老年学と老年医学の研究

概要

Quality of Care for Elders with Diabetes

Marjorie Howard*

The focus of high-quality care is essentially defined by general clinical recommendations for risk factor management in diabetes that are centred on the prevention and treatment of microvascular and macrovascular diseases. This emphasis on specific therapy targets has a number of drawbacks, too. One difficulty is that guidelines and recommendations for treating cardiovascular risk factors in diabetic patients are provided by a diverse range of stakeholder groups, and recommendations frequently vary; cooperation between guideline production groups has improved but is still far from ideal. Additionally, focusing just on the "ABCs" of A1c, blood pressure, and cholesterol for improving diabetes care may not be acceptable for many individuals, especially when linked to treatment aims. Other actions could include, among others, the avoidance of infections, hypoglycemia, patient satisfaction, quality of life, diabetes, or recurrent hospitalizations [1].