The challenges of type 1 diabetes in older people

Abstract Over 200 000 people in England and Wales have type 1 diabetes. After the discovery of insulin, it became clear that people with diabetes had a reduced life expectancy and in the 1950s someone with type 1 diabetes might only expect to live until their sixth decade before they died from diabetic complications. Since then, longevity has increased and significant numbers are living into their eighth decade. In 1985, Diabetes UK introduced the Nabarro medal for those who had lived with the condition for more than 50 years and, as evidence of increased life expectancy, the Macleod medal has been awarded since 2004 to survivors who have taken insulin for more than 70 years. In 2003, the Golden Years Study used data from 400 Nabarro medalists to provide important insights into the factors influencing longevity. Age impacts on people's ability to manage diabetes, particularly if accompanied by geriatric complications, such as dementia and frailty. There is a lack of research evidence on which to base guidelines for care in frail type 1 patients, but international diabetes organisations recognise the importance of this vulnerable group and have developed guidance for glycaemic targets and cardiovascular risk modification. We put forward recommendations which recognise the need to individualise treatment. These emphasise the importance of providing education and training for professionals responsible for older people with type 1 diabetes to ensure that they can manage this cond...
Source: Practical Diabetes - Category: Endocrinology Authors: Tags: Review Source Type: research