Diabetes mellitus is being diagnosed at increasing rates across the whole population, but specifically in the older population due to better outcomes and risk management strategies in diabetes, and the fact that people are living longer and healthier lives. 1,2
This article will investigate the impact of diabetes in older people and the ethical considerations for health professionals in decision-making with older people.3 It is important, but sometimes difficult, to balance the needs of the a patient and the need to achieve national targets for diabetes, for example, in the QOF.
To do no harm and achieve good outcomes for individual patients, care needs to be patient-centred, rather than target-driven. Practice and community nurses are at the forefront of providing individualised diabetes care for older people, and this article will explore the determinants of this care.
Prevalence and demographics
It is estimated that there are more than three million people in England aged 16 years and over with diabetes, a prevalence of 7.4 per cent, of whom almost a third may remain undiagnosed.
In Scotland, the prevalence is 6.7 per cent, and in Wales, it is 9 per cent. The prevalence of diabetes in the UK is expected to continue to increase owing to rising rates of obesity and an ageing population. 4
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