Managing Diabetes Awareness in Long-Term Care

Information management has become a hot topic in long-term care settings. Overburdened staffs are being challenged to stay up to date on the latest developments in diabetes treatment not only to improve long-term care but also to mitigate litigation, negative publicity, and other factors that have adversely affected the nursing home industry in recent years.

Many nurses and nursing assistants, however, are finding it nearly impossible to wade through the reams of material that come their way on a daily basis. Some rely on their education and training, which often do not take into account the most recent changes in diabetes care or constantly updated standards issued by the American Medical Directors Association (AMDA), American Diabetes Association (ADA), and other organizations. These standards cover virtually every aspect of the disease, from glycemic control and lifestyle modification to pharmacologic interventions and much more; understanding them is vital.

This article is designed to help nurses and others cut through the clutter and locate relevant, credible, and reliable sources of information that they can access quickly and easily. Providing user-friendly online resources, newsletters, and continuing education programs should give these busy professionals a good starting point to help them manage diabetes information effectively.

Meeting the Information Challenge
Finding reliable information is essential, given the seriousness of managing diabetes, particularly in the long-term care environment. Long-term care has seen a dramatic rise in type 2 diabetes among the geriatric population as a result of the current obesity epidemic in the United States. Studies have found that 26% of nursing home patients have diabetes and 30% have glucose intolerance.¹

From blood glucose monitoring and calculated exercise regimens to diet and visual inspection of key body areas, nursing staffs are facing increased pressure to deliver quality care to these elderly and medically fragile individuals. Managing diabetes, along with residents’ multiple coexisting medical conditions, is straining the resources of already overburdened nursing staffs. That said, nurses and nursing assistants can take several steps to obtain the latest information about diabetes management.

Make Use of the Web
One effective strategy is to make use of the numerous online diabetes resources. For example, the ADA’s Web site (www.diabetes.org/cpr) not only provides diabetes care standards but also reports on research (i.e., clinical trials), a diabetes risk test, and diabetes expos, among other topics. In addition, the site offers a range of information on meetings and educational opportunities, research, clinical practice recommendations, journals, books, research papers, and more.

Similarly, AMDA (www.amda.com) has issued a standard titled, “Managing Diabetes in the Long Term Care Setting,” as well as other information on diabetes care. Other credible Web sites include:

• The Centers for Disease Control and Prevention (www.cdc.gov/diabetes/faq/index.htm)
• U.S. Food and Drug Administration (www.fda.gov/diabetes)
• Joslin Diabetes Center (www.joslindiabetescenter.com)
• International Diabetes Center (www.parknicollet.com/diabetes)
• National Institute of Diabetes and Digestive and Kidney Diseases (www.niddk.nih.gov)
• National Federation of the Blind (www.nfb.org)

A comprehensive site (www.mendosa.com) developed by a freelance medical writer who specializes in diabetes lists articles, columns, and online pieces about all aspects of diabetes-from symptoms to the latest treatments. The site also lists and links to all of the 800 or so substantive resources for diabetes, including charitable organizations, publications, universities, medicines, companies, agencies, and so on. Web sites for 178 equipment suppliers are listed along with sites for medication, software, and blood glucose meters and nearly two dozen diabetes-focused food companies. Another 146 general diabetes sites, as well as directories, studies, and other material, can be found on this site. Because its area of coverage is wide, it might be worthwhile to delegate a staff member to set aside some time to explore this site.

Subscribe to Newsletters
Another way nursing staffs can stay up to date is by subscribing to newsletters that pertain to diabetes management. ADA has a wonderful electronic newsletter-Diabetes E-News Now! Health Care Professional Edition-that is very helpful. A recent issue, for example, discussed topics such as new diabetes drugs, weight gain and diabetes, the use of exercise to combat a diabetes-related metabolic syndrome among older adults, and news on various professional meetings.

Other newsletter sources include:

• Diabetes in Control (www.diabetesincontrol.com/index.php)
• DiabetesLibrary.org (www.diabeteslibrary.org)
• MEDLINEPlus (https://medlineplus.gov)
• CMEonDiabetes.com (www.CMEonDiabetes.com)

These newsletters and others look at a range of issues, including accelerated aging and diabetes, diabetic complications, eating healthy, controlling blood glucose, and other topics. Healthcare professionals can register for these newsletters on the Web sites.

Use Manufacturer Resources
Another key source of information comes from manufacturers, distributors, and medical equipment suppliers. Their Web sites offer a variety of materials-from fact sheets and flyers on products and services to studies and reports on various diabetes-related issues. Some firms have Frequently Asked Question (FAQ) sections on particular equipment, while others have established hot lines to respond to questions about specific devices, medicines, and treatments. Check with your specific vendors for information about their Web sites.

Take Continuing Education Programs
It is important that healthcare professionals keep current on diabetes management by participating in continuing education programs. MedCentrus, a healthcare communication and education company based in Minnesota and a division of Juntunen Group, has developed a program especially designed for nurses and nursing assistants working in long-term care facilities. The program, sponsored by Hypoguard, provides valuable information and insights into diabetes management to help nurses and other healthcare professionals understand the key areas of assessment, clinical goals, and variables involved in the evaluation and management of geriatric diabetes. The video-based training course describes diabetic testing equipment within the overall framework of the evaluation and treatment of diabetes among an elderly population.

To develop the course, an outline was created based on feedback from nurses. The outline looked at a variety of desired outcomes, such as:

• Key areas of assessment and the clinical goals for managing patients with diabetes in long-term care facilities
• Impact of food, exercise, and medications on the blood glucose levels of patients in long-term care facilities
• Variables in performing a blood glucose test using a blood glucose meter
• Symptoms of hyperglycemia and hypoglycemia
• Changes in care that may improve glucose control

An accredited company and knowledgeable spokesperson were then sought out to help develop the program. MedCentrus was chosen based on the firm’s knowledge, expertise, and convenient location. To date, more than 500 information kits have been distributed to various nursing homes and chains. For more information on this CE program, contact Hypoguard Customer Service at (800) 818-8877.

Healthcare professionals may find a variety of additional CE programs at www.findthatce.com. This Web site lists CE programs on topics such as type 2 diabetes, internal medicine and diabetes, and geriatric medicine, as well as a course titled “Care & Concerns for Effective Management of Diabetes in the Elderly.” The Web site www.criticalcareceu.com has a course that examines guidelines for diabetes care developed by the ADA and the American Association of Diabetes Educators.

Keep Looking for Resources
Clearly, a lot of information is available. The above-mentioned material should be considered as a starting point for continuing education about the latest developments in testing, diagnosing, and treating diabetes. By using information resources wisely, healthcare professionals in the long-term care environment can stay current on treatment trends and, in so doing, help them do their jobs more effectively and deliver the kind of care their vulnerable patients require.

Reference
1.Pandya N. Diabetes Management in Long-Term Care. Caring for the Ages 2003;4(2):21-4. Available at: www.amda.com/caring/february2003/diabetes.htm.