Clinical practice guideline for diabetes management in the post-acute and long-term care setting

Abstract

The newly revised Clinical Practice Guideline (CPG) for Diabetes Management in the Post-Acute and Long-Term Care (PALTC) Setting is an extremely useful resource that incorporates new evidence and perspectives related to overall goals in diabetes care. The CPG provides detailed information in usable Tables for how to use and manage the increasing number of medication alternatives for PALTC patients with diabetes. In addition, the CPG addresses the critical roles of all members of the interprofessional team for the optimal management of older adults living with diabetes. The primary goal of care as described in the CPG is to make diabetes management individualized and consistent with the patient's/resident's goals of care, and to optimize quality of life and the ability to live in the least restrictive setting possible. To achieve this, the CPG emphasizes the importance of understanding the patients' overall health status, what their preferences and values are, their life expectancy, the clinical benefit of tight versus more liberal control of glucose, risk of hypoglycemia, and impact of treatment on quality of life and ability to live in a certain setting of care (e.g., if injectable therapy is possible). As with other PALTmed CPGs, this new CPG takes the team through the process of recognition, assessment, treatment and monitoring. Implementation of the Diabetes Management in PALTC Settings CPG can help those working in these settings ensure that their patients and residents are getting the most appropriate and current evidence-based treatment for this challenging clinical problem.