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Assessment of glycemic control in nursing home residents with diabetes
- Source :
- Journal of Nutrition, Health and Aging, Journal of Nutrition, Health and Aging, Springer Verlag (Germany), 2017, 21 (4), pp.457-463. ⟨10.1007/s12603-016-0776-0⟩, Journal of Nutrition, Health & Aging, Journal of Nutrition, Health & Aging, 2017, 21 (4), pp.457-463. ⟨10.1007/s12603-016-0776-0⟩
- Publication Year :
- 2017
- Publisher :
- HAL CCSD, 2017.
-
Abstract
- International audience; Objective: To describe glycemic control in nursing home residents with diabetes and to evaluate the relevance of HbA1c in the detection of hypoglycemia risk.Design and methods: Diabetes treatment, geriatric assessment, blood capillary glucose (n= 24,682), and HbA1c were collected from medical charts of 236 southern France nursing home residents during a 4-month period. Glycemic control was divided into four categories: tight, fair, and moderate or severe chronic hyperglycemia using the High Blood Glucose Index or the analysis of blood glucose frequency distribution. Hypoglycemia episodes were identified by medical or biological records.Results: Glucose control was tight in 59.3 % and fair in 19.1 % of the residents. Chronic exposure to hyperglycemia was observed in 21.6 % of the residents (severe in 9.7 % and moderate in 11.9 %). Hypoglycemia was noticed in 42/236 (17.8%), in all categories of glycemic control. Relative hypoglycemia risk was significantly (P = 0.0095) higher in residents with moderate chronic hyperglycemia compared with those with tight control. The majority of residents with hypoglycemia (39/42) or chronic hyperglycemia (45/51) were insulin-treated. The relative risk of hypoglycemia was not significantly associated with HbA1c values.Conclusion: Hypoglycemia risk in nursing home residents is observed in all categories of glycemic control. In tight control, the potency of antidiabetic treatment should be reduced. In chronic hyperglycemia, diet and treatment should be reevaluated in order to reduce glucose variability. HbA1c is not sufficient for hypoglycemia risk detection; capillary blood glucose monitoring is warranted for nursing homes residents with diabetes.
- Subjects :
- Blood Glucose
Male
medicine.medical_specialty
HbA1c
endocrine system diseases
Medicine (miscellaneous)
Blood sugar
030209 endocrinology & metabolism
Hypoglycemia
03 medical and health sciences
0302 clinical medicine
Diabetes mellitus
Internal medicine
Medicine
Humans
Hypoglycemic Agents
Insulin
030212 general & internal medicine
Intensive care medicine
Glycemic
Aged
Blood glucose monitoring
Aged, 80 and over
Glycated Hemoglobin
Nutrition and Dietetics
medicine.diagnostic_test
business.industry
Chronic hyperglycemia
Blood glucose in long term care home residents
[SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology
nutritional and metabolic diseases
[SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism
medicine.disease
3. Good health
Nursing Homes
Blood chemistry
Relative risk
Hyperglycemia
Female
France
Geriatrics and Gerontology
Nursing homes
business
Subjects
Details
- Language :
- English
- ISSN :
- 12797707 and 17604788
- Database :
- OpenAIRE
- Journal :
- Journal of Nutrition, Health and Aging, Journal of Nutrition, Health and Aging, Springer Verlag (Germany), 2017, 21 (4), pp.457-463. ⟨10.1007/s12603-016-0776-0⟩, Journal of Nutrition, Health & Aging, Journal of Nutrition, Health & Aging, 2017, 21 (4), pp.457-463. ⟨10.1007/s12603-016-0776-0⟩
- Accession number :
- edsair.doi.dedup.....505aa272f52e3210f8dd619d79b59207