Fingerstick Glucose Monitoring in Veterans Affairs Nursing Home Residents with Diabetes Mellitus.
Fingerstick Glucose Monitoring in Veterans Affairs Nursing Home Residents with Diabetes Mellitus.
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DOI：
10.1111/jgs.16880
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发表时间：
2021-03
影响因子：
6.3
通讯作者：
Lee S
中科院分区：
文献类型：
--
作者：
Jeon SY;Shi Y;Lee AK;Hunt L;Lipska K;Boscardin J;Lee S
指南建议对疗养院（NH）居民进行较低强度的血糖治疗和较低频率的血糖监测。然而，很少有人知道的频率手指针刺（FS）葡萄糖监测在这一人群中。我们的目的是检查频率FS血糖监测退伍军人事务部（VA）NH居民糖尿病，II型（T2 DM）。在140名VA NH中进行的国家回顾性队列研究。2013年至2015年期间，患有T2 DM且年龄超过65岁的NH居民在从VA医院出院后入住VA NH。NH居民根据他们每天最高的低血糖风险降糖药物（GLM）分为五组：无GLM;仅二甲双胍;磺脲类;长效胰岛素;和任何短效胰岛素。我们的结果是每天的FS测量计数。在17,474名VA NH居民中，平均年龄为76岁（标准差（SD）= 8），平均血红蛋白A1 c为7.6%（SD = 1.5%）。在NH入院后第1天，49%的NH居民使用短效胰岛素，在第90天略微下降至43%。总体而言，NH居民在NH第1天的FS测量值平均为1.9（95%置信区间（CI）= 1.8-1.9），到第90天降至1.4（95% CI = 1.3-1.4）。接受短效胰岛素治疗的NH居民的FS测量频率最高，第1天为3.0次测量（95% CI = 2.9-3.0），第90天降至2.6次测量（95% CI = 2.5-2.7）。接受长效胰岛素（第1天2.1（95% CI = 2.0-2.2））和磺脲类药物（第1天1.7（95% CI = 1.5-1.8））的NH居民的FS测量频率较低。即使接受二甲双胍单药治疗的NH居民在第1天的测量值也为1.1（95% CI = 1.1-1.2），在第90天降低至0.5（95% CI = 0.4-0.6）。尽管指南建议NH居民减少血糖监测频率，但我们发现许多VA NH居民接受频繁的FS监测。鉴于不确定的受益和潜在的大量患者负担和伤害，我们的研究结果表明，减少FS监测可能是必要的许多低血糖风险NH居民。J Am Geriatr Soc 00：1-8，2020.
Guidelines recommend less intensive glycemic treatment and less frequent glucose monitoring for nursing home (NH) residents. However, little is known about the frequency of fingerstick (FS) glucose monitoring in this population. Our objective was to examine the frequency of FS glucose monitoring in Veterans Affairs (VA) NH residents with diabetes mellitus, type II (T2DM). National retrospective cohort study in 140 VA NHs. NH residents with T2DM and older than 65 years admitted to VA NHs between 2013 and 2015 following discharge from a VA hospital. NH residents were classified into five groups based on their highest hypoglycemia risk glucose-lowering medication (GLM) each day: no GLMs; metformin only; sulfonylureas; long-acting insulin; and any short-acting insulin. Our outcome was a daily count of FS measurements. Among 17,474 VA NH residents, mean age was 76 (standard deviation (SD) = 8) years and mean hemoglobin A1c was 7.6% (SD = 1.5%). On day 1 after NH admission, 49% of NH residents were on short-acting insulin, decreasing slightly to 43% at day 90. Overall, NH residents had an average of 1.9 (95% confidence interval (CI) = 1.8–1.9) FS measurements on NH day 1, decreasing to 1.4 (95% CI = 1.3–1.4) by day 90. NH residents on short-acting insulin had the most frequent FS measurements, with 3.0 measurements (95% CI = 2.9–3.0) on day 1, decreasing to 2.6 measurements (95% CI = 2.5–2.7) by day 90. Less frequent FS measurements were seen for NH residents receiving long-acting insulin (2.1 (95% CI = 2.0–2.2) on day 1) and sulfonylureas (1.7 (95% CI = 1.5–1.8) on day 1). Even NH residents on metformin monotherapy had 1.1 (95% CI = 1.1–1.2) measurements on day 1, decreasing to 0.5 (95% CI = 0.4–0.6) measurements on day 90. Although guidelines recommend less frequent glucose monitoring for NH residents, we found that many VA NH residents receive frequent FS monitoring. Given the uncertain benefits and potential for substantial patient burdens and harms, our results suggest decreasing FS monitoring may be warranted for many low hypoglycemia risk NH residents. J Am Geriatr Soc 00:1–8, 2020.
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影响因子：
16.2
作者：
Munshi MN;Florez H;Huang ES;Kalyani RR;Mupanomunda M;Pandya N;Swift CS;Taveira TH;Haas LB
通讯作者：
Haas LB
影响因子：
39
作者：
Young, Laura A.;Buse, John B.;Donahue, Katrina E.
通讯作者：
Donahue, Katrina E.
DOI：
10.1016/j.jamda.2008.06.003
发表时间：
2008-11-01
影响因子：
7.6
作者：
Pandya, Naushira;Thompson, Stephen;Sambamoorthi, Usha
通讯作者：
Sambamoorthi, Usha
影响因子：
16.2
作者：
通讯作者：
--
“其他人在这里比我更经常得到冰淇淋 - 它燃烧了我。”关于疗养院居民及其医生的糖尿病护理的观点。
影响因子：
4.1
作者：
Barnhart C;McClymont K;Smith AK;Au-Yeung A;Lee SJ
通讯作者：
Lee SJ