Facing the Future

Facing the Future: Ageing with type 1 diabetes and the need for change

For some time now, we’ve been hearing anecdotal stories from our community about the unexpected challenges faced by people over the age of 45 living with T1D. We set out to better understand the challenges faced by this group, how they manage their condition and what hopes and fears they have for the future.

To achieve this, Breakthrough T1D commissioned quantitative and qualitative market research to get insight into the issue of ageing with T1D. The results from the market research show that people are anxious about their future and they feel unsupported by a health and social care system that is unprepared to deal with these challenges.

Download the report

Our recommendations

Recommendations for inpatient care

• Mandate ongoing training for all medical staff on T1D and the importance of self-management, with a clear focus on maintaining a patient’s independence in managing their own care for as long as possible.
• Guarantee access to diabetes specialists or champions for all inpatients with T1D to prevent mismanagement. Alternatively, ensure the diabetes team is made aware when a patient with T1D is admitted and is kept updated on out of range blood glucose levels, as recommended by the GIRFT report for diabetes.
• Formalise the role of carers in inpatient care, including extended visiting hours, involvement in doctor consultations, and oversight of food intak
• Update NICE guidelines to reflect best practices in inpatient T1D care.

General support

• Ensure diabetes specialists provide clear, up-to-date information about available technology, recognising its critical role in easing T1D management, particularly as people age.
• Expand access to diabetes technology, acknowledging its potential to significantly improve care for older people.
• Implement personalised, regularly updated action plans for individuals with T1D, ensuring seamless care if they become unable to self-manage.
• Conduct further research to evaluate the usability, clinical benefits, and potential adaptations of HCL systems for individuals with reduced cognitive function.

Menopause and T1D

• Increase clinical research on the impact of menopause on T1D to ensure women are not left behind.
• Equip healthcare professionals with a deeper understanding of how menopause affects T1D management so that they can provide more tailored care.
• Update NICE guidelines on the use of HRT to minimise the effects of menopause on T1D.

Care

• Build on existing guidance to establish a clear, coordinated national strategy for managing T1D in care homes, ensuring individuals receive safe, consistent, and person-centred care when they can no longer self-manage.
• Introduce Care Quality Commission (CQC) guidelines requiring all care staff, both in care homes and the community, to be trained in T1D management, including safe and accurate insulin administration.