Medicine KNOW DIABETES. FIGHT DIABETES. Invited Review a Full Access Evidence-based diabetes care for older people with Type 2 diabetes: a critical review A. J. Sinclair , A. H. Abdelhafiz, A. Forbes, M. Munshi First published: 08 November 2018 | https://doi-org.ezproxy.uta.edu/10.1111/dme.13859 Citations: 48 Check for full text SECTIONS X PDF TOOLS < SHARE 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. What’s new? . This review represents a modern, up-to-date account of published evidence that seeks to examine the significance of previous research relating to the management of diabetes in older people. The review also provides a diagrammatic view of the development of the complex illness scenarios seen in ageing people with diabetes, and provides the first detailed algorithm for developing individualized care programmes in this often vulnerable group. Search N
The increasing prevalence of diabetes in our aging society has brought forth a substantial burden in terms of both health outcomes and healthcare expenditures. This reality has prompted the need for evidence-based approaches to diabetes care, particularly in the context of older individuals with Type 2 diabetes. The critical review titled “Evidence-based diabetes care for older people with Type 2 diabetes: a critical review,” authored by A. J. Sinclair, A. H. Abdelhafiz, A. Forbes, and M. Munshi, delves into the complexities of managing diabetes in the elderly population. This essay provides an overview and analysis of the key insights and implications of this significant review.
The review acknowledges the multifaceted challenges that clinicians encounter when managing older individuals with diabetes. These challenges arise not only from the condition itself but also from the potential comorbidities, complications, and high-risk clinical states associated with aging. The recognition of these complexities sets the tone for the review’s emphasis on evidence-based strategies to navigate these challenges.
The authors explore a wide range of aspects relevant to diabetes care in older adults, including glucose lowering, blood pressure management, lipid control, frailty care, and lifestyle interventions. The comprehensive scope of the review underscores the need for a holistic approach that accounts for various health domains that can impact diabetes outcomes.
A key theme that emerges from the review is the imperative of individualized care. The authors advocate for a tailored approach to diabetes management that considers the unique needs, circumstances, and clinical status of each older patient. This approach resonates with the principles of person-centered care and acknowledges the diversity within the older population.
While the review highlights the progress made in evidence-based diabetes care for older individuals, it also underscores the limitation of the current evidence base. The authors emphasize the need for more high-quality research, particularly with diverse trial designs. This call for action reflects a commitment to advancing the field through rigorous scientific inquiry.
A notable contribution of the review is the provision of a diagrammatic algorithm for developing individualized care programs for older people with diabetes. This algorithmic approach serves as a practical tool that clinicians can utilize to navigate the complexities of care planning, tailoring interventions to the unique needs of each patient.
In an era where diabetes care is challenged by the aging demographic, the review offers a significant contribution by synthesizing existing evidence and providing actionable insights. By emphasizing individualized care, comprehensiveness, and the call for further research, the review aligns with the principles of evidence-based practice and person-centered care. As healthcare professionals continue to grapple with the intricacies of diabetes management in older individuals, the critical review serves as a valuable resource that informs and guides clinical decision-making, ultimately enhancing the quality of care for this vulnerable population.
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