With nearly half of all people with T1D in the UK now over 50, this issue demands urgent attention. However, a stark lack of research, policy and healthcare services tailored to the needs of older adults with T1D still remains. As there is no preventing or curing T1D, action is required to better support this cohort with their chronic condition.

Breakthrough T1D commissioned research to understand the lived experiences of people aged 45 and over with T1D, which uncovered troubling findings. As the body ages, physical decline, cognitive impairment and dealing with other multiple health conditions becomes more common and makes daily diabetes management increasingly difficult. For example, reduced dexterity, mobility issues and visual impairment can make it harder to administer insulin, use diabetes technology or accurately monitor blood glucose levels. Similarly, studies show that HbA1c levels of 8-8.9% or higher comes with an increased risk of dementia, which presents challenges for accurately following treatment plans, responding to glucose fluctuations and making informed decisions about care.

Managing multiple conditions is also a significant challenge for older adults with living T1D. The polypharmacy attached to these conditions increases the risk of drug interactions, side effects and difficulties adhering to diabetes treatment plans.

For older women, menopause adds another layer of complexity, affecting their physical health, emotional wellbeing and blood glucose control due to the hormonal fluctuations during this stage. The findings from the report clearly indicate the need for specialised care and resources to support these women with guidance on dealing with diabetes management challenges.

Many described ageing with T1D as a constant battle, marked by anxiety, frustration, and fear about their future health. Individuals reported having to fight for appropriate care in hospitals and for access to treatments. There were also concerns about insufficient training among healthcare professionals in managing T1D in older adults, leading to inappropriate or unsafe care practices. The research uncovered widespread gaps in support and a lack of systems prepared to meet the demands of an ageing T1D population.

The report calls for health and social care systems to evolve, centring the voices and experiences of older adults living with T1D. By co-designing care, treatment and training with people living with the condition, there is an opportunity to improve their quality of life and reduce preventable complications.