Type 2 diabetes mellitus in older people: a brief statement of key principles of modern day management including the assessment of frailty. A national collaborative stakeholder initiative
File(s)Strain_et_al-2018-Diabetic_Medicine.pdf (323.07 KB)
Published version
Author(s)
Type
Journal Article
Abstract
Rates of population ageing are unprecedented and this, combined with the progressive urbanization of lifestyles, has led to a dramatic shift in the epidemiology of diabetes towards old age, particularly to those aged 60-79 years. Both ageing and diabetes are recognized as important risk factors for the development of functional decline and disability. In addition, diabetes is associated with a high economic, social and health burden. Traditional macrovascular and microvascular complications of diabetes appear to account for less than half of the diabetes-related disability observed in older people. Despite this, older adults are under-represented in clinical trials. Guidelines from organizations such as the National Institute for Health and Care Excellence (NICE), the European Association for the Study of Diabetes, and the American Diabetes Association acknowledge the need for individualized care, but the glycaemic targets that are suggested to constitute good control [HbA1c 53-59 mmol/mol (7-7.5%)] are too tight for frail older individuals. We present a framework for the assessment of older adults and guidelines for the management of this population according to their frailty status, with the intention of reducing complications and improving quality of life for these people. This article is protected by copyright. All rights reserved.
Date Issued
2018-07-01
Date Acceptance
2018-04-01
ISSN
0742-3071
Publisher
Wiley
Start Page
838
End Page
845
Journal / Book Title
Diabetic Medicine
Volume
35
Issue
7
Copyright Statement
© 2018 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK
This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/29633351
Subjects
Science & Technology
Life Sciences & Biomedicine
Endocrinology & Metabolism
TIGHT GLYCEMIC CONTROL
PHYSICAL-DISABILITY
POSITION STATEMENT
INSULIN DEGLUDEC
ELDERLY-PATIENTS
ADULTS
COMPLICATIONS
ASSOCIATION
PREVALENCE
MEDICATION
1103 Clinical Sciences
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2018-04-07