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Leicester doctors at heart of new European diabetes guidance

Leading diabetes experts from the University of Leicester have led the development of a major European-wide consensus statement on the safe glucose-lowering in older adults with type 2 diabetes.

Professor Kamlesh Khunti, who is also Professor of Primary Care Diabetes and Vascular Medicine at the university and also Co-Director of the Leicester Diabetes Centre, and Primary Care Fellow Dr Samuel Seidu, collaborated on the guidance for Primary Care Diabetes Europe which has now been published.

The guidance was inspired by the MSc dissertation of Dr Clare Hambling, lead author, at the University of Leicester.

Teaming up with a panel of experts in the field from across Europe, they undertook an extensive literature review of the subject area, and formulated a consensus opinion of primary care physicians and diabetes specialists across Europe.

Diabetes in later life is associated with a myriad of factors increasing the complexity of glycaemic management.

This Position Statement highlights many challenges facing older people living with type 2 diabetes and aims to support primary care clinicians in advocating a holistic, comprehensive geriatric assessment approach.

It emphasises the importance of the wishes of the individual and their carers when determining glycaemic goals, as well as the need to balance intended benefits of treatment against the risk of adverse treatment effects. Its ultimate aim is to promote consistent high-quality care for older people with diabetes.

The report was presented at the European Association for the Study of Diabetes conference in Berlin last year Professor Khunti.

Professor Khunti said:

“Diabetes in later life poses challenges, due to a myriad of interrelated factors and therefore holistic person-centred care is advocated to promote general health and wellbeing.

"A comprehensive geriatric approach aids proactive individualised glycaemic goals by primary care teams. In doing this with decision algorithms that offer clinical support for glycaemic management in older people, uncontrolled hyperglycaemia and hypoglycaemia can be avoided.”

When asked for his comment on the report, Co-author Dr Seidu said:

“Given the current and predicted prevalence of diabetes, research must focus on older people, including those with clinical complexities to further facilitate their individualised management in the primary care setting.

“Hyperglycaemia and hypoglycaemia risk adverse outcomes and functional decline. He highlighted the need to balance treatment of hyperglycaemia against the risk of harm associated with intensive glycaemic management and hypoglycaemia.”

Lead author, Dr Clare Hambling, stated that the uniqueness of this report is that it is very primary care focused. She noted that with the pace of change in the diabetes arena in recent years, a clear consensus around the complexities of diabetes management for busy primary care clinicians is of utmost necessity. Dr Hambling stated that the report is very generalisable across primary care teams across Europe as it draws upon the expertise from leading researchers in the field from various European countries.

The consensus statement was commissioned by Primary Care Diabetes Europe and is published simultaneously with the presentation in the Primary Care Diabetes Journal.

Based at Leicester General Hospital, the Leicester Diabetes Centre is responsible for world-leading clinical research, evidence-based education and cutting-edge innovation. It is a partnership between Leicester’s Hospitals and the University of Leicester and is now ranked as Europe’s largest diabetes research facility.

 

 


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