A Successful Diabetes Management Model of Care in Long-Term Care Facilities

J Am Med Dir Assoc. 2021 Jun;22(6):1322-1326.e2. doi: 10.1016/j.jamda.2020.06.046. Epub 2020 Aug 2.

Abstract

The management of diabetes in long-term care (LTC) facilities requires facility staff to perform most self-care activities on the behalf of the residents. A practical model of care to improve diabetes management was developed and implemented at 6 LTC facilities in the Northeast United States between 2009 and 2012. The components of the program included (1) developing an individualized education curriculum and educating LTC interdisciplinary staff; (2) educating patients and caregivers; and (3) developing a clinical care algorithm. Over 500 staff members were educated and achieved competence. There were 1031 residents screened for risk of hypo- or hyperglycemia on admission, and 245 residents (24%) experienced hypoglycemia and 240 residents (23%) experienced hyperglycemia. Hypoglycemia episodes resolved without recurrence in 73%-90% cases because of interventions initiated by LTC staff. The implementation of a practical model of diabetes management in LTC facilities can improve staff education and lead to improved diabetes management.

Keywords: Diabetes management program; diabetes education; long-term care.

MeSH terms

  • Caregivers
  • Diabetes Mellitus* / therapy
  • Humans
  • Hypoglycemia* / therapy
  • Long-Term Care
  • New England
  • Skilled Nursing Facilities