Evidence-based diabetes care for older people with Type 2 diabetes: a critical review

Diabet Med. 2019 Apr;36(4):399-413. doi: 10.1111/dme.13859. Epub 2018 Nov 29.

Abstract

In our ageing society diabetes imposes a significant burden in terms of the numbers of people with the condition, diabetes-related complications including disability, and health and social care expenditure. Older people with diabetes can represent some of the more complex and difficult challenges facing the clinician working in different settings, and the recognition that we have only a relatively small (but increasing) evidence base to guide us in diabetes management is a limitation of our current approaches. Nevertheless, in this review we attempt to explore what evidence there is to guide us in a comprehensive scheme of treatment for older adults, often in a high-risk clinical state, in terms of glucose lowering, blood pressure and lipid management, frailty care and lifestyle interventions. We strive towards individualized care and make a call for action for more high-quality research using different trial designs.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Aging / physiology
  • Diabetes Complications / epidemiology
  • Diabetes Complications / prevention & control
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / therapy*
  • Evidence-Based Practice* / standards
  • Health Services for the Aged* / standards
  • Humans