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Diabetics in Nursing Homes Need Improved Care

Published today in the American Diabetes Association journal Diabetes Care, Ohio University College of Osteopathic Medicine researchers say that the care of elderly patients with type 1insulin dependentand type 2 diabetes in extended care facilities fails to meet ADA Standards of Care.

Entitled Diabetes Care in Extended Care Facilities: Appropriate Intensity of Care?, a study authored Jay Shubrook, D.O., assistant professor of family medicine at OU-COM; Frank Schwartz, M.D., assistant professor of endocrinology at OU-COM; and second-year medical student Rachel Holt, examined the quality of care that diabetic patients receive in nursing homes through a retrospective chart review of 108 residents at 11 extended health-care facilities in Ohio and West Virginia over a period of one year.

Our study is based on the principle that there are guidelines on how to manage diabetes for the outpatient adult, and there are new guidelines for how to manage diabetes for patients in the hospital, but there are no guidelines for treating people in nursing homes, Shubrook said.

According to the study, only 38 percent of the patients monitored (98 percent) met blood glucose (sugar) goals. Only 55 percent of the patients monitored (94 percent) had satisfactory blood pressure levels. Only 31 percent of patients had lipids (serum total cholesterol) checks yearly, with 58 percent having acceptable levels. These three are critical areas that affect life expectancy for diabetics: control of hypertension (elevated blood pressure); cardiovascular risk factors, such as cholesterol; and blood sugar. Since heart disease is a most significant and common complication of diabetes, controlling hypertension and lipids are the number one and two treatment areas for the elderly diabetic. Blood glucose control is third.

Diabetes is expected to increase 336 percent by 2050 and will produce an enormous economic burden according to the study, making
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