nursing home diabetes care a critical avenue to explore. The Centers for Disease Control estimates that one out of three people born in the United States in 2000 will develop the disease in his or her lifetime.

According to Holt, an analysis of the data revealed the lack of a systematic approach to diabetes treatment in the facilities studied. The findings demonstrated that practice guidelines for this population must be developed in order to offer optimal care standards to nursing home residents.

Research released by the American Association of Clinical Endocrinologists indicates that three out of five people with type 2 diabetes have at least one other serious health problem related to their disease. These problems can be heart disease, diabetic retinopathy, kidney disease and foot problems.

Based on their findings, Shubrook and Schwartz are now developing treatment protocols for diabetes in nursing homes. These will be offered to medical directors of these facilities in order to improve the quality and consistency of patient care.

Some things are done extremely well in nursing homes for instance, foot exams and influenza vaccinations, Shubrook said. Others are not done as well.

Phase two of the study, which gets underway later this year, includes a second review of patients charts to determine if following the treatment protocols proposed by Shubrook and Schwartz results in quality of life changes for the residents.

The fastest growing population of young people with diabetes is in this region, Holt said. Imagine the implications of this.

And considering that the general population of Appalachia has two to three times the national incidence of diabetes, as diabetes rates increase, the number of elderly diabetics in nursing homes will also increase.

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