title: Evaluation of an intra-institutional diabetes disease management program for the glycemic control of elderly long-term care diabetic patients.
abstract: OBJECTIVE
  Increasing numbers of nursing home elderly patients suffer from diabetes requiring individually optimized glycemic control. This is a complicated challenge because of their high comorbidity level, and heterogeneous and changing eating status varying from independent to dysphagia and enteral feeding. In order to cope with these complex needs, we developed and implemented a diabetes disease management program. The purpose of the present study was to evaluate this program.
  
  
  METHODS
  We used the point prevalence approach by checking for fasting blood glucose, glycated hemoglobin and other routine biochemical tests. Eating status was evaluated by the Functional Outcome Swallowing Scale. Details about the diabetes disease management program are given in the text.
  
  
  RESULTS
  A total of 86 (36%) of the 234 patients on the study day were diabetics. Of these, 80 were eligible for the study. Their mean fasting blood glucose was 143.1 ± 60.6 mg/dL. The mean glycated hemoglobin level was 7.23 ± 1.39%.
  
  
  CONCLUSIONS
  No case of hypoglycemia was detected on the examination day, or during the preceding 3 weeks. No significant difference was found among the different Functional Outcome Swallowing Scale categories. These results are within satisfactory range for this category of patients suggesting that our diabetes disease management program contributes to a better glycemic control.
authors.affiliation: Geriatric Department, Shmuel Harofeh Medical Center, Beer Yaakov, Israel.
authors.forename: Emily
authors.initials: E
authors.lastname: Lubart
authors.forename: Refael
authors.initials: R
authors.lastname: Segal
authors.forename: Julio
authors.initials: J
authors.lastname: Wainstein
authors.forename: Galina
authors.initials: G
authors.lastname: Marinov
authors.forename: Alexandra
authors.initials: A
authors.lastname: Yarovoy
authors.forename: Arthur
authors.initials: A
authors.lastname: Leibovitz
mesh_terms: D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis*; D003920:Diabetes Mellitus / Q000097:blood* / Q000628:therapy*; D019468:Disease Management; D006442:Glycated Hemoglobin; D006268:Health Facilities; D006801:Humans; D008134:Long-Term Care; D015397:Program Evaluation
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: diabetes disease management; elderly; glycemic control; long-term care