Diabetes in the elderly: A perspective from the United Kingdom

Within some parts of the United Kingdom major deficiencies in diabetes care for older adults exist; these include lack of screening for the disorder, failure to evaluate complications, lack of individual management plans, and failure to appreciate the role of informal caregivers. The prevalence of diabetes in the elderly varies from 3% to 9% among the indigenous population, which, although considerably lower than in other European countries, may be a tremendous health care burden in the next century. Several community surveys testify to the high level of macrovascular and microvascular complications present in the older patient with diabetes, but the impact on patients' lives (and their caregivers' lives) often is underestimated, especially as a result of unrecognized disability. Premature death in aging diabetics also requires highlighting. Identifying the most suitable care model for managing the elderly diabetic is the subject of interest in the United Kingdom, with momentum growing to facilitate shared care between the family practitioner and the hospital specialist (diabetologist or geriatrician).