Care of diabetic subjects in nursing homes in the county of Heinsberg

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.