New guideline addresses shortfalls in diabetes care for older people

IDF has launched a global guideline to improve management of older people with type 2 diabetes. According to the guideline, care for many older people with diabetes is currently sub-optimal and fragmented leaving a large proportion of older people with unmet clinical and social needs. The guideline will support clinicians to make age and function-appropriate care decisions and set the standard of care governments and service providers should aim for.

IDF estimates that up to 19% of people between 60 and 79 years have diabetes. In numbers this represents 134 million people. By 2035 that number if projected to increase beyond 252 million people. IDF also estimates that up to half of all people with type 2 diabetes are undiagnosed, leading to the development of disabling complications before diagnosis.

IDF’s Managing Older People with Type 2 Diabetes Global Guideline is structured into chapters dealing with issues such as cardiovascular risk, education, renal impairment and diabetic foot disease. It also includes less commonly addressed areas such as sexual health and a chapter on end of life care. T

According to Professor Trisha Dunning, Vice-President of IDF and co-author of the guideline, “Managing diabetes is challenging, especially in older people who often have mental, physical and sensory changes that increases their vulnerability, shortens life expectancy and reduces dignity, comfort and quality of life”.

When combined with the natural ageing process and other age-related conditions, diabetes contributes to poorer outcomes in older people with diabetes compared to those without the disease. Peripheral neuropathy, which is common in older people with diabetes, increases the risk of falls and factures, as do hypo- and hyperglycaemic events.

People with diabetes are 1.5 times more likely to develop dementia than people who do not have diabetes.  They are also at increased risk of falling and sustaining injuries such as fractures, be in pain, have renal and liver damage that complicates prescribing and managing medicines and increases the risk of adverse events associated with medicines including interactions. Thus determining functional status and considering life expectancy is essential to planning quality care.

According to Professor Alan Sinclair, Professor of Medicine at the University of Bedfordshire and co-author of the guideline, “Research also shows many health professionals lack knowledge about how to provide education and care for older people.  It is essential that government health policies, including strategic plans, address the specific needs of older people and include strategies to build health professionals’ knowledge and competence to care for older people with diabetes”.

The guideline was launched at the World Diabetes Congress in Melbourne, running from December 2-6 in Melbourne Exhibition and Convention Centre.