Dunning T, Martin P (2018) Palliative and end of life care of people with diabetes: Issues, challenges and strategies. Diabetes Res Clin Pract 143: 454–63
- People with diabetes have a lower life expectancy than the general population because the condition is associated with various complications and comorbidies, including cardiovascular disease, obesity, cancer and frailty.
- Quality of life, symptoms, level of comfort and often function can all be improved with the early implementation of palliative care.
- The authors advocate early initiation of palliative care and proactive planning for the end of life as part of a patient’s personalised diabetes care plan.
- To aid the identification of patients with a high risk of 1-year mortality, the authors recommend that healthcare professionals use the Gold Standard Framework and diabetes-related indicators of reduced life expectancy.
- An evidence-based framework should be used to underpin early discussions with patients and their families about the many complex issues surrounding end-of-life care so their preferences and values can be incorporated in advance care plans.