Disability prevention in diabetes
Diabetes is a chronic condition affecting glucose metabolism. The prevalence of diabetes in the elderly population is almost 20 %, with at least 50 % of all diabetic patients being older than 65. It is anticipated that by 2050, the incidence of diabetes will increase 4-fold in patients older than 70. Diabetes has a high personal and social impact and is a significant public health burden in terms of rising health care cost. The EU-funded international consortium MID-FRAIL-STUDY examined the effectiveness of combining optimised medical management with exercise and dietary programmes to maintain quality of life in people 70 years and older who have Type 2 diabetes. The project focused on targeting the mechanisms involved in the development of frailty rather than traditional treatments of glucose and blood pressure lowering. Several sub-studies of the project addressed effect on health care expenditure and the role of genetic polymorphism as the determinants of response to treatment. During the first 18 months, the project completed its design of the global clinical trial protocols. The exercise, educational and nutritional programmes have been designed as well as the safety and surveillance strategies. The essential documents were translated into local languages and distributed to the study partners for review. More than 950 subjects were included in 74 trial sites in 9 European countries. Baseline characteristics between the project-designed intervention group and usual care group were comparable. The mean age of the patients was 78 years with 37.7 % being fragile including 50.9 % men. After 12 months of follow-up tests, the intervention group demonstrated statistically significant improvement in comparison to the usual care group. The results show that the MID-FRAIL intervention produced significant improvement in older patients with diabetes. Importantly, the intervention programme achieved better health outcomes at the same or lower cost than usual care. In conclusion, the intervention programme is efficient with consistent results. Clinical implementation of MID-FRAIL-STUDY outcomes could contribute greatly to the prevention of disability in old people with diabetes.
Keywords
Diabetes, frailty, quality of life, elderly population, MID-FRAIL-STUDY
