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An International Position Statement on the Management of Frailty in Diabetes Mellitus: Summary of Recommendations 2017

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Abstract

Aim

the 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.

Methods

the Review Group sought evidence from a wide range of studies that provide sufficient confidence (in the absence of grading) for the basis of each recommendation. This was supported by a given rationale and key references for our recommendations in each section, all of which have been reviewed by leading international experts. Searches for any relevant clinical evidence were generally limited to English language citations over the previous 15 years. The following databases were examined: Embase, Medline/PubMed, Cochrane Trials Register, Cinahl, and Science Citation. Hand searching of 16 key major peer-reviewed journals was undertaken by two reviewers (AJS and AA) and these included Lancet, Diabetes, Diabetologia, Diabetes Care, British Medical Journal, New England Journal of Medicine, Journal of the American Medical Association, Journal of Frailty & Aging, Journal of the American Medical Directors Association, and Journals of Gerontology - Series A Biological Sciences and Medical Sciences.

Results

two scientific supporting statements have been provided that relate to the area of frailty and diabetes; this is accompanied by evidence-based decisions in 9 clinical domains. The Summary has been supported by diagrammatic figures and a table relating to the inter-relations between frailty and diabetes, a frailty assessment pathway, an exercise-based programme of intervention, a glucose-lowering algorithm with a description of available therapies.

Conclusions

we have provided an up to date evidence-based approach to practical decision-making for older adults with frailty and diabetes. This Summary document includes a user-friendly set of recommendations that should be considered for implementation in primary, community-based and secondary care settings.

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Author information

Authors and Affiliations

  1. Foundation for Diabetes Research in Older People, Diabetes Frail Ltd and University of Aston, Birmingham, UK

    Alan J. Sinclair

  2. Rotherham General Hospital, Rotherham, UK

    A. Abdelhafiz

  3. Deakin University, Geelong, Australia

    T. Dunning

  4. Public University of Navarre, Pamplona, Spain

    M. Izquierdo

  5. Universitario Hospital de Getafe, Getafe, Spain

    L. Rodriguez Manas

  6. CHU Bordeaux, Bordeaux, France

    I. Bourdel-Marchasson

  7. St Louis University, Washington, USA

    J. E. Morley

  8. Harvard University, Cambridge, USA

    M. Munshi

  9. Hong Kong Geriatrics Society, Hong Kong, Hong Kong

    J. Woo

  10. Gerontopole and Hopitaux de Toulouse, Toulouse, France

    B. Vellas

  11. UMR 5536 Univ Bordeaux/CNRS, Bordeaux, France

    I. Bourdel-Marchasson

Authors
  1. Alan J. Sinclair
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  2. A. Abdelhafiz
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  3. T. Dunning
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  4. M. Izquierdo
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  5. L. Rodriguez Manas
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  6. I. Bourdel-Marchasson
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  7. J. E. Morley
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  8. M. Munshi
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  9. J. Woo
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  10. B. Vellas
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Correspondence to Alan J. Sinclair.

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Sinclair, A.J., Abdelhafiz, A., Dunning, T. et al. An International Position Statement on the Management of Frailty in Diabetes Mellitus: Summary of Recommendations 2017. J Frailty Aging 7, 10–20 (2018). https://doi.org/10.14283/jfa.2017.39

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  • DOI: https://doi.org/10.14283/jfa.2017.39

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