Table 2

Guideline recommendations for key clinical outcomes for older people with diabetes

ADA51ES30DC48IDF49European47Japan46
Healthy (few coexisting chronic illnesses, intact cognitive and functional status)Good health
(no comorbidity or 1–2 comorbidities and no ADL impairments)
Functionally independentFunctionally independent
(no impairments of ADLs, and receiving none or minimal caregiver support)
Free of other major comorbiditiesIntact/mild cognition and functionality
7.0%–7.5%<7.5%*≤7.0%7.0%–7.5%7%–7.5%7%–8%*
Complex
(multiple coexisting chronic illnesses, cognitive or functional impairment)
Intermediate health
(>3 comorbidities and mild cognitive or ADL impairment)
Functionally dependentFunctionally dependent
(impairments of ADL, and requiring additional medical and social care)
Dependent; multisystem disease, care home residency, and including dementiaSignificant cognitive, presence of multiple comorbidities & functional impairment
8.0%–8.5%<8%*7.1%–8.0%7.0%–8.0%7.6%–8.5%8.0%–8.5%*
Poor health
(end-stage medical condition, moderate to severe dementia, or long-term care facility resident)
Frail and/or dementiaSublevel frail or dementia
<8.5%*7.1%–8.5%<8.5%
  • *The A1C targets varies among older adults who are using medications known to cause hypoglycemia (eg, insulin and sulfonylureas).

  • ADA, American Diabetes Association; ADLs, activities of daily living; DC, Diabetes Canada; ES, Endocrine Society; IDF, International Diabetes Federation.