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

Aim To examine the diabetes management of older adults in nursing homes. Background Diabetes is an increasing problem in nursing homes, and diabetes care is defined as a neglected clinical area. Methods A retrospective collected data review of 166 older adults with known diabetes from four nursing homes. Results 65% older than 75 years had HbA1c levels lower than 7.5% (58 mmol/mol), 74% older than 85 years had HbA1c levels lower than 8% (64 mmol/mol). The HbA1c levels were 7.3% (56 mmol/mol) for those who had three and more chronic disorders and 6.8% (51 mmol/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). Conclusions 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. Implications for nursing management 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.