Hypoglycemia in hospice patients with type 2 diabetes in a national sample of nursing homes
Open accessAbstract
This retrospective cohort study examines whether patients with type 2 diabetes on hospice are assessed for dysglycemia, receive insulin or oral hypoglycemic medications, or experience hypoglycemia and hyperglycemia in the nursing home setting.
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An individual has the right to refuse testing and treatment, whereas health care professionals may consider withdrawing treatment and limiting diagnostic testing, including a reduction in the frequency of blood glucose monitoring.
“An individual has the right to refuse testing and treatment, whereas health care professionals may consider withdrawing treatment and limiting diagnostic testing, including a reduction in the frequency of blood glucose monitoring (175,176).”
From 13. Older Adults: Standards of Care in Diabetes—2026 (2026) · cites this paper as [176]
The opening section reports recommendations to relax glycemic targets and eventually discontinue diabetes medications as patients near death, supporting the treatment-withdrawal portion of the claim. It does not address an individual's right to refuse testing or treatment, or recommend limiting diagnostic testing or reducing the frequency of glucose monitoring. The Results section reports testing frequencies but does not present a recommendation to reduce them; page numbers are unavailable in our copy. (LLM, conf=0.86)
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Research works printed but not linked: 5
- Teno JM, Gozalo PL, Bynum JP, et al. Change in end-of-life care for Medicare beneficiaries: site of death, place of care, and health care transitions in 2000, 2005, and 2009. JAMA. 2013;309(5):470-477. doi:10.1001/jama.2012 .207624 · DOI
- Zheng NT, Mukamel DB, Caprio TV, Temkin-Greener H. Hospice utilization in nursing homes: association with facility end-of-life care practices. Gerontologist. 2013;53(5):817-827. doi:10.1093/geront/gns153 · DOI
- Angelo M, Ruchalski C, Sproge BJ. An approach to diabetes mellitus in hospice and palliative medicine. J Palliat Med. 2011;14(1):83-87. doi:10.1089/jpm.2010.0191 · DOI · Paper page
- American Diabetes Association. Standards of Medical Care in Diabetes-2017. Diabetes Care. 2016;40(suppl 1). doi:10.2337/dc17-S003 · DOI
- Bonds DE, Miller ME, Dudl J, et al. Severe hypoglycemia symptoms, antecedent behaviors, immediate consequences and association with glycemia medication usage: Secondary analysis of the ACCORD clinical trial data. BMC Endocr Disord. 2012;12(1):5. doi:10.1186/1472-6823-12-5 · DOI
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13. Older Adults: <i>Standards of Medical Care in Diabetes—2022</i>
American Diabetes Association Professional Practice Committee (2022) · Diabetes Care · doi:10.2337/dc22-s013 · Cited by 381 · see citing works
13. Older Adults: Standards of Care in Diabetes—2025
American Diabetes Association Professional Practice Committee, ElSayed, N. A., McCoy, R. G., Aleppo, G., Balapattabi, K., Beverly, E. A., Briggs Early, K., Bruemmer, D., Echouffo-Tcheugui, J. B., Ekhlaspour, L., et al. (2025) · Diabetes Care · doi:10.2337/dc25-s013 · Cited by 209 · see citing works
13. Older Adults: <i>Standards of Care in Diabetes—2024</i>
American Diabetes Association Professional Practice Committee, ElSayed, N. A., Aleppo, G., Bannuru, R. R., Bruemmer, D., Collins, B. S., Ekhlaspour, L., Hilliard, M. E., Johnson, E. L., Khunti, K., et al. (2024) · Diabetes Care · doi:10.2337/dc24-s013 · Cited by 161 · see citing works
13. Older Adults: Standards of Care in Diabetes—2026
American Diabetes Association Professional Practice Committee for Diabetes*, Bajaj, M., McCoy, R. G., Balapattabi, K., Bannuru, R. R., Bellini, N. J., Bennett, A. K., Beverly, E. A., Briggs Early, K., ChallaSivaKanaka, S., et al. (2026) · Diabetes Care · doi:10.2337/dc26-s013 · Cited by 87 · see citing works
- Authors
- Petrillo, L. A., Gan, S., Jing, B., Lang-Brown, S., Boscardin, W. J., & Lee, S. J.
- Affiliations
- University of California, San Francisco (US)
- Philips (China) (CN)
- San Francisco VA Medical Center (US)
- Department of Medicine, University of California, San Francisco, San Francisco
- Corresponding author
- Petrillo, Laura A.
- Venue
- JAMA Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2018-05-01
- Volume
- 178
- Issue
- 5
- Pages
- 713
- ISSN
- 2168-6106 (ISSN-L)
- PMC
- PMC5885911
- OpenAlex
- W2777951478
- Cited by
- 27
- References
- 0
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 3 · 2022: 6 · 2021: 2 · 2020: 2 · 2019: 4 · 2018: 1
- FWCI
- 1.51
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA Internal Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (P30AG044281)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- hypoglycemia, type 2 diabetes, hospice care, nursing homes, hyperglycemia, dysglycemia, insulin, oral antidiabetic drugs, end-of-life care, glycemic control
- MeSH terms
- Aged, Diabetes Mellitus, Type 2, Female, Humans, Hypoglycemia, Male, Nursing Homes, Retrospective Studies, United States, Veterans, Incidence, Hospice Care
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