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Diabetes and the older patient with diabetes

May 11, 2015

Repeatedly I hear from older patients that medicine is just not what it used to be. Their care provider seems to spend more time looking at the computer, checking off “something” and not really listening to what they are saying. In a recent study, older patients repeatedly expressed frustration at the lack of time they spend with their doctor and feel they are not being heard (1).

Recent standards for treatment of older patients with diabetes (2) include more flexibility in setting goals for this population – including current health status (co-morbid conditions) and expected lifespan. Due to the many pathways to help monitor and control diabetes, along with the variable and ever changing goals, more individualized time is required to assess and set a disease management course during the patient’s visit to their health care provider. This one on one time, in reality, is shrinking.

Diabetes educators to the rescue. Diabetes educators are uniquely qualified to listen to the patient with diabetes, address their concerns, design programs that fit the lifestyle and goals of the patient, connect with their health care providers, and monitor the progress of the patient through telephone, e-mail or face to face visits. Educators can also review the costs of medication and the patient’s ability to pay and connect them with patient assistance programs. In an era of checked boxes and universal goals we, as educators, must keep the needs and desires of each patient our focus. We must be their advocates and help them problem solve to achieve their individual goals. The December 2013 AADE Practice Synopsis: Special Considerations in the Management and Education of Older Persons with Diabetes, is a helpful tool to review in delineating the role of the diabetes educator in the care of the older adult. 

We as diabetes educators have such an important job. We can have a huge impact on the lives of the older person with diabetes and help to achieve the 2020 healthy goals for Americans which includes: “Reduce the disease and economic burden of diabetes mellitus (DM) and improve the quality of life for all persons who have, or are at risk for, DM”. 

1. Beverly EA, Wray LA, Chiu CJ et al. Older adults’ perceived challenges with health care providers treating their type 2 diabetes and comorbid conditions. Clin Diabetes. 2014:32(1)12-17
2. American Diabetes Association: Standards of Medical Care. 10. Older Americans. 2015;38(Suppl. 1):S67–S69

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  1. May 14, 2015

    This is an excellent, concise summary of the concerns with aging in general and particularly where diabetes and other chronic diseases are concerned. Coincidentally, I had just finished reading the 2015 ADA Standards of Medical Care. Great job.

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