Diabetes Management in Long-term Care
The management of diabetes in the long-term care tends to be difficult due to the fact that elderly are on multiple medications, have multiple co-moribidities, and do not present with the same symptoms as a younger person with diabetes <1>. In addition, due to the lack of studies on long-term care residents, there is a lack of consensus guidelines available to help guide healthcare professionals in the management of diabetes in long-term care<1>. Nevertheless, literature does provide healthcare professionals with several helpful considerations. Please consider reviewing the RxFiles:The Frail and Elderly (under the "resource/tools" tab) for a summary of general considerations in the management of diabetes in LTC. Also, please consider reading the following literature that discuss the issues surrounding diabetes management in long-term care and provides insight on how diabetes can be better managed.
- Holy RM, Schwartz FL, Shrubrook JH.Diabetes Care in Extended-Care Facilities.Diabetes Care 2007;30:1454-1458
- Clement M, Leung F.C. Diabetes and the frail elderly in long term care. Can J Diabetes 2009.33(2):114-121
- Cefalu C, Cefalu W. The older patient with type 2 diabetes: special considerations and management with insulin. Ann Long-Term Care 2006;14:17-24.
- Velussi M. Lispro insulin treatment in comparison with regular human insulin in type 2 diabetic patients living in nursing homes. Diabetes Nutr Metab 2002;15:96-100.
- Migdal A. Yarandi SS. Smiley D. et al. Update on Diabetes in the Elderly and in Nursing Home Residents. JAMDA 2011;12:627-632
- Rizvi AA. Management of diabetes in older adults. Am J Med Sci 2007;333:35–47.
- Brown AF, Mangione CM, Saliba D, Sarkisian CA. Guidelines for improving the care of the older person with diabetes mellitus. J Am Geriatr Soc 2003;51:S265–S280.
- Messinger-Rapport BJ, Thomas DR, Gammack JK, Morley JE. Clinical update on nursing home medicine: 2008. J Am Med Dir Assoc 2008;9: 460–475.
- Johnson EL, Brossuau JD, Soule M.Treatment of Diabetes in long-term facilities: a primary care approach. Clin Diabetes 2008; 26(4):152-156
References:
1. Clement M, Leung F.C. Diabetes and the frail elderly in long term care. Can J Diabetes 2009.33(2):114-121
1. Clement M, Leung F.C. Diabetes and the frail elderly in long term care. Can J Diabetes 2009.33(2):114-121