Management of elderly patients with type 2 diabetes in long-term care and skilled-nursing facilities

Gómez‐Huelgas, Ricardo; Pérez‐Belmonte, Luis M.; Rivera-Cabeo, Inmaculada; Morilla‐Herrera, Juan Carlos; Bellosta-Ymbert, José M; Bernal-López, María Rosa

doi:10.20452/pamw.4410

Cited by 2 publications

(1 citation statement)

References 8 publications

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“…A population-based, retrospective cohort study using data from a claims database demonstrated that for frail individuals, or those with multiple comorbidities, over three quarters with HbA 1c \ 6.5% did not have their therapy simplified (defined as discontinuation of at least one glucose-lowering medication) [38]. In addition, data highlight that older individuals managed with intensive glycaemic control are more likely to experience hypoglycaemic events [40,41].…”

Section: Current Evidence and Treatment Landscapementioning

confidence: 99%

Expert Panel Guidance and Narrative Review of Treatment Simplification of Complex Insulin Regimens to Improve Outcomes in Type 2 Diabetes

et al. 2022

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Given the progressive nature of type 2 diabetes (T2D), most individuals with the disease will ultimately undergo treatment intensification. This usually involves the stepwise addition of a new glucose-lowering agent or switching to a more complex insulin regimen. However, complex treatment regimens can result in an increased risk of hypoglycaemia and high treatment burden, which may impact negatively on both therapeutic adherence and overall quality of life. Individuals with good glycaemic control may also be overtreated with unnecessarily complex regimens. Treatment simplification aims to reduce individual treatment burden, without compromising therapeutic effectiveness or safety. Despite data showing that simplifying therapy can achieve good glycaemic control without negatively impacting on treatment efficacy or safety, it is

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Section: Current Evidence and Treatment Landscapementioning

confidence: 99%

Expert Panel Guidance and Narrative Review of Treatment Simplification of Complex Insulin Regimens to Improve Outcomes in Type 2 Diabetes

et al. 2022

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Diabetes in residential aged care: Pharmacological management and concordance with clinical guidelines

Bhalla,

Huang,

Seaman

et al. 2024

Australas J Ageing

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ObjectiveExisting studies have highlighted suboptimal diabetes management in residential aged care facilities (RACFs). However, understanding of diabetes management in Australian metropolitan RACFs has been limited. This retrospective cohort study aimed to explore the pharmacological management of diabetes in 25 RACFs in Sydney Australia and assess concordance with clinical practice guidelines (CPGs).MethodsData from 231 permanent RACF residents aged ≥65 years and over with type 2 diabetes mellitus over the period from 1 July 2016 to 31 December 2019 were used. Concordance was measured by assessing the medications and medical history data for each individual resident for concordance with evidence‐based CPGs. Multivariable logistic regression was used to estimate the effect of resident characteristics on concordance with CPGs.ResultsOf the 231 residents with diabetes, 87 (38%) were not taking any antidiabetic medication. Pharmacological management inconsistent with CPG recommendations was observed for 73 (32%) residents, with the most common reason for non‐concordance being the use of medications with significant adverse effects in older adults (47, 2%). Residents with hypertension or other heart diseases in addition to their diabetes had greater odds of their diabetes management being non‐concordant with CPGs (OR = 2.84 95% CI = 1.54, 5.3 and OR = 2.64, 95% CI = 1.07, 6.41, respectively).ConclusionsPharmacological diabetes management in metropolitan Australian RACFs is suboptimal, with a high prevalence of inconsistency with CPGs (32%) observed. Additionally, having hypertension or heart diseases significantly increased the possibility of non‐concordance among diabetic RACF residents. Further investigation into the underlying relationships with comorbidities is required to develop better strategies.

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Management of elderly patients with type 2 diabetes in long-term care and skilled-nursing facilities

Cited by 2 publications

References 8 publications

Expert Panel Guidance and Narrative Review of Treatment Simplification of Complex Insulin Regimens to Improve Outcomes in Type 2 Diabetes

Expert Panel Guidance and Narrative Review of Treatment Simplification of Complex Insulin Regimens to Improve Outcomes in Type 2 Diabetes

Diabetes in residential aged care: Pharmacological management and concordance with clinical guidelines

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