Adults aged 80 years and older represent the fastest growing segment of the diabetes population, yet their clinical needs remain underrepresented in published evidence. A scoping review in Diabetology mapped current knowledge on diabetes-related complications in this age group and identified significant research imbalances.

This review systematically searched MEDLINE, Embase and Web of Science for studies published from 1992 to 2024 that reported diabetes-related complications in adults aged 80 years or above. Two reviewers independently screened and assessed eligible studies, and findings were summarized using narrative synthesis and descriptive statistics.

Fifty-one studies met inclusion criteria, capturing outcomes from 17,630,083 older adults. Macrovascular complications were the most frequently reported. In contrast, microvascular outcomes were examined in fewer than 400,000 individuals, and peripheral complications were rarely addressed. Hypertension was the most prevalent comorbidity. Only five studies focused exclusively on adults aged 80 years or above. Further limitations included reliance on retrospective data, variability in outcome definitions and inadequate reporting of diabetes duration, glycemic control, frailty and cognitive status.

The findings indicate a persistent mismatch between research focus and the complications most relevant to function, independence and quality of life in older adults with diabetes. Standardized, age-stratified reporting that integrates geriatric assessments is needed to support person-centered care in this vulnerable cohort.