Older People with Diabetes Mellitus and Considerations for Diabetes Nurse Educators in Brunei

Brunei has a relatively high prevalence rate of diabetes and cardiovascular risk factors. It has also been shown that diabetic patients had poor knowledge and understanding of the condition and self-management skills. Older people are complex and have a higher absolute risk of diabetes related complications, thus should be a target group for DNE intervention. Management of older people with diabetes should be individualized. Comprehensive geriatric assessment takes into account medical, psychosocial and functional considerations. Many of the presenting complaints of older people are multifactorial. The reliability and objectivity of the history should also be considered. Other aspects of management include dentition, nutritional status, swallowing, medications, physical activity, fall prevention, palliative care and support services as well as pressure injuries in dependent older people. Finally, with the current COVID-19 pandemic, the approach for service delivery may also need adjustments to take into account infection prevention and control measures, such as use of virtual consultations.