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Minimizing the risk of hypoglycemia in older adults: a focus on long-term care.
Consult Pharm. 2009 Jun; 24 Suppl B:18-24.CP

Abstract

OBJECTIVES

To consider the risk and impact of hypoglycemia in older adults with type 2 diabetes (T2DM), to describe how to interpret blood glucose readings in an older patient's medical record, and to discuss strategies for avoiding hypoglycemia in this patient population.

DATA SOURCES

Live symposium presentation based on clinical practice and research, medical literature, and studies published between January 1990 and November 2008 on managing T2DM in older adults, government statistics, and medical society guidelines.

STUDY SELECTION

A literature search was performed. Search terms included: Diabetes, Elderly, Hypoglycemia, Insulin Pattern Management, Long-Term Care, Senior, Sliding Scale Insulin. Twenty-two articles were identified from various sources containing information relevant to the identification and treatment of hypoglycemia in elderly persons with diabetes.

DATA EXTRACTION

Data were extracted by the author and by Nicole Cooper (DesignWrite, LLC).

DATA SYNTHESIS

Numerous studies have demonstrated the benefits of achieving near-normal levels of glycemic control in patients with T2DM. However, avoiding hypoglycemia during intensive therapy can be challenging for older adults and may present a barrier to glycemic control in this population. Pharmacists working in long-term care settings can take several steps to help their older patients avoid hypoglycemia, including recommending the use of insulin regimens with more physiologic time-action profiles, such as insulin analogs. They also can help facilities develop protocols for treating hyperglycemia and hypoglycemia, offer insulin pattern management services, and help educate the staff about the optimal use of insulin therapies.

CONCLUSIONS

Consultant pharmacists can play a critical role in preventing hypoglycemia in long-term care facilities by recommending the use of more physiologic insulin regimens, developing facility protocols for glycemic management, and providing staff education.

Authors+Show Affiliations

Senior Care Consultants, Garland, Texas 75043, USA. hgarza@scc-texas.com

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

19555132

Citation

Garza, Hennie. "Minimizing the Risk of Hypoglycemia in Older Adults: a Focus On Long-term Care." The Consultant Pharmacist : the Journal of the American Society of Consultant Pharmacists, vol. 24 Suppl B, 2009, pp. 18-24.
Garza H. Minimizing the risk of hypoglycemia in older adults: a focus on long-term care. Consult Pharm. 2009;24 Suppl B:18-24.
Garza, H. (2009). Minimizing the risk of hypoglycemia in older adults: a focus on long-term care. The Consultant Pharmacist : the Journal of the American Society of Consultant Pharmacists, 24 Suppl B, 18-24.
Garza H. Minimizing the Risk of Hypoglycemia in Older Adults: a Focus On Long-term Care. Consult Pharm. 2009;24 Suppl B:18-24. PubMed PMID: 19555132.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Minimizing the risk of hypoglycemia in older adults: a focus on long-term care. A1 - Garza,Hennie, PY - 2009/6/27/entrez PY - 2009/7/30/pubmed PY - 2009/8/14/medline SP - 18 EP - 24 JF - The Consultant pharmacist : the journal of the American Society of Consultant Pharmacists JO - Consult Pharm VL - 24 Suppl B N2 - OBJECTIVES: To consider the risk and impact of hypoglycemia in older adults with type 2 diabetes (T2DM), to describe how to interpret blood glucose readings in an older patient's medical record, and to discuss strategies for avoiding hypoglycemia in this patient population. DATA SOURCES: Live symposium presentation based on clinical practice and research, medical literature, and studies published between January 1990 and November 2008 on managing T2DM in older adults, government statistics, and medical society guidelines. STUDY SELECTION: A literature search was performed. Search terms included: Diabetes, Elderly, Hypoglycemia, Insulin Pattern Management, Long-Term Care, Senior, Sliding Scale Insulin. Twenty-two articles were identified from various sources containing information relevant to the identification and treatment of hypoglycemia in elderly persons with diabetes. DATA EXTRACTION: Data were extracted by the author and by Nicole Cooper (DesignWrite, LLC). DATA SYNTHESIS: Numerous studies have demonstrated the benefits of achieving near-normal levels of glycemic control in patients with T2DM. However, avoiding hypoglycemia during intensive therapy can be challenging for older adults and may present a barrier to glycemic control in this population. Pharmacists working in long-term care settings can take several steps to help their older patients avoid hypoglycemia, including recommending the use of insulin regimens with more physiologic time-action profiles, such as insulin analogs. They also can help facilities develop protocols for treating hyperglycemia and hypoglycemia, offer insulin pattern management services, and help educate the staff about the optimal use of insulin therapies. CONCLUSIONS: Consultant pharmacists can play a critical role in preventing hypoglycemia in long-term care facilities by recommending the use of more physiologic insulin regimens, developing facility protocols for glycemic management, and providing staff education. SN - 0888-5109 UR - https://www.unboundmedicine.com/medline/citation/19555132/Minimizing_the_risk_of_hypoglycemia_in_older_adults:_a_focus_on_long_term_care_ L2 - http://www.diseaseinfosearch.org/result/9680 DB - PRIME DP - Unbound Medicine ER -