Is diabetes being overtreated in nursing home residents?

Older adults with diabetes who are living in nursing homes are at high risk of having low blood sugar levels—called hypoglycemia—if their diabetes is overtreated. A study published in the Journal of the American Geriatrics Society suggests that many nursing home residents continue to receive insulin and other medications that increase hypoglycemia risk even after blood tests suggest overtreatment.

Among 7,422 Veterans Affairs nursing home residents, most had blood test results at the start of the study suggesting tight control of their blood sugar levels, and most were on insulin. Only 27% of overtreated and 19% of potentially overtreated residents had their blood sugar–lowering medications appropriately adjusted within 2 weeks.

"I hope this work lays the foundation for future projects that promote appropriate deintensification of glucose lowering medications in nursing home residents," said lead author Lauren I. Lederle, MD, of the San Francisco VA Medical Center.