ABSTRACT
The management of diabetes in long-term care (LTC) facilities requires facility staff to perform most self-care activities on the behalf of the residents. A practical model of care to improve diabetes management was developed and implemented at 6 LTC facilities in the Northeast United States between 2009 and 2012. The components of the program included (1) developing an individualized education curriculum and educating LTC interdisciplinary staff; (2) educating patients and caregivers; and (3) developing a clinical care algorithm. Over 500 staff members were educated and achieved competence. There were 1031 residents screened for risk of hypo- or hyperglycemia on admission, and 245 residents (24%) experienced hypoglycemia and 240 residents (23%) experienced hyperglycemia. Hypoglycemia episodes resolved without recurrence in 73%-90% cases because of interventions initiated by LTC staff. The implementation of a practical model of diabetes management in LTC facilities can improve staff education and lead to improved diabetes management.
Subject(s)
Diabetes Mellitus , Hypoglycemia , Caregivers , Diabetes Mellitus/therapy , Humans , Hypoglycemia/therapy , Long-Term Care , New England , Skilled Nursing FacilitiesABSTRACT
Reducing barriers to self-monitoring of blood glucose (SMBG) remains an ongoing goal. One major reported barrier is lancing pain. This analysis was written in response to the article by Kocher and associates in this issue of Journal of Diabetes Science and Technology in which 157 patients with diabetes experienced in the use of SMBG compared high market share blood glucose monitoring systems and lancing devices. Upon review of their findings, we found that their conclusions-Accu-check systems and lancing devices were preferred-were valid within the limitations of the study. However, we noted some factors that would warrant further study and possibly change the outcome. Information from this and other studies on the topic will be useful as a reference for patients and providers in working towards removing barriers to SMBG.
