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“Figure options Download full-size image Download high-quality image (111 K) Download as PowerPoint slide !!!FRAG!!! Figure options Download full-size image Download high-quality image (95 K) Download as PowerPoint Selleck Alectinib slideUp to 1 in 5 older people have diabetes, and a similar proportion may have undiagnosed diabetes. This is not a trivial disease and poses

many significant challenges to the delivery of effective care. There is ample proof of the economic, social, and health burden of diabetes in the elderly population. Despite this recognition, diabetes care of older people has been relatively neglected in the medical literature, with few reports of large randomized clinical trials in

older patients. In addition, there is little evidence of structured diabetes care in many national diabetes care systems and virtually no Dasatinib mw specific provision for those who are housebound or living in institutional care. The effective management of the older patient with diabetes requires an emphasis on safety, diabetes prevention, early treatment for vascular disease, and functional assessment of disability because of limb problems, eye disease, and stroke. Additionally, in older age, prevention and management of other diabetes-related complications and associated conditions, such as cognitive dysfunction, functional dependence, and depression, become a priority. Various surveys suggest evidence of inequalities

in diabetes care owing to variations in clinical practice, particularly in relation to older people. This may be manifest as lack of access to services and inadequate specialist provision that lead to poorer clinical outcomes and patient and family dissatisfaction. Patient safety is an a priori issue for managing older people with diabetes but is often compromised by inappropriate Janus kinase (JAK) treatment choice, suboptimal specialist follow-up, and patient-centered issues, such as the development of cognitive dysfunction or depressive illness. Both of these conditions are more common in older people and may in fact be directly associated with the presence of diabetes. Depression is often not recognized and inadequately treated. Social isolation may be a feature of many older people with diabetes, particularly if they have few relatives or have mental health problems, and providing a well-supported social network is important. We recognize there is confusion within health care organizations and their providers on what the terms “elderly” or “older” actually represent. We have taken a “global” perspective in this Position Statement, and, as we are attempting to address issues in more vulnerable older patients, we have limited our scope to those 70 years and older.