Factors influencing safe glucose-lowering in older adults with type 2 diabetes: A PeRsOn-centred ApproaCh To IndiVidualisEd (PROACTIVE) Glycemic Goals for older people: A position statement of Primary Care Diabetes Europe

Prim Care Diabetes. 2019 Aug;13(4):330-352. doi: 10.1016/j.pcd.2018.12.005. Epub 2019 Feb 18.


Diabetes in later life is associated with a range of factors increasing the complexity of glycaemic management. This position statement, developed from an extensive literature review of the subject area, represents a consensus opinion of primary care clinicians and diabetes specialists. It highlights many challenges facing older people living with type 2 diabetes and aims to support primary care clinicians in advocating a comprehensive, holistic approach. It emphasises the importance of the wishes of the individual and their carers when determining glycaemic goals, as well as the need to balance intended benefits of treatment against the risk of adverse treatment effects. Its ultimate aim is to promote consistent high-quality care for older people with diabetes.

Keywords: Frailty; Glycaemic goals; Hypoglycaemia; Older people; Type 2 diabetes.

Publication types

  • Consensus Development Conference
  • Practice Guideline
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Age Factors
  • Aged
  • Biomarkers / blood
  • Blood Glucose / drug effects*
  • Blood Glucose / metabolism
  • Comorbidity
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Europe / epidemiology
  • Female
  • Health Status
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Male
  • Patient-Centered Care / standards*
  • Practice Patterns, Physicians' / standards*
  • Primary Health Care / standards*
  • Risk Factors
  • Treatment Outcome


  • Biomarkers
  • Blood Glucose
  • Hypoglycemic Agents