4.3.0.0 Healthy Pa­tients with Good Func­tion­al Sta­tus

There are few long-‍term stud­ies in older adults demon­strat­ing the benefits of in­ten­sive glycemic, blood pres­sure, and lipid con­trol. Pa­tients who can be ex­pect­ed to live long enough to reap the benefits of long-‍term in­ten­sive di­a­betes man­age­ment, who have good cog­ni­tive and phys­i­cal func­tion, and who choose to do so via shared de­ci­sion mak­ing may be treat­ed using ther­a­peu­tic in­ter­ven­tions and goals sim­i­lar to those for younger adults with di­a­betes (Table 12.1).

As with all pa­tients with di­a­betes, di­a­betes self-‍man­age­ment ed­u­ca­tion and on­go­ing di­a­betes self-‍man­age­ment sup­port are vital com­po­nents of di­a­betes care for older adults and their care­givers. Self-‍man­age­ment knowl­edge and skills should be reas­sessed when reg­i­men changes are made or an in­di­vid­u­al’s func­tion­al abil­i­ties di­min­ish. In ad­di­tion, de­clining or im­paired abil­i­ty to per­form di­a­betes self-‍care be­hav­iors may be an in­di­ca­tion for re­fer­ral of older adults with di­a­betes for cog­ni­tive and phys­i­cal func­tion­al as­sess­ment using age-nor­malized eval­u­a­tion tools (3,19).