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Printable Handouts
Navigable Slide Index
- Introduction
- Conflicts of interest
- Disclaimer
- Diabetes is a growing problem
- Prevalence of diabetes by age
- What is the point of geriatrics?
- Mortality and weight in older adults
- HbA1c differs for older adults (1)
- HbA1c differs for older adults (2)
- Evidence base for treating diabetes
- Older adults in clinical trials
- How do we define "old"?
- Age vs. frailty
- The frail, elderly patient with diabetes
- Pathophysiology: diabetes and dementia
- Hypoglycaemia and dementia
- The physiology of hypos
- The physiology of hypos in older patients
- Symptoms are nonspecific in older people
- Severe events present a financial burden
- Target-setting frameworks
- Individual management of hyperglycaemia
- Individualising treatment in a clinical trial
- Frailty assessment pathway in diabetes
- Frailty assessment pathway for referral
- New UK frailty assessment protocol
- Treatment targets
- ADA/EASD consensus for treating hyperglycaemia (1)
- In those with proven CVD (1)
- In those with proven CVD (2)
- ADA/EASD consensus for treating hyperglycaemia (2)
- Treating hyperglycaemia, avoiding hypos
- De-escalation thresholds
- NICE quality standards
- Take home messages
- Thank you for your attention
Topics Covered
- Diabetes as a growing problem
- Predicted outcome when diabetes and frailty are associated
- Accomplishing the assessment of frailty through short consultation
- The complexity of treating frail older adults with diabetes
- Predicting benefit of response by frailty when creating treatment targets – Determining HbA1c targets for older adults according to their frailty condition
- Targeting via HbA1c (~7.5%) in fit older adults to improve longevity
- Targeting via HbA1c (8%) in moderate frailty to reduce microvascular complications
- Targeting via HbA1c (8.5%) in severe frailty to improve quality of life
- Re-assessing interventions after three months due to dynamic nature of frailty
Links
Categories:
Therapeutic Areas:
Talk Citation
Strain, D. (2020, April 29). Treating diabetes in the elderly: overcoming challenges [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved November 23, 2024, from https://doi.org/10.69645/PXYN6027.Export Citation (RIS)
Publication History
Financial Disclosures
- Dr. Strain received speaker honoraria, conference sponsorship, unrestricted educational grants sponsored by: Astra Zeneca, Bayer, Boehringer Ingelheim, Eli Lilly, Napp, Novartis, Novo Nordisk, Sanofi Aventis, Servier, Takeda. Dr. Strain has no commercial or financial disclosures in relation to this work.
A selection of talks on Clinical Practice
Transcript
Please wait while the transcript is being prepared...
0:00
Hello. My name is David Strain.
I'm a Clinical Senior Lecturer at the University of Exeter Medical School.
I'm a lecturer actually in geriatric medicine,
but with a special interest in diabetes.
I'm going to be talking over the next 40 minutes or so
about the impact of treating diabetes in older adults.
Why that is different?
The rationale behind the new nice and core guidelines
that we've recently implemented in the UK.
0:29
Before I start any presentation,
I must declare my conflicts of interests.
At some point in my career,
I've interacted with most of the pharmaceutical companies that engage in diabetes.
That being said, everything that I tell you here are my own thoughts,
and my own words, and this presentation has been heard without any outside influence.
0:51
I also start every presentation I do with this slide.
These are the words of Abraham Lincoln,
who very famously said,
"Never allow scientists to partake in government.
When you give them a new piece of information,
a scientist will change their mind."
Now, I use this for two reasons.
The first is it's my excuse.
If at some point in the future,
you see a presentation that is telling different information,
then you may wonder, was I lying today?
Well, the answer is simple, no.
I'm presenting the most up-to-date evidence that we have.
However, as the evidence changes,
I do reserve the right to change my mind in the future.
The other reason I use this is to find out whether we are
practicing medicine as scientists or politicians.
Because if we're practicing medicine as a politician,
we will continue to do what we've always done
irrespective of the way the evidence appears.
But if we're practicing medicine as a science,
then as the evidence changes,
we will review those data,
we'll determine how that affects our patients.
Then if the data are better,
we will improve our practice accordingly.
There is no bigger area in medicine this applies to than diabetes.