Top Ten Tips Palliative Care Clinicians Should Know About Managing Diabetes at End-of-Life

Area of Science:

• Palliative Care
• End-of-Life (EOL) Diabetes Management
• Glycemic Control

Background:

• Palliative care frequently involves patients with diabetes, necessitating education on blood glucose control at the end of life (EOL).
• Limited evidence exists on de-escalating diabetes medications and monitoring in hospice settings.
• Current decisions rely on prognosis, symptom impact of glycemic extremes, and medication burdens.

Purpose of the Study:

• To guide palliative care clinicians in managing diabetes at the EOL.
• To address the impact of glycemic control, medications, and complications on symptom burden.
• To provide evidence-based recommendations for de-escalating diabetes care.

Main Methods:

• Review of current evidence on diabetes management in palliative care.
• Development of ten practical tips for clinicians.
• Focus on shared decision-making and patient/family education.

Main Results:

• Identification of key factors influencing de-escalation decisions (prognosis, symptoms, medication burden).
• Emphasis on shared decision-making and addressing emotional impacts of treatment changes.
• Strategies for managing glycemic control and diabetes complications to reduce symptom burden.

Conclusions:

• Optimizing diabetes care at the EOL requires careful consideration of individual patient needs and goals.
• Palliative care clinicians play a crucial role in guiding patients and families through complex treatment adjustments.
• Effective management can improve symptom control and quality of life for patients with diabetes nearing EOL.