Skip to Main content Skip to Navigation
Journal articles

Assessment of glycemic control in nursing home residents with diabetes

Abstract : Objective: To describe glycemic control in nursing home residents with diabetes and to evaluate the relevance of HbA1c in the detection of hypoglycemia risk. Design and methods: Diabetes treatment, geriatric assessment, blood capillary glucose (n= 24,682), and HbA1c were collected from medical charts of 236 southern France nursing home residents during a 4-month period. Glycemic control was divided into four categories: tight, fair, and moderate or severe chronic hyperglycemia using the High Blood Glucose Index or the analysis of blood glucose frequency distribution. Hypoglycemia episodes were identified by medical or biological records. Results: Glucose control was tight in 59.3 % and fair in 19.1 % of the residents. Chronic exposure to hyperglycemia was observed in 21.6 % of the residents (severe in 9.7 % and moderate in 11.9 %). Hypoglycemia was noticed in 42/236 (17.8%), in all categories of glycemic control. Relative hypoglycemia risk was significantly (P = 0.0095) higher in residents with moderate chronic hyperglycemia compared with those with tight control. The majority of residents with hypoglycemia (39/42) or chronic hyperglycemia (45/51) were insulin-treated. The relative risk of hypoglycemia was not significantly associated with HbA1c values. Conclusion: Hypoglycemia risk in nursing home residents is observed in all categories of glycemic control. In tight control, the potency of antidiabetic treatment should be reduced. In chronic hyperglycemia, diet and treatment should be reevaluated in order to reduce glucose variability. HbA1c is not sufficient for hypoglycemia risk detection; capillary blood glucose monitoring is warranted for nursing homes residents with diabetes.
Complete list of metadatas

Cited literature [33 references]  Display  Hide  Download

https://hal-amu.archives-ouvertes.fr/hal-01753852
Contributor : Marie-Christine Alessi <>
Submitted on : Thursday, May 24, 2018 - 4:43:45 PM
Last modification on : Thursday, May 7, 2020 - 4:58:04 PM
Long-term archiving on: : Saturday, August 25, 2018 - 2:40:47 PM

File

Retornaz_J_Nutr_Health_Aging_2...
Files produced by the author(s)

Identifiers

Collections

Citation

F. Retornaz, M. Grino, L. Mari, Charles Oliver. Assessment of glycemic control in nursing home residents with diabetes. Journal of Nutrition, Health and Aging, Springer Verlag (Germany), 2017, 21 (4), pp.457-463. ⟨10.1007/s12603-016-0776-0⟩. ⟨hal-01753852⟩

Share

Metrics

Record views

284

Files downloads

500