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Diabetes

Executive Summary

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  • Diabetes is the commonest metabolic long term condition in older people and is characterised by a high rate of vascular complications and subsequent disability, frequent hospital admissions, and increased institutionalisation.
  • Effective diabetes care for older people requires clinicians to aim for the highest category of health status and quality of life commensurate with achieving a level of metabolic control that minimises both diabetes-related complications and the adverse effects of treatment.
  • The Aims of Care can be classified according to both medical/healthcare team perspectives and patient/carer perspectives: these focus on maintaining a normal healthy lifestyle, a high level of functioning, minimising complications, and a ready access to education
  • The increased risk of cognitive and mood disorders, undernutrition, physical frailty, and care home residency require those involved in the direct care of older people with diabetes to have skills in geriatric assessment and access to additional specialist treatment
  • There are no age-related modifications required in either oral agent use or use of insulin in the management of diabetes in the elderly; as in younger people with diabetes, the emphasis is on a multifaceted approach that targets not only glucose but also cardiovascular risk modification

Review date: May 2012
Authors: Aspray, TJ; Yarnall, AJ; Croxson, SC;  Chillala, J; Sinclair, AJ. for the Diabetes Special Interest Group of the British Geriatrics Society

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