Diabetes.

Facing up to the diabetes challenge

As the number of elderly people in the population rises, society faces difficult questions from funding social care to revamping the pensions system. But increasingly doctors too are facing growing health challenges. On the one hand medical advances are improving the life expectancy of the elderly. But on the other, an increasing number of people are being beset with chronic conditions. One of these is diabetes. The disease currently affects 3% of the adult population, but among those aged 70 and above, the figure rises to between 7% and 9%. And experts say that the condition among the elderly brings with it a different set of medical problems which need special handling. You have to remember that many elderly people become frail and there is evidence to suggest that diabetes increases that level of frailty Alan Sinclair Last week saw the opening of Europe's first dedicated Institute of Diabetes for Older People at the University of Bedfordshire. Professor Alan Sinclair, who heads up the new institute, said that diabetes among the elderly had long been a neglected area. "With the ageing demographics of the population as a whole both in this country and in northern Europe the numbers of older people are higher - so the number of people with diabetes is higher. "Obviously, what is contributing to this is the advanced age of the population, plus increasingly levels of obesity and other risk factors. Neglected area "Care for older people is often absent from published clinical guidelines on diabetes. "Advice is often extrapolated from the young to the old rather than dealing with the specific needs and issues of older people. "Those sorts of special needs relate to the fact that as we get older we aren't as mobile, and we experience falls and memory changes which can impact on our quality of life. "This scenario is often exacerbated by chronic disease such as diabetes," he said. Professor Sinclair says elderly people with diabetes need special care Professor Sinclair said that, in general, issues such as mobility and memory deterioration were not considered when managing the condition, but said they should be. "You have to remember that many elderly people become frail, and there is evidence to suggest that diabetes increases that level of frailty." He said that as many as one in four residents of care homes are diabetic and need special care, and that although there are care guidelines for such residents, they need to be updated - something the institute plans to be involved with. There are also plans to liaise with other diabetes experts in the UK and overseas to collaborate in research into the effects of the condition and the drugs on the elderly. Giving confidence David Cohen, 81, was diagnosed with type two diabetes in 1990. He suffers headaches, poor vision and circulation, takes 14 tablets, and sleeps about 16 hours a day. He and his wife Joyce worry about his health, but say they get comfort from the fact that their doctors also specialise in treating elderly people with diabetes. It is important to address these issues to enable older people with diabetes to lead a full and active life Cathy Moulton Joyce said: "They make you feel confident here at the institute, and give you the confidence you need as an elderly diabetic. "Elderly people worry too much and their partners find it very stressful.'' Cathy Moulton, a care advisor at Diabetes UK, said a specialist centre for elderly diabetics was a very welcome addition. "The number of people with diabetes in the UK is growing fast. Our ageing population is playing a big part in this, as type two diabetes - the most common form of the condition - usually appears after the age of 40. Diabetes can damage the retina, and sufferers can go blind "Life expectancy is higher so people are more likely to develop diabetes and live with it for longer. "As a group whose voice is often not heard loud enough, support and research looking at how diabetes affects older people is very important. "Issues some older people with diabetes may face include an increased risk of blindness, reduced mobility due to nerve damage, needing care and support to take their medication, and eating healthily. "It is important to address these issues to enable older people with diabetes to lead a full and active life."