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June 2018

New guidance on treating diabetes in elderly and frail patients



New guidance has been published on managing diabetes in the elderly, including for the first time how to manage treatment for the particularly frail.

The guidance was produced from a collaboration between experts in diabetes medicine, primary care and geriatric medicine, led by Dr David Strain at the University of Exeter Medical School.

It will advise clinicians on helping elderly people with type 2 diabetes get the most out of treatment options, and for the first time contains guidance on how and when to stop diabetes treatments in particularly frail adults.

Dr Strain said: ‘Older adults have been systematically excluded from clinical trials and have very different ambitions from their diabetes management. This guidance puts the older person with diabetes firmly back at the centre of target setting, ensuring that appropriate goals are agreed to achieve the best quality of life possible, without continuing treatments that would not provide any benefit and potentially cause harm.’

The research was carried out in collaboration with NHS England and was published in Diabetic Medicine, the journal of Diabetes UK in April.

The report authors hope it will ultimately be incorporated into national guidance for GPs and practice nurses, to advise on the management of type 2 diabetes in elderly adults, aiming to reduce complications and improve quality of life.

The guidance will be adopted across Devon immediately. The authors hope local health and care commissioners will adopt and implement these principles in their own areas.

Pav Kalsi, Senior Clinical Advisor at Diabetes UK, said: ‘People with diabetes rightly deserve to have access to the right care and support at every stage of their life, and that means the care they receive needs to be adapted and tailored to suit each individual's changing needs. For example, those who are elderly, and potentially frail, often have different priorities, such as safety and quality of life.

‘We’re really pleased that these new guidelines will, for the first time, help healthcare professionals give this tailored support and will help them review and decide whether to stop diabetes treatment for particularly frail adults.

‘In the future, we hope these guidelines will have a positive impact on the lives of older people with diabetes.’



Strain WD, et al. Diabetic Medicine. ePub 07 April 2018 https://onlinelibrary.wiley.com/doi/full/10.1111/dme.13644

June 2018