title: Identifying persons with diabetes who could benefit from a palliative approach to care.
abstract: OBJECTIVE
  To determine the need for diabetes mellitus palliative care, we identified persons with a diagnosis of diabetes who accessed palliative care programs and those who may have benefited from a palliative approach to care.
  
  
  METHODS
  This retrospective, descriptive research used 6 linked databases comprising 66 634 Nova Scotians from 3 health districts who died between 1995 and 2009, each with access to a palliative care program and diabetes centres.
  
  
  RESULTS
  The percentage of persons with diabetes enrolled in palliative care increased from 3.2% in 1995 to 34.3% in 2009; 31.5% were enrolled within their last 2 weeks of life. Most did not have their diabetes recorded in palliative data. Among the 5353 persons with a diagnosis of diabetes who died between 2005 and 2009, 61.0% were in the Diabetes Care Program of Nova Scotia registry. An additional 19.6% were identified in the Cardiovascular Health Nova Scotia registry, and a further 3.7% in palliative data. Applying the criteria of Rosenwax et al to the 5353, 65.8% to 97.9% may have benefitted from a palliative approach.
  
  
  CONCLUSIONS
  Rates of palliative enrollment for persons with diabetes are increasing. Diabetes care providers need to prepare patients and their families for changes in diabetes management that will be beneficial as end of life approaches. Collaboration among chronic disease programs, palliative care and primary care is advised to identify persons at end of life who have diabetes and to develop and implement care guidelines for this population.
authors: School of Health Administration, Dalhousie University, and Surveillance and Epidemiology Unit, Cancer Care Nova Scotia, Halifax, Nova Scotia. Electronic address: grace.johnston@dal.ca.
authors: Grace M
authors: GM
authors: Johnston
authors: School of Health Administration, Dalhousie University, Halifax, Nova Scotia.
authors: Lynn
authors: L
authors: Lethbridge
authors: Diabetes Care Program of Nova Scotia, Halifax, Nova Scotia.
authors: Pam
authors: P
authors: Talbot
authors: Diabetes Care Program of Nova Scotia, Halifax, Nova Scotia.
authors: Margaret
authors: M
authors: Dunbar
authors: School of Health Administration, Dalhousie University, Halifax, Nova Scotia.
authors: Laura
authors: L
authors: Jewell
authors: Palliative Care Service, Colchester East Hants Health Authority, Truro, and Faculty of Medicine and Departments of Medicine and Family Medicine, Dalhousie University, Halifax, Nova Scotia.
authors: David
authors: D
authors: Henderson
authors: Palliative Care Service, Cape Breton District Health Authority, Sydney, Nova Scotia.
authors: Anne Frances
authors: AF
authors: D'Intino
authors: Division of Palliative Medicine/Capital Health Integrated Palliative Care Service, Capital Health, and Departments of Medicine and Family Medicine, Dalhousie University, Halifax, Nova Scotia.
authors: Paul
authors: P
authors: McIntyre
mesh_terms: D003920:Diabetes Mellitus / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D009674:Nova Scotia; D010166:Palliative Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies
keywords: chronic disease registry; diabetes; diabète; end of life; fin de vie; palliative care; population-based study; registre sur les maladies chroniques; soins palliatifs; étude en population générale