Diabetes - older people
Care of older people with diabetes can provide specific challenges as increasing numbers of people may also be experiencing concurrent complications and comorbidities, and this will impact on care requirements. Other challenges may be increasing frailty in later life and reduced ability to self-manage and self-care.
The following resources look at some of these issues and focus on the needs of older people. See also Residential care.
These resources were last accessed on 1 November 2012. Some of them are in PDF format - see how to access PDF files.
British Geriatrics Society (2009) Good Practice Guides 38: Diabetes
This guide focuses on the Principal Aims in Diabetes Care for older people summarised by the European Diabetes Working Party for Older People (EDWPOP) in 2004. It also highlights some of the "tensions" generated between treatment guidelines for type 2 diabetes and targeted care of frail older people. See also the updated guideline below from the EDWPOP and others published in the Journal of the American Medical Directors Association.
British Geriatric Society Diabetes Special Interest Group
This section of the BGS website provides information on membership of this group and a number of resources produced by the group.
Institute of Diabetes for Older People (IDOP)
A key mission of the Institute is: to enhance the quality of diabetes care for older people through new initiatives in clinical practice, audit, and research. In addition the Institute aims to provide a forum for scientific interchange between health professionals and scientists and involve people with diabetes and their carers in educational programmes. Research activities are described including a study in progress on diabetes and frailty.
Journal of the American Medical Directors Association (2012) Diabetes Mellitus in Older People: Position Statement on behalf of the International Association of Gerontology and Geriatrics (IAGG), the European Diabetes Working Party for Older People (EDWPOP), and the International Task Force of Experts in Diabetes
This position statement has been produced through a collaboration of expert groups and in particular focuses on the likely needs and experiences of those who are 70 years and older, while also recognising that older people are not a homogenous group of individuals. The expert groups have explored key issues that affect diabetes in older people aware that many clinical guidelines “have ignored the often-unique issues of frailty, functional limitation, changes in mental health, and increasing dependency that characterize many aged patients with diabetes”. It covers eight domains of interest which each has a set of consensus statements. The domains of interest are: hypoglycemia; therapy; care home diabetes; influence of comorbidities; glucose targets; family/carer perspectives; diabetes education; and patient safety. The position statement is published in Journal of the American Medical Directors Association 13(6) July 2012 pp.497-502.
NHS Diabetes Areas of care: Services for older people
This page is aimed at commissioners and providers of diabetes care. It brings together guidance, policy, commissioning guides, links to care pathways and examples of how services can be improved for older people with diabetes.
NHS Diabetes: Older people network
The older people network led by NHS Diabetes and the Institute of Diabetes for Older People, aims to bring together health and social care professionals from a range of disciplines, who share an interest in the care of older people with diabetes.
RCN Older people resource
This brings together a range of resources that can inform and support care of older people in general. It highlights work that the RCN has been carrying out on older peoples's care and includes examples that showcase good practice in the care of older people.