title: Prevalence, Clinical Correlates, and Use of Glucose-Lowering Drugs among Older Patients with Type 2 Diabetes Living in Long-Term Care Facilities.
abstract: Prevalence, clinical correlates, and use of glucose-lowering drugs were comprehensively evaluated among 863 nursing home older patients with diabetes (mean age 82.9 ± 2.1 years): functional dependence and cognitive impairment were present in 84.1% and 68% of patients, respectively, and 66.3% of patients had 2-4 comorbidities. HbA1c values < 7.0% were documented in 54.9% of diabetic; significantly lower HbA1c levels were observed in demented patients than in nondemented subjects. Documented hypoglycemic episodes were reported for 57 patients (6.6%), without significant association with age, functional dependence, cognitive impairment, or HbA1c levels. About one-fifth of older long-term facilities residents have diabetes, with concomitant poor health conditions and high prevalence of cognitive impairment and functional dependence. Roughly three-fourths of these older and frail diabetic patients have HbA1c values lower than optimal, suggesting a potential for hypoglycemic harm especially among patients with severe cognitive impairment.
authors.affiliation: Department of Medical Sciences, Geriatric Section, University of Turin, 10124 Turin, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Bo
authors.affiliation: Department of Medical Sciences, Geriatric Section, University of Turin, 10124 Turin, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Gallo
authors.affiliation: Department of Medical Sciences, Geriatric Section, University of Turin, 10124 Turin, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Zanocchi
authors.affiliation: ASL TO4, 10034 Piemonte, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Maina
authors.affiliation: Ospedale Civico "Città di Settimo Torinese", 10036 Settimo Torinese, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Balcet
authors.affiliation: Department of Medical Sciences, Geriatric Section, University of Turin, 10124 Turin, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Bonetto
authors.affiliation: Department of Medical Sciences, Geriatric Section, University of Turin, 10124 Turin, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Marchese
authors.affiliation: Department of Medical Sciences, Geriatric Section, University of Turin, 10124 Turin, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Mastrapasqua
authors.affiliation: Department of Medical Sciences, Geriatric Section, University of Turin, 10124 Turin, Italy.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Aimonino Ricauda
mesh_terms: D000369:Aged, 80 and over; D000375:Aging; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D003072:Cognition Disorders / Q000097:blood; D003704:Dementia / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D016330:Frail Elderly; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000097:blood; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008134:Long-Term Care; D008297:Male; D015995:Prevalence; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human