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ABCD releases Position Statement on frailty and diabetes

By Editor
21st January 2020
Older people

The Association of British Clinical Diabetologists (ABCD) has released a Position Statement on frailty and its association with diabetes.

The document, ‘Managing frailty and associated comorbidities in older adults with diabetes: Position Statement on behalf of the Association of British Clinical Diabetologists (ABCD‘, was drafted by Professor Alan Sinclair from the Foundation for Diabetes Research in Older People, Diabetes Frail, and Dr Alison Gallagher of the University Hospitals of Leicester NHS Trust.

It was written because frailty is emerging as a new complication of diabetes and has a significant impact in terms of increased adverse outcomes and reduced survival.

The document’s recommendations are based on a combination of research findings and “best clinical practice viewpoints”.

Frailty detection

The Position Statement also features examples to help healthcare professionals detect frailty using easy to implement assessment measures and recommendations in eight key areas using a format previously used by the International Diabetes Federation have also been provided.

It has been divided into three main section headings dealing with the definitions and clinical importance of frailty; followed by a summary of the key areas of management including glucose regulation, blood pressure and lipid management, role of exercise interventions and hypoglycaemia. It concludes with clinical audit aspects of frailty management and the development of a frailty care pathway in the NHS.

Speaking to The Diabetes Times, Professor Sinclair said: “This Position Statement emphasises the importance of individualised frailty care in diabetes becoming the norm and that frailty care should be part of routine diabetes care once people achieve the age of 70 years.

“Where possible, we have provided a set of evidence-based recommendations and we hope that all clinicians involved in this arena of clinical care will work collaboratively to improve the functional health status and well-being of this growing population of senior adults with diabetes and frailty.”

Key principles of the Position Statement

A set of key principles, based on recent international guidance in this area, were drafted for the statement. The principles are:

  • Individualising goals of care with functional status, complexity of illness including comorbidity profiles and life expectancy
  • Where possible, all therapeutic decisions should be based on a detailed geriatric assessment and risk stratification process (eg, risk of hypoglycaemia, falls risk, or risk of adverse events from treatment)
  • A clear focus on patient safety, avoiding hospital/emergency department admissions and institutionalisation by recognising the deterioration early and maintaining independence and quality of life to a dignified death
  • An emphasis to promote locally relevant interdisciplinary diabetes care teams to develop specific pathways for frail older people with diabetes • An encouragement to promote high-quality clinical research and audit in the area of frailty management in diabetes.

To read the statement in full, click here.

Picture credit: Frank Busch

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