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There are many similarities in the brains of people living with diabetes and the brains of people living with Alzheimer’s disease; however, diabetes only remains a risk factor. Some people with diabetes may go on to develop dementia, but many will not.
Diabetes management and diabetic self-care may be adversely affected by the presence of dementia. There is a need to know what interventions work best in the management of diabetes in people living with dementia (PLWD) in different settings and at different stages of the dementia trajectory.
We identified six context–mechanism–outcome (CMO) configurations that provide an explanatory account of how interventions might work to improve the management of diabetes in people living with dementia.
- Frances Bunn, Claire Goodman, Peter Reece Jones, Bridget Russell, Daksha Trivedi, Alan Sinclair, Ant...
- 2017
Jul 31, 2023 · The literature has revealed that there are many issues and challenges in terms of feeling overwhelmed and helpless and of failure among carers. There was little evidence of support, emotional or physical, for those living with both dementia and diabetes mellitus or their informal carers.
- 31 July 2023
- 40, Issue4
- Key Messages
- Key Messages For Older People with Diabetes
- Introduction
- Diagnosis and Screening
- Reducing The Risk of Developing Diabetes
- Organization of Care
- Self-Management Education and Support
- Targets For Glycemic Control
- Frailty
- Monitoring Glycemic Control
Diabetes in older people is distinct from diabetes in younger people and the approach to therapy should be different. This is especially true in those who have functional dependence, frailty, demen...In the older person with diabetes and multiple comorbidities and/or frailty, strategies should be used to strictly prevent hypoglycemia, which include the choice of antihyperglycemic therapy and a...Sulphonylureas should be used with caution because the risk of hypoglycemia increases significantly with age.DPP-4 inhibitors should be used over sulfonylureas because of a lower risk of hypoglycemia.No two older people are alike and every older person with diabetes needs a customized diabetes care plan. What works for 1 individual may not be the best course of treatment for another. Some older...Based on the factors mentioned above, your diabetes health-care team will work with you and your caregivers to select target blood glucose and glycated hemoglobin (A1C) levels, appropriate glucose-...This guideline refers primarily to type 2 diabetes in the older person. There is limited information on the management of type 1 diabetes in the elderly, but this is included wherever appropriate. The definition of “older” varies, with some studies defining the elderly population as ≥60 years of age. Administrative guidelines frequently classify pe...
As noted in the Definition, Classification and Diagnosis of Diabetes, Prediabetes and Metabolic Syndrome chapter, p. S10, glycated hemoglobin (A1C) can be used as a diagnostic test for type 2 diabetes in adults. Unfortunately, normal aging is associated with a progressive increase in A1C, and there can be a significant discordance between glucose-b...
Healthy behaviour interventions are effective in reducing the risk of developing diabetes in older people at high risk for the development of the disease (3). Acarbose (4), rosiglitazone (5)and pioglitazone (1,6) also are effective in preventing diabetes in high-risk elderly. Metformin may not be effective (3). Since several of these drugs have sig...
As interprofessional interventions specifically designed for older adults have been shown to improve glycemic control, referrals to diabetes health-care (DHC) teams should be facilitated (7–9). Pay-for-performance programs improve a number of quality indicators in this age group (10,11). Telemedicine case management and web-based interventions can ...
Self-management education and support programs are a vital aspect of diabetes care, particularly for older adults who may require additional education and support in light of other chronic conditions and polypharmacy (24). Recently, a population-based cohort study of older adults (≥65 years of age) living in Ontario found that attendance at a diabe...
The same glycemic targets apply to otherwise healthy older adults as to younger people with diabetes (see below), especially if these targets can be obtained using antihyperglycemic agents associated with low risk of hypoglycemia (see Targets for Glycemic Control chapter, p. S42). In older people with diabetes of several years' duration and establi...
Diabetes is a marker of reduced life expectancy and functional impairment in the older person. People with diabetes develop disability at an earlier age than people without diabetes and they spend more of their remaining years in a disabled state (43,44). “Frailty” is a widely used term associated with aging and disability that denotes a multidimen...
The same general principles pertain to self-monitoring of blood glucose (SMBG) in older people, as they do for any person with diabetes (Monitoring Glycemic Control chapter, p. S47). The person with diabetes, or family or caregiver must have the knowledge and skills to use a home blood glucose monitor and record the results in an organized fashion....
Jul 12, 2021 · More recent studies have shown that diabetes also increases your risk of dementia. What has not previously been investigated, however, is whether the age of onset of diabetes makes a difference in your risk of developing dementia.
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Do people living with dementia and diabetes mellitus need support?
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Can diabetes be managed in people with dementia?
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Health and social care systems need to foster a belief in health-care professionals (HCPs), people living with dementia and their family carers that people living with dementia have the potential to be involved in self-management (SM).
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