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

Abstract

Diabetes mellitus is a highly prevalent metabolic condition in ageing societies associated with high levels of morbidity, multiple therapies, and functional deterioration that challenges even the best of health care systems to deliver high-quality, individualized care. Most international 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. A collaborative Expert Group of the IAGG and EDWPOP and an International Task Force have explored the key issues that affect diabetes in older people using a robust method comprising a Delphi process and an evidence-based review of the literature. Eight domains of interest were initially agreed and discussed: hypoglycemia, therapy, care home diabetes, influence of comorbidities, glucose targets, family/carer perspectives, diabetes education, and patient safety. A set of "consensus" statements was produced in each domain of interest. These form a foundation for future policy development in this area and should influence the clinical behavior and approach of all health professionals engaged in delivering diabetes care to older people.Alan Sinclair, John E. Morley, Leo Rodriguez-Mañas, Giuseppe Paolisso, Tony Bayer, Andrej Zeyfang, Isabelle Bourdel-Marchasson, Ulrich Vischer, Jean Woo, Ian Chapman, Trisha Dunning, Graydon Meneilly, Joel Rodriguez-Saldana, Luis Miguel Gutierrez Robledo, Tali Cukierman-Yaffe, Roger Gadsby, Guntram Schernthaner, Kate Lori