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'.

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.