Diabetes Management in Older Adults: Seeing the Forest for the Trees.

Abstract

Diabetes is a burdensome chronic disease that affects older adults disproportionately. The Public Health Agency of Canada estimates that approximately 18% of adults aged 65 years of age and older have diabetes, and 21% of adults aged 70 years and older have diabetes (1). The unique and heterogeneous group comprising older adults presents challenges in the management of diabetes and its complications. The clinical management of diabetes has become increasingly difficult, straining even the most advanced and highquality healthcare systems (2). Thus, clinical guidelines to address diabetes management and education for diabetes in older adults are necessary. Over the past several years, 3 leading diabetes organizations, the American Diabetes Association (ADA), the Canadian Diabetes Association (CDA) and the International Diabetes Federation (IDF), published their respective guidelines for the management of diabetes in older adults; all 3 were met with some degree of applause, debate, confusion and appreciation. All 3 reported their respective recommendations for various aspects of diabetes management in older adults, including clinical management and glucose, blood pressure and cholesterol targets, as well as recommendations for education and psychosocial well-being (3–5).