Diabetes in British Nursing and Residential Homes
A pragmatic screening study
- Terence J. Aspray, MD12,
- Karen Nesbit, RGN2,
- Timothy P. Cassidy, FRCP1,
- Emma Farrow, MB, BS1 and
- Gillian Hawthorne, FRCP2
- 1Institute for Health of the Elderly, University of Newcastle upon Tyne, Newcastle General Hospital, Newcastle upon Tyne, U.K.
- 2Diabetes Centre, Newcastle Primary Care Trust, Newcastle General Hospital, Newcastle upon Tyne, U.K.
- Address correspondence and reprint requests to Dr. Terence Aspray, Institute for AgeingHealth, Newcastle University, c/o Sunderland Royal Hospital, Kayll Road, Sunderland, SR4 7TP, U.K. E-mail:
- EMI, elderly mentally infirm
- IFG, impaired fasting glucose
- OGTT, oral glucose tolerance test
- PPG, postprandial capillary glucose
In the U.K., 8–10% of those >65 years of age have diabetes (1), and more than a quarter of care-home residents may have the condition (2). Diabetes is often undiagnosed (2), and screening is recommended (3). However, the use of fasting glucose measurements alone has not been validated in the elderly population, and concerns have been expressed that results using this method are inconsistent in older people when compared with the oral glucose tolerance test (OGTT) (4). The aim of this study was to estimate the prevalence of diabetes and impaired fasting glucose (IFG) in a range of care-home types and to decide which tests were best for diagnostic screening: fasting capillary glucose, 2-h postprandial capillary glucose (PPG), or both.
RESEARCH DESIGN AND METHODS
Newcastle upon Tyne has a population of ∼260,000, of whom 3.5% have diabetes. There are 68 care homes in the city, comprising residential care homes offering 24-h social support and nursing homes offering additional nursing care. Residential and nursing homes for the elderly mentally infirm (EMI) provide specialist care for older adults with dementia. We recruited residents from all four types of care home.
After consent/assent was obtained, all volunteers gave 200 μl of capillary whole blood, for glucose estimation, using a glucose analyzer (glucose dehydrogenase method; …