Diabetes management of older adults in nursing homes: A retrospective study.

Abstract

To examine the diabetes management of older adults in nursing homes. Diabetes is an increasing problem in nursing homes, and diabetes care is defined as a neglected clinical area. A retrospective collected data review of 166 older adults with known diabetes from four nursing homes. 65% older than 75years had HbA1c levels lower than 7.5% (58mmol/mol), 74% older than 85years had HbA1c levels lower than 8% (64mmol/mol). The HbA1c levels were 7.3% (56mmol/mol) for those who had three and more chronic disorders and 6.8% (51mmol/mol) for those who had less than three chronic disorders. Individuals treated with insulin had higher HbA1c levels (p<.001) and glycaemia (p=.002). Age was associated with a number of chronic disorders (p=.031), a number of regularly prescribed medications (p=.038) and a number of medications as needed (p=.009). More than half to three quarters have diabetes well-managed. Nevertheless, there is still some potential for improving diabetes care, and these findings warrant further research for improving diabetes management of older adults in nursing homes. Interventions designed to promote a healthy lifestyle, documenting individuals' target level and regular monitoring of glycaemia and HbA1c levels may help to improve diabetes management, which may result in better well-being and quality of life for older adults with diabetes in nursing homes.