title: Trends in the prevalence and comorbidities of diabetes mellitus in nursing home residents in the United States: 1995-2004.
abstract: OBJECTIVE
  To estimate trends in the prevalence and comorbidities of diabetes mellitus (DM) in U.S. nursing homes from 1995 to 2004.
  
  
  METHODS
  SAS callable SUDAAN was used to adjust for the complex sample design and assess changes in prevalence of DM and comorbidities during the study period in the National Nursing Home Surveys. Trends were assessed using weighted least squares linear regression. Multiple logistic regressions were used to calculate predictive margins.
  
  
  METHODS
  A continuing series of two-stage, cross-sectional probability national sampling surveys.
  
  
  METHODS
  Residents aged 55 and older: 1995 (n=7,722), 1997 (n=7,717), 1999 (n=7,809), and 2004 (n=12,786).
  
  
  METHODS
  DM and its comorbidities identified using a standard set of diagnosis codes.
  
  
  RESULTS
  The estimated crude prevalence of DM increased from 16.9% in 1995 to 26.4% in 2004 in male nursing home residents and from 16.1% to 22.2% in female residents (all P<.05). Male and female residents aged 85 and older and those with high functional impairment showed a significant increasing trend in DM (all P<.05). In people with DM, multivariate-adjusted prevalence of cardiovascular disease increased from 59.6% to 75.4% for men and from 68.1% to 78.7% for women (all P<.05). Prevalence of most other comorbidities did not increase significantly.
  
  
  CONCLUSIONS
  The burden of DM in residents of U.S. nursing homes has increased since 1995. This could be due to increasing DM prevalence in the general population or to changes in the population that nursing homes serve. Nursing home care practices may need to change to meet residents' changing needs.
authors.affiliation: Divisions of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA. XZhang4@cdc.gov
authors.forename: Xinzhi
authors.initials: X
authors.lastname: Zhang
authors.forename: Frederic H
authors.initials: FH
authors.lastname: Decker
authors.forename: Huabin
authors.initials: H
authors.lastname: Luo
authors.forename: Linda S
authors.initials: LS
authors.lastname: Geiss
authors.forename: William S
authors.initials: WS
authors.lastname: Pearson
authors.forename: Jinan B
authors.initials: JB
authors.lastname: Saaddine
authors.forename: Edward W
authors.initials: EW
authors.lastname: Gregg
authors.forename: Ann
authors.initials: A
authors.lastname: Albright
mesh_terms: D000203:Activities of Daily Living; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity / Q000639:trends; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000150:complications / Q000453:epidemiology; D005260:Female; D015577:Geriatric Assessment; D006306:Health Surveys; D006801:Humans; D016018:Least-Squares Analysis; D007902:Length of Stay / Q000639:trends; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009735:Nursing Homes / Q000639:trends; D015995:Prevalence; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology