The American Geriatrics Society (AGS) is a professional medical society dedicated to improving the health and well being of all older persons. The AGS issues Clinical Guidelines to help set practice standards for the medical care of older adults.
At the AGS 2003 Annual meeting in Baltimore, Maryland, the AGS together with UCLA, released new
Guidelines for Improving the Care of the Older Person with Diabetes. The purpose of this guideline is to improve the care of older persons with diabetes. The Guideline was developed by a panel of experts in the care of older adults and Diabetes. It provides recommendations for care that are based on evidence in the medical literature and from respected authorities, based on clinical experience. The recommendations include both diabetes-specific recommendations tailored to persons with diabetes who are aged 65 years and older and recommendations for the screening and detection of geriatric syndromes.
The diabetes-specific topics covered by these guidelines include aspirin use, smoking cessation, hypertension management, glycemic control, lipid management, eye care, foot care, and diabetes education. The Guideline also makes recommendations for screening of geriatric syndromes that are common among persons with diabetes, including depression, polypharmacy, cognitive impairment, urinary incontinence, injurious falls, and persistent pain.
The clinical practice guidelines are published in the
Journal of the American Geriatrics Society, May Supplement. A webcast of the release at the Annual meeting can be found on the
AGS website.
In conjunction with the release of the AGS guideline, the AGS Foundation for Health in Aging has released a series of new public education materials based on the guidelines. The FHA encourages clinicians to print and reproduce these products for their patients as needed. Bulk quantities of the pamphlets may be ordered by calling MaryAnne Shannon at 212-308-1414, or by emailing
mshannon@americangeriatrics.org.
The new materials include:
- Patient Education Forum on Diabetes - written in a question-and-answer format designed to address some of the common questions about diabetes.
- Know Your Diabetes Medications - describes the various medications that are currently available for treating diabetes, including oral diabetes medications and the different types of insulin.
- Managing the Complications of Diabetes in Older Persons - provides an overview of the various complications that affect older persons with diabetes.
- Diabetic Neuropathy - describes the various kinds of diabetic neuropathy and ways neuropathic pain can be controlled.
- Lifestyle Changes for Living with Diabetes - addresses glycemic control, blood sugar monitoring, nutrition, diet, exercise, and lifestyle modifications
- Also available on the FHA website are publications on Depression, Falls, Pain, Memory Loss and, Urinary Incontinence.
Learning about self-management of diabetes is extremely important in maintaining optimum health and avoiding serious complications of the disease. Living with diabetes involves monitoring and managing your blood glucose level, along with understanding the importance of proper nutrition and diet, exercise, and lifestyle modification.
Diabetes education is available and covered by Medicare Part B. Your health care provider must write a prescription for you to receive diabetes education. You also must meet one of the following criteria over the past 12 months to be eligible:
Your diabetes has been recently diagnosed;
You have recently become eligible for Medicare coverage;
You have or are at risk for developing complications from diabetes, such as:
- glycemic control problems;
- diabetic foot problems,
- eye and/or kidney disease;
- have begun taking oral medications or switched from oral medications to insulin;
- or have been hospitalized or treated in an emergency room.
Diabetes education is provided by specially trained health care providers who have been approved by Medicare to offer this training. For the first year of eligibility, Medicare provides for 10 hours of diabetes education over a 12-month period. For subsequent years, 2 hours of training per year are provided. Your health care provider must prescribe each year of training.
The first 10-hours of training consist of 1 hour of individual education and 9 hours of group instruction. Patients with certain disabilities such as deafness or blindness are able to receive all 10 hours of their diabetes education on an individual basis, if this is requested in writing by the health care provider.
Medicare pays 80% of the approved cost of diabetes education. The patient pays 20% of the amount after the annual deductible is met.
Sources for more information:
1. Medicare.gov (
www.medicare.gov/Health/Diabetes.asp). New, free information will be published this year about Medicare coverage of diabetes supplies and services. This can be ordered by calling 1-800-633-4227 (TTY = 1-877-486-2048) or the information can be downloaded from the web site.
2. The National Diabetes Education Program (
ndep.nih.gov), 1 Diabetes Way, Bethesda, MD 20892-3600; 1-800-438-5383.
3. The American Association of Diabetes Educators (
www.aadenet.org), 100 West Monroe Street, Suite 400, Chicago, IL 60603; 1-800-338-3633. You can obtain a list of diabetes educators in your area.
