Tailored older people diabetes care should be mandatory says professor
A leading global expert on personalised care for older people has called for a change in approach to ensure tailored healthcare for all.
Professor Elbert S. Huang, Director of the Center for Chronic Disease Research and Policy (CDRP) at The University of Chicago, believes technology may hold the key to the universal introduction of personalised care.
Professor Huang made the comments during his keynote presentation titled ‘What can we Learn from Big Data in the Study of Older People with Diabetes?’ at a Diabetes Seminar staged on Monday, March 19, at King’s College London.
Professor Huang’s talk covered glycaemic control and medications in clinical trials, data from real-world practice, evolution of diabetes care guidelines, why personalise care does not appear to be happening and interventions to improve medical decisions, care, and outcomes.
Professor Huang said barriers to high-quality individualised care and medical decisions included psychological perspectives, were system-based and involved lack of time or support. But he said possible solutions included revising guidelines and performance measures to reflect a new evidence base for personalisation, generating and presenting data needed for personalisation and also engaging patients to collect data needed for preference-sensitive decisions.
He said: “We still don’t appear to personalise diabetes care but advances in computing and electronic medical records may allow us to deliver personalised recommendations more easily through prediction, pharmacogenomics and preferences.”
Professor Huang, who also praised Professor Sinclair for his many contributions to geriatric diabetes, talked about how real-world data from clinical practice can supplement research from randomised controlled trials, providing insights by looking at subgroups of patients and observational drug comparison studies. He said this approach can help researchers gain an understanding of the natural history of disease.
Professor Huang specialises in clinical and health care policy issues at the intersection of diabetes, aging and health economics. His main research focus is in the area of medical decision-making for older patients with type 2 diabetes, in which uncertainty exists regarding how to best individualise diabetes treatments based on clinical parameters and patient preferences.
Over the past decade, he has established one of the most active research programmes in geriatric diabetes in the world and is a principal investigator of the NIH-sponsored Diabetes and Aging Study, with Kaiser Permanente.
The second speaker, Professor Forbes, who is developing a significant focus at King’s College on issues relating to diabetes in older people, gave a brief overview of a study titled ‘Glycaemic (HbA1c) variability and mortality in older people (age ≥70 years) with diabetes mellitus: a retrospective cohort study’. The study is soon to be reported in The Lancet: Diabetes and Endocrinology.
The seminar closed with a panel discussion of the emergent issues in the care of older people with diabetes led by Professor Sinclair.
Diabetes Frail is a not-for-profit research and educational organisation which explores the emergence of frailty in ageing populations and its association with diabetes.