Reviews in Clinical Gerontology

Clinical geriatrics

Recent clinical trials in diabetes – implications for managing older patients

GC Hawthornea1 c1 and AJ Yarnalla2

a1 Diabetes Centre, Newcastle General Hospital, Newcastle upon Tyne, UK

a2 Department of Care of the Elderly, Freeman Hospital, Newcastle upon Tyne, UK

Summary

The prevalence of type 2 diabetes is set to increase, and with it the complications associated with diabetes. Since 2007 there have been a number of significant trials that may change the way we think about treating people with diabetes, especially our older patients. These trials include the Steno-2 trial, UKPDS legacy trial, ADVANCE, ACCORD and VADT. These trials are reviewed in detail in this article, including the implications for the patients we treat. Recent work assessing the effect of HbA1c on cognitive function and the effects of hypoglycaemia are also discussed. We conclude with suggestions for targets for glycated haemoglobin level based on NICE guidance.

(Online publication August 17 2009)

Correspondence:

c1 Address for correspondence: Dr Gillian Hawthorne, Newcastle Diabetes Centre, Newcastle General Hospital, Westgate Road, Newcastle upon Tyne NE4 6BE. Email: gillian.hawthorne@newcastle-pct.nhs.uk