Prevalence of diabetes in care home residents

OBJECTIVE - To determine the prevalence of known and undetected diabetes di agnosed either by an elevated fasting baseline sample or by a 2-h post-gluc ose load sample in a group of residents of care homes in an urban-district setting. RESEARCH DESIGN AND METHODS - We completed individual interviews with patie nts and caregivers in 30 care homes (both residential and nursing homes) in two metropolitan districts of Birmingham, West Midlands, U.K. All care hom es were under the supervision of primary care physicians (general practitio ners). We carried our 75-g oral glucose tolerance tests (OGTTs) in consenti ng residents without previous known diabetes. Criteria for diagnosis of dia betes were obtained from the World Health Organization (1998) and the Ameri can Diabetes Association (1997). RESULTS - Of 636 residents available for study, 76 residents (12.0%) were k nown to have diabetes; of the 560 remaining residents, 286 either refused t o participate or were deemed too ill or unavailable to undergo testing. Com plete data on 274 OGTTs were obtained (median age 83 years, range 45-101). A total of 46 subjects were diagnosed as having diabetes and 94 as having i mpaired glucose tolerance. Allowing for subjects who refused or were unable to participate, the calculated total prevalence (which includes known and newly detected diabetes) was 26.7% (95% CI 21.9-32.0). The calculated overa ll prevalence of impaired glucose tolerance was 30.2% (25.2-35.6). CONCLUSIONS - In a group of care home residents not known to have diabetes and able to undergo testing, a substantial proportion have undetected diabe tes based on a 2-h postglucose load. These residents warrant further study as they may be at higher cardiovascular risk and require an intervention.