Asian Best Practices for Care of Diabetes in Elderly (ABCDE)

Abstract

The elderly population with diabetes is diverse with the majority experiencing a decline in physical and mental capabilities, impacting the entire diabetes management process. Therefore, a need for geriatric-specific guidelines, especially for the Asian population, was identified and subsequently developed by an expert panel across government and private institutions from several Asian countries. The panel considered clinical evidence (landmark trials, position papers, expert opinions), recommendations from several important societies along with their decades of clinical experience and expertise, while meticulously devising thorough geriatric-specific tailored management strategies. The creation of the ABCDE best practices document underscores and explores the gaps and challenges and determines optimal methods for diabetes management of the elderly population in the Asian region.

Figure 1.

Aging and type 2 diabetes: Aging worsens systemic inflammation, increases oxidative stress, and poor mitochondrial function resulting in metabolic abnormalities. It also alters body composition predisposing older adults to develop visceral adiposity further inducing pro-inflammatory mediators and amplifying systemic inflammation. It also impacts the beta-cell physiology culminating in impaired responses to endogenous incretins, thus accelerating the development of clinical diabetes manifestations [18].

Figure 2.

Type 2 diabetes and cognitive dysfunction.