Diabetes mellitus in older people: position statement on behalf of the International Association of Gerontology and Geriatrics (IAGG), the European Diabetes Working Party for Older People (EDWPOP), and the International Task Force of Experts in Diabetes
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Diabetes mellitus is a highly prevalent metabolic condition in ageing societies associated with high levels of morbidity, multiple therapies, and functional deterioration that challenges even the best of health care systems to deliver high-quality, individualized care. Most international clinical guidelines have ignored the often-unique issues of frailty, functional limitation, changes in mental health, and increasing dependency that characterize many aged patients with diabetes. A collaborative Expert Group of the IAGG and EDWPOP and an International Task Force have explored the key issues that affect diabetes in older people using a robust method comprising a Delphi process and an evidence-based review of the literature. Eight domains of interest were initially agreed and discussed: hypoglycemia, therapy, care home diabetes, influence of comorbidities, glucose targets, family/carer perspectives, diabetes education, and patient safety. A set of "consensus" statements was produced in each domain of interest. These form a foundation for future policy development in this area and should influence the clinical behavior and approach of all health professionals engaged in delivering diabetes care to older people.
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The goal of palliative medicine is to promote comfort, symptom management and prevention (pain, hypoglycemia, hyperglycemia, and dehydration), and preservation of dignity and quality of life in the setting of limited life expectancy.
“The goal of palliative medicine is to promote comfort, symptom management and prevention (pain, hypoglycemia, hyperglycemia, and dehydration), and preservation of dignity and quality of life in the setting of limited life expectancy (169,170).”
From 13. Older Adults: Standards of Care in Diabetes—2026 (2026) · cites this paper as [169]
The Diabetes in Care Homes consensus statements (indexed under Hypoglycemia; page unavailable) call for preventing hypoglycemia, recognizing and managing pain, and introducing timely end-of-life care. They do not state the broader goal attributed to palliative medicine, including preservation of dignity and quality of life or prevention of dehydration. (LLM, conf=0.82)
Experimental — accuracy not yet measuredSpecial management considerations include the need to avoid both hypoglycemia and the complications of hyperglycemia.
“Special management considerations include the need to avoid both hypoglycemia and the complications of hyperglycemia (2,126).”
From 13. Older Adults: <i>Standards of Care in Diabetes—2024</i> (2024) · cites this paper as [126]
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Schott, G., Martinez, Y. V., de Silva, R. E. E., Guiteras, A. R., Vögele, A., Reeves, D., Kunnamo, I., Marttila-Vaara, M., & Sönnichsen, A. C. (2017) · BMC Geriatrics · doi:10.1186/s12877-017-0571-8 · Cited by 47 · see citing works
Hanlon, P., Butterly, E. W., Lewsey, J., Siebert, S., Mair, F. S., & McAllister, D. (2020) · BMC Medicine · doi:10.1186/s12916-020-01752-1 · Cited by 46 · see citing works
Avogaro, A., Dardano, A., de Kreutzenberg, S. V., & Prato, S. D. (2014) · Diabetes Obesity and Metabolism · doi:10.1111/dom.12319 · Cited by 45 · see citing works
Pasquel, F. J., Powell, W., Peng, L., Johnson, T. M., Sadeghi-Yarandi, S., Newton, C., Smiley, D., Toyoshima, M. T., Aram, P., & Umpierrez, G. E. (2015) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2015-000104 · Cited by 44 · see citing works
Abdelhafiz, A. H., & Sinclair, A. J. (2019) · Current Diabetes Reports · doi:10.1007/s11892-019-1135-4 · Cited by 44 · see citing works
Self-citationDeterminants of frailty in primary care patients with COPD: the Greek UNLOCK study
Ierodiakonou, D., Kampouraki, M., Poulonirakis, I., Papadokostakis, P., Lintovoi, E., Karanassos, D., Maltezis, K., Chorti, M. S., Petrovitsos, E., Dimopoulou, S., et al. (2019) · BMC Pulmonary Medicine · doi:10.1186/s12890-019-0824-8 · Cited by 41 · see citing works
Sinclair, A. J., & Morley, J. E. (2013) · The Lancet · doi:10.1016/s0140-6736(13)61676-1 · Cited by 41 · see citing works
Self-citationSchernthaner, G., Barnett, A. H., Patel, S., Hehnke, U., von Eynatten, M., & Woerle, H. J. (2014) · Diabetes Obesity and Metabolism · doi:10.1111/dom.12321 · Cited by 40 · see citing works
Self-citationMorley, J. E. (2013) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/mco.0000000000000005 · Cited by 40 · see citing works
Self-citationFlaherty, J. H., & Morley, J. E. (2013) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2013.06.009 · Cited by 40 · see citing works
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- Authors
- Sinclair, A., Morley, J. E., Rodriguez-Mañas, L., Paolisso, G., Bayer, T., Zeyfang, A., Bourdel-Marchasson, I., Vischer, U., Woo, J., Chapman, I., Dunning, T., Meneilly, G., Rodriguez-Saldana, J., Gutierrez Robledo, L. M., Cukierman-Yaffe, T., Gadsby, R., Schernthaner, G., & Lorig, K.
- Affiliations
- University of Bedfordshire (GB)
- Saint Louis University (US)
- University of Campania "Luigi Vanvitelli" (IT)
- Agaplesion Bethesda Krankenhaus (DE)
- University Hospital of Geneva (CH)
- Chinese University of Hong Kong (HK)
- The University of Adelaide (AU)
- Barwon Health (AU)
- University of British Columbia (CA)
- University of Vienna (AT)
- Stanford Medicine (US)
- Corresponding author
- Sinclair, Alan
- ORCID
- Venue
- Journal of the American Medical Directors Association
- Publisher
- Elsevier BV
- Published
- 2012-07
- Volume
- 13
- Issue
- 6
- Pages
- 497-502
- ISSN
- 1525-8610 (ISSN-L)
- OpenAlex
- W2149971684
- Cited by
- 422
- References
- 0
- Citations by year
- 2026: 9 · 2025: 7 · 2024: 18 · 2023: 12 · 2022: 32 · 2021: 22 · 2020: 27 · 2019: 26 · 2018: 34 · 2017: 44 · 2016: 31 · 2015: 42 · 2014: 54 · 2013: 53 · 2012: 9
- FWCI
- 40.55
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of the American Medical Directors Association (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
- Funders
- International Association of Geriatrics and Gerontology
- European Diabetes Working Party for Older People
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- diabetes mellitus, older adults, frailty, functional limitations, hypoglycemia, diabetes treatment, care homes, comorbidities, glycemic targets, diabetes education, patient safety, clinical guidelines, geriatric diabetes care
- MeSH terms
- Aged, Aged, 80 and over, Diabetes Mellitus, Geriatrics, Humans, Societies, Medical, Advisory Committees, Consensus
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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