title: Diabetes treatment and hypoglycaemic episodes in elderly patients at nursing homes in Uppsala County.
abstract: OBJECTIVE
  The aim of this study was to examine the situation for elderly patients with diabetes living in nursing homes with regard to diabetes treatment, clinical variables, and vascular complications associated with diabetes. A second aim was to evaluate if the patients were at risk of hypoglycaemia.
  
  
  METHODS
  This was a cross-sectional study including diabetes patients from all 30 nursing homes in Uppsala County, Sweden. Current antidiabetic medications, HbA1c, hypoglycaemic events, and diabetes complications were registered from the medical records. The patients were stratified into a general group and divided into three groups according to HbA1c (<52, 52-73, and >73 mmol/mol).
  
  
  RESULTS
  Of 1,350 individuals, 218 patients were identified with diabetes mellitus. The diabetes duration was 11.2 ± 9.4 years and their serum HbA1c concentration 56.0 ± 1.2 mmol/mol. Hypoglycaemic events were reported in 24% of the diabetic individuals, and 43.1% of them had HbA1c <52 mmol/mol (mean value 44.0 ± 1.1 mmol/mol). Of these, 36% were taking antidiabetic drugs. Another 35.8% of the patients had HbA1c values between 52-73 mmol/mol (mean value 60.0 ± 1.1 mmol/mol), and 82% of these patients were taking antidiabetic drugs. Almost 80% of the diabetic patients had either micro- or macrovascular complications, with diabetes duration as an association for both micro- or macrovascular complications and hypoglycaemic events.
  
  
  CONCLUSIONS
  A reduction of the use of antidiabetic drugs with follow-up of HbA1c level should be considered, especially for multimorbid elderly patients with low HbA1c and hypoglycaemia.
authors.affiliation: a Östervåla Primary Health Care Centre , Östervåla , Sweden ;
authors.forename: Angelica
authors.initials: A
authors.lastname: Walfridsson
authors.affiliation: b Uppsala University , Faculty of Biomedicine , Uppsala , Sweden ;
authors.forename: Maja
authors.initials: M
authors.lastname: Sehlberg
authors.affiliation: c Uppsala University Hospital (Akademiska Sjukhuset) , Uppsala , Sweden ;
authors.forename: Ulrika
authors.initials: U
authors.lastname: Gillespie
authors.affiliation: d Uppsala Läns Landsting , Uppsala , Sweden ;
authors.forename: Jonathan
authors.initials: J
authors.lastname: Dahlkvist
authors.affiliation: a Östervåla Primary Health Care Centre , Östervåla , Sweden ;|e Department of Public Health and Caring Sciences/Geriatrics , Uppsala University , Uppsala , Sweden.
authors.forename: Hans-Erik
authors.initials: HE
authors.lastname: Johansson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007003:Hypoglycemia / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D007004:Hypoglycemic Agents; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D009735:Nursing Homes; D012307:Risk Factors; D013548:Sweden
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human
keywords: Diabetes medication; HbA1c; elderly patients; hypoglycaemia; nursing homes