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Diabetes and older people: ensuring individualised practice

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Diabetes mellitus is increasingly common in older people, partly because diabetes outcomes and risk management strategies have improved and partly because people are living longer and healthier lives.

This article considers the impact of diabetes in older people and the ethical considerations when making decisions regarding the care of older people. It is important, but sometimes difficult, to balance a person's individual needs with the need to achieve national targets for diabetes, such as those in the QOF.

To do no harm and achieve good outcomes, care must be person-centred and not target-driven. Practice, nurses, GPs and community nurses are at the forefront of providing older people with individualised diabetes care.

Prevalence and demographics
Diabetes is being diagnosed at an increasing rate across the population, but especially in the older population.1 It is estimated that there are more than 3 million people age 16 years and over with diabetes in England (a prevalence of 7.4 per cent) and almost one third of these people may be undiagnosed.2

In Scotland, its prevalence is 6.7 per cent and in Wales it is 9 per cent. Owing to rising rates of obesity and an ageing population, the prevalence of diabetes in the UK is expected to continue to increase.5

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