Leading professor slams ‘fragmented’ type 1 care for older people


Diabetes care for older people is “fragmented” and urgent steps need to be taken to restore the “health and dignity” of older people, according to a leading expert.

Professor Alan Sinclair, from the Foundation for Diabetes Research in Older People and King’s College, London has dedicated much of his career to studying how various forms of diabetes can impact older people.

He plans to address some of the key issues he has discovered, alongside another leading expert, Dr David Strain, a Senior Clinical Lecturer at the University of Exeter Medical School, at Diabetes Professional Care (2019).

Professor Sinclair said: “Our review of the available literature and practices show the level of diabetes care is likely to be fragmented which is quite worrying because older people, particularly those with diabetes, are more likely to be admitted to hospital when they are unwell. This is because diabetes can have an additional effect on the illness and the illness can impact on their diabetes.

“Without proper management, it can lead to frailty, dependency, disability and reduced life expectancy, not to mention the damage it does to someone’s dignity. There is also the added strain on the NHS as a result of frequent hospital admissions to treat diabetes-related complications which are costly, not to mention unsettling for the patient.”

Dr David Strain, a Senior Clinical Lecturer at the University of Exeter Medical School, said he believes “individualised care plans” are essential for adults with type 1 diabetes as they are for those with type 2 diabetes..

He added: “Tailoring care is so important, especially for those who are older and may have other complex health conditions.

“We also need to talk palliative care among older adults with type 1 diabetes, having a care plan in place ensures everybody knows what is expected. More training for diabetes care staff, introducing better interventions and encouraging a change in attitude is all going to contribute towards improved health outcomes for older people with diabetes.

“Type 1 diabetes isn’t a straightforward condition when it comes to treating older people because they may have limited functionality. If they are frail, have dementia or live in a care home, their needs will be greater than someone who is completely healthy”.

Professor Sinclair added: “David and I both agree that we wish to see national and international health organisations to do more to include diabetes in older people within their policies and guidelines as this will ensure global collaboration at a high level of influence and pave the way for better health outcomes in this rather vulnerable group of individuals.”

Professor Alan Sinclair and Dr David Strain will introduce the session, Type 1 Diabetes in Older Adults – Key Features and Management Guidance, on day one of DPC2019 in the Theatre at 16:10-16:50.

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