The Foundation for Diabetes Research in Older People (FDROP) was originally launched in 2015. The Foundation at Diabetes Frail has been very active over the last five years completing at least four European Union-funded studies. The Foundation has recently participated in a further large European-wide randomised controlled trial (SPRINTT) over 5 years which examined the influence of structured exercise and nutrition in older adults with frailty and sarcopaenia (many of whom have diabetes) and this was completed in October 2020. In addition, the Foundation, via its Director, has had new collaborations with the University of Toulouse (the INSPIRE Project), IDF Atlas Group – 9th Edition), King’s College, London, Diabetes UK, Joint British Diabetes Societies – Inpatient Group, and the International Conference for Frailty, Sarcopenia Research, ICFSR).
In September 2019, Professor Sinclair, representing the Foundation, joined five other clinical scientists in presenting the Harvard Conference on Diabetes in Older Adults in Boston, USA. This was attended to by more than 40 leading clinicians and academics in the field. The evidence base for clinical decision-making in managing diabetes was scrutinised by a rigorous process and the conference report adapted into a Lancet Diabetes & Endocrinology manuscript which was subsequently published: see link:
https://www.thelancet.com/pdfs/journals/landia/PIIS2213-8587(20)30230-8.pdf
In late 2018, the Foundation and the European Diabetes Working Party for Older People (EDWPOP) began collaboration with the European Union Geriatric Medicine Society (EUGMS) to develop a European-wide consensus document on managing older adults with diabetes in primary primary care. This work is ongoing and publication of this work is expected in the Spring of 2021. This work is led by Professor Sinclair, Professor Stefania Maggi (Padua, Italy) and Professor Isabelle Bourdel-Marchasson (Bordeaux, France).
At the start of the Covid-19 pandemic in the UK, Professor Alan Sinclair as Director of the Foundation coordinated and co-led a Covid-19 National Rapid Response Action to develop management guidelines for those residents with diabetes and covid-19 in living in care homes. This was a multi-stakeholder group which produced guidance for care home staff and this was widely disseminated via the internet and social media, and is available at the ABCD (Association of British Clinical Diabetologists) and Diabetes UK websites, for example, at:
This work was also published in the Diabetic Medicine journal:
National Advisory Panel on Care Home Diabetes
In July 2020 towards the end of the first wave of Covid-19, Professor Sinclair established a large National Panel of leading clinicians, diabetes organisations and other stakeholders to develop a number of work streams to produce a comprehensive Strategic Document of Diabetes Care in care homes that will go beyond clinical care recommendations and produce guidance for care home staff, community-based nursing staff, primary care physicians, social care, public health and the independent care home sector.
The background to this work was discussed in Diabetes Times recently at:
https://diabetestimes.co.uk/tag/professor-alan-sinclair/
The guidance is scheduled for consultation in May-June 2021 and release in July-August 2021.
Meanwhile, guidance to help care home staff look after people with diabetes who are being treated for COVID-19 with dexamethasone or receiving oxygen treatment has been issued.
Published by the European Diabetes Working Party for Older People (EDWPOP) and European Geriatric Medicine Society (EuGMS), the document addresses the need to provide clinically relevant and practical guidance for long-term care staff working in care homes who require consideration for dexamethasone and oxygen therapy.
Entitled ‘Dexamethasone and Oxygen Therapy in Care Home Residents with Diabetes – A Management Guide and Algorithm for Treatment‘ it was drafted as a rapid response statement following a series of consensus discussions between the EDWPOP and EuGMS in January and February 2021.
Its main aim is to minimise morbidity and mortality from serious acute illnesses including COVID-19 requiring these treatments within the long-term care sector.
Other Activity of the Foundation
Difficult Cases Panel
Diabetes in older people is often a very complex illness associated with a high comorbidity profile, frailty, and multiple medications including polypharmacy. As a response to increasing numbers of enquiries to the Diabetes Frail and the Foundation from patients and their families seeking help to assist in diagnosing problems, improving management, and enhancing their overall quality of life, the Foundation has established a Difficult Cases Panel. This is chaired by Professor Alan Sinclair and at present the other Panel members are Dr Srikanth Bellary, a Consultant Physician in Diabetes and Reader in Medicine at the University of Aston, and Dr Ahmed Abdelhafiz, a senior physician in Rotherham.
The Panel has been involved with three recent complex cases. In each instance, we ask the patient to give consent to study medical information about them and to confirm that their GP has also given permission for the Panel to access their care records. It is made clear to all that the Panel will not directly become involved in management.
Key publications
Professor Sinclair is the Senior Editor of the 6th edition of the textbook, Principles and Practice of Geriatric Medicine (Wiley-Blackwell). This notable and well established international textbook has been completed and will be published in the summer of 2021.
| Several other key articles involving Professor Sinclair have recently been published: |
| Sinclair AJ, Heller SR, Pratley RE, Duan R, Heine RJ, Festa A, Kiljański J. Evaluating glucose-lowering treatment in older people with diabetes: Lessons from the IMPERIUM trial. Diabetes Obes Metab. 2020 Feb 26. doi: 10.1111/dom.14013. [Epub ahead of print]
Sinclair A, Saeedi P, Kaundal A, Karuranga S, Malanda B, Williams R. Diabetes and global ageing among 65-99-year-old adults: Findings from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2020 Feb 14:108078. Sinclair AJ, Dunning T, Dhatariya K; an International Group of Experts. Clinical guidelines for type 1 diabetes mellitus with an emphasis on older adults: an Executive Summary.Diabet Med. 2020 Jan;37(1):53-70 LeRoith D, Biessels GJ, Braithwaite SS, Casanueva FF, Draznin B, Halter JB, Hirsch IB, McDonnell ME, Molitch ME, Murad MH, Sinclair AJ. Treatment of Diabetes in Older Adults: An Endocrine Society* Clinical Practice Guideline. J Clin Endocrinol Metab. 2019 May 1;104(5):1520-1574. Rodriguez-Mañas L, Laosa O, Vellas B, Paolisso G, Topinkova E, Oliva-Moreno J, Bourdel-Marchasson I, Izquierdo M, Hood K, Zeyfang A, Gambassi G, Petrovic M, Hardman TC, Kelson MJ, Bautmans I, Abellan G, Barbieri M, Peña-Longobardo LM, Regueme SC, Calvani R, De Buyser S, Sinclair AJ; European MID-Frail Consortium. Effectiveness of a multimodal intervention in functionally impaired older people with type 2 diabetes mellitus. J Cachexia Sarcopenia Muscle. 2019 Apr 23. Rodriguez-Mañas L, Laosa O, Vellas B, Paolisso G, Topinkova E, Oliva-Moreno J, Bourdel-Marchasson I, Izquierdo M, Hood K, Zeyfang A, Gambassi G, Petrovic M, Hardman TC, Kelson MJ, Bautmans I, Abellan G, Barbieri M, Peña-Longobardo LM, Regueme SC, Calvani R, De Buyser S, Sinclair AJ; European MID-Frail Consortium. Effectiveness of a multimodal intervention in functionally impaired older people with type 2 diabetes mellitus. J Cachexia Sarcopenia Muscle. 2019 Apr 23. Munshi MN, Meneilly GS, Rodríguez-Mañas L, Close KL, Conlin PR, Cukierman-Yaffe T, Forbes A, Ganda OP, Kahn CR, Huang E, Laffel LM, Lee CG, Lee S, Nathan DM, Pandya N, Pratley R, Gabbay R, Sinclair AJ. Diabetes in ageing: pathways for developing the evidence base for clinical guidance. Lancet Diabetes Endocrinol. 2020 Oct;8(10):855-867. Srikanth V, Sinclair AJ, Hill-Briggs F, Moran C, Biessels GJ Type 2 diabetes and cognitive dysfunction-towards effective management of both comorbidities. . Lancet Diabetes Endocrinol. 2020 Jun;8(6):535-545. |