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ADA issues guidance on managing diabetes in LTC

February 9, 2016
by Nicole Stempak, Associate Editor
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Diabetes management is a challenge for those affected—and an even greater challenge when diabetics aren't able to manage the disease themselves.

Type 2 diabetes affects a disproportionate number of seniors, a population that's expected to grow and one that's increasingly living in a group setting. The American Diabetes Association has issued its first position statement on managing diabetes in long-term care in the February 2016 issue of "Diabetes Care."

"The differences in caring for older people with type 2 diabetes aren’t well understood and haven’t been the focus of guidelines for managing the disease," says statement lead author Medha N. Munshi, MD, Director of the Joslin Diabetes Center Geriatric Diabetes Program and assistant professor at Harvard Medical School. "We wanted to give long-term care facilities very clear guidelines for caring for patients with diabetes that they can adapt into their care protocols."

People aged 65 and older are six times more likely to have diabetes than people aged 20-24, about 26 percent compared to 4 percent, according to the Centers for Disease Control and Prevention. Managing diabetes for seniors poses additional concerns based on their health status and possible comorbidities. They are also at increased risk for certain age-related conditions, including cardiovascular disease, cognitive impairment, falls, persistent pain and urinary incontinence.

The ADA's statement addresses specific medical needs for seniors with type 2 diabetes and offers recommendations for general approach to care; goals and strategies; diabetes management during transitions of care; diabetes management in patients at end of life, including issues for palliative care and hospice patients; and integration of diabetes management into long-term care facilities.

"Care of older patients with diabetes needs to be patient-centered and focused on individualized goals," says Munshi. "It is also important to educate endocrinologists, who may not have experience with long-term care facilities, and geriatricians, who may lack a comprehensive understanding of diabetes care," she says.

Read the statement here

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