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The older person with diabetes: considerations for care

02 April 2019
Long-Term Conditions
02 April 2019
Volume 24 · Issue 4

Abstract

With the increasingly ageing population worldwide, more older people are living with diabetes. The conditions that often accompany older age, such as dementia, renal impairment, visual impairment and manual dexterity difficulties, can make diabetes management complex and self-care challenging. However, the status of older people varies considerably, and so choice of glucose-lowering agents and clinical targets should be individualised to maximise safety and ensure that the risks of treatments do not outweigh the benefits. For many patients, there will be an increasing dependence on others to manage their diabetes care, so an appropriate skill mix among healthcare professionals and carers, adequate training and regular competency assessment are crucial to support patients to remain safe and symptom free from diabetes.

The population worldwide is ageing dramatically: it is expected that between 2015 and 2050, the proportion of the world's population aged 60 years or older will nearly double, from 12% to 22%. The number of people aged 60 years or older will outnumber children younger than 5 years old by next year. Further, there are 125 million people in the world aged 80 years or more today, but by 2050, this number is expected to be 120 million people in China alone (World Health Organization (WHO), 2018).

Diabetes prevalence is also rapidly increasing with population ageing, with 592 million people predicted to have diabetes by 2035 (as opposed to the 382 million people in 2013). Older age is associated with increased risk of developing type 2 diabetes, and an increasingly older population has significant public health cost implications for the future (International Diabetes Federation (IDF), 2013). Older age and diabetes are both important risk factors for the development of functional decline, disability and impaired quality of life (Wong et al, 2013).

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Diabetes
Ageing
Treatment targets
Competence in care
Self-management