Type 1 diabetes, ageing and frailty: an underexplored intersection – published online 17/02/2026

Giuseppe Maltese, Janaka Karalliedde, Jugdeep Dhesi, Srikanth Bellary

People living with type 1 diabetes are increasingly reaching older age, with a heterogeneity of ageing trajectories. While many individuals age well with preserved function, others develop diabetes-related complications, which together with age-related hormonal changes and other pathologies may contribute to multimorbidity, functional and cognitive decline and frailty. Frailty negatively influences both diabetes-related and non-diabetes-related outcomes, including hypoglycaemia, hospitalisation, disability and mortality. Failure to identify and address frailty risks undermines the benefits of advances in diabetes care. In this review, Maltese et al (https://doi.org/10.1007/s00125-026-06681-x) highlight the need to move beyond a glucose-centric approach to the management of older adults living with type 1 diabetes towards more individualised, multidisciplinary models of care that integrate geriatric principles. The authors discuss the potential role of diabetes technology and tailored support in improving quality of life, maintaining independence and improving outcomes of ageing individuals with type 1 diabetes. They conclude that future clinical strategies should focus on the early identification of frailty in people with type 1 diabetes. The figures from this review are available as a downloadable slideset.

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