title: Trends in prevalence, incidence and pharmacologic management of diabetes mellitus among seniors newly admitted to long-term care facilities in Saskatchewan between 2003 and 2011.
abstract: OBJECTIVE
  We aimed to describe trends in the prevalence and incidence of diabetes mellitus and also report the overall use of diabetes medications among patients newly admitted to a long-term care facility (LTCF).
  
  
  METHODS
  A retrospective cohort study was done using health administrative databases in Saskatchewan. Eligible patients were newly admitted to LTCF in Saskatchewan between 2003 and 2011 and maintained LTCF residency for at least 6 months. Prevalence of diabetes was defined with physician or hospital claims in the 2 years preceding admission. Antihyperglycemic medication use was estimated from prescription claims data during the first 6 months after LTCF admission. All data were descriptively analyzed.
  
  
  RESULTS
  The validated case definition for diabetes (≥2 diagnostic claims) in the 2 years before or 6 months after admission was met by 16.9% of patients (2471 of 14,624). An additional 965 patients (6.6%) had a single diabetes diagnostic claim or antihyperglycemic prescriptions only. Among patients receiving antihyperglycemic therapies, 64.9% (1518 of 2338) were exclusively managed with oral medications, and metformin was the most commonly used medication. Glyburide was commonly withdrawn after LTCF admission. Insulin use was observed in 23.9% of diabetes patients, with a mean daily average consumption of 54.7 units per day.
  
  
  CONCLUSIONS
  Use of diabetes medications appear to generally align with Canadian practice recommendations as evidenced by declining use of glyburide and frequent use of metformin. Future studies should examine clinical benefits and safety of hypoglycemic agent use in LTCFs.
authors.affiliation: College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
authors.forename: Mhd Wasem
authors.initials: MW
authors.lastname: Alsabbagh
authors.affiliation: College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
authors.forename: Kerry
authors.initials: K
authors.lastname: Mansell
authors.affiliation: Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Lix
authors.affiliation: Saskatchewan Health Quality Council, Saskatoon, Saskatchewan, Canada.
authors.forename: Gary
authors.initials: G
authors.lastname: Teare
authors.affiliation: College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Shevchuk
authors.affiliation: Saskatchewan Health Quality Council, Saskatoon, Saskatchewan, Canada.
authors.forename: Xinya
authors.initials: X
authors.lastname: Lu
authors.affiliation: Drug Plan and Extended Benefits Branch, Ministry of Health, Government of Saskatchewan, Regina, Saskatchewan, Canada.
authors.forename: Anne
authors.initials: A
authors.lastname: Champagne
authors.affiliation: College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. Electronic address: d.blackburn@usask.ca.
authors.forename: David F
authors.initials: DF
authors.lastname: Blackburn
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D005905:Glyburide / Q000627:therapeutic use; D006707:Homes for the Aged; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D015994:Incidence; D007328:Insulin / Q000627:therapeutic use; D008134:Long-Term Care; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D015995:Prevalence; D012189:Retrospective Studies; D012525:Saskatchewan / Q000453:epidemiology
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin; D005905:Glyburide
keywords: agents antihyperglycémiques; antihyperglycemic agents; elderly; long-term care; longitudinal trend; personnes âgées; soins de longue durée; tendance longitudinale