Background and Objective: Little information is available on the diabetes m
anagement of elderly people under institutional care. It was therefore aim
of this study to assess the quality of diabetes care in this patient group.
Patients and Methods: In the county of Heinsberg, North Rhine-Westphalia, a
fter agreement in the local public health conference, all 41 nursing homes
were addressed and asked to fill out a structured, detailed questionnaire.
Thirty-nine institutions participated in the study representing 99.6% of al
l patients under such care.
Results: Out of the 1936 residents 507 had known diabetes mellitus (prevale
nce 26.2%) with an age-dependent decrease- 37.0% of the diabetic subjects w
ere treated with insulin, 46.7% received oral hypoglycemic agents. Advanced
late complications were reported in a minority of patients (3.4% amputatio
ns, 13.6% blindness or severe visual impairment, 1.0% hemodialysis). In the
majority of patients, the metabolic control was assessed by blood glucose
measurement, but only in low frequency. Eye examination within the previous
12 months was reported for only 50.0% of the diabetic subjects. Although t
he diabetics were frequently seen by their doctors (48.1% > 2 consultations
/ month, 48.7% With 1 to 2 consultations/month), 30.8% had at least 1 hospi
tal stay during the previous 12 months. Among the 834 nurses with the full
,, dataset only 4 had a special training in diabetology.
Conclusion: The results of this study indicate that the diabetes management
of patients living in nursing homes only partially fulfills the current re
quirements for diabetes care. There appears to be a particular need to impr
ove the nurses training in diabetes as well as the communication between nu
rsing homes and doctors.