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Feature Article

Palliative and end-of-life care for patients with diabetes

Trisha Dunning, Peter Martin

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Abstract

Diabetes complications are common and can contribute to unpleasant symptoms, depression and reduced quality of life. A palliative approach to diabetes care in patients with complications, including modified metabolic targets, can reduce symptoms and hospital admissions and improve quality of life and care transitions. GPs have a key role in co-ordinating palliative and end-of-life care in these patients.

Key Points

  • Palliative care aims to improve comfort and quality of life, optimise function and help patients make decisions about their end of life.
  • A palliative approach can start early in the course of diabetes care for patients with complications and comorbidities and can be combined with active diabetes treatment.
  • Key strategies in palliative care for people with diabetes include modifying glycaemic targets, minimising hyperglycaemic and hypoglycaemic episodes, managing medicines (particularly diabetogenic medicines), maintaining nutrition and hydration, and supporting family and carers.
  • The Gold Standard Prognostic Indicator and assessment of the end-of-life stage can help GPs determine life expectancy, which can aid GPs, patients and their carers in deciding when to withdraw treatment.

    Picture credit: © and.one/Dollar Photo Club.

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