We found a high prevalence (7.4±9.3%) of diabetes in elderly residents (mean age 82 years for women, 77 years for men) in nursing homes. Most of these patients were unable to manage their diabetes. Many of the patients (37% in one district) were not recorded in the district register. Recording of eye, foot and blood pressure checks varied. Carers were in need of information and education about diabetes care. Care of elderly patients in nursing homes should be structured, with close liaison between all carers. There are unmet needs and problems in communication. Closer cooperation is needed between carers in homes and doctors and nurses in primary and secondary care. In districts where diabetes remains under-resourced, this will provide challenges for innovative work. A district-wide register of patients with diabetes will facilitate the provision of structured care for a substantial number of elderly patients with diabetes who are literally`out of sight-and out of mind'.

A 57‐year‐old morbidly obese man with type 2 diabetes for five years, poorly controlled on gliclazide therapy, was referred with hyperglycaemic symptoms including severe daytime malaise and weariness. Features of obstructive sleep apnoea syndrome (OSA) were identified, and confirmed by limited polysomnography. Treatment with nocturnal nasal continuous positive airways pressure (CPAP) was instituted with dramatic relief of daytime symptoms, including morning headaches and also nocturia, which might otherwise have been attributed to changes in blood glucose. Copyright © 2003 John Wiley & Sons, Ltd.

We found a high prevalence (7.4–9.3%) of diabetes in elderly residents (mean age 82 years for women, 77 years for men) in nursing homes. Most of these patients were unable to manage their diabetes. Many of the patients (37% in one district) were not recorded in the district register. Recording of eye, foot and blood pressure checks varied. Carers were in need of information and education about diabetes care. Care of elderly patients in nursing homes should be structured, with close liaison between all carers. There are unmet needs and problems in communication. Closer co‐operation is needed between carers in homes and doctors and nurses in primary and secondary care. In districts where diabetes remains under‐resourced, this will provide challenges for innovative work. A district‐wide register of patients with diabetes will facilitate the provision of structured care for a substantial number of elderly patients with diabetes who are literally ‘out of sight‐and out of mind’. Copyright © 2000 John Wiley & Sons, Ltd.

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