Review: Management of diabetes mellitus in the nursing home

Research output: Contribution to journalReview article

Abstract

Diabetes mellitus (DM) is common in older adults and frequently affects residents of nursing homes (NH). Most have complex health status owing to comorbid illness, frailty, and the presence of geriatric syndromes. This complexity increases the risk of adverse events related to treatment. As a result, management of DM in the NH setting requires supreme clinical judgment that balances an understanding of the effects of comorbidity, functional disability, and geriatric syndromes with the resident's healthcare preferences and estimated life expectancy. Developing goals of care and implementing treatment plans requires knowledge of the balance of potential benefits and burdens of certain treatments, including lifestyle modification and pharmacotherapy. Prevention of macrovascular complications through intensive blood pressure and lipid management is achievable in a much shorter time period than the prevention of microvascular complications through intensive glycemic control. Furthermore, it is often necessary and important to address geriatric syndromes, which may significantly impact the resident's quality of life.

Original languageEnglish (US)
Pages (from-to)27-33
Number of pages7
JournalAnnals of Long-Term Care
Volume15
Issue number5
StatePublished - May 1 2007

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ASJC Scopus subject areas

  • Gerontology
  • Geriatrics and Gerontology

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