title: Type 2 diabetes mellitus treatment patterns in U.S. nursing home residents.
abstract: BACKGROUND
  The prevalence of type 2 diabetes mellitus (diabetes) in nursing home residents (NHRs) is increasing, concurrently with obesity and other comorbid conditions. NHR would benefit greatly from antidiabetic medications that would improve glycemic control and give a lower risk of hypoglycemia but that do not contribute to weight gain in obese individuals.
  
  
  OBJECTIVE
  To examine the prescription patterns to NHRs with diabetes, including the use of newer injectable therapies such as glucagon-like peptide-1 (GLP-1) receptor agonists.
  
  
  METHODS
  Treatment patterns of diabetes in NHR were analyzed using Minimum Data Set records and prescription claims from the Omnicare Senior Health Outcomes data repository (May 2011-September 2012).
  
  
  RESULTS
  The prevalence of diabetes in this population of 229,283 NHRs was 35.4%. Among the 44,665 NHRs with diabetes and prescription claims data, the prevalence of obesity (40.3%) and multiple comorbidities (100%) was high. Approximately 20% of the NHRs with diabetes were aged <65 years. Overall, 20% of NHRs had diabetes that was untreated with medications during the study period. Insulin was the mainstay of treatment (>80%), followed by oral agents (54%). GLP-1 receptor agonist use was low (0.5%) and associated with poor treatment persistence.
  
  
  CONCLUSIONS
  Considerations other than glycemic control may drive prescribing decisions, contrary to recommendations from the American Diabetes Association, American Medical Directors Association, and European Association for the Study of Diabetes.
authors: Omnicare Senior Health Outcomes, Inc. , Cincinnati, OH , USA.
authors: Barbara
authors: B
authors: Zarowitz
authors: Carrie
authors: C
authors: Allen
authors: Terrence
authors: T
authors: O'Shea
authors: Mehul R
authors: MR
authors: Dalal
authors: Mark
authors: M
authors: Haumschild
authors: Andres
authors: A
authors: DiGenio
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D000067757:Glucagon-Like Peptide-1 Receptor; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D061266:Insulin, Short-Acting / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians'; D018027:Receptors, Glucagon / Q000819:agonists / Q000627:therapeutic use; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
chemical_list: C000593833:GLP1R protein, human; D000067757:Glucagon-Like Peptide-1 Receptor; D007004:Hypoglycemic Agents; D061266:Insulin, Short-Acting; D018027:Receptors, Glucagon
keywords: Type 2 diabetes; elderly nursing home residents; insulin treatment; minimum data set; obesity; prescription patterns