Document Detail


Use of basal insulin and the associated clinical outcomes among elderly nursing home residents with type 2 diabetes mellitus: a retrospective chart review study.
MedLine Citation:
PMID:  25364239     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: The management of type 2 diabetes mellitus in long-term care (LTC) settings can be complex as a result of age-related complications. Despite guideline recommendations, sliding scale insulin remains commonplace in the LTC setting and data on basal insulin use are lacking.
METHODS: This retrospective study used medical chart data and the Minimum Data Set from elderly LTC facility patients who received basal insulin (insulin glargine, insulin detemir, or neutral protamine Hagedorn insulin) for the treatment of diabetes, to investigate the practice patterns and associated clinical outcomes.
RESULTS: A total of 2,096 elderly, insulin-treated patients in LTC were identified, with 59.5% of them (N=1,247) receiving basal insulin. Of these, more than 50% of patients received sliding scale insulin in co-administration with basal insulin. Despite its ease of use, insulin pen use was very low, at 14.6%. Significant differences were observed between the basal insulin groups for glycated hemoglobin level and dosing frequency. Hypoglycemia was uncommon -17.2% of patients experienced at least one event, and there was no significant difference in the prevalence of hypoglycemia between the groups.
CONCLUSION: These data suggest the underutilization of basal insulin in the LTC setting and worryingly high combinational use with sliding scale insulin. Differences in glycated hemoglobin and dosing frequencies between types of basal insulin warrant further comparative effectiveness studies.
Authors:
Keith L Davis; Wenhui Wei; Juliana L Meyers; Brett S Kilpatrick; Naushira Pandya
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Publication Detail:
Type:  Journal Article     Date:  2014-10-23
Journal Detail:
Title:  Clinical interventions in aging     Volume:  9     ISSN:  1178-1998     ISO Abbreviation:  Clin Interv Aging     Publication Date:  2014  
Date Detail:
Created Date:  2014-11-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101273480     Medline TA:  Clin Interv Aging     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  1815-22     Citation Subset:  IM    
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