ADA Standards of Care 2023 – Older Adults and Diabetes

Challenges and Strategies for Diabetes Management in Older Adults Diabetes Spectrum 2020 Aug; 33(3): 217-227.

Assessment Tools

Standardized Mini-Cog Instrument

Diabetes Distress Scale

PHQ-9 Depression Screening Scale

Suicide Screening Questions

Adverse Childhood Experiences Screening Tools – ACE screening tools for children and adults, in English and Spanish too.

Depression is not a normal part of getting older – CDC website full of info and resources

“Some Older Patients Are Treated Not Wisely, but Too Much,” This 2015 New York Times article raises important concerns about the over the treatment of people with diabetes;

Appropriate Prescribing for Patients With Diabetes at High Risk for Hypoglycemia – National Survey of Veterans Affairs Health Care Professionals published in JAMA, 2015. In older people with diabetes, for instance, maintaining very low blood sugar — often called “tight control” — can do more harm than good. “People can feel fatigued and weak, get cold sweats, feel like they’re going to pass out,” said Dr. Tanner Caverly, lead author of the Michigan survey.

Rates of Deintensification of Blood Pressure and Glycemic Medication Treatment Based on Levels of Control and Life Expectancy in Older Patients With Diabetes Mellitus – JAMA, December 2015. Conclusions and Relevance  Among older patients whose treatment resulted in very low levels of HbA_1c or BP, 27% or fewer underwent de-intensification, representing a lost opportunity to reduce overtreatment. Low HbA_1c or BP values or low life expectancy had little association with de-intensification events. Practice guidelines and performance measures should place more focus on reducing overtreatment through de-intensification.

Do I need a flu vaccination – Great infogram to get people motivated to get their flu shot.

Go4Life – Go4Life, an exercise and physical activity campaign from the National Institute on Aging at NIH, is designed to help you fit exercise and physical activity into your daily life.

American Geriatrics Society’s Choosing Wisely panel, Recommends that a 7 to 7.5 percent A1c target is a reasonable goal for healthy seniors. For those with additional health problems and life expectancies of less than 10 years, the panel suggested a 7.5 to 8 percent goal, rising to 8 to 9 percent for those with many medical conditions and few years ahead. This page has a lot of sound advice for serving our seasoned citizens.

Hypoglycemia and Hyperglycemia Patient Education Teaching Sheet – This handout is one of my favorites. Cartoon characters depict the signs and symptoms of low and high blood sugars and then detail steps to take.  

Medication Wallet Card – Add your program’s logo and provide your clients with a useful, customized document that includes contact info, list of medications, and critical health data.

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Level 2 – Older Adults and Diabetes 1.5 CEs – $29.00

Provides critical information on the ADA goals of care for older adults. Blood glucose, blood pressure, and lipid goals are based on the unique characteristics of the older individual and carefully co-determined based on their cognitive and functional status. These guidelines provide specific targets based on a careful and detailed assessment of their status and life situation. This online course highlights key areas of assessment, intervention, and advocacy for older clients living with diabetes. 90-minute course.