Editorials

Managing diabetes in residential and nursing homes

BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7125.89 (Published 10 January 1998) Cite this as: BMJ 1998;316:89

Presents a complex set of problems with no one solution

  1. Robert Tattersall, Professor of clinical diabetesa,
  2. Simon Page, Consultant physiciana
  1. a University Hospital, Nottingham NG7 2UH

    The prevalence of diabetes in the elderly is around 10% and it imposes an enormous burden on healthcare systems. In America in 1992 nursing home care for people with diabetes cost $1.83 billion.1 Elderly diabetics have much microvascular and macrovascular disease and are two to three times more likely to need hospital admission than their non-diabetic counterparts.2 One might expect a higher prevalence of diabetes and its complications in residential or nursing homes. Several American studies have found diabetes in 20% of nursing home residents,3 and in one almost 90% of diabetic residents had coronary artery disease, strokes, or peripheral vascular disease—with 6.4 major diagnoses compared with only 2.4 in non-diabetic residents.4 In Alabama (and probably England) nursing home patients generate a disproportionately large number of out of hours calls.5

    In a recent issue of the BMJ Benbow and coworkers surveyed 44 residential and nursing homes in Liverpool comparing 109 diabetic residents with 107 age and …

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