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9 The five-item FRAIL score (a questionnaire comprising five components: Fatigue, Resistance (difficulty walking up stairs), Ambulation, Illness, and Loss of weight) 8 Managing frailty in the context of type 2 diabetes Effective management of type 2 diabetes in older adults requires healthcare professionals to appreciate the increasing complexity of the illness and that care may need to operate over four decades (60–90 years and older) and respond to the changing circumstances of an individual’s health status. 9 Managing type 2 diabetes in high-functioning older people with an anticipated long-life expectancy is often similar to those for younger people. However, these approaches are inappropriate and potentially unsafe if applied to functionally impaired or frail individuals. ....
Tailor your approach While it is important to emphasise the seriousness of CV-related risks, this does need to be done in a sensitive way. It is important that health professionals’ approach with empathy first and education thereafter. Using negative and stigmatising language is rarely motivating. The role of the nurse is sensitively to encourage and positively reinforce the importance of making changes that will lead to CV risk reduction. Tailoring treatment conversations around the individual needs of the person is key, especially in light of the newer options available. Now we have evidence of the cardiovascular and renal benefits of certain diabetes drugs in addition to their blood glucose lowering capability, it is important we consider this when deciding on a therapy. ....