The Clinical Guidelines provide an opportunity to summarise the interpretation of relevant clinical trial evidence for older people with diabetes. They are intended to support clinical decisions in older people with diabetes and the primary focus is enhancing high quality diabetes care by the use of best available evidence.
The principles used for developing the recommendations are drawn from the Scottish Intercollegiate Guidelines Network (SIGN) based in Edinburgh, Scotland. Using SIGN 50, the Guidelines developer's handbook, each reviewer evaluated relevant and appropriate studies which have attempted to answer key clinical questions identified by the Working Party. Searches were generally limited to English language citations over the previous 15 years but the wide experience and multinational nature of the Working party ensured that citations in Italian, French Spanish, and German were considered if relevant. All relevant published articles were identified from the following databases: Embase, Medline/PubMed, Cochrane Trials Register, Cinahl, and Science Citation. Hand searching of 13 key major peer-reviewed journals was undertaken by two reviewers and included the Lancet, Diabetes, Diabetologia, Diabetes Care, Diabetes and Metabolism, British Medical Journal, New England Journal of Medicine, and the Journal of the American Medical Association.Access paper
A collaborative Expert Group of the IAGG and EDWPOP and an International Task Force have explored the key issues that affect diabetes in older people using a robust method comprising a Delphi process and an evidence-based review of the literature. Eight domains of interest were initially agreed and discussed: hypoglycemia, therapy, care home diabetes, influence of comorbidities, glucose targets, family/carer perspectives, diabetes education, and patient safety.
A set of "consensus" statements was produced in each domain of interest. These form a foundation for future policy development in this area and should influence the clinical behavior and approach of all health professionals engaged in delivering diabetes care to older people.Access paper
The International Position Statement provides the opportunity to summarise all existing clinical trial and best practice evidence for older people with frailty and diabetes. It is the first document of its kind and is intended to support clinical decisions that will enhance safety in management and promote high quality care.