Diabetes Management in End of Life

Abstract

The increasing coexistence of cancer and diabetes within the elderly population requires specific palliative care skills on diabetes treatment. We report our experience of diabetes management in a palliative care setting. In our retrospective 3-year activity sample (n = 563), 27.2% of patients have a diagnosis of diabetes mellitus: 80% have cancer whereas 20% have a main diagnosis of other severe chronic diseases. As to the presence/absence of diabetes, no differences emerge in the examined clinical indicators and global survival, with the exception of body mass index and days of hospitalization. At lifetime analysis, Barthel index and palliative prognostic index are the only parameters significantly related to death. Even if diabetes seems not to modify the prognosis, it significantly influences the health care burden and the team engagement.

Comparison of muscle and fat parameters measured by ultrasonography and dual‐energy x‐ray absorptiometry between older palliative care patients with and without type 2 diabetes mellitus

“…In a study investigating the management of DM in a palliative care service, 27.2% of the patients had DM. 37 In another study, the prevalence of DM was 17.1% in geriatric palliative care patients. 38 The differences may be attributable to variations in the age, lifestyle, ethnic and genetic backgrounds of the populations analyzed.…”

“…Depending on these characteristics, the prevalence may also vary. In a study investigating the management of DM in a palliative care service, 27.2% of the patients had DM 37 . In another study, the prevalence of DM was 17.1% in geriatric palliative care patients 38 .…”