Institute of Diabetes for Older People

Professor Alan Sinclair (Director, IDOP) has been asked to work with the European Association for the Study of Diabetes (EASD), in collaboration with The International Association of Geriatrics and Gerontology (IAGG) and the American Medical Directors’ Association (AMDA), in an initiative to identify the major issues involved in providing enhanced diabetes care for older people in Europe, the United States, and throughout the rest of the world.

This initiative recognises important gaps in the current provision of diabetes care to this often-neglected sector of the diabetic population. Examples are frequent lack of structured and integrated diabetes care, infrequent specialist follow-up, inadequate goal setting, poor outcome assessment, and failure to appreciate the influence of functional change caused by both physical and cognitive factors.

The Global Initiative will work in the following areas to:

• set up an international working group to explore unresolved issues in diabetes care for older people in order to identify key priorities to be addressed on an international scale
• publish a Position Statement on diabetes and older people which will present a view on the current state of diabetes care and the key priorities required to appreciably enhance the quality of care delivered
• facilitate an international survey and clinical audit of diabetes care in older people in a sample of countries from each major continent. The primary focus would be on collecting data, on clinical service models, barriers to accessing optimal care, outcome data, hospitalisation rates, use of insulin and rationale for use or oral agents
• establish research studies in such areas as the use of developed clinical risk scores, analysis of data from existing large national and international data bases, best practice models, and a patient safety initiative.

Currently, the Global Initiative has achieved its initial goal by setting up an international working group which met in Frankfurt at the end of June 2010. A number of international diabetes experts met in a Roundtable session and were joined by other world experts in a teleconference. Discussions ranged around the following topics:

Frankfurt main square

• Hypoglycaemia
• Insulin therapy
• Care home diabetes
• Influence of comorbidity
• Glucose targets
• Family/carer perspective
• Diabetes education
• Patient safety

Following the conference, a Position Statement will be published by December 2010.