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Type 2 diabetes management in residential aged care

Type 2 diabetes more than doubles a person’s risk of dying from cardiovascular (CV) causes.

A holistic approach to managing type 2 diabetes lowers the absolute risk of CV events and improves outcomes.

What are the priorities?

  • Lower blood pressure and LDL-cholesterol for an immediate effect in reducing CV risk in the short term (3–5 years).
  • Tight control of blood glucose in people who are newly diagnosed with type 2 diabetes to prevent CV events in the long term.
All residents should make healthy lifestyle changes (i.e. diet, exercise and weight loss) regardless of the need for drug treatment. People with a high absolute CV risk benefit the most from lipid-lowering and antihypertensive treatment, whereas people with low-to-moderate CV risk should trial healthy lifestyle changes alone before drug therapies are prescribed.

Read more information on understanding type 2 diabetes and cardiovascular disease risk

How have aspirin recommendations changed?

Recent studies show that aspirin benefits people with established CV disease, but for those without CV disease — including those with diabetes — the risk of adverse events outweighs the benefit of treatment. Low-dose aspirin is no longer routinely recommended in people without known CV disease. Monitor those using low-dose aspirin for the adverse effects such as gastrointestinal bleeding.

Support patients in their treatment plans

Patients should be kept at the centre of management decisions. Discuss ways of implementing lifestyle changes with the residents and carers and explain why medicines are important for them. Support them to improve adherence to prescribed treatment plans and lifestyle changes.

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