Diabetes in an ageing society – the role of multimorbidity
As populations age around the world, multimorbidity is an increasingly significant global challenge. The latest module launching today on the EASD e-Learning site explores the impact of multimorbidity and its corollary, polypharmacy, on people with type 2 diabetes and on healthcare systems, and looks at the practical steps care providers can take to provide co-ordinated, tailored solutions.
Cees Tack, Professor in Diabetology at the Netherlands’ Radboud University Medical Hospital, begins his module with a lesson in demographics. Comparing current population patterns in Europe with those in Japan over the past half century, the trend points inexorably towards the emergence of a ‘super-aged’ population.
“An ageing society will lead to a higher percentage of people that are elderly and thus to a higher prevalence of diabetes,” Professor Tack warns. “Secondly, as people become older, nowadays not 75 but perhaps even 90 or 95, there will be a higher prevalence of diabetes. And finally, the success of our treatments – people that are diagnosed with diabetes nowadays live longer with their diabetes. This is also called the triple wave or the triple ageing of diabetes. And with these huge numbers, then this will also be a costly matter. While diabetes in itself is not that expensive as a disease, if there are such huge numbers, that is going to be very costly for society.”
Ageing is, of course, not the only determinant of type 2 diabetes’ rising prevalence. Other factors are at play here – not least obesity and socio-economic background. Nevertheless, ageing is a particularly accurate predictor not just of diabetes but of multimorbidity – the presence of two or more chronic conditions. As Professor Tack points out: “Between 60 and 65, about 50% of people already have two or more diseases – and that increases with age, particularly with diabetes.”
The focus of Professor Tack’s module is on the impact of the rising prevalence of diabetes and multimorbidity on people with type 2 diabetes, healthcare professionals and healthcare systems. He examines in detail the ‘treatment burden’ faced by people with multiple conditions, having to juggle the demands of multiple, potentially conflicting treatment targets and medications. In particular, he examines the characteristics associated with polypharmacy in people with type 2 diabetes and multimorbidity, and the need to balance potential benefits and harms. The module also includes practical case studies to support healthcare professionals in planning a co-ordinated approach to the care and management of people with type 2 diabetes and multimorbidity.
For Professor Tack’s module ‘Diabetes in an ageing society – the role of multimorbidity’, which launches today, enrol on the EASD e-Learning course ‘Multimorbidity and diabetes’.
Any opinions expressed in this article are the responsibility of the EASD e-Learning Programme Director, Dr Eleanor Kennedy.