‐Publication Data
Names: Dunning AM, Trisha, author. | Sinclair, Alan (Alan J.), author.
Title: Care of people with diabetes : a manual for healthcare practice /Professor Trisha Dunning, Professor Alan Sinclair.
Description: 5th edition. | Hoboken, NJ : Wiley‐Blackwell, 2020. | Includes bibliographical references and index.
Identifiers: LCCN 2019024442 (print) | ISBN 9781119520856 (paperback) | ISBN 9781119520863 (adobe pdf) | ISBN 9781119520870 (epub)
Subjects: MESH: Diabetes Mellitus
Classification: LCC RC660 (print) | LCC RC660 (ebook) | NLM WK 810 | DDC 616.4/620231–dc23
LC record available at https://lccn.loc.gov/2019024442
LC ebook record available at https://lccn.loc.gov/2019024443
Cover Design: Wiley
Cover Image: © Robert Kneschke/Shutterstock
Diabetes is a serious and complex condition.
No one chooses to get diabetes, but for those living with the condition, there is no respite – diabetes is 24/7 through all ages and stages.
Within a generation, there have been unprecedented advances in our approach to diabetes – in its treatment and management and more broadly. For example, new technologies (both approved and DIY) have greatly diminished the need to constantly draw blood to check glucose levels; insulin and metformin are on the cusp of being replaced as first‐line oral therapies; we now better appreciate that diabetes is both a physical as well as a psycho‐social challenge; and we strive to use and encourage health professionals and the media in particular to use, nonjudgemental language when referring to diabetes.
Faced with this degree of change, it's not surprising that this important manual of healthcare practice has now been updated for the fifth time in 25 years.
I congratulate Professors Trisha Dunning AM and Alan Sinclair, along with all their expert advisors, for their unstinting efforts in helping those who care for people living with diabetes to navigate this rapidly changing environment. The breadth of issues highlighted in the 18 chapters of this manual reflects the often complex daily challenges faced by people living with diabetes, as well as by those health professionals advising them. From first symptoms to end‐of‐life care and all the phases in between, what shines through all these pages is empathy, compassion, and a desire to help those people living with this relentless condition to lead long, dignified, healthy, and productive lives – all of which are truly universal aspirations. In updating this manual, Professors Dunning and Sinclair have tapped into their extensive Australian and UK networks and have also been well supported by diabetes colleagues working elsewhere in the world – an impressive and very commendable collaboration.
I hope future editions will document even more progress, reflecting our greater understanding of all types of diabetes resulting from the simply breathe‐taking quality and quantity of research currently underway in so many centres across the world. Perhaps we will finally learn how to prevent type 2 diabetes as well as some of its serious complications; be clearer about whether type 2 diabetes can ever be reversed; and one day find a cure for type 1 diabetes and other similar autoimmune conditions.
On behalf of an organisation that strives to support, empower, and campaign for all those affected by, or at risk of, diabetes, I'm optimistic.
Melbourne, Australia
Craig Bennett is a health economist by training; the CEO of Diabetes Victoria; and an Adjunct Professor at Deakin University.
It is humbling to be preparing the fifth edition of Care of People with Diabetes: a Manual of Nursing Practice and to change the title to Care of People with Diabetes; A Manual for Healthcare Practice to reflect the broad range of readers it attracts.
It is certainly an honour to have my dear friend and colleague, Professor Alan Sinclair, co‐edit this edition with me. Alan brings with him a wealth of experience as an acknowledged world expert in diabetes care. The book has evolved a great deal since the first edition was published in 1994. Many readers will not know that the first edition was volume 2 of my Master of Education degree. It originated from comments given by the nursing staff from St. Vincent's Hospital Melbourne who suggested, ‘It would be good to have some guidance about nursing care for “diabetics” besides the guidelines, which are mostly medical’.
I developed a draft based on their suggested topics, and they used those draft versions to guide care and then provided feedback about the usefulness, clinical relevance, and ease of use. We developed several iterations before we reached consensus about the content and presentation of the information. The evaluation process became volume 1 of my thesis and the information became volume 2, and ultimately the first edition of Care of People with Diabetes: a Manual of Nursing Practice.
Readers will find much that is the same in this fifth edition. Obviously, there are changes that reflect new research and technological and philosophical changes. Therefore, there are some new text and references. There is emerging global interest in ‘the language of diabetes’, and its impact on outcomes, which were mentioned in the preface to the fourth edition. The fifth edition continues to advocate for shared decision‐making and personalised (person‐centred/tailored) integrated care plans developed with the individual, and holistic care.
These include the increasing prevalence of type 1, type 2, and gestational diabetes, population ageing, the focus on prevention and the need to maximise value while containing the spiraling cost of diabetes care. The need to proactively plan for end of life care is emerging globally and represents a challenge for many clinicians. Obviously, there are differences among countries, even within countries, but these are common global trends.
The book was designed to support clinical practice guidelines, not replace them. It is impossible to include ‘everything’ in any publication: we hope readers will find something of value that will help them improve the care they plan for people with diabetes.
We sincerely thank Blackwell for supporting the first edition of the book published in 1994 and Wiley for supporting subsequent editions. We especially thank Mr James Watson, Commissioning Editor for Wiley, for commissioning the 5th edition, Ms Yogalakshmi Mohanakrishnan, project editor, for her collaboration and advice and for taking such good care of our work, and Ms Monisha Swaminathan for the fine editing that went into this project.
We both work in supportive teams of doctors, nurses, and allied health professionals, and with wonderful academic colleagues. Our special thanks go to them for their friendship and critical comment on various aspects of the book. We especially thank those people who reviewed the book and gave very useful feedback, most of which has been incorporated in this edition.
We acknowledge the generosity of the Australian Commonwealth Department of Health and Ageing for permission to reproduce the figure depicting how the Quality Use of Medicines framework can be applied to diabetes management that appears in Chapter 5. We acknowledge colleagues Dr Sally Savage, Nicole Duggan, and Professor Peter Martin for giving permission to include our hypoglycaemia risk assessment tool in Chapter 7. We thank Natalie Whischer, Heather Hart, Kate Marsh, and Jennifer Hunter for comments about Chapters 2, 14, 4, and 19, respectively, and especially Professor Jane Speight for her advice and contribution to Chapter 15 on psychological and quality of life issues.
We sincerely thank Virginia Dicson‐Smith and Tara Watts for assistance with checking the references and Dr Joan Ostakiewictz for her interest and ongoing support during the revision process.
We are in awe of the people who undertook the research and critical thinking cited in this edition and other researchers and clinicians who contribute so much information about diabetes that challenge, inform, and inspire us. As Isaac Newton said: “If I [we] have seen further it is by standing on the shoulders of Giants.”
We both learned, and continue to learn, a great deal about diabetes from the people with diabetes and their families whom we teach and care for/with, and who participate in our research as participants, advisors, and co‐researchers, as well as their families. It is a privilege to be with them and share information and their stories: they inspire us.
We sincerely thank Mr Craig Bennett, CEO of Diabetes Victoria, for agreeing to write the foreword for this edition.
Finally, and most importantly, we thank our respective families for their support and understanding, not just during the revision of this book but over the years.
A very special thank you and our love go to John Dunning and Caroline Sinclair ‘for everything’, and our furry four‐legged family, Flora Weadora Dunning and Posey and Pippen Sinclair.
The acronyms are generally spelled out the first time they appear in the text, often spelled out the first time used in a chapter. All abbreviations are internationally accepted and recognised.